2021 forecast: COVID-19 brings infectious disease R&D out of the wilderness

Infectious disease was a long way down the list of the hottest areas of biopharma R&D going into 2020. There were signs that companies and investors were reconsidering the sector, but they were overwhelmed by the torrent of activity in oncology and gene therapy. Today, it is plausible infectious disease R&D will be a fast-growing area for years to come as the world learns the lessons of the past 12 months.

COVID-19 has had an obvious, immediate effect on interest in developing drugs and vaccines against the pandemic coronavirus. Governments and biopharma companies have poured billions of dollars into the search for interventions that may control and ultimately end the pandemic. The effects of the pandemic on R&D will continue to be felt after the crisis is averted in ways that could drive the ongoing resurgence in interest in infectious diseases.  

“[People won’t think of] vaccines as a money losing proposition the way they do today, broadly, but rather as an armamentarium that reduces the need for many of the expensive therapies we have,” Flagship Pioneering CEO Noubar Afeyan said in April.

Afeyan’s prediction has already begun to play out. Sanofi paid Translate Bio $425 million upfront to expand their infectious disease mRNA vaccine alliance, having paid out just $45 million to strike the original deal in 2018. The effectiveness of mRNA vaccines at preventing infectious diseases has since been validated by late-phase COVID-19 trials. Sanofi disclosed the expanded Translate deal weeks before GlaxoSmithKline paid CureVac $294 million to collaborate on mRNA infectious disease R&D.

There were signs of rising interest in infectious disease R&D in the years before the pandemic, albeit versus the easy comparator of a period of relative inactivity. Flagship, for example, identified Health Security as a new focus area in the second half of 2019, reflecting a belief the technology exists to move to a more proactive, preventative form of healthcare. The focus area is broader than infectious diseases, but its value was nonetheless illustrated by the pandemic.

Funding data reveal other signs of rising interest in infectious diseases. Neglected disease funding hit (PDF) a new high in 2018 following three years of growth, the final year of which featured the largest real annual funding increase since the G-FINDER project began providing data in 2007. Rising industry funding, most of which came from multinational pharma companies, was a driver of the growth.

In 2020, the G-FINDER project turned its attention to emerging infectious diseases and again showed (PDF) funding rising well before the pandemic hit. Funding in 2018 was $886 million, five times the level of 2014. The G-FINDER team said changes in methodology explains some of the growth, but “most of it reflects a genuine and ongoing increase in R&D for emerging infectious diseases.”

The genuine and ongoing increase was underpinned by two main factors, namely the establishment of the Coalition for Epidemic Preparedness Innovations (CEPI) and the effect of outbreaks of Ebola and Zika on investment. Ebola and Zika accounted for much of the growth over the analyzed period and accounted for 64% of the total 2018 funding. Coronaviruses accounted for 5% of the funding.  

Other diseases outside of the scope of the G-FINDER report have attracted more investment. Pfizer was pumping money into vaccine R&D before becoming a leading player in the COVID-19 response. The non-coronavirus investments have positioned Pfizer to protect its $5.9 billion Prevnar franchise and drive growth with its late-phase vaccines against meningococcal disease, Clostridium difficile and respiratory syncytial virus.

Pfizer was far from the only company to see pre-pandemic potential in infectious diseases. Believing multidrug resistance in China has become a pressing enough problem to make the commercial case for new antibiotics, Brii Biosciences used some of the $260 million it raised in 2018 to move into the biopharma backwater of antibiotic R&D. Brii disclosed its plans last year, months after Gilead Sciences teamed up with AbCellera to develop antibody treatments for infectious diseases.

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Some of the pre-pandemic activity shaped the response to the pandemic. BioNTech partnered with Pfizer on COVID-19 on the back of a 2018 mRNA influenza vaccine collaboration worth $120 million upfront. AbCellera had an informal relationship with Eli Lilly before partnering on an anti-SARS-CoV-2 antibody.

Companies that embark on post-pandemic infectious disease programs will do so in an environment shaped by the truncated timelines seen in 2020. The decision by COVID-19 vaccine developers to save time by running more activities in parallel is the obvious example, but business development also sped up significantly. AbCellera and Lilly took 13 days to agree on their COVID-19 deal, having spent months working on a separate multi-target agreement.

“Despite all that we do to try and speed up drug discovery, very often making these deals is what is dragging down the time. If you want to get drugs to patients faster, we need to work on that part of the problem,” AbCellera CEO CEO Carl Hansen said earlier this year.

The response to COVID-19 has shown there are other, faster ways to get things done. One question for 2021 and beyond is whether aspects of those ways of working become part of the new normal or the industry snaps back to something more closely resembling its pre-pandemic state.