Post-Pandemic Drug Discovery and Development: Facing Present and Future Challenges

The history of drug discovery and medicine is as ancient as humanity with, according to numerous historians, the first evaluation of the medicinal values of some herbs as early as a few thousand years B.C. in China and in India. Indeed, the practice of Ayurveda, traditional Chinese medicines and the evidence of medicinal practice in Egypt have been documented thousands of years ago. Then in Greece, Hippocrates started to transform medicine from art to science. Intellectual contributions of many great minds from different countries developed over two thousand years gradually established the foundation of scientific medicine. Modern drug discovery started to emerge by the end of the 20th century. Today, this immense field of investigation is characterized by highly complex, time consuming, expensive (yet profitable), often unsuccessful, multidisciplinary processes carried out by a myriad of local, national and international public and private organizations. These players may have divergent interests, and are sometimes driven by concerns other than patients’ health. Given the complexity of drug discovery and development as a field, any attempt to improve the odds of success requires humility, consideration of opposing views and escaping intellectual silos. Although history cannot always foretell the future, there are certainly some lessons to be learned from the past. Strong statements about exploring only some specific scientific areas, with most of the time substantial budget cuts to other disciplines or other departments, should be avoided. For instance, in 1999, it was suggested that the Human Genome Project would transform drug discovery by 2010 and that by 2020 significant improvements in patient care through tailored therapies (personalized medicine) would take place. While the human genome project might change everything in the future, translation to new drugs has been limited (Joyner and Paneth, 2019). The problem is obviously not the human project in itself but the fact that it was oversold, expectations were not realistic and the complexity of the human body in the health and disease states largely underestimated. Along the same line of reasoning but about technologies, J. Bezdek proposed in 1993 a curve showing how technologies tend to progress with time and in silico drug design strategies were analyzed with this approach (Van Drie, 2007). The “Bezdek phases” usually involve an overreaction to immature technology, a peak of hype, followed by despair because the results do not match the expectations. Eventually, after years of efforts, true user benefits are noticed. As today artificial intelligence is increasingly over-advertised in drug discovery and development, the Bezdek theory may apply, suggesting that a curious enthusiastic but cautious approach is advisable (Schneider et al., 2020). Related to this is the need of high quality data that are often missing or maintained confidential in health-related research (Scannell and Bosley, 2016; Bender and Cortés-Ciriano, 2021). Nowadays, while fashionable research topics appear unavoidable, decision makers, scientists and patients should keep in mind that hype cycles may turn out to hype bubbles and that such cycles can be detrimental to science (Rinaldi, 2012).

In the field of drug discovery and development, several different challenges seem to be awaiting us and the dramatic COVID-19 pandemic could be one catalyst accelerating the changes (Aghila Rani et al., 2021). Among the numerous challenges, some are briefly discussed below.