36-37 - COVID-19: Triumph over adversity

Government, health systems and industry worked in tandem like never before to develop effective responses to the coronavirus. It is vital that these learnings are translated into more effective ways of developing new technologies, effective diagnosing and treating people.

Dame Dr Jenny Harries, Chief Executive of the UK Health Security Agency, recently reflected that improved working between public bodies and the life sciences industry was essential in coordinating an effective response to the COVID-19 pandemic. Dr Harries’ recommendations were clear that this collaboration should progress further to ensure that the UK is well placed to identify and plan for emerging health threats and improve targeted healthcare for the population.

As UK country lead for Thermo Fisher Scientific I was proud to work alongside industry and Government colleagues to scale up projects, technology and infrastructure at short notice. We were intrinsically involved in supporting UK health authorities, private testing laboratories, biotech and the pharma industry – from laboratory development, antigen and antibody test production to vaccine research, clinical trials, approval and manufacture.

What we’ve learnt from the outset – echoed by the Government and public health bodies – is that the technology and processes developed during the pandemic have the capabilities to be translated to other pressing health conditions.

For example, Government ministers are rightly proud that our manufacturing centre in Swindon is the global distribution hub for the Pfizer COVID vaccine. The centre ensures that the UK is playing a crucial role in the supply of vaccines to the UK and other parts of the world, which saw much lower uptake levels.

Our company among others in pharma is committed to prioritising global health equity and we work alongside global health partners, including the World Health Organization, Clinton Health Access Initiative, UNICEF and the Africa CDC, to aid target countries in their pandemic response.

Crucially, the technology and capacity at the sites such as ours can be employed for developing messenger ribonucleic acid (mRNA) and other innovative technologies that can assist with the UK’s response to other public health emergencies, now and in the future.

mRNA technology is a truly revolutionary therapy that came to the fore during the pandemic. Indeed, no mRNA vaccine had been made at scale before and the success of the BioNtech/Pfizer vaccine is raising expectations about how ‘messenger’ RNA can be harnessed to help our bodies produce antibodies in response to other viral infections including HIV, cancer and shingles.

The prioritisation of mRNA studies is also directly linked with investment into the UK and the new strategic partnership between Moderna and the Government to open a vaccine research and manufacturing centre is very promising. It is important to reflect on how mRNA has been adapted so successfully and take this lesson forward to drive innovation and ensure other therapeutics reach patients.

The pandemic taught us that infectious diseases are a ‘whole of society issue’ and the enforced lockdown forced health systems to rethink how to deliver services and care. Expectations and norms changed for people as well – self testing in homes became commonplace, linked into a wider centralised framework.

It is important that industry, including Thermo Fisher, supports NHS and public health bodies to build on this behavioural shift to ‘democratise healthcare’ and construct a system that encourages people to take greater ownership of their health through increased engagement with information and more routine testing.

Diagnostics have shifted from a cost burden in healthcare to a value driver, enabling earlier intervention and better outcomes. There is growing appetite from people to understand more about the predictive signs of future conditions, and the right balance needs to be struck between screening to identify high risk individuals and not creating a swell of enquiries into the NHS.

Home testing kits should continue to be a part of the diagnostics pathway, but this will require prioritisation and funding to continue the operations of the Lighthouse Labs – used to good effect to process COVID PCR tests. Lighthouse Labs have been downscaled but the trusts and universities that delivered them continue to work in partnership with Academic Health Sciences Network (AHSNs) and industry.

For example, the North East England Innovation Hub is assessing and evaluating the diagnostic tests that can be used nationwide. There is untapped potential at the largest Lighthouse Lab – the Rosalind Franklin Institute – which remains our primary COVID testing lab; the challenge is to predict fluctuating demand and use the centre’s resources to diagnose other conditions.

As the Department of Health and Social Care develops a new ten-year Cancer Plan, objectives to increase the proportion of cases caught early, and more ambitiously, to genome sequence tumours in order to monitor people proactively needs to build in a wider community and home testing approach.

A system needs to be built whereby people can expect to receive a routine blood test in the post or on their high street via ‘community diagnostic hubs’.

To improve the UK’s clinical research environment, we must also learn the lessons of what was successful during COVID, combined with a plan for how to differentiate following our departure from the European Medicines Agency (EMA).

COVID-19 merged the lines of healthcare and research and raised awareness of research as a care option to an all-time high in the general public. Moving forward we need to maximise this integration and we are seeing positive signs, with an example being the Government’s recent guidance around revolutionising data access with research in mind.

The Medicines and Healthcare products Regulatory Agency (MHRA) will be significant in capitalising on this. While it is a concern that the MHRA is being reduced in size during this transformative period, it is encouraging that initiatives are underway to accelerate the journey of therapies from discovery through to widespread use. An example of this is the MHRA’s use of rolling reviews during COVID vaccine assessment – similar flexibility should also be adopted with other highly innovative technologies moving forward.

The rules governing the regulation of clinical trials in the UK are changing and proposals have been set out to improve their efficiency and flexibility as well as increasing public and patient involvement. The hope is that the right infrastructure and regulatory framework is in place support the development of therapeutics from discovery through clinical trials and commercialisation.

Part of these reforms should encourage the use of decentralised, digitally transformed clinical trials. Numerous contract research organisations were able to continue their work during the pandemic thanks to adopting newer trial design elements. These include direct-to-patient models, telemedicine, utilising wearable devices, home visits or mobile sites that make it easier for an individual to participate in research.

We’ve seen a continuation in the adoption of these decentralised strategies post COVID that are now enabling research to access under-represented communities, promote diversity and accelerate overall timelines.

It is an exciting time for the life sciences sector with opportunities to build on the learnings of the pandemic. Pharma will continue to collaborate with industry, government and health systems to help translate best practice into other healthcare challenges and, if necessary, assist with future pandemic preparedness.