Here's how we prevent the next killer virus

Last year, as the Ebola epidemic appeared to be contained, Bill Gates warned, "There is a significant chance that an epidemic of a substantially more infectious disease will occur sometime in the next 20 years."

That same month, the spread of the Zika virus was linked to the harrowing increase in microcephaly among babies in Brazil — at a rate nearly 20 times greater than in previous years. The World Health Organization declared a public health emergency, but there were no anti-virals and no vaccines to battle the outbreak. The next epidemic was here, but we were no better prepared than we had been for Ebola.

The devastation imparted by the Zika virus, portrayed in the haunting images of babies with severe birth defects, is the latest example of the urgent need to better support medical research so we can respond effectively to new infectious diseases.

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The lesson from Ebola — and before that, from HIV/AIDS — should have been that research to find treatments and vaccines requires sustained, proactive investment. The alternative, i.e., formulating solutions in the heat of a health crisis, is dangerously inadequate; reacting to each outbreak instead of consistently funding research means that we will always be behind, never ahead of the crisis.

Doctors without Borders (Médecins Sans Frontières/MSF) was the 2015 recipient of the Lasker-Bloomberg Public Service Award in recognition of their work to fight Ebola. At that time, MSF President Joanna Liu said, "The lack of effective treatments and vaccines escalate the toll. Ebola exposed a global research and development infrastructure that is unfit for the purpose of saving lives." She called for "inter-epidemic" research that would allow the fast-track use of experimental vaccines during an outbreak.

Ebola was well known to medicine before the latest outbreak and we missed opportunities to develop a vaccine. Zika was also known, but until recently not recognized as capable of causing severe consequences like fetal death, microcephaly and Guillian Barre syndrome, in which the body's immune system attacks its nerves. But we still could have — and should have — been better positioned to respond.

The Centers for Disease Control has argued that vaccine platforms be developed proactively and at-the-ready, "so that they can be quickly modified for protection against emerging threats." Scientific leaders at the NIH's infectious disease institute (NIAID) have pointed out that "a number of existing flavivirus vaccine platforms could presumably be adapted" to formulate a Zika vaccine. (Flavivirus is a genus of viruses that includes West Nile and Zika.)

Such vaccine platforms can help prepare for future outbreaks since they can be relatively "quickly modified to express immunogenic antigens of newly emerging viruses." In other words, it is essential that we support ongoing research into basic virology and vaccine development so that we can move quickly to respond to future outbreaks.

According to the World Bank, a single severe flu pandemic could reduce global wealth by a staggering $3 trillion or nearly 5 percent of world GDP. The cost of prevention, by comparison, is dramatically less. NIAID Director Anthony Fauci calculated that less than one dollar per person would make the world far more resilient to epidemic. Could it be more obvious that upstream investment in virus research and preventative vaccines is a cost effective use of societal dollars? As Mary Lasker said, "If you think research is expensive, try disease!"

In January, the National Academy of Medicine's Commission on Global Health Risk Framework for the Future called for investing $4.5 billion dollars to contain a next pandemic, including $1 billion for "accelerated research." Pope Francis has advocated for more research to develop a Zika vaccine, as has President Obama, who recently asked Congress for $1.8 billion to deal with the Zika crisis, including funding for basic vaccine research.

Congress has not agreed to this request, questioning the need and suggesting that "leftover" NIH dollars allocated to fight Ebola could be used instead. In reality, cannibalizing the last NIH research dollars for Ebola will threaten the progress made on designing an Ebola vaccine and still be inadequate to conquer Zika.

Instead of shuttering labs and cutting back on promising research, we need to spend the money now and sustained into the future — proactively — to understand more about basic virology, immunology, and epidemiology; to develop vaccine platforms; and to translate those insights into development of new vaccines and therapies.

Now is the time to invest in the future prevention of disease. The "next killer virus" may well already be among us. Will we let this next one outsmart us, too?

Commentary by Claire Pomeroy, M.D., M.B.A., is president of the Albert and Mary Lasker Foundation, dedicated to improving health by accelerating support for medical research.

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