Prevention is better than cure, goes the old saying. As the global population grows and ages, the demand for healthcare services is set to increase substantially. However treatment can be expensive, placing a large cost burden on individuals and healthcare systems alike.

For this reason, a lot of focus will be on prevention of diseases by promoting healthy habits and a holistic approach to well-being. A key input into that process will be the development of vaccines to prevent infectious diseases and cancers. Covid-19 has accelerated some technologies to help address some of these challenges.

Messenger RNA (mRNA) technology has been on the fringes of scientific innovation for over a decade but Covid-19 has brought it to the fore. Companies such as Moderna and BioNTech have been working to perfect the technology for years but never had enough buy-in to get it to the mainstream because it was new and untested. Covid-19 changed all that.

In a pandemic, the emphasis is on speed. The world was in an emergency and mRNA could help, and therefore there was a more receptive welcome. These companies sprung into action, using the mRNA vehicle to carry Sars-CoV-2 viral RNA into human cells and induce an immune response.

The human immune system is complex and multi-layered, but vaccines induce antibody protection. Typically a foreign body is recognised by immune cells which then make antibodies to bind to it and present it to killer T-cells for elimination.

Traditional vaccines use either a weakened or inactivated virus to stimulate the response. This is a complex process and some people react to the weakened virus. mRNA achieves the same aim by putting instructions into cells to generate specific proteins, known as antigens, found on the virus to which the immune system reacts and makes antibodies. Hence with mRNA vaccines, no active or inactive virus is administered.

The immune system works for viruses as it does for other potential threats: bacteria, fungi and cancer. Antibodies against cancerous cells allow the killer T-cells to differentiate them from normal cells and eliminate them.

mRNA is thus a platform technology that can be used to deliver instructions to make potentially any foreign body antigen to stimulate an antibody response. In fact, BioNTech is not a vaccine company but rather a cancer company that just modified its technology for Covid-19. As we look to the future, platforms such as mRNA will be key to prevent diseases and cancer.

The United Nations’ Sustainable Development Goal 3 of Good Health and Well-Being is best achieved through prevention. Prevention of disease is cheaper and a more efficient use of scarce resources.

Vaccination has made a significant difference for diseases such as tuberculosis, diphtheria, tetanus and measles, to mention but a few. Zoonotic diseases are likely to become more common as human interactions with animals increase and more remote areas are explored.

Zoonotic diseases are likely to become more common as human interactions with animals increase and more remote areas are explored.

Vaccines will be key to prevent infection and/or severe disease which will shield the health services to continue to cater for other non-vaccinable conditions.

Platforms such as mRNA will be important in providing the versatility needed to deal with the many as yet unknown threats that will emerge. We are already  seeing some of that versatility already with mutations of the Sars-CoV-2 virus where the Covid-19 vaccines are being re-engineered to deal with these mutations.

We have every confidence that vaccines will play a central role in healthcare as we look to 2030. There is a long laundry list of potential threats. Pandemic preparedness will now be at the front of minds for governments everywhere. There will be increased investment in research and development, but also manufacturing and distribution capability.

Technology platforms such as mRNA make it easier to reconfigure the necessary response as quickly as possible. A new threat will likely see a vaccine developed in months, and not take years to decades as was the case before Covid-19.

One of the few positives to come from the Covid-19 pandemic is that is has accelerated technology platforms such as mRNA, while simultaneously increasing the appreciation for vaccines as a key tool for the safeguarding of public health, now and into the future.