Wednesday / Apr 22 2020
Newspaper : The News
The prime minister of Pakistan had established a Task Force on Knowledge Economy which he chairs and of which I happen to be the vice-chairman.
The task force had initiated carefully selected projects led by the best scientists and engineers in the country as well as those among our diaspora abroad. The projects included those directed at increasing agriculture and livestock quality and yields through application of biotechnology, artificial intelligence and allied disciplines of computer science, establishment of engineering universities, mineral development and distance education.
In many of these projects, the planning ministry requires that a feasibility study be undertaken before the project is initiated. In most cases the scientists feel that this is a huge waste of time and national resources but we must comply. So many of these projects, including the establishment of a university in the PM House Islamabad, have been put on hold by the Central Development Working Party, pending the completion of “feasibility studies”. Time is slipping by and we lack a sense of urgency to deliver.
Meanwhile, a massive global calamity has descended on us in the form of the novel coronavirus, and we have temporarily diverted our expertise to tackling this huge challenge. For this it is necessary to understand its structure and determine where the weak points may lie so that they can be attacked by existing or new drugs. Studies carried out at the Jamilur Rahman Centre for Genomics Research under the leadership of Prof Iqbal Choudhary, Dr Ishtiaq and colleagues have established that the virus has changed somewhat from the original virus found in Wuhan China. It has nine changes (mutations) as compared to the structure originally reported from China, a feature not uncommon among viruses. The virus can be depicted as a molecular necklace with about 30,000 nucleotides strung together, and some changes in the sequence in which these ‘molecular beads’ are attached can influence how fast it can spread and how lethal it can be.
The Ministry of Science & Technology formed a Coronavirus Task Force under my chairmanship and I brought into play the expertise available in the country and abroad through the Prime Minister’s Knowledge Economy Task Force. The blending of the efforts of the two task forces has yielded spectacular results. Work was begun at a remarkable pace on several fronts and much has been achieved during the last six weeks, The four critical areas of focus have been: 1) Initiating clinical trials on coronavirus patients using existing drugs; 2) exploring the possibility of using certain Chinese herbal drugs that were successfully employed to contain the spread of the virus in China and to treat patients; 3) magnifying the national testing facilities; and 4) exploring the possibility of indigenous manufacture of ventilators.
A major clinical trial (named ‘PROTECT’) has been initiated initially on three drugs, hydroxychloroquine, azithromycin, and oseltamivir. Several thousand patients will be involved in this trial now underway at the University of Health Sciences, Lahore under the dynamic leadership of Prof Javed Akram. Similar trials are underway in other parts of the world. In one such trial carried out in France, the hydroxychloroquine/azithromycin combination was found to be very useful. In another trial in Chicago, USA, an antiviral drug Remdesivir manufactured by Gilead Sciences was found to be very effective in the treatment of very sick and moderately sick patients suffering from Covid-19. So there is light at the end of this dark tunnel, and it is highly likely that within a month or so, scientists in Pakistan as well as in Europe and the US will have discovered a few existing drugs that can help cure coronavirus patients.
Another exciting medication that is presently under approval by DRAP relates to Chinese herbal drugs that were found to be very useful in China in relieving the symptoms caused by Covid-19. Traditional Chinese medicine is widely used in China in a form integrated with modern medicine, and it has played a key role in the Chinese success against the novel coronavirus. Once DRAP gives its approval for clinical trials and for marketing in Pakistan, this too would become widely available. Another clinical trial initiated by Dr Tariq Shamsi and colleagues involves passive immunisation through plasma obtained from recovered coronavirus patients. Again DRAP has given a fast track approval and trials have begun.
A major problem in Pakistan is the fact that the quality control under which testing is done is often lacking, and that although we have a capacity of doing 20,000 tests per day, we have only achieved an output of about 7,000 tests per day. We should be doing 50,000 to 100,000 tests per day to be able to clearly understand the magnitude of the spread of this virus in Pakistan. Therefore, detailed discussions were held by our task force members with Chairman NDMA Lt-Gen Afzal to expand the capacity and train technicians.
In one initiative undertaken by our task force, the International Center for Chemical and Biological Sciences at the University of Karachi, which is the premier postgraduate research institute of Pakistan, has helped expand the capacity of Indus Hospital from 800 tests per day to 2,500 tests per day. In another initiative of our task force undertaken by Dr Ghazna Khalid, a grant has been procured from the British government and the capacity to carry out 1,500 tests per day has been created in the Punjab Forensic Science Agency in Lahore.
It is noteworthy that Pakistan’s first National Center for Virology has been built as a part of the International Center for Chemical and Biological Sciences at the University of Karachi, reflecting the foresight of its leadership on the need for a top class center in this field. In this connection the chief minister of Sindh has approved Rs58.28 million for the early completion of Biosafety Level (BSL) III facilities at the National Institute of Virology as a new Testing Facility for Covid-19 in province of Sindh. The new facility will use existing RT PCR machines and trained staff for carrying out 800-1000 tests every day (subject to the availability of validated kits).
Exciting progress in the manufacture of ventilators in Pakistan has also been achieved by our task force under the leadership of Prof Shoab Khan. After a nation-wide call for proposals by the Knowledge Economy Task Force, over 40 designs were submitted and a few were approved by the Pakistan Engineering Council. Prototypes are now under development and manufacturing can begin as soon as the trials are completed and DRAP approval given.
The fast-track approval given by DRAP under the able leadership of its CEO is praiseworthy. The tremendous efforts of the NDMA and the PM and his colleagues also deserve our appreciation.