US biopharma is falling behind

My interview with Noubar Afeyan of Flagship Pioneering

I’m out today with a column in Science with quotes from industry leaders in the pharmaceutical and biotechnology industries about the lack of action of the United States in responding to the impressive rise of these industries in China. Professor Mike Kinch, who does a great job following the pharmaceutical industry said about the competition, “we are now a Ford Mustang racing against the Chinese-built BYD Yangwang U9 supercar.”

The BYD supercar.

Perhaps one of the most stunning findings of late is that one-third of the drugs licensed by US pharmaceutical companies are compounds from China. What’s surprising about this is that many Western scientists realize that China now dominates rankings in fields like engineering and materials science, while the US still leads in life sciences. For those of us who believe that knowledge is a public good, the success of China in the life sciences is to be commended, and the logical solution is de-risked collaboration. But given the bipartisan description of China as an adversary by the US government, it is surprising not to see a more carefully articulated response. The National Institutes of Health did not respond to a request for comment for my column.

One of the industry leaders sounding the alarm is Noubar Afeyan, the leader of Flagship Pioneering. Flagship starts biopharma companies from scratch with a novel model that is different from traditional venture capital. In his annual letter, Afeyan called for more aggressive support for the scientific method and recognition of the intense competition the US is facing. I interviewed Afeyan for my column, and the full Q&A is below.

Why did you decide to make such a bold statement right now?

The last few years, the annual letters have been more about the environment and then I wrote about poly intelligence last year, which was kind of a different way to think about how AI and nature and humans will interact. And I think in this year, especially in the last few months, it’s become increasingly clear that however we look at it, it’s not just isolated to one technology, one science, one institution. There is this underlying doubt being cast on the process by which the output comes. And so while any one of these lines of criticism to vaccines or technologies seems in an isolation specific to that, if you add it all up, it really does create a really tough environment for the science and the science output, which impacts society through our industry biotechnology, and for that matter, many others.

So I thought that it was important to point that out. It really does feel to me, holding 39 years into doing startups in the science technology arena, as a moment poised for the unexpected in the positive sense of the word by virtue of where we’re seeing with AI giving humans capabilities we just didn’t have. And so the two together, let alone China with a competitive, increasing competitive presence that is very much doubling down on the outputs of the scientific method and the scientific enterprise, that we thought this needed to be put out there for debate.

I’m really interested in the rise of Chinese biotechnology and the inability of the US to respond to it, or in some cases even be aware of it. You’ve got a lot of this in the letter, but tell me some of the high points of how China is rising in pharmaceutical science and biotech.

Well, it’s really doing what the US has done for decades, which is to essentially in a consistent, somewhat longer term kind of way, commit to excellence in science. They obviously have a great education system plus people who are coming back from US and European institutions to together create the human capital. I think that the ability for them to collect data and make it available is giving an advantage to a lot of the AI activities and model training. In the letter, we mentioned they are allowing people to do physician-sponsored trials very quickly, there’s a massive advantage in getting some human data, which as you know, is the determinant of business development interest often.

Often you have to try to attract partnerships with pharma by showing animal data and by kind of hoping that investors will come in early and then help the biotech companies along [to eventually get data from humans]. Now, [China is] coming with similar molecules developed quite rapidly, but then with human data. I would say that’s an advantage that should be emulated. And I know that the FDA has talked a bit about figuring out how they can stay competitive with that without obviously creating any safety concerns. Those are some of the examples, but there just seems to be a clear moment in acceleration that happens to coincide with what I see as a deceleration or certainly a lot of uncertainty being created with cuts in academic funding, cuts in immigration policies or visas and all the other things that I mentioned.

In 1945, the US was were able to rally the public around American science because the bomb won the war in a lot of people’s minds and the Nazis almost got one. In the ‘50s, the same thing happened with Sputnik. We’re at a similar moment. This is a Sputnik moment with China in many ways, but why do you think the US isn’t responding in the same way?

The moment is being cast as skepticism about one or another piece of science, but I think that there is, from a political ideology standpoint, seemingly greater doubts about the scientific enterprise and therefore the scientific process, which is embodied in that enterprise, as though there’s another way we can arrive at the these objective truths. I believe we’ve relied upon an approach that said, “You don’t have to believe my data, my output, you can try to replicate it, but if you have another set of data that I need to take into account, present it in that way.” What’s happening is much of the discussion has become a large body of data-driven argumentation counteracted by data-less argumentation or sparse data that doesn’t stand up to the same rigor.

