Prof. Chas Bountra, Ph.D., is Professor of Translational Medicine in the Nuffield Department of Clinical Medicine and Associate Member of the Department of Pharmacology at the University of Oxford in England. He is also a Visiting Professor in Neuroscience and Mental Health at Imperial College, London. Dr. Bountra is an invited expert on several government and charitable research funding bodies, and an advisor for many academic, biotech and pharmaceutical drug discovery programs. Prior to returning to Oxford, Dr. Bountra was Vice President and Head of Biology at GlaxoSmithKline. He was involved in the identification of more than 40 clinical candidates for many gastrointestinal, inflammatory and neuropsychiatric diseases.
In the 80th Synergia Virtual Forum, Chas Bountra (Pro-Vice-Chancellor for Innovation Oxford University), Prof. K VijayRaghavan (Principal Scientific Adviser to the Government of India), Mr Pankaj Patel (Chairman of Cadilla HealthCare), and Mr Sharad Tyagi (Managing Director at Boehringer Ingelheim India Pvt. Ltd.) came together to discuss Accelerating Development of Novel and Affordable Therapies.
Dr. Chas Bountra highlighted the state of community healthcare, unaffordability, and lack of innovative research in the UK. He said 50-70% of the time; people were unable to reproduce available academic literature. The demand as of now, by patients, their relatives, caregivers and society, is for novel, effective, and affordable therapies. Dr. Bountra also highlighted what Oxford University is doing in contributing its services to translate academia into practice.
HEALTH CHALLENGES CONFRONTING MANKIND
Across the globe, there is a rising apprehension that the pharmaceutical industry is not producing enough new drugs and even those that are being produced for critical diseases, are too expensive for low and middle-income countries. As regards the search for newer and more affordable therapies, due to intense competition in the market, there is an innate sense of secrecy resulting in duplication of biomedical research. There is also a paucity of cutting edge medical literature being produced as the industry is too engrossed in its day to day manufacturing. The patients wantnovel, effective and affordable medicines, and they want them now, especially now that a pandemic is infecting millions.
Amidst this chaotic state in the world of health care and pharmaceuticals, the world is staring at a grim future. As per Dr Chas Bountra, in a population of 68m in the UK (which is 5 percent of India), in the next 12 months, 350,000 people will be diagnosed with cancer, that is one every 90 second and 1000 per day. Across the planet, 24 million will be struck with cancer in the next year.
Similarly, with an ageing population, UK has 850,000 dementia patients who are expected to go up to 2.1 million by 2050. Today, out of every six 80 plus old person, one has dementia. Alzheimer is equally widespread, and despite sinking billions of dollars in research, there has not been any new therapy since 2002. UK expects that in the next two decades, there will be a 120 percent increase in pensioners, 180% increase in cancer in those over 65 years of age, 120 percent increase in diabetics.
Mental health is yet another significant concern; a situation made even more acute by the economic devastation caused by the pandemic. 25 percent of Europeans have some sort of mental health episode, 20 percent suffered from depression at some point in their life, and one in every 150 fifteen-year-old girls in the UK has an eating disorder.
Treatment of rare diseases is another worrying issue. There are about 7000 rare diseases, and patients are taking 5 to 8 years to be properly diagnosed. It is estimated that there are 350 million suffering from rare diseases and 95 percent of patients get no treatment.
This is a snapshot of the emerging medical landscape in the UK and Europe based upon the research conducted by Oxford University. It can be safely assumed that the situation in India will only be more challenging, considering that the Indian public health care infrastructure is far inferior to the British NHS.
THE OXFORD EXPERIMENT
The University of Oxford has decided to try and pool resources to share risk stated Dr. Bountra. Working with nine large pharmaceutical companies, including Boehrimger Ingleheim, there are attempts to work with several patient organisations through funding by the U.K. government.
There has been a conscious decision to work only on novel ideas; ideas that 50 labs are already working on have not been taken up. The unique ideas oftentimes are those that people think are impossible to work on. The university is also working on generating tools for novel proteins and genes in the starting points for drug discovery, which are of high quality. This quality can be ensured because of collaborations with the large pharma companies. In this way, Oxford is attempting to drive innovation. Additionally, the university takes no intellectual property rights on their research. The findings are made freely accessible to find a way to crowdsource research and responses. Research is shared with the world immediately. These methods: pooling resources to share risks, working in novel and impossible areas, making everything freely available to crowdsource research, and releasing findings, are the highlights of the work Oxford University is undertaking.
THE COVID VACCINE
Dr. Chas Bountra also discussed the platforms created by the university to identify small molecule binders to proteins that people think are undruggable, which involves crystallography. In the past four months during the pandemic, they have identified a new target for treating COVID infections and shared it with the world. Now chemists in India, Africa, Australia and Brazil have optimised this data and are working on generating a clinical module. This is a way, Dr. Chas said, of getting the global community to focus on a particular problem.
He also discussed the Oxford- AstraZeneca deal — which was made possible by the U.K. government, regulators and funders — to generate a billion samples of the vaccine as soon as possible. The vaccine provoked a response within 14 days of vaccination from the white blood cells, and an antibody response within 28 days. Two doses of the vaccine have shown the most promising results as per the Oxford research. The results of Phase I/II trial were published in The Lancet and indicate no early safety concerns. The global programme of Phase III trial is to be held in the U.S., enrolling 30,000 patients, a paediatric study, as well as Phase III trials in low-to-middle income countries, including Brazil and South Africa, which are already underway.
Astra-Zeneca has also given licence to Serum Institute of India to produce the drug. All the partners have a goal — to generate a vaccine that is effective, safe, and cheap, as quickly as possible.
BUILDING MEDICAL DATA HUBS
There is an attempt to attract global industry into Oxford, and create up to 25 companies a year. The aim is to get more entrepreneurs and build more innovation space because there is the need to take research and translate it to benefit society. Dr. Chas expected that like the top trillion-dollar companies in the world, which are tech data based like Apple, Google and Microsoft, the world would see the emergence of a trillion-dollar healthcare data tech company in the next decade. One of the consequences of the pandemic could be more investment in healthcare and increased international partnership.
However, this would all be possible only through a culture of recognition of the larger problems in the world, enforced with the notion that they could only be solved by coming together and collaborating.