New York–based organisation, PrEP4All Collaboration is advocating for the development of a pre-exposure prophylaxis (PrEP) drug as scientists search for a vaccine to fight the global pandemic.
PrEP can help prevent HIV infection in people who don’t have HIV and are at very high risk of becoming infected, according to United States medical organisation, Mayo Clinic. In this instance, Covid-19 PrEP would be a drug that will prevent the development of the virus in the human body.
The report states that existing research into PrEP for Covid-19 is far too limited and uncoordinated. It found that 61% of the non-vaccine Covid-19 trials are testing the same drug, chloroquine/hydroxychloroquine, while “promising compounds like remdesivir aren’t even being tested in the context of prevention”.
“We really do need to see is a process [for] what we are doing in Covid-19 new treatment, where WHO is running multiple clinical trials that are evaluating multiple different drugs to test out their effectiveness in treating Covid-19, we need to see the same sort of efforts being coordinated at the national and international level to evaluate PrEP modalities,” says James Krellenstein, co-founder of PrEP4All and member of the Covid-19 Working Group New York.
Lessons from HIV
According to WHO’s director-general Tedros Adhanom Ghebreyesus, a Covid-19 vaccine may take almost two years to develop.
Krellenstein argues that even if a vaccine is developed there is no guarantee that it will be effective in preventing Covid-19. He says that as HIV has shown, PrEP is a more efficient way of preventing a person being infected by the virus.
“HIV PrEP has come a pretty long way. It took a while in the development of HIV science, but it still became before the development of an effective HIV vaccine, which, to this day has eluded us,” Krellenstein says.
This is why PrEP4All is advocating that scientists should not solely focus on the development of a Covid-19 vaccine.
“Everyone wants a vaccine, just like we really want a vaccine for HIV as well. But one of the lessons that we should take from the search for an HIV vaccine is that just because we want something to be developed, doesn’t mean that it’s going to happen. And given the sort of cataclysmic scale of the Covid-19 pandemic. We should really as humanity, be exploring all different approaches to Covid-19 prevention, including PREP,” Krellenstein explains.
He says that it would be easier to develop a Covid-19 PrEP than a vaccine.
“The ability of the world to synthesise what we call small molecule drug is generally easier to do to bring up vaccines, or production for example, obviously there’s a difference in that you know vaccines only require one or multiple rounds of immunisation and then you’re good for period of time. But it is possible that if we once again identify a small molecule that is effective at inhibiting SARS-CoV-2 we could really bring that production up to scale pretty quickly and ensure pretty widespread access, and perhaps faster than the vaccine.”
Recommendations from leading health experts
The report noted failures such as the lack of collaboration between health organisations, health funders, and scientists. But the PrEP4All Collaboration has recommended the following:
“Develop a coordinated process to rapidly expand the number and diversity of anti-viral molecules being tested. A centrally coordinated, high throughput screening programme, orchestrated by the federal government, could help quickly identify potential antiviral inhibitors of SARS-CoV2 in vitro.
Create a cross-institutional committee at NIH and the WHO to coordinate promising candidates for clinical trial. An expert panel from across academia and industry would evaluate which candidate molecules have demonstrated antiviral potential in vitro and should move forward to a clinical trial.
Establish and fully fund a mechanism, such as a trial network, to oversee clinical trial research across institutions and nations. The trial network would play an important role in preventing duplication and ensuring that all promising candidates are evaluated in properly designed randomised placebo-controlled clinical trials.” – Health-e News
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