The Impossible Turned Out To Be Possible After All
As a kid, I loved flipping through magazines like Discover and Scientific American. I couldn’t get enough of the headlines that highlighted the latest discoveries, and I was fascinated by the cutting-edge research that scientists were doing every day. Maybe a vaccine could be used to treat and prevent Alzheimer’s disease! Maybe stem cells could be used to reverse diabetes! The stories were full of hope, and the future seemed promising. More often than not, it sounded like the next breakthrough was right around the corner. Unfortunately, as an adult, that optimistic outlook isn’t nearly as accessible to me anymore.
These days, any spark of excitement I get from reading the latest scientific headlines intended to inspire is quickly dampened by a more realistic assessment of the situation. For example, news about a new medical intervention that was demonstrated to have a promising effect in animal studies is tempered by the knowledge that the chances of replicating the effect in humans is low. A 2006 review published in JAMA showed that only 37% of the most-cited animal studies in prestigious scientific journals were replicated in human randomized clinical trials.
Furthermore, according to a study published in 2018 by researchers at the Massachusetts Institute of Technology, only 14% of all drugs in clinical trials eventually become FDA-approved (and that’s a higher percentage than previous studies indicated). Unfortunately, even the medications that receive FDA approval are sometimes found wanting. Consider, for example, the recent controversy surrounding Aduhelm (aducanumab), a new medication developed for the treatment of Alzheimer’s disease. Ten of the eleven experts on the FDA advisory panel voted against approving the medication due to insufficient evidence of its effectiveness, but the FDA approved it anyway.
In light of this decision, many people have raised concerns about an “inappropriately close relationship between the FDA and the [pharmaceutical] industry.” As a result of these allegations, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services announced it would review the FDA’s use of the accelerated approval pathway, including its use of this pathway to approve Aduhelm. The reports of the OIG’s findings are expected to be issued in 2023. If it is found that there were inappropriate ties between the FDA and the pharmaceutical industry, it wouldn’t be the first time.
The more I learn about the inner workings of the medical-industrial complex, the easier it is to get discouraged. However, when I find myself on the brink of this particular black hole of despair, I think back on my memories of reading science magazines as a kid. Specifically, I read a lot of articles about climate change, cars, and fossil fuel. The big question was, Would scientists be able to develop an environmentally-friendly alternative to gasoline? It was a nice idea, but it seemed impossible; and sure enough, making ethanol from corn turned out not to be the solution. But there was a solution. Here we are in 2022, and electric vehicles are everywhere. It’s an invaluable reminder that every once in a while, the impossible turns out to be possible after all.