Research Universities and Big Pharma’s Wicked Problem
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to the precision that we have engineering knowledge. We cannot generate a blueprint specifying how the human body works.
How do we know if a drug is doing any good? An airplane cockpit is crammed with indicators that monitor the status of almost every important function. If something begins to go wrong, it is quickly detected and the pilot can know whether corrective actions are indeed working. The pharmaceutical industry usually lacks good measures of the efficacy of its interventions. How do we know if a drug for Alzheimer’s or schizophrenia or cancer is having an effect? Lacking quantitative biomarkers that reflect the progress of a disease makes it a huge challenge to measure drug efficacy. We cannot fix what we cannot measure.
We also lack a theory of drug efficacy. We may scoff at the old theories from Galen’s time of balancing the humors by medical intervention, but in truth we are not much more sophisticated now. Drugs are essentially poisons. We treat a disease by poisoning the patient. To continue the airplane analogy: it is like repairing a defect in an airplane by breaking something else. Yet drugs do often succeed in improving the quality of life for patients. The explanation of this paradox is emerging, albeit slowly, as we move from reductionism to look at the human body as a set of interlocking systems. Aircraft engineers have followed a systems approach for decades.
Comparison with the aviation industry dramatizes for us the wicked problem. The pharmaceutical industry needs a much more precise blueprint for the human body; greater knowledge of its interlocking regulatory systems; and accurate monitors of functional defects. It needs clinical doctors working with research scientists and bioengineers.
There is a win-win solution. A great research university, given the incentive of a deal like the BP-Berkeley arrangement, may be able to pull together the bio-innovation ecosystem necessary to solve the pharmaceutical industry’s wicked problem.
[Editor's Note: This editorial is also being posted on the QB3 website.]