part0061

Looking ahead to the subsidence of COVID-19 as an existential threat, some social commentators have remarked on the need to reconceptualize what is or should be “the new normal.” The new normal they envisage does not merely encompass designer face masks and elbow bumps instead of handshakes. Rather, it should be a “normal” that takes account of the social issues and divides—indeed, in a deep sense, social contradictions—that COVID-19 has laid bare. With respect to the United States, these include, in no particular order:

The behavior of the biopharmaceutical industry in the face of COVID-19 described in other essays in this volume stands in stark contrast. Old competitive postures were set aside in favor of solidarity and cooperative endeavor; protracted, legalistic contracting was often replaced by handshake (or at least elbow bump) agreements relying on the honor of industry colleagues; the best ideas were sought and embraced, regardless of the national origins, gender, sexual orientation, religion, political party, or ideology of their originators; and, facts and data, not economic and/or political power, determined the way forward. As several authors comment here, these behaviors represent our industry at its best; in the words of Lincoln’s Second Inaugural Address, COVID-19 called forth “the better angels of our nature.”

Against that backdrop, what does it mean for the biopharmaceutical industry to “return to normal”? As many of the authors here suggest, manifold lessons can be drawn for “our new normal” from our industry’s response to COVID-19, e.g. open sharing of precompetitive information; cooperation among companies, NGOs, philanthropic foundations, and government agencies; risk-sharing to enable investments “ahead of the curve” in infrastructure and capabilities essential to the protection and well-being of our society as a whole; and a willingness to sacrifice sacred cows and to speak truth to power in favor of responding with agility to emerging factually grounded data, whether positive or negative.

In addition, some commentators have noted that, like conquering heroes returning victoriously from mortal combat, our industry has a shining moment in which to reestablish our good standing with the public: our industry was viewed among the most admired in the 1970s and 1980s, but had fallen to rank among the most vilified by December 2019

Yet, I find myself wanting to ask: is that all that should characterize the new normal for biotechnology? While no doubt salutary, the new behaviors can be readily embraced and supported in a Friedmanesque framework that stipulates that the social responsibility of corporate leadership begins and ends with the obligation to maximize profits. To do so, one need only extend from quarter to quarter the horizon in which the profits are to be maximized. From this perspective, the new normal is governed by the same principles as the old normal. The new behaviors and governing norms are embraced contingently , to be cast aside as soon as they are judged not to be expedient to profit maximization.

As for the industry’s political engagement, the old rules will also continue to apply. Politicians, political parties, and social policies are to be supported (or not) based solely on their contribution to profit maximization (prototypically, support for corporate tax cuts and lower marginal income and capital gains tax rates, for surely the latter are necessary to attract the best, most capable to the leadership of our companies). Finally, seizing upon our newly restored reputation will be seen to involve little more than dispensing free doses of our new COVID-19 vaccines and therapeutics to people lacking health insurance, plus a well-designed and funded PR campaign.

In contrast to this perspective, I want to suggest that the biotechnology industry’s new normal should be characterized by an engagement in the social/economic/political arena that is powered by and requires active advocacy for leaders and polices true to the fundamental founding principles and motivations of our industry’s. (Lincoln’s call, after all, was not to seek extrinsic angels that might be of expedient utility; he entreated us to find those better angels in our own nature .) Conversely, our politics should involve active opposition to those who advocate policies that are inimical to our industry’s nature. A politics of expediency may gain us a seat at the table; however, the price of a seat at the table is too high and too fraught if its cost is the loss of the moral authority of biotechnology’s leaders to speak for our patients, our employees, and our communities. 36

For me, our industry’s essential nature and the political engagement it requires of us can be found in three areas: the industry’s origins in the Enlightenment, the industry’s commitment to human health, and the personal backgrounds, moral character, and motivations of key founders of our industry.