And you might say, “What does that have to do with why aren’t we jumping to this public moment?” I think that it’s being somewhat undermined by this doubt that’s been infused into the system, which, as I write in the letter and I thought long-believed, science is an activity of organized skepticism. It is kind of a collective process that from which the then truth can emerge and then can be revisited. That’s not being followed in a lot of the discussion. Ultimately, we got to a good place with tobacco. Ultimately, we got to a place with a number of environmental contaminants. There was a healthy debate, there is still some on climate, but if you can kind of approach this in a way that you could dismiss science behind things and set policy based on other considerations, somebody has to rise and say, “Look, we’re going to really hurt ourselves through this process,” but it hasn’t happened.

Obviously, my letter and those activities of others are attempting to create this awareness and I’m hoping that folks who are in the policy world would take this issue up and either put forward an alternative view, an alternative way to settle the facts other than science scientific method, or we should agree that this is a real growing concern, and take some proactive steps to strengthen our position here. I think there’s a lot of strengthening of the American position being discussed. We’re seeing it in AI with a lot of expenditures, but I don’t see that in science and the scientific output.

And so if the US got the message, what would be the first set of things that they would do in response to what you’re saying?

We have to undo the indiscriminate cuts in funding of basic and applied research and academia. Congress has been pushing back, but the notion that you would even put forward these massive, massive cuts as though the whole process is kind of not essential to many of the things we’re talking about here and many needs we have in health, human health and many other activities [is unacceptable]. I think that some of it is to kind of revisit that and understand how these things are tied together. And so funding is an important element of it. I think that restricting the talent from coming to this country and adding to what has always been a melting pot of ever stronger, ever more devoted people who want to join the US kind of scientific enterprise. I think that is doing damage to ourselves and I think that should be for sure revisited.

And for the policy makers and the administration, what’s their theory? I mean, if you say, China’s putting these many more medicines on the market and a third of the licensing deals are now Chinese products and they’re going to pass us, what would their theory be as to why it’s going to come out okay? Why do we not need to worry about that? Is there something special about America and how we’re going to be able to adapt to this or something? Like what’s the theory?

I’m a self-professed paranoid optimist, which is how I think you have to be in the startup innovation world. So the optimist part of me believes that they do not deeply recognize the impact these levels of multiple fronts of attack are having to the underlying scientific enterprise, and that there will be some realization driven adjustments and that it isn’t like there is an alternative theory. And if there is one, I really hope my letter and discussions around it can reveal what that might be. I also think that there is an anti-expertise, anti-kind of institutional authority element to the thinking that has been espoused in various circles.

This is not just to me the administration. There are ideologies out there that people who are professing saying a lot shouldn’t be trusted, shouldn’t be followed. And that contrarian view of scientific authority, if I may, is being debated. And I think that’s in the scientific method, that’s a healthy debate in the sense that everybody should be able to express their views and back it up with facts, but if you don’t have to back it up with facts, then it becomes the realm of politics, not science nor political science. So I think that’s kind of the way I see it, and I’m hoping that people realize that we’re doing damage to our own self-interest in the US.

I can imagine them saying, “Oh yeah, but America will be better at commercializing it.” We’re the ones who have the intellectual property (IP) protection and the ability to put the financial resources behind these assets. And so if the drugs are invented in China, that’s not the end of the world. Do you think there are people who think that?

Let me put it this way, in starker terms: we are seemingly wanting to bring back to the US manufacturing jobs as it relates to the ingredients of low cost drugs, which has been previously outsourced to China. Everybody got alarmed that, “Oh my God, we don’t control our own supplies of drugs. We’ve got to control it.”

In this process, we’re now outsourcing high paying innovation jobs and IP creation jobs. In our industry, the manufacturing of the IP, and I’m using those words carefully, the manufacturing of the IP is a far more profit generating, long-term value generating and constantly improving on itself portion of the enterprise than is the manufacturing of the input ingredients. So the trade we’re making of insourcing, frankly, well, manufacturing jobs and outsourcing innovation jobs is, in my view, not economically sensible.