There have been many times in my long life where I have witnessed stark adversity. Among them, my arrival at Yale in 1970 as one of the University’s first black professors. It was a time of seething social unrest and during the Black Panthers trials. But I was fearless. I have spent three and a half wonderful decades as a Professor of Epidemiology (Microbiology) and Director of International Medical Studies at Yale.
However, I am intimidated now.
I recently read the Commonwealth Fund report on the state of health care. He compared the United States to 10 other high-income countries. According to the report, the United States “ranks last overall, although it spends a much larger share of its gross domestic product on health care.” How can the United States spend nearly $ 3.8 trillion on healthcare per year, which is similar to Germany’s entire GDP, when we come last for access to healthcare , administrative efficiency, equity and health care outcomes?
In my troubled state, I summoned the wise philosopher Rumi, who said: “Where there is ruin, there is hope for treasure. It gave me hope and awareness: this pandemic offers us an opportunity.
If now is not the time to cut health care in the United States, during a deadly and prolonged pandemic, I don’t know when.
Of course, we have witnessed political, social and scientific efforts to improve our health care system in the past – perhaps too often to list them. These efforts, while valiant, have not been sufficient to reduce morbidity and mortality in the United States. Health care is and should be prevention oriented. But that’s not how our current system works. Without a real focus on preventive care, the outcome we have achieved is expensive, poor quality, and ineffective.
What we lack is disruption.
Fortunately, this is an idea that Americans tend to adopt. We’ve seen it with Amazon’s transformation of retail and Uber’s disruption in the transportation industry.
But the disruption has yet to hit our healthcare system. That is to say until now.
Among those leading the charge is my former student who studied infectious diseases at Yale Medical School, Dr. Ryan Saadi, MD, MPH. In June 2020, Dr Saadi partnered with bone marrow transplant expert Dr Neal Flomenberg, MD, professor and chair of the Department of Medical Oncology at Thomas Jefferson University, with the overall goal of bring immunology products to oncology patients more quickly. , at an affordable price and of better quality.
They focused on the biggest barrier to T cell therapy – the need to personalize therapies for each patient – and asked why it had to be done this way? Many T cell products, such as CAR-T, are widely known to be effective against cancer, but they cost both time and money. Today, CAR-T requires that each patient meet with a team of doctors several times for a long preparation and often the treatment requires hospitalization. So the process is not cheap and does not happen quickly.
Drs Saadi and Flomenberg have determined that from a single T cell donor, a common therapy can be developed and used to treat many patients sharing the same type of human leukocyte antigen (HLA). The convenience of ‘off the shelf’, meaning that it has already been manufactured and is available on hand or literally ‘off the shelf’ in a doctor’s office or hospital, provides fast and cost-effective therapy in eliminating the need for specialized medical care. facilities which in themselves will improve health outcomes.
Armed with affordable and transformational capabilities, they have since developed therapy aimed at curing high-risk COVID-19 patients under Tevogen Bio, a company focused on improving public health with its T cell products. Tevogen aims to be the first biotech company truly focused on patient equity, which is one of the reasons the Yale School of Public Health has partnered with Tevogen Bio on an initiative to improve public health.
The fearless spirit of Dr Saadi and Dr Flomenberg is not unique.
As Dr. Saadi’s teacher, I noticed that he exemplified some of the same qualities as another Yale graduate, Noah Webster, the author of the First American English Dictionary. Webster also published the first treatise on public health and medicine – an evidence-based approach to public health. Webster was a disruptor of his time, his innovation changed the course of another public health crisis in the United States – yellow fever in the 1790s.
Like Webster, Dr. Saadi’s ability to ignore background noise and focus on the basics of infectious diseases led him to tackle problems early in his career, such as his development of a new treatment guideline for community acquired pneumonia which led to a 41% reduction in healing time or time spent in hospital.
My hope is that healthcare professionals take inspiration from what Dr Saadi and others like Noah Webster have created and develop their own new methods to deliver effective, quick and less expensive solutions. It requires disruptors who aren’t afraid to question the way things have always been done. Is there another sector more important to achieve this than health care?
As this pandemic continues on its deadly course, with new variants emerging and groundbreaking cases discovered almost daily, the United States is poised to disrupt public health. It is not impossible, but it will take collaboration, a tireless spirit, empathy and, of course, disruption.
For the first time since the start of this pandemic, I have hope.
Curtis Patton, PhD., Professor Emeritus at Yale University, is a scientist and public health expert. He has held a variety of administrative roles at Yale, including Division Head of Microbial Disease Epidemiology and Acting Head of Global Health. He has also served as Director of International Medical Studies and Chairman of the International Health Committee at Yale and currently serves on the Tevogen Bio Board of Directors in an advisory capacity.