Doctor prescribes cure to some PH ills

Julie Louise Gerberding

A doctor and world renowned infectious disease and public health expert, Julie Louise Gerberding, joined a private pharmaceutical company to fulfill a dream.

That is to be instrumental in the elimination of life-threatening but preventable illnesses in the world, with cervical cancer as her top priority.

Dr. Julie, as she is fondly called by colleagues, is the executive vice president and chief patient officer of Merck & Co. (or MSD in the Philippines).

Prior to her stint at Merck, she served as the first woman director of the US Centers for Disease Control and Prevention (CDC) where she led some emergency responses to public health crises including anthrax bioterrorism, SARS and natural disasters.

It was during her stint at CDC when Dr. Julie realized there was a world out there that was hardly reached by much needed help and tools to fight preventable diseases.

Heart-breaking scene

It was during a CDC outreach in Vietnam to help battle a SARS outbreak when she witnessed a heart-breaking scene in a hospital where a paralyzed little boy was fighting for his life because of tetanus, a life-threatening disease that was preventable by a vaccine.

The problem, she said, was that many people in poor countries could not even afford vaccines, not to mention their lack of knowledge about their benefits.

The same is true in many cases in Africa where people, especially girls, get afflicted with infections like HPV (human papillomavirus) and HIV (human immunodeficiency virus) which could also have been avoided with appropriate vaccines.

“It was during those times when I realized that many good vaccines were not globally available, not accessible especially to people who needed them most. It bothered me that girls in poor countries who needed cervical cancer vaccine didn’t have access. So I took that on as a personal mission,” she says.

Those instances and that personal mission convinced Dr. Julie to join Merck, which she believes produces the best available vaccines for most illnesses she wants eliminated, such as cervical cancer, measles and tetanus.

Thus, she says the post in Merck is a “dream job” for her.

Dr. Julie, born in South Dakota, earned a bachelor’s degree in chemistry and biology and obtained her medical degree at Case Western Reserve University in Cleveland.

She completed her internship and residency training at the University of California, San Francisco and got her Masters in Public Health at the University of California at Berkeley in 1990.

She became the first woman director of CDC in 2002 after her stint as director for health care quality promotion in the same agency.

She joined Merck in 2010 as president of Merck Vaccines, where she helped globalize the business and deliver life-saving vaccines.

Her team made Merck’s vaccines available at the lowest possible cost, especially to countries in the list of Gavi (Global Alliance for Vaccines and Immunization), the Vaccine Alliance, a public-private global health partnership committed to increasing access to immunization in poor countries.

Her stint at Merck has added a business component to her job but this did not make her lose her focus. She and her team are continuously working on balancing what the people they seek to help actually need and want and what still makes business sense to the company.

This requires them to figure out creative ways to address the challenge, such as entering into partnerships and cooperation arrangements with other groups, including nonprofit organizations and venture capitalists, who are willing to share the costs.

That, on top of the company’s efforts to bring down its costs.

As chief patient officer, a relatively new position in the pharmaceutical sector, she is tasked with promoting a culture of patient-centered care by directly interacting with patients and the organizations representing them, the physicians, regulators and Merck’s or MSD’s teams that serve these patients.

Key inputs

Dr. Julie also sits on the company’s board, thus, the inputs she obtains from the field surely reach decision makers in the company.

“Creating scientifically legitimate information about patients’ perspective on drug development and use is critical to make sure the medicine we create will actually be used and create health value for the people,” she explains.

Her role, she says, is to define the areas that need to be addressed.

These include “affordable access” to medicines, which is a universal challenge in every country and a broad issue for the pharmaceutical industry; the insights that patients and patient advocacy groups on what matters as new medicines are developed, including how many pills a day should be taken, how big the pill , how the clinical trials are conducted and other concerns, the patients’ actual experience with MSD and advocacy, because what the patient organizations and what MSD want are aligned.

“We both want fast, affordable access to new and better medicines and vaccines that work,” she says.

Touching base

Her jobs at Merck has taken her to different countries she and her company are trying to reach.

She recently visited the Philippines as part of her Asian tour that was aimed at touching base and interacting with MSD’s teams and their stakeholders, particularly the patients through their organizations and regulators.

Dr. Julie is aware of the Dengvaxia controversy in the country and how it eroded the confidence of many Filipinos in vaccination.

“There are a lot of issues. In the United States, it is the measles vaccine. In Japan, it’s the HPV vaccination and here in the Philippines, it is Dengvaxia,” she says.

Dr. Julie says that what these circumstances have in common is that many people have difficulty really understanding the true and full benefit of vaccination.

“What has to be done about the [dengvaxia] issue is a complex process because there is no easy fix in situations like this. The people who make vaccines have a large role to play in making sure the vaccines they produce are safe and are of high quality. But we also need collaboration in monitoring vaccine safety on an ongoing basis. There should be a system in collecting information about the potential events and make sure they are investigated thoroughly with the help of public health experts to put the situation in context. That requires the full engagement of the public health system in addition to manufacturers,” she explains.

Ultimately, she says, the most important resource is the doctor. “People will believe the voice of trusted medical professionals that they know or have relationships with,” she says.

“We have different touch points but there is no substitute to being in these countries. Coming right to the market and interacting with the team is really the best way to figure out what they need, what’s going on and how we can help,” she says.

“We don’t have the answers to all these problems but my experience has so far taught me that if we just listen, we will learn a lot and that’s the first step toward becoming more relevant and helpful to patients,” she adds.