Biden Science Chief Talks Next Pandemic, Operation Warp Speed

(Bloomberg) -- Five days before Joe Biden was sworn in as U.S. president, he sent a letter to Eric Lander, the mathematician-turned-geneticist who was founding director of the Broad Institute in Cambridge, Massachusetts. “Even as we work urgently to overcome the coronavirus pandemic,” Biden wrote, “we must learn from this moment by grappling with the challenges, inequities, and opportunities we’ve seen in order to better prepare for the future.” What, the president-elect asked, did Lander think the U.S. should do to better prepare for forthcoming pandemics? 

Within a month, Lander was working on a plan. No stranger to the White House, Lander was a key figure in the Human Genome Project and was later tapped in 2009 to serve as co-chair of the President Barack Obama’s science advisory council. Taking leave from the Broad, he was also named Biden’s science adviser, the first time a president created such cabinet-level position.

Now director of the Office of Science and Technology Policy, he’s leading the charge in preparing the U.S. government’s defenses against future pandemics. And on Sept. 3, Lander unveiled a $65.3 billion, 10-year proposal to protect the nation against biological threats. In an exclusive interview, the 64-year-old told Bloomberg what he’s learned from the novel coronavirus, how the U.S. could advance technology and what steps need to take place so that the government doesn’t repeat mistakes. His remarks have been edited for clarity and readability. 

Bloomberg: What makes this plan different from the Bush and Obama administration’s?

Lander: The major difference is where science has gotten to right now. We’re at a cusp. Our pandemic response has benefited tremendously from scientific advances, like mRNA vaccines, that just wouldn't have even been conceivable five years ago. So previous pandemic plans could not have thought about transforming our capabilities so that we could think about producing vaccines in 100 days, or producing therapeutics or diagnostics at very large scales and cheaply. In five years, we can, and we must, do so much better.

There’s an opportunity right now to make sure that infectious disease outbreaks in the future don't turn into pandemics. The challenge for us is to move with enough focus to make sure we seize that opportunity.

The plan assumes there will be “future and potentially catastrophic biological threats, whether naturally occurring, accidental or deliberate.” What threats are on the U.S. government’s shortlist for further investigation and preparation?

It's always a little risky to prioritize which one virus or a couple of viruses, because nature's very clever. Respiratory viruses are an obvious one, but there are others: hemorrhagic fever viruses, which right now are not as easily transmitted. Who's to say they could not evolve a capability to do that? We have to recognize there's a wide range of threats and be prepared for all of them. We can't fight the last war, but happily, there's a finite number of threats, something like 26 viral families. And if we understand them, we can put ourselves in a very good position to be ready for whatever comes next.

Now a household word, mRNA has proved to be a successful technology to quickly develop vaccines after identifying a new virus. Are there other platforms you think could help prepare us for biological threats?

Absolutely. RNA vaccines are a wonderful technology, but I might put them into a broader category of programmable technologies, meaning, whatever shows up, we have a general way to fight back. Maybe it's to make drugs that are targeted against the sequences of viruses. But there are other ways, certainly with diagnostics, where you drop in the sequence of the virus and you look for early warning in a population. This is something that's just a big change compared to a decade or two ago.

How important is it that we develop a pan-coronavirus vaccine, or a shot that could target multiple coronaviruses?

It's very important to try to develop pan-coronavirus or universal coronavirus vaccines. You know how everybody says there's no cure for the common cold? Well, coronaviruses cause common colds. I'm just speculating here, but if there was a pan-coronavirus vaccine, it might be very effective against the common cold. So it might not be that we'd stockpile it just for the future. Many of the things in the plan are going to be useful in public health here and now.

What kind of inspiration did the plan draw from Operation Warp Speed, the Trump administration effort to accelerate Covid vaccines?

[Warp Speed] demonstrated the value of bringing together [the Department of Health and Human Services] and the Department of Defense and having them work seamlessly to invest seriously in new technologies before you were absolutely certain they would work. Warp Speed told us we could risk money in order to save lives. It also taught us about the power of ensuring that the regulatory agencies are prepared in advance for the kind of submissions that they're going to receive, so that they're thinking months in advance about what they're going to have to review. There are a lot of learnings that we're trying to gather from things that worked well, and frankly, things that didn't work as well.

