Unleashing the power of bioscience for human health

The 21st century is said to be the century of bioscience, with the promise of revolutionising human health. Every week we hear of dramatic discoveries in research labs, new genome links to disease, novel potential treatments for diseases like cancer and Alzheimer’s, nanotechnology applications to create miniature machines for inside the human body, and digital health tools to track the state of our health as we go about our lives. More than two million academic biomedical science papers pour out each year, over 14,000 patents are filed, and thousands of possible new drugs are studied – the statistics are impressive and rising, as governments and private industry invest more heavily in life sciences than any other field.

And yet only 30-40 new drugs are approved each year, each after more than ten years of effort and millions of dollars spent in clinical trials. Only a small handful of cell and gene therapies reach patients, despite more than two decades of investment in these powerful new regenerative medicine modalities. Worse still, many of the new treatments that manage to penetrate the market reach only a small fraction of patients who could benefit. In reality, digital health fails to deliver the promised revolution in how we manage and monitor our health. The question that needs to be asked is what’s going on?

If we compare the changes in human health to information technology, the contrast is dramatic. On the basis of a few advances in basic electronics, many of which are 20 years old – and their steady miniaturisation – we have new generations of powerful devices and applications every year. Smart phones, tens of thousands of new apps, exciting advances in artificial intelligence, and the Internet of Things all around us – we see the ultra-fast translation of technology into useful products and services. In fact, they seem often to arrive faster than we can track and adopt them. So why is this speed of new innovation not visible in bioscience?

Most of our new science is getting ‘lost in translation’. Consensus over who is to blame is lacking, with criticism falling on the industry, regulators, over-conservative doctors, and stingy health systems. They are blamed for the growing innovation gap – the gap between what science now makes possible and what actually results in patient benefit and creates new models of care. Like many human diseases of course, this disease of the system, this gap in translation could be said to be “multi-genic”, with many causes and no easy simple answers.

An overhaul of the innovation system for life sciences seems called for. Indeed, worried governments, challenged by ever more activist patients seeking cures for their diseases, are launching dramatic-sounding initiatives like ‘21st Century Cures’ in the United States or the ‘Accelerated Access Review’ in the United Kingdom. Can these initiatives make the crucial difference, close the innovation gap, and bring the life-changing products that patients need more quickly, affordably, and reliably, to transform our health systems? Only time will tell, and the fact remains that government motivation for such initiatives is not only to improve the health of their populations, but also to generate economic growth and to secure better returns for their rising spend in bioscience.

In order to effectively tackle this problem and unleash the power of bioscience for healthy human lifespan, we must look beyond simplistic remedies and understand the major factors in poor translation:

1. How basic bioscience is focused (or not) on human disease
2. The translation of scientific breakthroughs into potential new products
3. Approval for use and reimbursement of new products
4. Practical adoption by doctors and patients of new products
5. How we learn from practical real-world use to shape the future R&D agenda

All of these five gaps can stymie life science innovation and so result in poor returns for government and company investment.

I believe there is a golden thread that runs through most of the solutions needed to address this failure in translation: Precision Medicine. We are learning how the molecular basis of disease can help us find more targeted treatments and then match them to those patients most likely to benefit, making new therapies less costly to trial, more likely to be successfully licensed, more affordably reimbursed, and more readily adopted.

Currently there is a lot of talk about longevity: can we increase the human lifespan? At the moment, however, it is unhealthy longevity that risks bankrupting our health systems. Diseases that strike in the second half of our lives, often several at a time, with the consequent cost in human and economic terms. Precision Medicine holds the promise of reshaping our innovation ecosystem so we can target our limited resources to maximise healthy human lifespan – which should surely be the goal of every health system on the planet.

Featured image credit: Life by Huy Phan. CC0 public domain via Unsplash.