By Dr. Eric Lander, President Biden’s Science Advisor and Director of the White House Office of Science and Technology Policy
Coronavirus vaccines can end the current pandemic if enough people choose to protect themselves and their loved ones by getting vaccinated. But in the years to come, we will still need to defend against a pandemic side effect: collective amnesia.
As public health emergencies recede, societies often quickly forget their experiences — and fail to prepare for future challenges. For pandemics, such a course would be disastrous. New infectious diseases have been emerging at an accelerating pace, and they are spreading faster.
Our federal government is responsible for defending the United States against future threats. That’s why President Biden has asked Congress to fund his plan to build on current scientific progress to keep new infectious-disease threats from turning into pandemics like covid-19.
As the president’s science adviser, I know what’s becoming possible. For the first time in our history, we have an opportunity not just to refill our stockpiles but also to transform our capabilities. However, if we don’t start preparing now for future pandemics, the window for action will close.
Covid-19 has been a catastrophe: The toll in the United States alone is more than 614,000 lives and has been estimated to exceed $16 trillion, with disproportionate impact on vulnerable and marginalized communities.
But a future pandemic could be even worse — unless we take steps now.
It’s important to remember that the virus behind covid-19 is far less deadly than the 1918 influenza. The virus also belongs to a well-understood family, coronaviruses. It was possible to design vaccines within days of knowing the virus’s genetic code because 20 years of basic scientific research had revealed which protein to target and how to stabilize it. And while the current virus spins off variants, its mutation rate is slower than that of most viruses.
Unfortunately, most of the 26 families of viruses that infect humans are less well understood or harder to control. We have a great deal of work still ahead.
The development of mRNA vaccine technology — thanks to more than a decade of foresighted basic research — was a game-changer. It shortened the time needed to design and test vaccines to less than a year — far faster than for any previous vaccine. And it’s been surprisingly effective against covid-19.
Still, there’s much more to do. We don’t yet know how mRNA vaccines will perform against other viruses down the road. And when the next pandemic breaks out, we’ll want to be able to respond even faster.
Fortunately, the scientific community has been developing a bold plan to keep future viruses from becoming pandemics.
Here are a few of the goals we should shoot for:
The capability to design, test and approve safe and effective vaccines within 100 days of detecting a pandemic threat (for covid-19, that would have meant May 2020); manufacture enough doses to supply the world within 200 days; and speed vaccination campaigns by replacing sterile injections with skin patches.
Diagnostics simple and cheap enough for daily home testing to limit spread and target medical care.
Early-warning systems to spot new biological threats anywhere in the world soon after they emerge and monitor them thereafter.
We desperately need to strengthen our public health system — from expanding the workforce to modernizing labs and data systems — including to ensure that vulnerable populations are protected.
And we need to coordinate actions with our international partners, because pandemics know no borders.
These goals are ambitious, but they’re feasible — provided the work is managed with the seriousness, focus and accountability of NASA’s Apollo Program, which sent humans to the moon.
Importantly, these capabilities won’t just prepare us for future pandemics; they’ll also improve public health and medical care for infectious diseases today.
Preparing for threats is a core national responsibility. That’s why our government invests heavily in missile defense and counterterrorism. We need to similarly protect the nation against biological threats, which range from the ongoing risk of pandemics to the possibility of deliberate use of bioweapons.
Pandemics cause massive death and disruption. From a financial standpoint, they’re also astronomically expensive. If, as might be expected from history and current trends, we suffered a pandemic of the current scale every two decades, the annualized cost would exceed $500 billion per year. Investing a much smaller amount to avert this toll is an economic and moral imperative.
The White House will put forward a detailed plan this month to ensure that the United States can fully prepare before the next outbreak. It’s hard to imagine a higher economic or human return on national investment.