What didn’t work well?

At the beginning of the pandemic, because we didn't have access to diagnostics at scale, many people were not getting tests. Or people would have to go out and travel to try to seek a test. Along the way, they risked infecting other people. There's no reason why we can't make these extremely cheap and incredibly accessible.

The truth is, if everybody, every day, knew whether they were infected, everyone else might be able to go to work. If you manage the pandemic in the presence of complete diagnostic information, it would look very different. That wasn't feasible this time, but maybe it could feasible next time.

Throughout the pandemic, the U.S. has relied on the private sector to bring forth diagnostics, drugs, vaccines and protective equipment. How is the government going to put an economic floor under some of these efforts so that companies don’t stop developing or manufacturing these tools?

It’s important to think about the range of uses of these vaccines and antiviral drugs in everyday public health. One way to put a floor under things, as you say, is to make sure we’re serving the public health needs today that are going unanswered. We can use public money to support the creation of capabilities, and between that and serving public health needs, we should be in a stronger position.

How do you strengthen public health at the local level? Did the federal government successfully coordinate with state and local health departments throughout the pandemic?

There are a lot of challenges coordinating the federal government and 50 states and countless counties and municipalities that each have their own public health departments. All of these entities do not have common data systems, making it very difficult, even amongst willing parties, to exchange data because their computer systems don't speak the same language. We've also had chronic underfunding of public health in this country.

It's not that the answer is top-down direction from the federal government. The question is, how do we manage to coordinate together? How do we ask the public health official in a Massachusetts city or Mississippi city to write their own data system or procure their own supplies? There's just not a reasonable expectation. What the federal government can help do is make sure that people at all these levels are empowered, supported, and can connect with each other. It’s going to take years — not weeks or months.

And how we’re going to do it requires one clear step: listening. The amazing thing about the U.S. is we have these 50 laboratories of innovation, but it means we have to understand each is its own, right? So we've got to start by listening. I have a lot of respect for the people who do public health every day, and they know much more about what needs to be fixed. I don't think central solutions promulgated from Washington are the way to do it. I think this requires a real partnership.

The plan doesn’t dive much into global preparedness. How are you thinking about the resilience of our global supply chains?  

Viruses don’t seem to be impressed by national borders. So what does that mean? Countries like the U.S. that are amongst the best in the world at developing new capabilities have a practical and moral responsibility to develop those capabilities and make sure they’re available broadly. The U.K. also has extraordinary capabilities and opportunities to step up and do things for the world. And the U.S. and U.K. have been in conversation over the past seven months on pandemic preparedness. 

This has to be a global solution. That’s underscored by the evolution of variants. If we solve the problem in the U.S., and think we’re safe, we’re forgetting that a viruses evolving anywhere else in the world could evolve resistance to our vaccines. It’ll not be long before it arrives on our shores.

What’s the single most important piece of this plan our readers should be aware of?

Four words. We can be prepared. They might be afraid of a next pandemic. I'm afraid of the next pandemic, but I know that if we put our minds to it, we can be prepared. And we have to be prepared. That's what the plan is about. Let us not forget about this. Let's not have amnesia. Let's just attend to the problem.

You’ve worn many hats. What can you take away from your time at the Human Genome Project or the Broad Institute that can be applied to this preparedness effort?

That many things that on first glance seem impossible are tractable if you tackle them piece by piece. I felt that about the Human Genome Project. There was a major gulp at the beginning, thinking. “How in the world were we going to sequence the human genome?” But step by step, we got it done. At the Broad, many projects came along like that: At the beginning, they seemed inconceivable. Then they become conceivable. Then they become tractable. I feel the same way about pandemic preparedness. There's a tremendous amount to be done, but if we take the pieces that are laid out here and apply ourselves with serious national purpose, we can get this done.

©2021 Bloomberg L.P.