Cross-testing of direct-action antivirals, universal vaccines, or search for host-level antivirals: what will sooner lead to a generic capability to combat the emerging viral pandemics?

Abstract

ABSTRACT Introduction Mitigation of future viral pandemics is an enormous technical problem, but its solution is essential for preservation of life, economic well-being, and social stability. The author examined host-level, direct action antiviral, and universal vaccine approaches while presenting a specific screening proposal. Areas covered The author examined the most recent biomedical literature publicly available in the databases and identified the publications supporting the principle of cross-applicability of direct-action antivirals (DAA) within similar viral families and at greater phylogenetic distances. Expert opinion Comparing different approaches, the author showed that the cocktails of DAAs, including parent compounds that passed Phase I trials need to be preemptively tested for all major viral families, approved, and stockpiled (or dual-use production facilities designated). The quick distribution of the pre-approved and pre-positioned antiviral cocktails (even of moderate efficiency) reduces mortality and economic damage many-fold, resulting in the trillion-scale savings in a pandemic context. This pre-positioning approach is only one in the combinatorial toolkit that needs to be included in the plan for all viral families of importance. A dedicated international public-private initiative can achieve savings in these proactive preparedness efforts, as well as to keep the focus of politicians and public on the problem.