Q&A: Investing now in preparation for COVID-19's successor

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What can COVID-19 teach the global health community? Photo by: Martin Lopez from Pexels

Warning that COVID-19 won’t be the last pandemic, Dr. Martin Fitchet, head of global public health at Johnson & Johnson, says now is the time for an increased investment into pandemic science.

Ahead of Universal Health Coverage Day, the physician — who took over leadership of the health care company’s dedicated unit for global public health, or GPH, earlier this year — said a lesson to take from the novel coronavirus is that we should be better prepared for the next pandemic. “We should be learning and begin investing now — not just in the emergency of the pandemic, but expecting that this will hit humanity again. And it will. We need to invest in new ways of working,” he said.

For example, if a vaccine is available, Fitchet asked, how can mass vaccination be achieved even faster in terms of distribution and supply chains, data capture, and data analysis? According to the World Health Organization, there are currently 51 candidate vaccines for COVID-19 in clinical evaluation, one of which is being developed by J&J.

Health system strengthening, investing in our front-line health workers, harmonization of regulatory rules, and advancing innovative platform technologies for vaccines, therapeutics, and diagnostics are other areas that should be further invested in based on the lessons learned so far, he added.

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Such investments will accelerate the detection and response to a disease with pandemic potential, and they will help avoid the disruption in care for other disease areas — especially in low- and middle-income countries, where Fitchet said COVID-19 has led to diversion of resources, which could jeopardize recent progress. But new developments around COVID-19 could also help bolster global health efforts going forward.

Speaking to Devex, Fitchet explained the ways in which COVID-19 has impacted other diseases, how global health will be prioritized going forward, and what that means for J&J’s vision for investing in this space.

This conversation has been edited for length and clarity.

What are the biggest ways COVID-19 has impacted global health efforts?

It's shone a significant light on the inequities in health. The actual infrastructure, the access routes, and the care pathways for people in LMICs with devastating diseases such as HIV, tuberculosis, malaria, [and] mental health problems were stretched already. But COVID created an immediate diversion of resources.

Diagnostic machines previously used for conditions such as TB were immediately diverted to COVID-19. There was a shutdown of the transport systems — people couldn't get to the clinics, couldn't get to care, couldn't get to their medication — and there was also a fear of catching COVID-19, so people stayed away from hospitals.

What we saw was an almost universal stress on, or even collapse of, the care systems, which were already stretched and fragile in these underserved communities around these devastating diseases that need constant care and attention.

The other thing COVID-19 did is make the world, the community, really think, "Now we've got to vaccinate the planet — we can't do this in a two-tiered way.” If you think about a pandemic, nobody in the world is safe until everybody is safe. And so we have had to think about true equitable distribution of health care and think about how we can offer the highest-quality tools, vaccines, and therapeutics at the same time in both richer and poorer countries.

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I don't think we've ever truly done that before, and I would say the fact that the pandemic came to rich countries and poor countries at the same time really forced us to think in that way. And it's a good way to think; it’s the right way to think. And I hope we can begin to think that way around other diseases and problems in underserved communities.

How do you think that lessons learned from the pandemic will impact how the world views and prioritizes global health going forward?

I think all of this has been a humanitarian and economic disaster for the world, no doubt about it. But from my perspective, from a scientific perspective, the sharing of data and information has been remarkable. From the genetic code of the virus coming from China in January to actually having efficacy data from multiple phase-three programs and an approved vaccine in December, it's remarkable.

That's a humanitarian triumph coming out of a humanitarian crisis. … We now know we can do things very, very quickly and to a very high degree of quality and safety if the need is there, the drive is there, and the resources are there. And in the case of COVID-19, those resources are coming together very, very quickly from industry and government. This is a very positive response. Now we have to build on that and move form reactive mode to being fully prepared for the next challenge.

And there's one other thing that we need to work even harder on: that's vaccine confidence. This means investing in the education programs and the discussions around the world with different communities, with governments, and with the general public around the confidence in vaccines — not through a patronizing, lecturing dynamic, but with an open and listening discussion around vaccine confidence. This is so we can build the confidence in these vaccines, which are, the science tells us, well tolerated and demonstrate effectiveness.

You’ve been in your role for about a year now. What’s your vision for the future, and how has the pandemic impacted that?

What I saw very quickly is that we had a proven innovation and impact model. Organized around key disease areas, I saw innovative medicines, enabling technologies, and delivery solutions being developed and deployed from the lab to the “last mile.” And this was happening in areas of significant unmet medical need in high-burden, underserved communities where we believed we could make the most meaningful impact.

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Add to this our team of innovators with deep expertise in global health research and development, access, health economics, and supply chain to optimize access, and finally teams on the ground to ensure effective implementation and impact. That was the model I inherited and to me it was perfect. … It completely fit with my world vision that we bring to the table what we are best at end-to-end and find the best partners to complement that.

One of our most effective programs is our TB work, which has increased access to a lifesaving medicine twentyfold since we launched GPH thanks to trusted and effective global partnerships. So my vision for the future is simple: Let's amplify this, let’s aim for even greater impact, expand our disease focus where innovation can match the challenge, collaborate more, and let’s apply what we have learned this year.

What will J&J GPH look like in 2030?

We are on track to have an even greater impact on patients than we do now. Our model is one which I strongly believe in, and our innovation pipeline is strong. If we continue to focus on our strengths — which is developing innovation at the core and enabling access, as well as supply chain and implementation expertise around it with very strong partners — we'll be able to reach more patients and improve outcomes for broader populations.

Right now, our focus is on multidrug-resistant TB, HIV, mental health, and neglected tropical diseases, such as soil-transmitted helminths. We will continue to invest in those core areas. We will also see a much greater emphasis on vaccines with Ebola, with COVID-19, and — hopefully soon — with HIV. And we aim to do much more to address the inequity of access to quality surgical care in resource limited settings. It's going to be an incredibly exciting decade of innovation in public health.

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