(This is part 3 of a series on clinical trials and the most important problems in biology. Part 1 discussed the costs and economics of clinical drug trials, and part 2 explored the fact that drug development costs can vary by a factor of 100× between different (or sometimes not-so-different) drug candidates.)

This is a placeholder stub for now. When it's fleshed out, I'll claim that the "most important problems" are as follows.

For additional context, this post is in part an answer to the conference organizers' proposal for the most interesting questions, with which it has 0/4 overlap.

Make clinical trials cost less than a bajillion dollars and take less than five years

(with some explanations)

End a bunch of endemic infectious diseases

(with some explanations)

• cytomegalovirus is plausibly as bad for society as lead poisoning was
• it's practically impossible to tell how much of the human baseline of aging, neurodegeneration, cancer, and general problems is due to repeated viral infections

Prepare a toolbox of non-vaccine countermeasures to novel biological threats

AI is going to make the next century real weird. I think it's favored that this goes basically great for humanity when all the chips are down. However, a big chunk of the ways it could go badly are because AI makes it easy for some actor (whether their brain runs on carbon or on silicon) to release an engineered pandemic that biological humanity can't handle.

We should (a) make it hard to use an AI for that, (b) make it hard to get the resources to engineer a pathogen in secret, (c) have society-wide tools for detecting outbreaks of new pathogens, (d) establish a baseline of anti-disease-transmission design in buildings and (e) prepare non-medical countermeasures like next-gen personal protective equipment. (These are largely challenges of policy, engineering, and social coordination, not biology per se.)

And, as a final layer of defense, we should (f) have multiple plans for creating new medical countermeasures to a never-before-seen pathogen. Vaccines ((f1)) are generally great, but I don't want us to rely only on them. For one, it's not clear that all viruses can be vaccinated, since some don't even leave you immune from re-infection!

So, in addition to all the other layers of defense, we should (f2) have plans for non-vaccine countermeasures. Broad-spectrum antiviral molecules, host-targeting antiviral treatments, sequence-programmable antivirals, and scalable antibody production techniques are all approaches to having day-1 and day-10 answers to a new pandemic that don't require getting lucky with its interactions with our immune system.

idk something else I haven't reached the end of my list

(no next post planned in the series so far)