The Five Things to Get Right Before the Next Pandemic

In January 2017, a lengthy proposal showed up at the offices of the Biomedical Advanced Research and Development Authority in Washington. Running 112 pages, the document described a strategy for stopping future pandemics. It outlined a number of vaccine technologies to pursue, including messenger RNA and adenovirus vectors, and recommended that a team of 180 scientists, doctors, and other experts be created to carry out the plan. There were intricate technical details, an org chart, and an estimated cost: $595 million over 10 years.

Congress created Barda, a division of the U.S. Department of Health and Human Services, in 2006 for precisely this kind of thing. It’s charged with developing and procuring drugs and vaccines, and ensuring that the country is researching countermeasures to combat bioterrorism and chemical warfare, as well as pandemic influenza and other emerging infectious threats. The agency has historically been small, though, and the proposal, which came from the pharmaceutical company GlaxoSmithKline Plc, would have entailed one of its more ambitious efforts. Following the massive 2014 Ebola outbreak in West Africa, which killed more than 11,000 people, Glaxo researchers wanted to identify viruses likely to cause major epidemics and tackle several of them at once. “The idea was to just make vaccines against all the viruses,” says Moncef Slaoui, who was then chairman of the company’s vaccines unit and later served as chief science adviser to the Trump administration’s Operation Warp Speed.

Glaxo owned an underutilized lab and a decommissioned biotech plant in Rockville, Md., and it was already relocating vaccine researchers there as part of a corporate reorganization. Under its Barda proposal, the company would have provided scientific staff and facilities at the Rockville site while government agencies and nonprofits funded vaccine development for multiple “platform” technologies through early human trials and manufacturing. That way, if an outbreak happened, Glaxo would have prototype vaccines ready for final-stage trials.

A team from the company spent months refining the proposal, according to a person familiar with the effort, and had reason to believe it might get funded. Barda officials met with Glaxo scientists on multiple occasions, toured the Rockville facility, and urged the company to submit a formal proposal, the person recalls. After it was submitted, Barda quietly considered it for several months. Finally, in late 2017, the agency suggested that Glaxo come up with a scaled-down plan focused mainly on influenza. That proposal never got funded either, leaving the world without a key weapon against emerging viruses when the pathogen that causes Covid-19 was discovered.

Vaccines have since been developed using mRNA and adenovirus vector approaches similar to those originally suggested by Glaxo. Many of the vaccines benefited from grants from Barda during the pandemic and from government-sponsored basic research beforehand. Still, the failure to put more extensive infrastructure in place ahead of time was a lost opportunity to build up capacity that could be bolstering its vaccine supply right now. It was a failure, even a refusal, to fully plan ahead—a blunder that ranks with the White House decision to disband the dedicated pandemic response unit at the National Security Council in May 2018 and the inability of the Centers for Disease Control and Prevention to quickly develop a Covid test for wide distribution.

In late 2019 every infectious disease expert knew something like the novel coronavirus was coming sooner or later, just as they know today that Covid won’t be the last pandemic. As depressing as the current situation is, though, the next one—and there will be a next one—doesn’t have to be this bad. Shortly before his inauguration, President Biden proposed spending $20 billion to speed up vaccination rollouts. That’s a start. But a complete plan—one that can protect the U.S. from mass death, catastrophic economic damage, and (let’s hope) incompetent political leaders who squander the public’s trust—will have to be more comprehensive. It will likely involve at least five separate areas of research and investment. Most of all, it will require careful preparation.