Strengthening research and development activities to effectively contain the epidemics of infectious diseases: World health organization

Dear Editor,

Time and again, the world has been threatened by the outbreaks of infectious diseases, which over a period of time have assumed epidemic proportions and has even spread to different nations and continents.^[1] In the last 2-3 years, thousands of people have lost their lives due to the Ebola virus disease, which started in West Africa and then spread to ten different nations. Another virus Middle East Respiratory Syndrome (MERS) that has been isolated in more than 25 nations, and is still spreading, or even the latest Zika virus disease has again resulted in the loss of lives and serious fetal complications.^[1],[2],[3] Not only that, amidst the rise in international travel, and globalized trade, any infectious disease outbreak can acquire the status of a public health emergency of international concern (PHEIC), and if urgent countermeasures are not implemented, it is expected to result in enormous loss of lives and burden on the public health system.^[1],[2]

Most of these infections could have easily been prevented through simple preventive measures, but owing to the lack of preparedness and numerous shortcomings in the health care delivery system or loopholes in the international health regulations, not only the national authorities, but even the international welfare agencies had no answer to contain the disease outbreak.^[2] Even though, the strategies of surveillance, contact tracing and preventive measures occupies the centre-stage of the emergency response, it is quite essential to invest in the better understanding of the infectious agent, as it will play a significant role in preventing the development of a full-blown epidemic, and in minimizing human and financial losses.^[1],[2]

Infact, the major share of the rise in the incidence of the diseases has been attributed to the lack of research and development activities in the area of prevention and control.^[1] For instance, Zika virus and Ebola virus were first detected in 1952 in humans and in 1976 respectively, and even after the passage of multiple decades, the health sector has no weapons in terms of availability of a prophylactic vaccine or specific treatment to effectively contain the disease.^[2],[3],[4] This clearly reflects the dearth in research activities and the lack of interest, which the global stakeholders have shown.^{[1],[2],[3],[4]}

• Furthermore, the 2014 Ebola outbreak has highlighted various areas of gap, namely:
• no framework to fast-track vaccine clinical trials or drug testing or data sharing,
• lack of research and development activities regarding the epidemiological aspects of the disease or the utility of personal protective equipments,
• absence of a well-informed plan to ensure community engagement right from the initial stages of the detection of outbreak, and
• lack of a funding source, which could be easily mobilized at times of disease epidemics.^{[1],[2],[3],[4],[5]}

To acknowlede the need to strengthen the research and development activities, the World Health Organization in collaboration with other partners is developing a blueprint to formulate a preparedness plan and implement measures to prevent epidemics across the globe.^[1] It is anticipated that it will assist the health authorities to strengthen their emergency response by increasing the proximity between medical technologies and patients, especially during epidemics.^[1],[4] In addition, it advocates for the coordination between different stakeholders to improve the capacity to promptly evaluate investigational drugs and vaccines (with the highest scientific and ethical standards), and thus accomplishes reduction in the time interval between the declaration of a PHEIC and the availability of effective tools (diagnostic tests, vaccines and medicines) to contain the disease.^[1],[2]

The proposed blueprint is a definite reality, as it has been observed during the Ebola outbreak, in which the usual research and development activities have been compressed from more than ten years to less than one year. At present, we have at least one safe and effective vaccine, different diagnostic tools and laboratories providing results in a few hours, and expedited development of novel therapies.^[1],[2] However, to enhance its utility, the need of the hour is to:

• prioritize global infectious disease threats;
• ascertain research priorities and reach a consensus on standard procedures to promptly assess new health technologies;
• ensure global coordination through involvement of different stakeholders, sharing of data, and capacity building;
• promote continuous assessment to revise the blueprint subsequently; and
• explore options for funding to achieve research and development preparedness.^[1],[2],[3]

To conclude, the emergence of epidemics can be prevented and the lives of thousands of people can be saved, provided the learnt lessons are incorporated in the proposed blueprint for research and development, and all the global stakeholders coordinate with each other in the planned activities.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.213157