An Atypical Patient Advocate
Merck EVP Dr. Julie Gerberding has not followed a classic professional path, either for a physician or a pharma executive. Instead, her unique career has been guided by a simple compass – the needs of patients
As the CVs of senior pharma execs go, Dr. Julie Gerberding’s is one of the most unusual. Starting out as a respected academic at the University of California San Francisco (UCSF), she became the first woman to lead the US Centers for Disease Control and Prevention (CDC), guiding the organization through more than 40 public health crises including anthrax bioterrorism, SARS and natural disasters. As a world-renowned infectious disease and public health expert she has advised many governments on urgent issues as pressing as pandemic preparedness, AIDS, antimicrobial resistance, tobacco and cancer.
In 2010, she arrived at pharma’s door to lead the global vaccine business at Merck & Co. and was appointed as the Chief Patient Officer in 2016. The move to industry may have surprised some of her contemporaries but, for Gerberding, the move made perfect sense.
“I began my medical training at the same time as HIV emerged in San Francisco. I remember how the AIDS epidemic affected my cohort of interns before we even knew it was an infectious disease. It was very hard to learn medicine when all your patients died,” she says.
Now, HIV treatment is a success story, she says. “We all regret that we don’t have a vaccine yet but we have drug treatments that are really game-changing for patients.”
Currently Executive Vice President, Strategic Communications, Global Public Policy, and Population Health at Merck, Gerberding says her early experiences as an intern have shaped her worldview and career ever since.
“These experiences had a lasting impact on me; importantly, I learned about patient-centricity. The patients I took care of in our public hospital were very empowered – they knew more about their disease than I did. They were activists and very much in charge of the decisions about their own care, and that taught me that you have to co-create health and health decisions with patients, not for them,” she says.
“It was impossible to maintain the more traditional paternalistic model of medicine when you were practicing at San Francisco General Hospital in that era. In a sense, my career has come full circle from the bedside of patients with AIDS to the Chief Patient Officer role for Merck. “
Gerberding brought these personal insights to Merck at a time when the industry was beginning to embrace patent-centricity as a core value. Merck was ahead of the game in putting patients front and center, she says.
“Patient-centricity is more of an attitude than an initiative. It’s a conscious articulation of the fact that, in the words of George Merck, one of the most important leaders of our company, we try to always remember that medicine is for the patient, not for the profits and as long as we have remembered that, the profits have followed.”
Patients are becoming more “agile consumers of healthcare” and are advocating for a voice, she says. “Patient wants a say in what drugs are developed, how they are developed, how trials are conducted and, most importantly, what risks and benefits they’re willing to take. Patients want a stronger voice in the regulatory process and a seat at the table on important decisions about how their medicines are being made.”
Gerberding also believes there is a logical connection between patient care and population health. “In San Francisco, we were focused on each AIDS patient but we also saw the population epidemic. In CDC, it was about recommending actions to protect individual people but also protecting the public’s health.”
At Merck, the focus remains the same. “We have to have a patient in mind when making ethical judgments about drug discovery and development, but, at the same time, we are a company that develops medicines and vaccines that target large-scale population health issues like infectious diseases, cancer, Alzheimer’s disease, cardiovascular diseases, and diabetes.”
As an expert, at the forefront of new developments in infectious diseases, what do the next ten years herald? “Inevitably, new infectious disease threats will emerge – that has been an accelerating pattern for the past decade,” she says. “We will be able to predict some of them, but no doubt there will be surprises like SARS or Zika virus. In terms of expected problems, antimicrobial-resistant bacteria are a major threat. Animal-vectored diseases like Ebola will continue to emerge as well, because urbanization bring people into areas that used to be rural so animals and humans are coming into greater contact.”
She points to Merck’s Ebola vaccine awaiting approval by regulators. “We have already created a vaccine for Ebola that is reported to be effective, and hope to be able to rapidly deploy it when the next outbreak appears. We also participate in CEPI – the Coalition for Epidemic Preparedness Innovation – a global, public-private initiative that is creating a collaborative platform to develop vaccines to prevent epidemics where the incentives for commercial investment are limited. No company has the resources to invest in candidates for all the priority pathogens, but by doing it collectively, we can have candidate vaccines ready for Phase 3 evaluation should a disease emerge.”
Speaking of commercial opportunity, what does Gerberding feel about criticism in recent years of pharma’s failure to develop new antibiotics? “Merck is one of the companies that does have an antibiotic pipeline and an active discovery team – so we are still very committed in this space.”
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