A comprehensive strategy for pandemic preparedness with neutralizing monoclonal antibodies

The success of nucleic acid-based vaccines during the COVID-19 pandemic positioned these technologies at the forefront of global preparedness. A retrospective analysis, however, demonstrates that while vaccines play a central role, they do not provide universal protection. Therapeutic interventions, such as monoclonal antibodies (mAbs), are also critical for an effective pandemic response, as they ensure both prophylaxis and treatment of vulnerable populations, prevent overload of healthcare systems, and safeguard the continuity of critical infrastructures. Despite the proven efficacy of antiviral mAbs, the rapid emergence of SARS-CoV-2 variants frequently diminished their effectiveness. Thus, innovative strategies are required to accelerate the development, manufacturing, and adaptation of mAbs to continuously evolving viral targets. Viable approaches consist of targeting conserved viral epitopes and producing multi-mAb formulations to maintain therapeutic efficacy. Notably, the development of prototype mAbs can help to protect high-risk groups and exposed medical personnel early in a pandemic. Here, we propose that a comprehensive mAb strategy - encompassing targeted support for research and development, expansion of resilient manufacturing capacities on a regional level, and collaborative networks integrating standardized procedures for development, production and distribution - should be considered a hallmark of pandemic preparedness, to ensure the rapid and effective deployment of mAbs in future pandemics.