Joe Hammang, PhD, is Senior Director of Worldwide Science Policy at Pfizer, Inc. The following is excerpted from an interview.
The unpredictable rate of change:
When I read about these technologies and think back on these last couple decades, I'm always struck by one thing: It's incredibly hard to project the trajectory of new technologies. People will say something's going to happen tomorrow or next year, and it's inevitably much slower. Technologies don't advance as quickly as we want, because we're human beings, we're impatient. We want to see advances, and we want to make medicines to help people, but the trajectory is always very difficult to predict. Something you think is a reality very soon can actually be very far off.
A really good example is gene therapy, a technology that in the '90s we thought would have rapid uptake, but had a massive setback. Another example is stem cell technology. When human embryonic stem cells were first identified, there were those who thought the technology would be ready within a couple of years. That's clearly not the case, and what we found is that in order to bring safe and effective products into the marketplace, massive investments are needed both at the governmental level and at the private level, in the biotechnology and biopharmaceutical areas. I think what happened was that we saw a very strong draw towards developing therapies-that is, cell replacement therapies-and not enough towards tool development, to use those incredible cell technologies to screen medicines and to learn about the behavior of the cells, to learn about cell cultures and cell processes. That took a bit of a backseat to therapies. Today I believe that is reversed; because technologies have been slow to come, now I believe there is a much greater emphasis on tool development. And the great news is that this tool development-what we learn from it, and the investments that the biopharmaceutical industry makes in tool development and drug screening-will have direct benefits down the road for cell therapies. The same information is required: what makes cells safe and effective, what makes them reproducible from one batch to the next, and what makes them decide to become different cells of the body.
I think another important point is that not only do we need massive investments over time at both the government and industry level, but there's also a lot of luck involved. It's serendipity sometimes when discoveries are made, and when the right people have that information and are able to synthesize it and understand what these advances really mean. Sometimes the advances we see are very revolutionary and things change quickly overnight, but there's no replacement for the continued investment in research.
You can look at the National Cancer Institute investment over time, contrasted with an area like the National Institutes of Aging and the National Institutes for Neurological Diseases, which provide the primary amount of Alzheimer's disease funding in the U.S. If you look at the NCI's investments from the 1960s to present, the cumulative total is about $90 billion to date. We now have a much greater understanding of the genetics of the disease. We know that cancer is not one disease, like science thought when President Nixon declared war on cancer. That's allowed us to hone in on very specific mutations so that we can develop very specific medicines tailored to these mutations, and that will certainly continue over time. What it means, though, is that the investment made by the federal government-it's critical, but it's just the start. There's more and more work that needs to be done to take that basic information and continue to invest hundreds of billions of dollars in making new medicines against those targets, something that the biopharmaceutical industry does very well.
In contrast, when you look at the National Institutes of Aging budget-considering that today's NCI spends about $5 or $6 billion annually-what we spend on Alzheimer's disease is just over half a billion dollars, so less than a tenth of the NCI spending. That may have a significant role to play in the fact that this very complicated disease is very poorly understood today. We've made significant advances, but there's so much more that needs to be understood there. Imaging technologies are needed, biomarkers are desperately needed, and continued investment is going to be required. My point is that if we hope to crack a huge problem like Alzheimer's disease, it's probably going to require much more significant investments at both the government and the biopharmaceutical level. The stakes are so high, and the cost to society with Alzheimer's disease is going to be so great, especially as the population ages.
Personalized medicine for cancer, Alzheimer's, and pathogens:
Our understanding of the genetics of disease in cancer has led to incredible advances. We are now actually treating people with cancer with specific medicines that are tailored to these segments of the population. The more of those medicines that are developed, and the more we understand about how those drugs work-and about why those drugs don't work in specific patients-I think it's going to push the field of oncology forward very quickly in comparison to other areas.
Alzheimer's disease appears to be a much more complex problem, so the advances of personalized medicine aren't going to come as quickly there. We aren't going to see the revolutionary changes there as quickly. I have faith that it will come, that we will understand the genetics of Alzheimer's disease, but the point is that we don't have that understanding today. If we don't have that, it's very hard to see these advances coming as quickly.
I think that our understanding of genetics allows companies like ours, and the entire biopharmaceutical industry, to get huge advantages in the area of vaccines. Our abilities to create vaccines that are specific to bacterial populations, emerging pathogens which are creating massive public health problems here and throughout the world, are going to be greatly aided by next generation vaccines, vaccines which can be targeted against multiple strains of bacteria. It's going to revolutionize public health treatment here in the U.S. and abroad. One can see particular advantage abroad, in places where medical structure is nil or nonexistent. These technologies, I think, are going to advance greatly over the next decade or two. This idea of being able to allow an individual to fight infection before it becomes infection is extraordinarily powerful.