Vaccines to the Rescue

As the COVID-19 toll is rising, all the pharmaceutical companies in India and abroad have started testing their new drug candidates or the already existing antiviral drugs for their effects on the SARS-COV-2 virus. Also, some labs are trying to develop vaccines against it. The antiviral drugs may be essential in some scenarios like healthcare settings where the healthcare professionals need them to fight off the high load of viruses, as they deal with patient after patient affected with COVID-19. However, history demonstrates that, most often, antimicrobial resistance has risen from these very healthcare settings where the drugs have been used incessantly for treatment as well as prophylactic purposes. Antimicrobial resistant strains of the pathogens have also risen from immunocompromised patients who had been put on those antimicrobials to reduce the impact of the disease as their bodies were not capable enough to fight the pathogen.

It is only natural that a virus or, for that matter, any pathogen will evolve a resistance mechanism against any antimicrobial that is used against it. That is how our world has evolved. It is called host–parasite co-evolution, where the host, that is, the humans/animals try to devise mechanisms to kill the pathogen, but the parasite or the pathogen matches up to it by mutating its own genes. The sublethal doses of the antimicrobial drug select the mutant strains that are better able to survive even in the presence of the drug. That is the reason we are no longer able to contain the infections by using first-line drugs. We need as much as third-line drugs or combinations of those drugs in high doses to combat the diseases. Then why is it that there is so much emphasis on inventing/discovering an antimicrobial drug? The answer lies in the selfish greed of the pharma companies that want to make more money. In India, the total healthcare expenditure (THE) is just about 3% of the gross domestic product (GDP), whereas government health expenditure is just 1.1% of the GDP. About 30% of this THE is spent on pharmaceuticals. And all this money is mostly out-of-pocket expenditure by the people of the country. Obviously, the poor bear the brunt of this most acutely. Still, the synthesis of these drugs is promoted and the use of such drugs is prescribed by the medical professionals. Instead of this, a stronger emphasis needs to be on vaccination strategies. Vaccine development is crucial to fight any disease, including COVID-19, as one of the public health measures.