A Life in Medical Innovation and Philanthropy

— A discussion with the former CEO of the Bill & Melinda Gates Foundation

Ƶ MedicalToday

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The Bill & Melinda Gates Foundation, with an endowment of over $50 billion, is one of the largest and most influential philanthropic organizations in the world. With a focus on addressing global health, poverty, and education, its initiatives have led to the reduction of malaria mortality by 60% over the past two decades, the near eradication of polio, increased educational opportunities for millions of students, and improved sanitation conditions in developing countries.

For 6 years, oncologist , was the CEO of this organization. Prior to that, she served as Chancellor of the University of California San Francisco, as well as president of product development at Genentech, where she oversaw the development of trastuzumab (Herceptin), bevacizumab (Avastin), rituximab (Rituxan), and other blockbuster cancer drugs that are now staples in the arsenal of many medical oncologists.

The topics that Desmond-Hellman discussed with Henry Bair and Tyler Johnson, MD, in this episode are as varied as her career, and include how seeing the work of her pharmacist father encouraged her to pursue a career in medicine, how her early experiences treating HIV patients in Uganda spurred her to tackle global health challenges, how she discovered a passion for product development in the pharmaceutical industry, how she reconciles the ethical quandaries of developing medications that can cause serious adverse effects and that can sometimes cost hundreds of thousands of dollars per dose, what her mission was while at the Gates Foundation, and her perspectives on the role of artificial intelligence (AI) in human health and well-being now that she has joined the board of directors of OpenAI, the company behind ChatGPT.

In this episode, you will hear about:

  • 2:50 How working in her father's pharmacy led Desmond-Hellmann to a career in medicine
  • 4:56 A brief summary of Desmond-Hellmann's multifaceted career trajectory
  • 15:36 What the day-to-day work of pharmaceutical drug development looks like
  • 18:30 The challenging ethical concerns that surround drug approvals, especially pertaining to safety concerns
  • 23:44 Desmond-Hellmann's experiences in Uganda that forever transformed her views on poverty
  • 27:55 The aims of the Gates Foundation
  • 30:47 How Desmond-Hellmann views her work both in the nonprofit and the for-profit sectors
  • 37:15 Desmond-Hellmann's mission when she took on a leading role at the Gates Foundation
  • 38:38 How Desmond-Hellmann thinks about shaping the future of AI as she takes a seat on the board of OpenAI
  • 45:14 Desmond-Hellmann's advice on navigating the many opportunities available to medical trainees and clinicians along their career path

The following is a partial transcript (note errors are possible):

Bair: Sue, it's an honor to speak with you. Thank you so much for taking the time to join us, and welcome to the show.

Desmond-Hellmann: Thank you.

Bair: So, as we discussed in the opening, your career has spanned clinical medicine, academia, industry, public health, philanthropy, and both the nonprofit and for-profit sectors. That's a lot we can dive into. But to kick us off, can you tell us what first drew you to medicine?

Desmond-Hellmann: That's an easy one. I was the daughter of a pharmacist. My dad really enjoyed the practice of pharmacy. He read about it, talked about it, hired part time most of his kids to help in the drugstore. So, that was a big part of my childhood. And experiencing what it was like for my dad to help people by giving them medicine and to collaborate with our family doctor made a huge impact on me. We have a funny picture, when I was probably 8 or 9 years old, in one of my dad's white shirts and a plastic stethoscope, so I know it was pretty early that I decided that a life in medicine was the good life for me.

Johnson: That forges an immediate connection between us, because I had a grandfather who was an entrepreneur, who was a proprietor of his own -- as they called them then -- drugstore. And I remember going to his house when I was little, and he would have these enormous, like 5-inch black three-ring binders that were his pharmacopeia, where he would look up all of, you know, his drugs and whatever as he was filling prescriptions.

And then I didn't learn until later, much later, after I had gotten into medical school, that he had actually wanted to become a doctor when he was young, but his family circumstances were not such that he could, you know, put aside sort of family and financial responsibilities long enough to go through the arduous training process. And so he became a pharmacist, sort of, as he viewed it, as sort of the next best thing anyway, which is just to say that I think that connection through family pharmacy is lovely.

Desmond-Hellmann: My brother and my sister-in-law are also pharmacists. I think it's a wonderful profession. I still love whenever I get to collaborate with my wonderful pharmacists.

For the full transcript, visit .

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