Bound By Blood

Elaine Quilici

Elaine Quilici is Pharmaceutical Executive's Senior Editor. Email her at equilici@mjhlifesciences.com

Pharmaceutical Executive, Pharmaceutical Executive-01-01-2021, Volume 41, Issue 1

Deeply shaped by the experiences of his parents and an early charge to help drive social change, Global Blood Therapeutics’ Ted Love comes at sickle cell disease from a place of caring and urges pharma to follow suit to bring justice to all.

Ted W. Love, MD, loves a good story. Whether the president and CEO of Global Blood Therapeutics (GBT) is sharing an anecdote to make a point or simply explaining something, he knows how to connect with people. This not only makes Love a well-liked leader and colleague but helps him reach out to patients suffering from sickle cell disease (SCD), an inherited blood disorder that affects nearly 8% of African Americans, and people of Latino, Middle Eastern, and South Asian descent. By taking the time to understand the unique journey of individuals impacted by SCD, Love creates trust that translates into hope.

Love’s empathetic side has been strengthened throughout his years in pharma, but it’s nothing new. Even in his youth, he picked up on the injustices of the world and wanted to be part of the solution. When he reached a point where he could make a difference, he felt a social responsibility to do so—even if it meant coming out of retirement to lead the GBT fight against SCD.

A foundation of resolve

As a child growing up in Alabama, Love watched his parents struggle. He saw his father, who probably made less than $10,000 a year, wake up every morning and drive 30 miles to an uninspiring job because he had to put food on the table. He also witnessed his father getting pulled over by a policeman without clear cause and talked to condescendingly. Though Love didn’t fully understand the challenges his family faced as a youngster, he easily recognizes them today.

“I watched my parents go through all of this,” says Love. “I never went to work with my dad, but I can guarantee you, a Black man with a fourth-grade education working in [an Army storage facility] is experiencing a lot of discrimination and a lot of condescension.”

As a student at Haverford College outside Philadelphia, Love recalls thinking about that situation with tears in his eyes. “I thought to myself, I’m really going to try to be in a position where I have a job and am excited to be there,” he says. “I’m not going there just to put food on the table. I want to be excited to be there because of what we’re doing and the role that I can play in doing it. That was part of me becoming a physician.”

After earning his BA in molecular biology at Haverford, Love attended medical school at Yale University, followed by postgraduate training at Harvard University and Massachusetts General Hospital. He subsequently joined the faculty at Harvard before considering a transition to industry.

Phasing Into pharma

Love’s first invitation to pharma was when his mentor at Harvard was recruited by Bristol Myers Squibb and asked him to join. Though he turned down that opportunity and another from Merck, Love ultimately signed on with Genentech.

“I thought a lot about the best environment for me to learn and explore a new industry. Ultimately, I went to Genentech because I believed an intimate and small team led by experienced leaders was the best environment for me to start in,” says Love. “I learned pretty quickly and had quite a lot of success.”

Despite his accomplishments, Love looks at his career path with humility and knows the importance of being prepared from his days as a “very cocky medical student.” So in order to best prepare himself for a bigger role in pharma, Love left Genentech for the upstart environment of Advanced Medicine (now Theravance). There he strengthened his skills and learned how to build a company from scratch, including how to assemble a board and management team, and how to raise money.

When the opportunity to become CEO of Hyseq arose, he jumped at the chance to further enrich his leadership skills by working alongside biotech trailblazer George Rathmann, founding CEO of Amgen.

“I felt like learning how to be a CEO from arguably one of the best CEOs ever would be a great training ground,” says Love. “I didn’t think the company was very good, but I said with a great leader, a great mentor, who knows, maybe we’ll turn it around.”

Hyseq nearly collapsed and reorganized as Nuvelo, but one thing Love learned from Rathmann during the most difficult moments was to ride out the highs and lows.

“He told me you shouldn’t get too low when things are tough because they will get better,” says Love. “But by the same token, when things are going great, don’t get full of yourself, because they’re going to get tough again. You’ve got to stay level and you’ve got to lead from a place of perspective for the future rather than the moment. I thought that was very good advice.”

Called to action

When Love moved on from Nuvelo, he became head of R&D for Onyx Pharmaceuticals, then eventually decided to focus on his work as a board member for various pharma companies.

“GBT came about after I’d retired,” says Love. “But it was impossible for me to turn down because of the sickle cell mission, because of all of the historical disparities in sickle cell disease—extensions of the broader inequities that Black and other patients of color experience in the US healthcare system. As an African American, these things were very personal to me.”

Though SCD is not in his family, Love developed a connection with these patients as a medical student at Yale. Most people don’t realize that SCD causes significant complications including severe pain that is unmeasurable. As a med student, Love experienced the stigma associated with SCD. He would see many poor, young African Americans come in for treatment and hear people quickly judge them as drug seekers.

“These patients, as terrible as their situation is, routinely shower, dress up, put on makeup before they go to the hospital, because they know they’re going to encounter all this stigma,” says Love. “It just didn’t feel right, and I knew it wasn’t right, but I couldn’t do anything about it. I was a young medical student with little decision-making authority.”

This bias is something SCD patients deal with their whole lives, and Love has seen them highly stigmatized throughout his career. Thus, when the opportunity to work to develop novel therapies for SCD presented itself, Love jumped at the chance to make an impact for patients.

“We really hadn’t done anything in SCD of the nature that was getting done in CF (cystic fibrosis),” says Love. “GBT wanted to bring that kind of scientific integrity, that kind of sophistication to try to solve this problem. That, to me, was exciting intellectually. But it was also exciting emotionally, to try to help people that were so desperately in need of help.”

