IEEE Robotics & Automation Magazine - March 2021 - 35

Screening typically examines the effect on cells that must be
grown in a consistent manner. This requires the careful
preparation, feeding, and monitoring of many cell cultures,
in parallel, 24/7. Automated tools have made good progress, and robotic systems are widely used, with the added
benefit that cells are protected from contamination by
human operators.
Antiviral drugs have tended to be small molecules that
may be created using chemical processes. For large-molecule
drugs (proteins or antibodies), cells are used to generate the
candidates via protein synthesis, and, again, cell culture automation provides quality and productivity [54].
Promising drug candidates are further adapted, submitted for more evaluation, optimized, and tested again in
a number of iterations. The creation of multiple dose-
response curves benefits from automated sample handling
and robotics in terms of productivity and repeatability.
Drug candidates with a suitable profile may then be moved
to testing in animals-typically, rodents (hamsters or mice)
and, later, primates-to obtain information about the effect
of the drugs in a biological system [55]. The management
of these animals is demanding work, and larger facilities
are equipped with automation for care, feeding, and cleaning (Figure 9).
Traditional animal testing has many challenges, including the representativeness of the results for a broad human
population as well as ethical and cost issues. Scientists have
been developing models that can more faithfully replicate
human biology by using tissue models, such lab-on-a-chip
and organ-on-chip (OoC) technologies. These create multiple samples that can be studied using robotic and automation technologies already in the lab. The first reports of such
OoC technologies applied to COVID-19 have begun to
appear [56], [57].
Candidates remaining at this stage can be prepared for
clinical trials in humans, initially to understand how the
healthy body responds and then in carefully selected groups
of patients. These steps are highly regulated and make
extensive use of hospital labs to track changes and detect
many problems. Still, seven out of eight candidates fail in
these trials [53].
A further aspect of drug development that has an important impact on efficacy and patient acceptability is the design
of the drug-delivery systems, from tablets to an injectable
form via nanomaterials [58]. These raise challenges in terms
of performance and stability, for which automated testing is,
again, very valuable.
One approach that has generated a lot of excitement in
searching for new drugs effective against COVID-19 is
the repurposing of existing drugs. Approved medicines
with known safety profiles may be used for disorders
other than their original targets with some success, a
practice termed off-label use. AI tools have also been
applied to search databases of potential compounds. The
repurposing of such compounds against COVID-19 still
requires lab tests to determine efficacy [55], [59] but

avoids having to repeat the full set of safety and pharmacological tests, potentially getting drugs to the market and
bedside faster.
Medicine Manufacturing
While production is generally undertaken with existing
robotics and automation solutions dedicated to manufacturing (having much in common with the chemical and
food/beverage industries, such as fermentation), pharmaceuticals manufacturing has very high quality standards
and regulations in common with semiconductor manufacturing, and so it also makes use of laboratory facilities
for quality control and troubleshooting. The very high
volumes expected to treat COVID-19 will lead to stresses
on existing processes. One important example is the quality control and sterility testing required for all product
batches and performed manually [60].
Many process steps and tools were originally developed for
laboratory technicians and are well adapted to manual manipulation. Robots replicating aspects of such methods have been
deployed with some success (Figure 10).
Development of New Vaccines
As with medicines, effective vaccination against SARSCoV-2 is still an active area. In fact, relatively few vaccines
are available: the Centers for Disease Control and Prevention
lists 59 against 26 diseases (United States), and there are vaccines against 40 diseases worldwide [61]-[63]. This reflects
an underdeveloped and poorly funded area. There are four
major suppliers with the capability to manufacture at scale, as
others have withdrawn. The SARS, Zika, and Ebola outbreaks resulted in substantial interest from newer biotechnology firms and the formation of organizations to

(a)

(b)
Figure 9. An (a) Ambr cell culture robot and (b) animal cage-cleaning
robot. [Sources: (a) Sartorius and (b) TecniplastUK; used with permission.]

MARCH 2021

IEEE ROBOTICS & AUTOMATION MAGAZINE

IEEE Robotics & Automation Magazine - March 2021

Table of Contents for the Digital Edition of IEEE Robotics & Automation Magazine - March 2021