In the final weeks of 2019, a new virus took the human population by storm. Without any immunity to this pathogen, the virus has since passed between individuals, communities and through countries leaving a trail of destruction that seems to have no boundaries. The speed at which this public health challenge can be overcome will largely be driven by how quickly science can develop the necessary toolkit to treat, track, and prevent illness throughout the world.

Philanthropy remains one of the most flexible and responsive mechanisms to drive scientific progress. The Milken Institute Center for Strategic Philanthropy has worked to direct more than a billion dollars for scientific funding over the last decade through deep due diligence, working in lock step with scientific and philanthropic partners to determine investment priorities that would make the biggest impact in the field.

As we watch the pandemic unfold, we see a number of key biomedical challenges – and ways the philanthropic community can help bring the crisis to an end.

Our understanding of the virus and resulting disease is limited. Although SARS-CoV-2, which causes COVID-19, is new to humans, it is a member of a broader class of viruses known as coronaviruses. This relationship has given scientists a head start on understanding key aspects of the virus but there are still major gaps in our knowledge. Characterizing how the virus moves between people, how it makes a person sick, and how unique conditions in an individual’s genetic makeup or health situation might change the resulting illness are key to developing treatments and slowing or even stopping transmission. Research investment in virology, clinical research, and epidemiology needs to be amplified. Philanthropic funders can drive increased understanding of COVID-19 disease mechanisms by working with academic institutions to deploy funding to strengthen partnerships between basic science departments and clinical research centers. This research will drive progress in all other domains.

We lack sufficient methods to detect viral infection. Communities around the world are looking ahead at how best to resume “normal” life. Some have already started. However, all plans rely on the ability to detect and track active infections and immunity following infection. Unfortunately, testing for both active infections and antibody responses have been fraught with difficulty ranging from scalability to accuracy. Innovation and scale are both still needed to drive reliable policy making, and personal decision-making. Individual and family philanthropists can play a key role in their communities by facilitating increased local testing as was spearheaded by two local philanthropists in Bolinas, CA. Additionally, increased investment in the development of detection methods will drive further innovation and potentially identify new scalable methods that can be deployed. An early example of this innovation was a 15-minute test for active infections. Imagine what other improvements could result from redoubled efforts.

There are no evidence-based treatments. FasterCures’ Treatment Tracker is a continually updated source for monitoring potential vaccines and treatments in development or trial. Even one proven treatment that reduces hospitalization rates or ICU usage would dramatically change the course of the pandemic. While it is difficult to predict which treatment will be effective, scientists need an arsenal of tools to combat virulent viruses. Testing of these approaches will take time and iteration.

A number of high-impact philanthropists stepped in early to fund these trials, but greater philanthropic engagement is necessary. Philanthropists can work with clinical centers around the world to fund more trials, bolster existing trials, and refine strategies that look promising. Additionally, clinicians are actively working to collect data on how patients progress and what treatments are working. Analysis of medical records may provide beneficial in this endeavor and can take place using real world data outside of care settings. These findings will further inform clinical practice, resource usage, and ultimately save lives.

There is unprecedented demand for vaccine development, production, and distribution. Production of a coronavirus vaccine is happening at a record-breaking pace, and some clinical trials have already begun. As of this writing, the Milken Institute has identified 111 vaccine candidates being developed by various groups around the world, but the earliest estimates of an effective vaccine being widely available are 18 months from now. Once a vaccine is available, it will be important to ensure that it will be available for everyone, not just in regions with more money or more modern medical infrastructure.

Department of Health and Human Services Secretary Alex Azar suggested that a coronavirus vaccine might not be available to everyone, and is against the idea of instituting pricing controls. Looking ahead, assurances will be needed for equitable access to the vaccine. Philanthropists can play a key role in expanding the infrastructure needed to mass produce a vaccine once developed and tested. This will ultimately accelerate global immunity and save lives.

The impacts of the crisis are many – too many for the private sector, government or civil society to manage alone. Individual and private philanthropies have long been credited as major players in advancing the sciences that have changed our world for the long-term. With so much at stake, philanthropists are in a prime position to unlock the necessary resources to invest in the biomedical pipeline. And now is the time.


By Cara Altimus, PhD, Director, Milken Institute Center for Strategic Philanthropy.