Speaking Up for Science and Health. Even When Inconvenient

“By their fruits, ye shall know them”

–Matthew 7:16

Immediately following the election of Donald Trump, a number of publications asked leaders of the biopharmaceutical industry and investment community to share their thoughts on how his likely policies and appointees to key positions of leadership will affect our industry.

Many of these leaders counseled us to “wait and see” before making predictions or expressing concern.

Others looked on the bright side. They anticipated benefits by way of lower corporate tax rates, less regulation and bureaucracy (particularly in the FDA), and a more permissive attitude toward mergers and acquisitions.

When a few days later, Trump announced the appointment of Robert F. Kennedy, Jr., to become Secretary of Health and Human Services, there were more expressions of concern, some rising to condemnation.

Even then, many told us, “Don’t worry. He’ll never be able to implement his most problematic health policies. Moreover, he’ll never be approved by the Senate”. (Having watched both, “Impeachment I” and “Impeachment II, The Sequel”, I am less sanguine about finding five Republican Senators to vote against the President’s wishes.)

More recently, Dr. Mehmet Oz, a former TV show host who promoted pseudoscience to millions of viewers, including the notion that hydroxychloroquine was an effective treatment for Covid, has now been nominated to run the Centers for Medicare and Medicaid Services – the federal agency that pays the healthcare bills of over 90 million of our elderly and poorest citizens.

We are counseled to sit quietly, tallying our scorecard. We assign each new appointee (and policy) a value and hope the sum will come out a net positive for our industry. And the “wisdom” of quiet waiting, while obvious, goes unstated: do not anger a President known to be vindictive and retributive.

What is lacking in this approach to what already confronts us and lies ahead? For me, it is the recognition and acknowledgement that all of the policies and all of these appointees are connected by a deep thread of fundamental beliefs and values, and intersecting ideologies.

These range across:

• What constitutes a fact and how do we ascertain and justify the truth of our claims to know a fact?
• Does our government and do those of us who have economically thrived in our society have any responsibility for the well-being of those who have been less fortunate?
• Do we believe that certain voices—as a function of their race, ethnicity, country of origin, economic status, class, biological sex, gender identity or orientation, religious belief, loyalty to power—deserve a privileged place in our electoral system and public discourse?
• Do we believe that experience as a television personality who opines on matters relating to health qualifies such an individual to run massive government organizations that are responsible for the health of the people of our country? Or do we believe that relevant training, knowledge, and experience should be a prerequisite for such roles?

Sitting back and waiting also fails to acknowledge the nature and values of the biopharmaceutical industry that distinguish it from many other industries such as,  social media, computer games, investment banking, fossil fuels, and private equity.

These include:

• The overwhelming majority of the men and women in the biopharmaceutical industry, scientists and non-scientists alike, have been drawn to our profession by the noble mission of creating new medicines to address suffering from disease. We place human health and well-being for all as among the highest of goals to be sought, pursued, and supported by a democratic nation, a free market, and society.
• The ability of the biopharmaceutical industry to create new medicines is grounded in the power of the scientific method, itself grounded in rational discourse. The power of an argument lies in its fidelity to the facts, its logic, and its ability to elucidate our world, not the status or power of the speaker. [See, In re Heliocentrism; Galileo Galilei vs. Urban VIII, Sacra Congregatio Romanae et Universalis Inquisitionis (1633 AD)]. Admitting or not admitting the views of another as a matter of the speaker’s loyalty to power and/or membership in a preferred status group is the moral equivalent of discounting data that contravenes one’s preferred result.

Industry leaders have the privilege, but also the responsibility, to further the fabric of a richer, more just, and equitable society. This responsibility is especially acute for the leadership of an industry whose raison d’être is the health and well-being of all. 

While biopharmaceutical industry leaders have the responsibility to represent the economic interests of their shareholders, they do so best by investing in and finding groundbreaking medicines to treat crippling disease and then working to ensure their availability to all who can benefit from them. They need to fearlessly advocate to safeguard the preconditions in our country that make this endeavor so much as possible.

In addition, biopharmaceutical leaders need to motivate and represent their dedicated colleagues — particularly their younger colleagues — who devote their lives to finding these medicines with the sole mission of improving the lives of patients. Their work is based on the scientific method and grounded in this fundamental moral value. Both must be defended vigorously.

Cassandra was blessed with the ability to see the future and cursed not to be believed. If you take solace in the thought that last time round it wasn’t so bad (after all, we got Scott Gottlieb at the FDA) and believe that plus ça change, plus c’est la même chose, (the more things change, the more they stay the same) I ask you to look again.

If tens to hundreds of thousands of excess deaths resulting from “false facts” about, and the politicization of, Covid will not convince our industry’s leadership of the danger of focusing exclusively on the next quarterly earnings-per-share implications of the coming administration’s appointees, policies and underlying ideologies, then I don’t know what will. The long-term future of the industry depends on using our voices to defend the scientific method, loyalty to rational discourse not power, and humane policies that benefit us all.

 

Steven Holtzman currently serves as a Board member of and/or strategic advisor to several biotech companies.