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How can large pharma improve D&I in its companies?
Recently, I had a conversation with a white female scientist and former colleague about the importance of diversity and inclusion (D&I) in drug innovation. She reminded me of common things that we had experienced during our time in large pharma. One was the clear difference in the treatment of white males versus women during succession planning discussions. White male candidates got the “opportunity to fail” or were given coaches to bridge gaps, whereas female candidates had to be perfect and already operating at the level to which they could be promoted. The second observation was that white males were invariably selected to lead major projects. She referred to it as the “White Mandemic in Large Pharma.” In the wider healthcare arena, the repeated refusal to appoint Dr. Janet Woodcock commissioner of the FDA is one of the most current visible examples of this “mandemic.”
In 1997, as the new EVP responsible for research and development at Hoechst Marion Roussel (which later merged with RhonePoulenc Rorer to form Aventis, later acquired by Sanofi), I introduced a number of changes. These were focused on leveraging the diversity of approaches in the three companies, Hoechst, Marion Merrell Dow, and Roussel Uclaf, to improve drug innovation. One of these changes was the focus on common mechanisms of action. This encouraged the profiling of new lead compounds in all relevant disease models irrespective of the geographic location or nationality of the scientist who had originally synthesized the drug.
Later, in 2000, with the announcement of the deciphering of the human genome, we introduced chemical biology platforms, such as kinase, protease, ion channels, and G protein-coupled receptor (GPCR) platforms that further encouraged collaboration among the three discovery centers and academic laboratories in the US, France, and Germany. These platforms were hubs of multidisciplinary communities of practice across the discovery centers and product development.
Today, the business case for D&I is even more compelling. For example, in 2019, 70% of the 3,000 drugs in Phase III clinical trials reportedly came from small biotech companies.
An analysis of companies’ 2017 annual reports by STAT found that only 10 out of 44 Pfizer compounds in clinical development came from in-house discovery and only two out of 18 J&J compounds came out of its own labs. In short, drug innovation is occurring increasingly more frequently in small biotech startups and academic laboratories.
How can large pharma improve D&I in its companies? First, each has to have the courage to make structural and organizational changes to foster equity and opportunity for everyone in its employ. Equity has to exist internally as well as characterize the interactions with external stakeholders. Employees who feel that they are not being treated equitably and experience few opportunities to advance within the company will be less motivated and less likely to create innovative solutions that inspire their peers.
Second, in addition to testing the rules and regulations for consistency with equity, they should ask three questions: What behaviors are rewarded? Who gets promoted? And, are the criteria for rewards and promotions transparent and offer everyone equal opportunity to achieve? This approach should be the same whether one is trying to ensure that every contributor and innovative idea has the same opportunity to be seen and heard in a multinational company as it is in a US-based organization with privileged groups.
Third, old excuses such as “the pipeline of such individuals does not exist” should be buried in the dustbin of history. The COVID-19 pandemic has shone light on the known health and opportunity disparities among underrepresented minorities. The paucity of Black clinical investigators and the lower percentages of Blacks participating in clinical trials were evident in this pandemic. This is particularly stark given the contribution of Dr. Kizzmekia Corbett in innovating the Moderna vaccine and the well-recognized fact that trusted advisors are the best persons to treat vaccine hesitancy. Large pharma can bridge these opportunity gaps by establishing collaborative research centers at select HBCUs. They will narrow the “opportunity gap” as was so poignantly identified by Kenneth Frazier, the only Black CEO in large pharma, who recently retired from Merck.
Systemic racism will be in retreat when equity and opportunity reinforce empathy, and replace the use of stereotypes.
Frank L. Douglas, MD, PhD, Former professor at the Massachusetts Institute of Technology, where he was involved in founding the Center for Biomedical Innovation