Six years after COVID-19 exposed the consequences of an underprepared world, a new report from the Global Preparedness Monitoring Board (GPMB) has reached a stark conclusion: The world is not safer from pandemics. Notably, it found that infectious disease outbreaks are becoming more frequent and more damaging, and that a decade of investment has not kept pace with rising risk. The same week, the World Health Organization (WHO) declared the Bundibugyo ebolavirus outbreak a global public health emergency, serving both as a timely and sobering illustration of what that assessment means in practice.
For drug developers, the picture is sharper still. New data from the INTREPID Alliance's fifth edition of its "Antiviral Clinical and Preclinical Development Landscape", published the same week, show that the pipeline of treatments in development against high-risk viral threats remains critically thin — concentrated around a small number of pathogens while leaving most viral families of pandemic concern largely untouched.
Where the pipeline is
The INTREPID analysis tracked antiviral development activity across 14 viral families identified as priorities for pandemic potential or emerging viral disease risk. The findings paint a picture of a pipeline heavily skewed toward the familiar. COVID-19 and influenza together accounted for 80 percent of clinical evaluations — 37 of 46 — and 62 percent of preclinical evaluations. Three viral families — Adenoviridae, Hantaviridae, and Peribunyaviridae — had no clinical or preclinical evaluations with new, unapproved antivirals at all.
"Significant gaps remain across 14 viral families of concern for pandemic potential or emerging viral diseases," Jim Demarest, a scientific consultant for the INTREPID Alliance, told DDN. "There is still a gap in Phase-2-ready non-COVID-19/non-influenza antivirals — only nine clinical compound programs within four of the 14 viral families."
The Ebola picture is particularly stark. For filoviruses, there are no currently approved direct-acting antivirals for Orthoebolavirus or Orthomarburgvirus infections. The main direction of activity is indication expansion — testing previously approved antivirals for possible broad-spectrum activity across related viruses. Three compounds, favipiravir, obeldesivir, and remdesivir, have clinical phase evaluations for Ebola virus (EBOV), Marburg virus (MARV), and Sudan virus. In the preclinical space, favipiravir, galidesivir, and remdesivir are under exploratory evaluation for MARV, though preclinical evaluation of galidesivir for EBOV was discontinued. Two novel compounds, Nanosota-EB1 and Nanosota-EB2, are in early preclinical evaluation, Demarest told DDN, though activity against Bundibugyo ebolavirus specifically has not yet been confirmed.
A structural problem, not just a scientific one
The thinness of the antiviral pipeline is not primarily a failure of biology. It is a failure of economics and policy. James Anderson, Executive Director of R&D Innovation at the International Federation of Pharmaceutical Manufacturers & Associations and Chair of the INTREPID Alliance Board, told DDN that the barriers to building a more robust antiviral pipeline are structurally different from those in other therapeutic areas — and harder to solve with conventional incentives.
"Episodic outbreaks — like Bundibugyo, which last happened over a decade ago — need a tailored development and regulatory pathway," Anderson told DDN. "These viruses require the highest biosafety levels, meaning fewer researchers are able to work on them."
Beyond the scientific constraints, the economics are punishing. Investors prioritize oncology and chronic diseases, both of which offer more predictable markets. Antivirals for rare, unpredictable outbreaks offer no equivalent market signal. "There is practically no demand for episodic and unpredictable outbreaks and emerging threats," Anderson said. "That uncertainty makes it significantly harder to sustain long-term private-sector investment in research and development."
What is needed, he argued, is a different economic model. One that combines push incentives, such as sustained government funding of academic research and biosafety infrastructure, with pull incentives that reward successful development of countermeasures for low-probability, high-consequence threats. He pointed to the Biomedical Advanced Research and Development Authority (BARDA)'s SMART Antiviral Prize competition and the European Health Emergency Preparedness and Response Authority's support for the Therapeutics Development Coalition as steps in the right direction, while noting that more is needed. Strengthening coordination and resourcing for the US Strategic National Stockpile, expanding domestic manufacturing capacity, and reauthorizing key pandemic preparedness authorities under the Pandemic and All-Hazards Preparedness Act were among the priorities Anderson identified.
The GPMB report reinforces this framing. The report found that although several preparedness initiatives have been introduced over the past decade, they have not kept pace with rising risks driven by geopolitical fragmentation, ecological disruption, global mobility, and declining development assistance. Anderson's read aligns directly: "Pandemics should not be treated as isolated shocks, but as a persistent and escalating threat that requires sustained commitment and collective effort across the private and public sectors," he told DDN.
What the Ebola outbreak makes visible
The declaration of the Bundibugyo ebolavirus outbreak as a global public health emergency arrived as a concrete demonstration of what inadequate preparedness looks like in real time.
The current outbreak is the first significant emergence of Bundibugyo ebolavirus since 2012, and data on the susceptibility of Bundibugyo virus to compounds under evaluation for related filoviruses remains limited, meaning that even the thin pipeline of broad-spectrum candidates cannot be readily applied with confidence.
BARDA's response has been swift in at least one dimension: The agency issued a Request for Information for AI-enabled discovery of broad-spectrum small-molecule inhibitors for filoviruses, seeking input on approaches to identify potent, safe therapeutics using advanced analytics and in silico methods. Whether AI-assisted approaches can compress the timeline from discovery to clinical readiness for pathogens in the highest biosafety categories remains to be demonstrated — but the solicitation reflects recognition that conventional timelines are not compatible with outbreak response.
For drug developers working in infectious disease, the INTREPID data and the GPMB report together point toward the same conclusion Anderson drew. "Building a response-ready antiviral ecosystem requires long-term commitment to preparedness through a broad R&D pipeline — not just emergency-driven action," he said.
