The US went all in on vaccines. I'm disappointed but not surprised that the US didn't fund more academic R&D; that's the MO I expected during that administration.
I was following some research into repurposing existing drugs for COVID that started early last year. Only last month did they complete gathering enough people for the experiment.
I worked with a group trying to get a drug repurposing study running in June of last year. U01 submissions were often Sept-Aug with no cash until April 2021. To a degree, these NOTs and RFAs are deeply unserious and woefully underfunded. There are 10s of absurdly narrow sub-focuses (e.g. "Medical Consequences of Smoking and Vaping Drugs of Abuse in Individuals with HIV and COVID-19" really??) that are great add-ons to some existing research problem, but totally miss the point. It's not wrong to study these the ideas, but why prioritize over larger more impactful studies of drugs to treat ARDS or ALI?
Much like The Fed provided public and private debt support, these applications are more pork for existing investigators with deep knowledge of the NIH bureaucracy, but sadly likely of little relevance to the larger issue.
I'm glad we did. Vaccines were a home-run solution. In a crisis, what does academic R+D get you on the margin? Better testing for sure, but that wouldn't solve the crisis like vaccines would.
I will say the drug repurposing landscape was an absolute fiasco last year. Every funding opportunity wanted reams of data supporting use in COVID19 which takes time to generate. Yet, somehow on-patent anti-IL-6 drugs were tried again and again and again even in the absence of elevated IL-6.
UK and the NHS really got this right by centralizing repurposing efforts. In the US, there aren't more than ~50 experts in drug repurposing. Why didn't HHS/CDC round them up, lock them in a room, and have to rank-order molecules for proposed basket repurposing trials? We could have saved ~10-100k lives in the US with better drugs for early- and mid-stage disease, but nobody wants to fund a drug that can't generate an ROI. Truly a market, and institutional, failure here.
I was following some research into repurposing existing drugs for COVID that started early last year. Only last month did they complete gathering enough people for the experiment.