TEDMED 2012 was an experiment in the “new.” Last year it was held in San Diego with a smaller number of attendees. For 2012, it was a much larger extravaganza in Washington D.C., with a heavier focus on advocacy vs. technology. The reviews from past attendees were mixed – some missed the intimacy of the old format while others celebrated the breadth of speakers and robust networking. For me, the discussion was moot. This was my first TEDMED and it was, undoubtedly, an experience – an opportunity to engage with and connect new ideas, hear from the greats like Edward O. Wilson, see old friends and expand my network. Here’s just some of what I learned and heard:
1) We’re in an arms race with the bugs, and as anyone knows from studying history, no one ever really wins an arms race. Even to keep pace requires exponentially more money, time and innovation. Right now we’re not even keeping pace with the bugs we already figured out how to kill. This year, according to TEDMED speaker Andrew Read, a University of Pennsylvania professor and infectious disease specialist, more than 100,000 will die in the U.S. alone from bacterial infections we could easily treat with antibiotics not 30 years ago. What’s required is a global, coordinated plan to manage microbial evolution, which in and of itself will require new evolutionary science plus the willingness of physicians, patients, regulators and others to prioritize the future effectiveness of the drugs we have now when thinking about how to treat patients with minor infections. We need more investment in research and physician and patient education programs, plus immediate regulatory action. Fortunately, as FDA Commissioner Peggy Hamburg was pleased to announce during the conference, the FDA has just moved to restrict antibiotics use in farm animals to help prevent overuse and the development of microbial resistance. But though the FDA is leading the initiative, already it is under fire for failing to specifically restrict continued use of antibiotic therapies to compensate for overcrowded or unsanitary conditions.
2) Patient engagement leads to improved quality and reduced cost of healthcare. Todd Park, U.S. chief technology officer, called for putting the power of information in consumers’ hands via technology that enables better engagement and collaboration in providing patient care. But the role of the patient in healthcare is still hotly contested; as someone put it, “If patients are customers, does that mean the customer is king, or buyer beware?” Still, the trend is already underway – new networked tools that map health data are already available, and flourishing online health communities are encouraging people to pursue nutrition, fitness and weight loss goals while providing community support.
3) We need to be clear headed about getting in front of the growing prevalence of Alzheimer’s. Look around. Will the people around you reach 80? Will they reach 80 and still remember their children?Gregory Petsko, professor of neurology at Weill Cornell Medical College, says 80 is more feasible than ever these days – there will be 32 million octogenarians in the U.S. by 2050. But 80 without Alzheimer’s disease? The world is looking at having to treat and care for more than 300 million Alzheimer’s disease patients by then. We’re aging and the therapeutic and diagnostic technologies aren’t keeping up with us. In fact, more and more pharmaceutical companies are exiting neuroscience research altogether (let’s hear it for Janssen Pharmaceutical Companies of Johnson & Johnson, which continues to advance new science and research against Alzheimer’s and other diseases of the brain.) What’s needed is a new way of approaching science – not iteratively but in a way that allows for scientific theory and practice to move forward in a cross-disciplinary and parallel way. Unlocking the mysteries of the mind isn’t easy, and we are running out of time.
4) Imagination is the key to scientific and medical innovation. Edward O. Wilson, research professor emeritus at Harvard and inventor of the field of sociobiology, told us that “in science what is crucial is imagination” and “advances in science rarely come from upstream, but instead they are the product of downstream imagination.” Yet several speakers took issue with how we select for medical and science professionals – valuing deep knowledge and book smarts over imagination and the ability to see the big picture – as well as how science is brought forward in increasingly deep and narrow silos. The prescription is putting greater focus on and incentivizing imaginative, holistic thinking that uncovers unexpected connections across scientific disciplines and enables greater convergence among them.
I’d give my right arm (and, yes I’m right- handed) to see what we’re discussing at TEDMED in another 10 years – which of these problems we’ve solved and which we’ve still barely cracked. Science and technology are increasingly challenging– let’s hope our downstream imagination will enable us to create meaningful – and affordable – solutions from complexity.