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Gates Package, p.1014 · gates:exh:00424
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I feel sure we will have better treatment options in the next big outbreak than we did for COVID.
One of the keys to making that happen will be big libraries of drug compounds that let us quickly
scan to see if existing therapies work against new pathogens. We have some of these libraries
already, but we need more. This will require substantial investment to bring together academia,
industry, and the latest software tools.
We need libraries that cover many types of drugs, but there are some types that should be
a top priority. The most promising, in my view, are the ones known as pan-family and broadspectrum therapies--either antibodies or drugs that can treat a wide range of viral infections,
especially those that are likely to cause a pandemic. We could also have better ways of activating
what's known as innate immunity, which is the part of your immune system that kicks in just
minutes or hours after it detects any foreign invader--it's your body's first line of defense. (It
stands in contrast to the adaptive immune response, which is the part that remembers the
pathogens you've encountered before and knows how to fend them off.) By boosting your innate
immune response, a drug could help your body stop an infection before it takes hold.
To deliver on these promising approaches, the world needs to invest more into
understanding how various dangerous pathogens interact with our cells. Scientists are working
on ways to mimic these interactions so that they can quickly figure out which drugs might work
in an outbreak. A few years ago, I saw a demonstration of a "lung on a chip," an experimental
device you could hold in your hand that operated just like a lung, allowing researchers to study
how different drugs, pathogens, and human cells affect each other.
With advances in artificial intelligence and machine learning, it's now possible to use
computers to identify weak spots on pathogens that we already know about, and we'll be able to
do the same when new pathogens arise. These technologies are also speeding up the search for