Global health equity is a complex problem that impacts every country, and the biotech industry can be part of the solution, according to panelists at a BIO International Convention session yesterday. The panelists saw the need to reduce differences between richer and poorer countries, as well as internal differences in levels of care within each country.
As Stephen Sammut of the University of Pennsylvania put it: “You can throw a rock in any direction and hit a health and equity topic or need.”
In the “Achieving Global Health Equity with BioPharma and Medtech” panel at the BIO International Conference, Pierre Theodore, MD, the Vice President of Health Equity at Johnson & Johnson headed up a conversation with:
- Jennifer Dent, the President of BIO Ventures for Global Health (BVGH);
- Jennifer Miller, PhD, an Associate Professor at Yale University, and President of Bioethics International;
- Josette Gbemudu, the Executive Director for Health Equity at Merck; and
- Stephen Sammut, PhD and Senior Fellow at the University of Pennsylvania’s Center for Technology Transfer.
“I think when talking about health equity, you have to start by defining what you even mean,” said Theodore.
Among the global health equity challenges discussed were:
- differences in health care access between more and less developed countries;
- the need for broad improvements to the health care infrastructure and system, to insure equal access;
- and the need for diversity at every level of the biotech industry.
“There is a huge lack of health equity globally, especially across the African continent,” said Jennifer Dent of BVGH.
Clinical trial diversity
Jennifer Miller from Yale University noted that health care inequities begin at the stage of drug development. “A number of studies, including our own, have found that clinical trial study participants tend to be younger, healthier and identify as white. That’s a big problem,” she said. “If you look at a novel drug approved by the FDA. We tested in about 23 countries, but most of those countries tend to be higher income countries.”
Clinical trial inequity also exists in a developed country like the United States. “If you look at U.S. oncology numbers, we know that African Americans have the highest mortality rate,” but they still make up the smallest percentage of clinical trial participants, said Josette Gbemudu of Merck.
As Bio.News has reported, “the lack of diversity in clinical trials is not due to a lack of interest among diverse groups, but a lack of access and engagement among minority populations.” This is in addition to issues associated with the exclusion of patients with co-morbidities, who are found most often in minority populations.
BVGH, Merck, J&J, and Sammut’s investment company, Alta Semper, are all working to take the statistics into account and address health equity issues in different ways, often in cooperation with each other, the panelists said.
“We take a patient centered approach by working on a grassroots level,” said Dent of BVGH. In one example noted by Bio.News, BVGH’s Rwandan, “Educate, Screen, and Treat” program ensured that 6,567 women in Rwanda were screened for cervical cancer.
Diversity drives equity
“We have to think broader than just clinical trial diversity,” Gbemudu told the panel.
As with the Best Practices for Building an Inclusive Biotech Company session at the BIO International Convention earlier yesterday, this panel noted that health equity is dependent on diversity from the top down.
That is where hiring and diversity metrics become important. “Companies like metrics when they score well and don’t like them when they don’t,” Miller said. “Companies can have a policy statement that sounds really good, but if the internal metrics are not there to back it up, then the odds of it being implemented is less good.”
“We create the brain drain,” said Sammut, “People leave their jobs when they are dissatisfied. It has little to do with payment and more to do with being able to do meaningful work and reach wider patient populations. That is a management problem.”
Addressing these concerns are key to addressing equity and improving health care, for everyone, panelists agreed. “When you look through the lens of health equity, the entire health care landscape changes,” noted Theodore from Johnson & Johnson.
