Everyone still has in mind the two years of human, health, economic and social crisis caused by the Covid-19 pandemic. Even if we are not yet immune to a rebound, a number of observations can now be made on the management of the epidemic. I would like to focus here on the contrasts observed with regard to the actions of certain developed countries, including our own, in terms of research and health policy.
In the United States, thanks to a solid research base around the National Institute of Health (NIH), the rapid mobilization of scientific teams, in conjunction with the industrial dynamism of small and large companies, the development of vaccines was a success in record time. It took only 65 days between the identification of the viral genome sequence and the first injection of a volunteer with Moderna’s RNA vaccine: results of phase III studies known as of November 2020 and start of vaccination in December. This impressive response was also made possible by the massive support of the US government (“Operation Warp Speed”), which mobilized approximately $18 billion and enabled manufacturers, including Moderna and Janssen, to carry out clinical trials without delay on several tens of thousands of volunteers and to mass-produce vaccines. The NIH used a single monitoring and follow-up committee for the various clinical trials, which facilitated their progress. Let us add another major effort by this institute, in April 2020, to develop and deploy diagnostic tests. On the other hand, in contrast, the American health record in terms of vaccination coverage and mortality is clearly worse than that of Western Europeans. There is no doubt that the health system and its serious inequalities as well as the strong reluctance to vaccinate a fraction of the population, including the former President of the United States himself, have led to insufficient vaccination coverage, in particular minorities.
In Great Britain, where there is also a strong tradition of research in life sciences and medicine, the University of Oxford very quickly developed an adenoviral vector vaccine, based on the experience acquired for the Ebola outbreak, a vaccine that was developed by Astra Zeneca with support from Operation Warp Speed. While it did not have the same success as its RNA counterparts, it was nonetheless effective and widely used. The British National Health System (NHS) has a very well established network allowing the realization of large clinical studies. This is how the Recovery trial was set up in March 2020, which tested a certain number of therapies, and made it possible to conclude in June on the effectiveness of treatment with corticosteroids for severe forms of Covid and on the uselessness of a number of other drugs. This remarkable result had an immediate impact on patient care. However, the British record in terms of the effectiveness of protective measures against Covid is more mixed with regard to mortality and vaccination coverage.
And France in all this?
In Germany, the research fabric in place has enabled Ugur Sahin and Ozlem Türeci to rapidly develop, through their company BioNTech, then allied with Pfizer, an effective RNA vaccine, taking advantage of government aid. Christian Drosten, a virologist from Berlin, was able to develop the first diagnostic tests in record time. Germany, which has a more developed social protection system than the United Kingdom, has better limited the health consequences of the pandemic.
And France? We have not produced vaccines, diagnostic tests, or conducted large-scale clinical trials, although our research has made notable contributions to mathematical modeling of the pandemic and studies of pathophysiology. On the other hand, our country has conducted a relatively effective public health policy allowing it to rank in a very honorable position in the management of the health crisis.
Obviously, public health policy and performance in research and innovation are not linked. We hope to see the development in France and within the European Union of a research system as efficient as that of the NIH, associated with the capacity to set up clinical trials at the height of the NHS while safeguarding an admittedly shaky social protection system, but who has proven himself!