Looking beyond just diagnosis and quarantine

Looking beyond just diagnosis and quarantine

Part of: GS Prelims and GS-III S&T

The author of the article calls for greater attention towards the development of therapeutic options against epidemics in India.

Background:

• The world has suffered numerous pandemics and COVID-19 will certainly not be the last. Future pandemics are a certainty.
• Ebola, Zika, Nipah, SARS, MERS, H1N1 and COVID-19 are some of the viral diseases.
• Unlike bacterial infections such as cholera, typhoid which have drug and vaccine options, some of the viruses do not have vaccines or drugs available as yet. Also, mutations of known viruses periodically cause havoc.
• In India, given the population density and unsatisfactory hygiene conditions and awareness, citizens can face serious situations even though the disease may have originated elsewhere.

Details:

• In India, the options against epidemics are always limited to diagnosis as per World Health Organization protocols and seem to be limited to the exclusive domain of the National Institute of Virology (NIV), Pune and its designated centres.
• There is much scope for improvement in terms of development of therapeutic options in India.

Therapeutic approach:

Sequencing:

• The first requirement is to sequence the genome of all the isolates from infected patients.
• COVID-19, being an RNA virus, would require conversion to DNA data. Then the sequence of the alphabets (ATGC) of the nucleic acids would be determined.
• COVID-19 can be sequenced in 24 hours in India.
• It is important to sequence the virus isolates in at least three different institutions in India to ensure that sequencing errors are eliminated.
• The knowledge of genome sequence is essential to designing drugs and vaccines.

Short term measures:

• A quick response for the development of treatment regimes would involve the evaluation of repurposed known drugs.
  • This drug development strategy depends on the reuse of existing licensed drugs for new medical treatments.
  • For example, in the case of COVID-19, anti-HIV drugs and antimalarial drugs are being evaluated.
• Passive immunisation provides an effective measure for treatment.
  • This technique uses the plasma derived from convalescing patients, who have completely recovered, which is then injected into infected patients. This would boost antibodies in the patients.
  • Another strategy of passive immunisation involves cloning of B cells from patients to make therapeutic antibodies and their subsequent injection into patients.

Long-term approach:

• A long-term approach in developing therapeutic options involves cloning the genome, making recombinant antigens and testing for vaccine potential and new drug design.
• The virus needs to be cultured for drug screening.
• A phage library expressing all possible human antibodies (single chain) is available for screening.
• This approach eventually needs clinical trials to be taken forward on fast-track with the cooperation of the office of the Drug Controller General of India.

Way forward:

• There is a need in India for a rapid response research and development team to handle viral onslaughts.
• India should come out with a framework for drug and vaccine development domestically.
• India can use the vast expertise of its organizations, scientists and medical professionals to effectively implement such a framework.
• Apart from the state organizations, there should be ample opportunity for including the private sector too, given its expertise.