Solving the healthcare challenges of today and tomorrow

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Over the past 18 months, the Covid-19 pandemic has impacted the health and well-being of societies, businesses and economies across the world. During this period we have witnessed unprecedented levels of innovation and interdisciplinary working between industry, the public sector and academia to deliver solutions. While we are far from clear of this viral threat – which we will need to learn to live with, as we have done successfully with influenza – current scientific and medical advances are helping to speed up our recovery.

The UK’s biotechnology community of academic and industry experts has led the way in RNA vaccine development for Covid-19, with the timeline from concept to clinical deployment having been astonishingly short. In addition to tackling the immediate Covid-19 challenge, this development helps us prepare for the future. We are now well placed to rapidly counteract new pathogenic organisms or strain variants as they emerge. Along with the wider potential applications of nucleic acid therapeutics, such as gene therapies, this prompts renewed interest in how these entities may be manufactured efficiently and cheaply at scale. These can be complex and involve challenging chemical processes; harnessing nature’s synthetic machinery (enzymes) for biocatalytic processes shows promise and warrants further investment and exploration.

With the emergence of new Covid-19 variants, ongoing vigilance is paramount. There is real need for rapid new diagnostics for community surveillance and individual diagnoses at the point of care, as well as at home and in the workplace. This remains a challenge and a continuing requirement, not least in connection with early deployment of vaccines and the identification of variants that are resistant to vaccination attempts.

Current and emerging diagnostics solutions make use of a range of biological agents for detection: PCR tests for laboratory-based detection of virus genes; nanopore sequencing of complete virus genomes; and established antibodybased testing in lateral flow devices (now being adapted with newer approaches based on artificial RNA receptors or sugar-binding technologies). The diagnostics community is embracing the full spectrum of what nature offers us, adapting and deploying the components to great effect in ways that nature had not intended.

The acquisition and preparation of samples is instrumental to the transition from diagnostic theory to roll-out for scalable use in the community. The Manchester Institute of Biotechnology (MIB) is heavily engaged in studies that aim to gather diagnostic information from a breath sample or a skin swab, rather than an uncomfortable nasal swab or invasive blood sample. MIB embraces academia-industry-stakeholder collaboration, and the resulting activities, which require integrated thinking that transcends traditional disciplines, are currently seeing development at unprecedented pace.

While we contemplate ways to manage current and future pandemics, we also need to consider the valuable role that antiviral drugs can have. HIV infection rates have plummeted in those parts of the world where antiviral drugs have become routinely available, demonstrating the power of chemistry to tackle this deadly infection. Moving forward, there is a need to identify cheap and sustainable routes to manufacture for antiviral drugs. Specifically, approaches are needed that are suitable for deployment in the developing world, where high-end manufacturing capability and infrastructure may be limited. A key technology that is embraced in other fields worldwide, and has been for millennia, is fermentation (bread making, brewing and fermented foods). Challenges and opportunities lie in harnessing that historic knowledge and capability through adapting the micro-organisms that we use so that they make molecules that nature did not intend them to produce. This goal can be realised through bio-engineering, which offers real scope for sustainable drug manufacture.

While we must ride the Covid-19 wave, we cannot forget that antimicrobial resistance, neurodegenerative diseases, cancer and other pressing healthcare challenges have not gone away. The pandemic has heightened awareness among government and society of the power of contemporary, problem-solving science and the relative investment that is required. Biotechnology lies at the heart of the solution to the myriad of real-world challenges that we face today; our increasing ability to precision-engineer biological systems provides powerful new opportunities for future healthcare.

Rob Field is director of Manchester Institute of Biotechnology at the University of Manchester

Find out more about how biotechnology is helping us to understand Covid-19 at: uom.link/covid-prognosis

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