"The world had been warned. The SARS epidemic of 2002-2003 from China and that of MERS that developed in 2012 in Saudi Arabia had made it clear that large regions of the Earth could have been held in check, even in the future, due to lethal viruses. The similarity between the two previous acute respiratory syndromes, whose family the current SARS-CoV-2 (also known as Covid-19) belongs to, could favour the industrial development of important pharmacological research lines which had, as a matter of fact, already been started by scholars from many countries. Instead, nothing was done, and precious years were lost. An incalculable damage: to date, in the world - which is practically half blocked - we count 5 million infected and 200 thousand dead. And it’s not over."
This is a precise denunciation made by Claudiu T. Supuran, professor of pharmaceutical chemistry of international importance, who authored - together with other Italian and foreign scholars, including Fabrizio Carta, another University researcher - a heartfelt editorial in the magazine Expert Opinion on Therapeutic Patents (“A deadly spillover: SARS-CoV-2 outbreak” https://doi.org/10.1080/13543776.2020.1760838). The other coauthors of the study are Dr. Mattia Mori from University of Siena, Dr Clemente Capasso from CNR, Naples, Italy, and Prof. William A. Donald from University of New South Wales, Australia.
Tell us more, Professor Supuran.
“Researchers' knowledge of the biochemical machinary of these viruses has been fairly detailed for years. We know a lot about the genetics, molecular biology and life cycle of these pathogens. For example, research in several laboratories has identified the viral proteases among the targets to be hit by possible drugs, as these proteins allow viruses to multiply. Over the years, protease inhibitor drugs have also been developed, which are now used, for example, in the treatment of hepatitis C and HIV: they are drugs that block the virus machinary and have low toxicity. I myself am currently working on an international project for the development of a protease inhibitory therapy, related to Covid-19. But the effectiveness of the drugs depends largely on the specific design for one type of virus. "
Is that why the remedies that are currently under experimentation are not decisive?
“Precisely. As a matter of fact, the drugs currently used against Covid-19 have been designed and manufactured for other pathologies: for this reason, they are less effective. As far as the candidate drugs specific for the current virus are concerned, they are lagging behind, even if the pathways had already been traced by researchers, as mentioned above.”
What was lacking?
“Researchers, who have limited resources, are not enough to develop a new drug. The investment required is huge: an average of one billion dollars is estimated for the discovery, experimentation and launch of a new drug. The process - between the preclinical phase, assessment of toxicity, verification of efficacy and side effects, comparison with the medicines currently available, up to the final approval and commercialization - can take 10, or even 15 years. In particular cases, as for anti-HIV drugs, the times were reduced: 5 or 6 years. In the case of CoV viruses (others than the one of this outbreak), researchers have continued to investigate in recent years, but with very limited funding. The big pharmaceutical companies, however, have deemed not worthy to invest heavily in the discovery of drugs for diseases that affected limited numbers of people: both in the case of SARS and MERS the global victims were of the order of a thousand. What we have before our eyes shows how wrong they were.”
How was that possible?
“A lack of vision beyond the short term and immediate interest, but also a short-sightedness in reading reality and in its interpretation. In this regard, I remember that significant rumours had arisen. These days, the media recalled a 2015 Bill Gates speech in which he argued how, in the future, an epidemic would be more dangerous than a war. But already in 2012 David Quammen, American writer and disseminator, wrote a text on the evolution of epidemics, in which he predicted - with surprising details - the coming of a future pandemic caused by a virus transmitted by a wild animal to humans.”
What conclusion can we draw from all this?
“That there is also a responsibility of states and governments: the development of strategic drugs for epidemics cannot be left only in the hands of pharmaceutical companies. Large countries and international institutions such as the World Health Organization, which is highly and deservedly criticized for the irresponsible manner in which they dealt with the outbreak in its initial phase, should directly finance programs for the development of therapies in the interest of public health or make alliances with the private sector for this purpose. We have to start from this awareness.”
