A universal influenza vaccine? The next big pandemic? What can we expect from the current presidential administration in dealing with emerging or re-emerging infectious disease?
Opening Lecture speaker Anthony S. Fauci, MD, explained that while we may not be able to predict the future, the lessons he’s learned as director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health under six presidential administrations can help inform better approaches to future problems.
Dr. Fauci on Saturday shared some of those lessons from each administration he’s served during Emerging & Re-Emerging ID: From AIDS to Zika.
“We have always had emerging infectious diseases. We have emerging infectious disease now. And we will always have emerging infectious diseases. It is incumbent upon us to take it seriously and be prepared,” he said.
In describing his earliest meetings with President Trump’s cabinet, he explained that each of his previous administrations faced an infectious disease pandemic in the first year of the administration, from HIV during the Reagan administration to H1N1 influenza during the Obama administration.
“What can three decades of pandemic threats teach us about the future? History has taught us that the new administration is likely to experience at least one infectious disease crisis of significance,” said Dr. Fauci. “We cannot predict what the next one is going to be, and that’s, again, the lesson to be learned.”
He cited the example of H7N9 influenza, a bird flu with a high mortality that jumps from chicken to human, although it doesn’t spread efficiently from human to human.
“But here’s the problem and the frustration,” he said, describing the vaccine created for H7N9 in 2013 that worked well in protecting people during outbreaks in 2014, 2015, and 2016. “The outbreak in 2017 had a slight mutation, which now makes it completely non-protected by the vaccine we made in 2013. We spent a couple hundred million dollars making that vaccine, so we now have to start all over again. That’s trying to tell us something.”
He said that it’s trying to tell us that there is a need for a universal influenza vaccine, an initiative that NIAID is vigorously pursuing. A June workshop brought together scientists and clinicians to develop a strategic plan and research agenda for the purpose of developing a universal flu vaccine. A report summarizing the workshop’s findings was published in October in Immunity.
“I can’t tell you when we are going to have a universal influenza vaccine, but I hope it is going to be in the next several years,” he said.
A number of lessons learned from previous pandemics should inform the path forward, he said. Global surveillance and the need to be transparent, communicative, coordinated, and collaborative are essential.
“We need infrastructure and capacity building. They had nothing in West Africa, which is why Ebola exploded in 2014-2016,” he said, pointing to the spread of the disease through Guinea, Sierra Leone and Liberia, which also introduced Ebola to U.S. soil.
Adaptable platforms and a public health emergency fund are also needed.
“I have been arguing for (a public health emergency fund) for several years given what happened with Zika, where we had to wait nine months before we got the money (to develop a vaccine),” he added.
Also during the opening session, ACR President Sharad Lakhanpal, MBBS, MD, addressed the membership with an update on the new mission statement, vision statement, and brand promise as well as the launch of ACR Beyond, a new streaming platform. He and ARHP President Afton Hassett, PsyD, also honored a number of members during the awards recognition ceremony.