Love realizes the confluence of SCD, health disparities, and racial injustice is a problem that won’t be easily fixed as it is so ingrained in society. What he believes can be done to better the situation is to transform the disease through innovation, as has been done with HIV and CF.

“If we could make the disease essentially inactive, then we could get in front of it, and people won’t be going to hospital with pain episodes or organ damage,” says Love. “I actually think we’re going to get there. Oxbryta is a very big step in that direction.”

GBT’s Oxbryta (voxelotor), an oral therapy to treat SCD, was approved in November 2019 as the first drug to target the root cause of red blood cell sickling and destruction in SCD, which is when mutated hemoglobin form rigid chains, making cells sickle. This defect also leads to the destruction of red blood cells, causing anemia. Though improvement in long-term survival may take time to determine, GBT has shown Oxbryta can help inhibit hemoglobin from forming chains and reduce the destruction of red blood cells. While the therapy is currently indicated for people with SCD 12 years and older, the company will seek to expand that indication to children 4 and over. The ultimate aim of the company is to be able to administer the drug earlier in life, around 6 or 9 months old, to put children on a path of normalcy as soon as possible.

Leading the way

Because of SCD’s prevalence in the Black community, GBT knew it had to do something to help address racial disparities and begin to rebuild trust between communities of color and medical researchers, which has historically kept communities of color from enrolling in clinical trials.

“What we did wasn’t magical, but it was bold because many companies are not as intentional as GBT is about solving this problem,” says Love. “We spent a significant amount of time in the community that our patients come from, and we talked to them and had them unpack the barriers for them being in clinical studies. Then, most importantly, after getting all that information, we made an investment in solving the problem.”

For GBT, one of the key takeaways from these conversations was learning that traveling to health centers often requires multiple forms of public transit that can be long, tedious, and expensive. To avoid that, GBT provided debit cards to pay for transportation. When center hours weren’t convenient for people’s work schedules, GBT set up sites with after-work and weekend hours. The company was deliberate about responding to circumstances that created barriers to participation in their clinical trials.

“While we were doing that, we were also working to address another problem—distrust of the industry,” says Love. “Even before our clinical studies, I was going to sickle cell meetings and GBT was buying blankets to distribute at the meetings, because sickle cell patients get cold and that can bring on a crisis. They need to hydrate, so we provided them water. Our employees also attended. We have really walked the walk to be with them, and that has helped us a lot. It’s been easy for us, because we really do care. Great medicine is meeting patients where they are, not the other way around.”

When COVID struck in the spring, Love knew it was going to have a disproportionate impact on poor communities of color. To help, GBT donated more than $350,000 to support the SCD community, including personal contributions from the company’s board and employees. This included a donation of $100,000 to the Sickle Cell Disease Association of America and the creation of the GBT Community Fund to support US nonprofit organizations to help those in need. “People will work for money,” says Love. “People will work harder for money and a boss that they really love. However, I’ve found that people will work hardest for a cause they are passionate about.”

To help cultivate this environment, GBT lets employees know their ideas and perspectives are valued and shows it by staying connected through open dialogue, which has been especially important during the pandemic. As a result, the company has been able to attract top talent, maintain a low turnover rate, and achieve high employee job satisfaction.

“We’re committed to fostering workplace development, diversity, and inclusion at our company and throughout the biotech industry,” says Love. “It starts with the leadership, where we have had people of color and women on our board for years.”

Diversity among GBT’s team a priority—not just because its medicines address the needs of minorities, but because it understands the value of converging a multitude of perspectives and experiences. Because of this, the company’s recruitment and retention numbers among people of color and women have increased organically. More than half of its 350-plus employees are women and more than half are people of color.

The bigger picture

After the death of George Floyd in May, the nation paused to take stock of society’s shortcomings in regard to racial issues. The biopharma industry, with its inherent interest in improving the lives of humanity, also was forced to look inward. Since then, the industry has been investing in ways to improve. Companies are establishing relationships and donating funds to historically black colleges and universities. Biotechnology Innovation Organization (BIO), for which Love is a board member and chair of the Emerging Companies Section, has been focusing more than ever on tools, technologies, and best practices to share across the industry.

Love says doctors who acknowledge the validity of their patients’ fears can build trust, optimize care, and improve the overall experience. He also encourages educating physicians about the importance of offering clinical studies to people of color.

“I think it was quite extraordinary what Moderna did,” says Love. “They actually extended their [COVID vaccine] study to get more people of color in the trial. I doubt that’s going to become routine, but I do think that people are seriously now trying to figure out how to solve this.”

This combination of training, investment, and best practices will help facilitate progress, but the issue needs to remain a priority and efforts need to be measurable.

“If you say if this study doesn’t have at least 9% African Americans in it, we’re going to discontinue it, guess what, you’ll get 9%,” says Love. “And if people’s bonuses are less because the trials have to be extended to do that, then people will fix that. If we give people the tools and resources and hold them accountable, I think we’ll make progress.”

Love believes that businesses—including those in biotech and pharma—which don’t embrace diversity at all levels are destined to underperform. A diverse organization guided by diverse leadership not only helps achieve greater innovation, creativity, and productivity internally, but better positions companies to work with external stakeholders in an increasingly global marketplace.

“I’d like to see the biopharmaceutical industry truly leading on issues of racial inequity, especially those plaguing our healthcare system,” says Love. “I believe that if any industry could pull it off, it ought to be ours.”

Elaine Quilici is Pharm Exec’s Senior Editor. She can be reached at equilici@mjhlifesciences.com.

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