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OVID-19 helped force the world to better appreciate how certain health conditions disproportionately impact marginalized groups, exacerbating known disparities in already vulnerable populations.
Indeed, some BIPOC (Black, Indigenous, and people of color) populations experienced hospitalization from COVID-19 infection at a rate more than threefold higher than White populations. The pandemic also highlighted how lack of diversity in medical research undermines health equity and how historically, the most vulnerable may have benefited less from discoveries because they were not as well understood in these populations.
While the issue of health inequity was propelled into public discourse in large part due to the pandemic, Dr. Aida Habtezion, Pfizer’s Chief Medical Officer and Head of Worldwide Medical and Safety knew marginalized communities experienced health disparities long before COVID-19. Having lived in four countries and on three continents, her experiences working with medical professionals and treating patients from diverse backgrounds and communities prepared her well for the global nature of her role. Listening to her patients helped her be a better physician, scientist and to empower them to be involved in their own care.
Working with many vulnerable populations instilled a deep sense of empathy and compassion in Dr. Habtezion for her patients.
“I would see the same disease impacting patients of different backgrounds differently,” says Dr. Habtezion. “I saw worse outcomes in patients from underserved populations. It’s frustrating because you continue to see it. It’s always there.”
One of the challenges in addressing these disparities was where to start. Which part do you address first? For Pfizer, the answer was using translational research to embed equity from scientific concept – the very beginning of the research and development lifecycle. Known as “bench-to-bedside,” translational research describes how research transitions from the laboratory bench to the patient’s bedside as a new therapy or treatment.
“We in the research community need to focus more on unmet needs to strengthen the link between bench-to-bedside and bedside-to-bench relationships,” says Dr. Habtezion. “There is information that can be relayed from the clinic: what are the unmet needs? What’s most impactful and meaningful to patients? Where and what are the gaps? Why and where is the lack of health equity? How do we take that back to our discovery? How does it inform our scientific knowledge? How do we use this scientific knowledge to also help us address those unmet needs in a manner that is transformative and paradigm shifting?”
Pfizer’s core value of Equity resonated deeply with Dr. Habtezion. “So, to be asked to be Pfizer’s Chief Medical Officer felt like an opportunity of a lifetime – to bring my experience, expertise, and skills from my own clinic and lab to a global company and positively impact patients globally.”
IDENTIFYING A BASELINE & BUILDING A ROADMAP
After Dr. Habtezion joined Pfizer during the pandemic at the end of 2020 and start of 2021, Pfizer launched the Institute of Translational Equitable Medicine (ITEM) in November 2021 under the auspices of the Chief Medical Office. “We established ITEM with the goal to achieve health equity by preventing, treating, and identifying disease drivers that disproportionately impact underserved and minority populations nationally and globally,” says Dr. Habtezion. “Our goal is to use data and science to help better understand the drivers of health inequities in order to better address them.”
ITEM’s first initiative was to identify disease-specific evidence of disparities from population-based studies through a targeted literature review of the 38 disorders in its pipeline. Dr. Habtezion intuited that a visual representation would be more impactful than raw data alone, so she and the team distilled the results into a “heat map,” a graphical representation that shows the magnitude of a phenomenon by depicting key values by color. Habtezion found that visualizing the data would be the most effective way to show the most severe disparities in health outcomes among patient populations. “Although data for all ethnic groups remains limited, we did this because a heat map is easy to look at, like a traffic light,” says Dr. Habtezion. “Red signals that you have a lot of disparity—indicating that you need to stop and think about it.”
“Our goal is to use data and science to help better understand the drivers of health inequities in order to better address them.”
DR. AIDA HABTEZION, PFIZER’S CHIEF MEDICAL OFFICER AND HEAD OF WORLDWIDE MEDICAL AND SAFETY
CANCER DISADVANTAGING MARGINALIZED COMMUNITIES
The heat map helped Dr. Habtezion and her team to look at disease disparities across prevalence and incidence amongst minority and underserved populations, as well as disparity of patient outcomes. It provided a starting point for ITEM to develop partnerships with stakeholders that focus on addressing unmet needs where they saw gross disparities. After Dr. Habtezion’s team reviewed the data, it became abundantly clear that despite significant disparities in health outcomes across different ethnic and racial groups, that there are very few research studies statistically powered to investigate cancer risk and outcomes in people of African ancestry.
Data from the heat map also showed that despite significant advancements and improvements in cancer research, certain patient populations including those of African-Ancestry disproportionately develop aggressive, high-grade cancers, particularly in breast and prostate tissues. Racial disparities in cancer incidence and outcomes are well-documented in the U.S., but the underlying causes are poorly understood. Research suggests hereditary risk and genetic determinants for specific cancer subtypes may contribute to disparities, as well as social determinants of health and the interplay between biology and environment.
Acting on this research, ITEM recently announced its first milestone collaboration for ITEM with Fox Chase Cancer Center, Sylvester Comprehensive Cancer Center, and the African Caribbean Cancer Consortium (AC3) Women’s Cancer Working Group- to launch a genomics study to characterize novel genetic, molecular, and social determinants of cancer across populations of African ancestry and create a cancer genome registry of ethnically diverse patients designed to expand existing resources and advance health equity through genomics, molecular epidemiology, and social determinants of health research in African Ancestry oncology patients.
PARTNERING WITH AFFECTED COMMUNITIES
Race, ethnicity, age, sex, environment, and other social determinants of health can all impact how different people respond to the same medicine or vaccine, which is why inclusivity, starting at the earliest phases of research, is so important. Armed with data, Pfizer is even more able and committed to increasing diversity in research and forging trusted alliances within underserved populations so that all communities can benefit from scientific advances.
“To build trust, you have to involve the people who are actually being impacted – which is why we’re partnering with communities affected by the disparities,” says Dr. Habtezion.
One key example is led by Pfizer’s Multicultural Health Equity Collective. This cooperative of Pfizer colleagues and US-based organizations focuses on achieving health equity across ethnic groups and other underrepresented communities facing significant health disparities. The team works in partnership with key groups across the US – including patient advocacy organizations, healthcare provider associations, community groups, and legislative caucuses – to address health disparities among the most vulnerable populations through unique community programming and outreach.
By strategically working in multi-sectoral partnerships through the Pfizer Foundation, Multicultural Health Equity Collective, ITEM, and key stakeholders, Pfizer is taking bold steps to fundamentally change the way it engages with healthcare systems, providers and patients to improve outcomes for underserved populations nationally and globally.
“Patients are our North Star,” says Dr. Habtezion. “We are focused on achieving transformational change by applying not only our science, medicines, and vaccines; but our people, resources, and expertise to make a meaningful difference in people’s lives.”
“Patients are our North Star,” says Dr. Habtezion. “We are focused on achieving transformational change by applying not only our science, medicines, and vaccines; but our people, resources, and expertise to make a meaningful difference in people’s lives.”
