Addressing health inequities: Biopharmaceutical companies are rising to the occasion

By Freda Lewis-Hall, MD, DFAPA, MFPM

My uncle was a paraplegic because of a polio infection when he was six years old. By the time I reached the same age, I was so inspired by the care my uncle received that I decided I wanted to be a doctor. Years later when I entered Howard University College of Medicine in 1976, I learned that my uncle’s story of excellent care and a fruitful life well into his seventies was atypical for people of color affected by polio. Theirs were stories of racism, mistreatment and denial of care.

Dr. Lewis-Hall earned her undergraduate degree from The Johns Hopkins University in 1976. Her mother, father and uncle attended her graduation ceremony.

That settled it for me: moving from health disparity to health equity, finding a way to deliver care to those denied, delivering healing for all no matter their race and creating healthier communities across the globe were to be my life’s work.

2020 has been a year of awakenings and re-awakenings for all people and across all industries. In this time of covid-19 and increased awareness of racial injustice, the biopharmaceutical industry is critical to the health of all citizens of our nation and the world. More than ever, the discovery and manufacturing of medicines to treat people of varying ethnic and racial backgrounds is essential to good health outcomes. To continue achieving this, the biopharmaceutical industry must take a greater leadership role in eliminating health disparities and creating health equity. I have worked in medicine development and corporate leadership for nearly three decades. If there has ever been a time to lean in, it is now.

Nearly 30 years ago, it was surprising to both myself and many others that I would choose to pursue a career in the biopharmaceutical industry. Few in my Black and Brown community knew the industry and even fewer trusted it. But the notion of being part of an industry that discovers, develops, manufactures and delivers innovations that save or change the lives of many millions around the world was enticing. The idea that I might be able to harness the power of this industry to deliver its healing to all communities was irresistible. Over the years, I have seen many barriers overcome and challenges met. I believe the industry is coming into its next phase of extraordinary innovation.

And now, the industry has been challenged to bring its best science and business innovation to the development of diagnostics, therapeutics and vaccines in response to a global pandemic. At the same time, we have also been challenged to address racial injustice. Can we apply our scientific and business acumen to this longstanding—and some feel intractable—problem? I think we can.

In July, the industry trade association PhRMA made a public statement regarding its commitment to having an open, honest and real conversation about racial equity and what it means to have a culture of inclusion. While there are many more conversations to be had, the ones thus far have indeed been open, honest and real. A big takeaway is that Black and Brown communities need a trusted partner in the biopharmaceutical space, and that the biopharmaceutical industry is not currently viewed as trusted or as a partner. Here’s what I believe it will take to step up for these long-neglected communities:

• First, the industry needs to commit to building a workforce that represents the diverse communities that it serves now and in the future. To that end, PhRMA is urgently improving recruitment and development efforts to hire and advance the workforce to be more diverse from entry level to the board room. Companies are investing in the creation of better pathways to our industry for people of color by starting with investments in STEM, life science, data analysis and other key finance and management curricula that serve underrepresented students. These industry commitments will help ensure increased diversity and inclusion in all dimensions of business.
• Second, the industry needs to diversify business practices so they open the economic engine to all communities. This means adopting a comprehensive vision of expanding opportunities through collaborations, vendors, partners, suppliers, consultants and advisors. The biopharmaceutical industry should examine the best practices of other industries that have made progress in this area. Companies will be challenged to execute improved communications with diverse organizations to better understand the community and develop unique ways to meet mutual needs.
• Third, the industry must increase its efforts to advance research and policy solutions to address health disparities. The biopharmaceutical industry has an opportunity to use its research expertise to identify issues and develop new therapies and health care solutions, especially in disease areas that have a disproportionate impact on people of color. To be a trusted partner, the industry must seize the opportunity to incorporate the input of communities of color as we develop medicines, diagnostics and vaccines, and be part of interactive communications that institutionalize medical screening and disease awareness to increase the number of patients in treatment.
• Fourth, the industry must continue to diversify clinical trial populations to better reflect the patients that will use a new therapy or vaccine. Despite decades of effort, little progress has been made and we continue to see underrepresentation of minorities, even in those trials where people of color bear a higher burden of disease or poorer outcomes. Given centuries of abuse by the medical system, the industry will be required to develop relationships of trust with communities of color. The industry must shape the clinical trial environment to meet the needs of diverse patients. It’s clear that communities of color do not want solutions devised for or just given to them. Rather, they wish to be a part of designing those solutions directly. We must increase the participation of clinical trial investigators and study coordinators of color and the engagement of health care centers that serve the underserved. And, we must create pathways for participation in the clinical trial process from beginning to end by including health care professionals, patient advocates, community leaders, patients and caregivers that are in and of the community.

Creating a trusted partnership between the biopharmaceutical industry and communities of color will not happen overnight. It will take a sustained commitment to establish meaningful relationships that move us from health disparity to health equity. I urge you to follow the progress at PhRMA.org/Equity.