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cover of episode #346 - Scaling biotech and improving global health: lessons from an extraordinary career in medicine | Susan Desmond-Hellmann, M.D., M.P.H.

#346 - Scaling biotech and improving global health: lessons from an extraordinary career in medicine | Susan Desmond-Hellmann, M.D., M.P.H.

2025/4/28
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我于1982年在旧金山开始内科住院医师培训,正值艾滋病疫情初期,当时对艾滋病的了解非常有限,医学界对这种疾病充满恐惧和不确定性。我的患者主要表现为肺炎和卡波西肉瘤等症状,这些症状在当时非常罕见,也凸显了艾滋病的严重性和神秘性。在与艾滋病患者的接触中,我深刻体会到医学的人文关怀和科学研究同等重要。 之后,我选择肿瘤学作为我的专业方向,并于1989年至1991年在乌干达工作,治疗艾滋病相关的癌症。在乌干达的工作经历让我深刻认识到,在全球健康危机中,流行病学、患者护理和政策的整合至关重要。当时,乌干达的艾滋病疫情非常严重,缺乏有效的治疗药物,许多患者在短时间内死亡。我亲眼目睹了艾滋病的残酷,这对我产生了深远的影响。 从乌干达回国后,我进入制药行业,参与了紫杉醇、赫赛汀和阿瓦斯汀等突破性抗癌药物的研发。在药物研发过程中,我学习到许多宝贵的经验,也深刻认识到科学研究和商业运作之间的平衡。赫赛汀的研发成功证明了靶向治疗在肿瘤治疗中的巨大潜力,而阿瓦斯汀的高昂价格也引发了人们对药物可及性的担忧。 在基因泰克公司工作期间,我参与了多个药物的研发,并担任了多个领导职务。这段经历让我积累了丰富的管理经验,也让我对药物研发和商业运作有了更深入的了解。 之后,我担任加州大学旧金山分校校长,负责学校的财务和发展工作。这段经历让我学习到如何筹集资金,并管理一个大型的学术机构。 最后,我担任比尔及梅琳达·盖茨基金会首席执行官,负责基金会的全球健康和发展项目。这段经历让我有机会接触到全球范围内的健康问题,并参与到解决这些问题的行动中。

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Susan Desmond-Hellmann is a physician and scientist whose remarkable career has spanned clinical medicine, oncology, biotech innovation, and global health leadership. In this episode, Susan shares insights from her journey training in internal medicine during the early AIDS crisis, treating HIV-related cancers in Uganda, and developing groundbreaking cancer therapies like Herceptin and Avastin. She reflects on her leadership roles at UCSF and the Bill and Melinda Gates Foundation, offering lessons on guiding large-scale health initiatives, navigating uncertainty, and fostering scientific innovation. The conversation explores the promise of precision medicine, the integration of patient care and policy, and the evolving role of artificial intelligence in transforming diagnostics, drug development, and global access to care.

We discuss:

  • Susan’s medical training, the start of the AIDS epidemic, and the transformative experiences that shaped her career [3:00];
  • Susan’s experience working on the frontlines of the HIV/AIDS crisis in Uganda [12:30];
  • Susan’s time working in general oncology and her transition to biotech where she helped develop taxol—a top-selling cancer drug [26:30];
  • Genentech’s origins, and its groundbreaking use of recombinant DNA to develop biologic drugs [33:45];
  • Susan’s move to Genentech, and her pivotal role in the development and success of Herceptin as a groundbreaking therapy in targeted oncology [44:00];
  • The rise of antibody-based cancer therapies: the development of Rituxan and Avastin [52:15];
  • The step-by-step drug development process and the scientific and strategic challenges involved [1:01:30];
  • The ethical and economic controversy surrounding Avastin’s high cost and limited survival benefit [1:12:30];
  • Susan’s tenure as chancellor at UCSF: leading during a financially strained period, and her strategic approach to fundraising and institutional development [1:14:45];
  • What Susan learned as CEO of the Bill and Melinda Gates Foundation: strategic processes and decision-making frameworks [1:26:00];
  • Susan’s philosophy of leadership and how she sought to build an empowering, values-driven culture at the Gates Foundation [1:35:15];
  • The erosion of public trust in science during COVID, the communication failures around controversial treatments like ivermectin, and the need for better public health engagement and transparency [1:39:30];
  • The role of AI in transforming medicine: from drug development to cancer detection and beyond [1:53:00]; and
  • More.

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