Elsewhere 37 , I have argued that biotechnology’s roots in a commitment to the scientific method bequeathed to us by the Enlightenment is intrinsically connected to a commitment to the quest for social justice, the Enlightenment’s second crowning bequest to the modern world. In brief, both arose in response to, and as a rebuke of, a world order in which what constituted truth and justice was the dictate of the powerful—whether that power was political, military, economic, or ecclesiastical. If you are doing science, you cannot exclude data because they are contrary to the prevailing dogma of the powerful; you cannot exclude the voice of another scientist because of their color or gender or nationality. Our industry’s new normal must feature political activism in favor of those who support policies grounded in science, not ideology, and in social justice. We must equally raise our voices in opposition to those who would devalue the roles of science, data, and facts in public policy formation and who exclude participation based on racist, sexist, or other supremacist attitudes. Truth and justice, science and humanism: in each case, two sides of the same coin.

Our industry is devoted to developing new medicines to ease human suffering and engender human well-being. To use an example in which I was involved, when Biogen developed a novel, longer-lasting Factor VIII to treat hemophilia, we did not say to ourselves, “This will be great for the hemophiliac children of wealthy, white Americans of Northern European descent.” Our commitment is to all of humanity, and our goals are fully achieved only when all who may benefit from the products of our labor do so. Moreover, while enabling people to have (relatively) pain- and disease-free lives is a good in and of itself, we also care about this because, in its absence, humans are not fully able to develop their potential and capabilities, to fully exercise their freedom and flourish. Our quest is incomplete unless and until there is universal accessibility to the medicines we develop, and all, when they have achieved health, have a chance to flourish. Our active political engagement should reflect this commitment.

The biotechnology industry was born in the late-1970s. It decidedly was not a child of corporate America or the brainchild of corporate managers. The new industry’s founders were academic scientists and entrepreneurs. They saw the potential of the recombinant DNA revolution to improve human health. This became their mission, their passion. And, as the 1970s became the 1980s, and the biotechnology industry grew, that mission attracted a next generation of scientific and business leaders who shared with the industry’s founders that commitment, that goal, and a fundamental set of moral values. 38 Also noteworthy: unlike the leadership ranks in corporate America at that time, many of biotechnology’s business and scientific leaders were immigrants or first-generation Americans.

Elsewhere 39 , I have reflected on David Brooks’s commentary on the distinction between having a career (something you choose) and having a vocation (something you are called to and cannot not do) and what this means for how leaders lead. I have suggested that to build a career, it is of singular importance not to make (or be seen to have made) a mistake; that fulfilling one’s vocation, on the other hand, requires putting one’s self at risk of being (publicly) wrong and taking responsibility for your error; that our industry’s founders—on the whole—were driven by such a sense of vocation; and, that in critical moments when the most is at stake, the soul of a biotechnology leader is revealed as being driven either by risk aversion and personal gain or the industry’s founding values and mission.

And, what if we do not seize this opportunity to create a new normal for ourselves, do not seek to realign our actions with the better angels of our nature?

In 1846, Henry David Thoreau spent an evening in jail in protest of slavery, for refusing to pay the poll tax. As legend has it, Ralph Waldo Emerson visited Thoreau that evening and had the following exchange: “Henry, why are you here?” to which Thoreau replied, “Why are you not here?”

Thoreau was entreating Emerson to realize that who Emerson claimed to be in virtue of his Abolitionist principles and beliefs about the repugnance of slavery was belied by his own actions. Thus, Thoreau was not criticizing Emerson from Thoreau’s perspective. Rather, he was inviting Emerson to see that he was failing his own better angels. Emerson was living in contradiction, and living in contradiction with one’s own nature is not a state of factual or (merely) political error: it is the stuff of tragedy.

Leaders of our industry have the opportunity right now to shape the future of biotechnology in the time after COVID-19. That future can be one in which we act, and act publicly and assertively, in a manner consonant with our nature. The alternative, I fear, is not a return to a mere lack of public support, it is tragedy.

From 1985 through 2020, Steven Holtzman served as a co-founder and EVP of DNX Corporation, an early leader and CBO of Millennium Pharmaceuticals, a co-founder, CEO, and Chair of Infinity Pharmaceuticals, the EVP of Corporate Development of Biogen, and the first CEO of Decibel Therapeutics. He currently is a board member of Molecular Partners, the chair of the boards of Camp4 Therapeutics and Qihan Bio, and a board member of the Berklee College of Music.