The Covid-19 fight

Wednesday / May 20 2020

Newspaper : The News

As scientists work day and night in laboratories all over the world to find a cure or a vaccine for Covid-19, exciting progress is being made both in discovering drugs that could be effective against this virus as well as in vaccine development.

Clinical trials led by the National Institute of Allergy and Infectious Diseases (NIAID) in the US showed that remdesivir, a drug developed some years ago by a US company Gilead Sciences against the ebola virus, can be beneficial for the treatment of Covid-19 patients. The clinical trial was carried out on 1063 hospitalised patients with advanced Covid-19 and showed that patients treated with remdesivir had 31 percent faster recovery times than those receiving a placebo. There was also a slight improvement in the percentage of deaths that fell from 11.6 percent to 8 percent. While M/s Ferozsons have agreed to produce this drug in Pakistan, Gilead has signed similar agreements with four companies in India to locally produce the drug there.

In efforts to find existing approved FDA drugs used against other diseases that may also have activity against the coronavirus, a process commonly known as ‘drug repurposing’, scientists at Institut Pasteur Korea have been investigating the activity of many common drugs against this coronavirus. Nafamostat showed the strongest antiviral efficacy against the Covid-19 virus among about 3,000 drugs analyzed through cell culture experiments by the Korean scientists. Initially 24 drugs were shortlisted of which nafamostat was the most effective. Nafamostat appears to be 600 times more effective than remdesivir in its antiviral activity in laboratory studies.

Korean researchers have said that “Nafamostat is an anticoagulant that removes thrombosis associated with an acute respiratory distress syndrome, and will be effective in improving symptoms such as thrombosis, the main pathology of Covid-19 pneumonia”.

“Nafamostat, which has several hundred times stronger antiviral effects at the cellular level than Remdesivir, will contribute to putting an end to the Covid-19 crisis”, claims Ryu Wang-sik, director of Institut Pasteur Korea. The claim is important because many patients die of blood clotting (thrombosis) as a result of the Covid-19 attack rather than just respiratory failure. The Korean Ministry of Food and Drug Safety (MFDS) have formally approved Institut Pateur from going ahead with their clinical trials which will involve 10 hospitals. Since the drug has already been approved in both Japan and Korea as a pancreatitis medication, researchers need not do any animal testing but go ahead with human trials.

Huge efforts are also underway by over a hundred companies worldwide for development of vaccines to protect us from this virus. This is done through injecting humans with a vaccine that boosts our immune system against the attack of Covid-19. According to the WHO, there are presently seven vaccine candidates that have been tried on humans. Normally vaccine research involves a long process spread over three phases during which the safety, side effects and ability to induce immunity are carefully assessed. This can take up to 10 years, but fast tracking the process, as has been done in this case because of the global emergency, can reduce the time period to about 12-18 months.

Probably the most advanced of the seven candidates is that being developed by the Chinese Biotech firm CanSino Biologics jointly with a branch of the People's Liberation Army. Labelled as AD5-NCOV, it is in phase II clinical trials. Some other Chinese companies are also involved in vaccine development and have successfully completed Phase II trials.

Another related vaccine, ChAdOx1, is being developed by the Oxford group, and they have ordered large-scale manufacture of the vaccine through several manufacturers even before the trials have been completed. One of the manufacturers contracted is Serum Institute of India. The clinical trials will not be completed before May next year, but the British researchers are hopeful to get permission for emergency usage well before completion of the trials, if the initial trial results are positive. A number of other vaccines are under development in the US, Germany and other countries.

A number of excellent efforts are underway in Pakistan to fight the virus. These include large-scale trials on existing drugs that have shown promise against this virus, expansion of national testing facilities, manufacture of ventilators and of other devices. These initiatives have been taken under the supervision of the Coronavirus Task Force under my chairmanship that was formed by Minister of Science and Technology Fawad Choudhary. An impressive exhibition of some of these initiatives was held a few weeks ago in the COMSTECH building Islamabad, which was attended by the prime minister as chief guest. It illustrated the tremendous potential of Pakistani scientists and engineers to come together at times of national emergency.

The next two months are critical for Pakistan. We need to come together as one nation, leaving political differences aside, and fight together to save thousands of lives through discipline and social distancing. Simultaneously, we need to focus on trying to set up joint industrial plants, with China as a partner, for manufacture and export of high-technology goods. Therein lies the future of Pakistan.

In October last year, Minister Fawad Choudhary and I had met the Chinese minister of science, and it was agreed that a joint China-Pakistan Committee will be formed for manufacture and export of high-technology goods under CPEC. This can be a huge game-changer. It is important that this committee, which is chaired by General Asim Bajwa, should meet quickly. It should: (a) identify industries to be set up; (b) set up technical training institutions so that we have the manpower to operate those industries; and (c) come forward with long-term tax holidays and other major incentives so that the largest industrial groups of China can be persuaded to shift some of their production plants to Pakistan. These industries should include the production of vaccines against the coronavirus, as there is a huge opportunity to manufacture and export these vaccines all over the world.