In June, I had the opportunity to moderate a panel discussion at the Diversity & Clinical Trials Symposium in Chicago. Prior to introducing my distinguished panel, which included Karen Brooks, senior director with Pfizer, Dr. Vince Bufalino, SVP with Advocate Healthcare, and Dr. James Powell, principal investigator at Project IMPACT, I looked out at the audience and stated, “Diversity in clinical trials is NOT a race issue.” It was fairly clear that I was in the minority at this event in both my race and with this opinion. So I clarified by reiterating my previous statement along with my opinion that diversity in clinical trials is a best business practice. If you are developing a drug for a disease which has an affinity to manifest itself in a particular race or gender, then it makes sense to have that race or gender well-represented in your clinical trial. Panel member Dr. Powell pointed out that diversity in clinical trials is best represented by genetic diversity, not necessarily racial diversity. I echo his sentiment.
Unfortunately, many of the genetic traits we possess, such as skin, eye, and hair color, are some of the superficial traits which clinicians often use to determine whether or not to enroll or offer enrollment in a clinical trial. Dr. Augustus White III, M.D., Ph.D., describes this as unconscious bias. According to White, coauthor of “Seeing Patients: Unconscious Bias in Healthcare,” there are 13 groups in the United States which receive disparate medical treatment (African-Americans, Native Americans, Asian-Americans, Latinos, prisoners, Appalachian poor, immigrants, disabled individuals, certain religious groups, gays, obese, elderly, and women). We know that the risk of inheriting certain diseases comes down to genetics. For example, sickle cell anemia is more common in families from Africa, India, the Mediterranean, Saudi Arabia, and South and Central America. In the United States, it most commonly affects African-Americans and Hispanics. Though diversity in clinical trials should be a best business practice, it seems to remain an issue driven by race, or perhaps bigotry.
After this event, I attended two very large industry shows — BIO International and DIA. I had the opportunity to interact with executives and key opinion leaders from vendors, pharma/bio companies, and academia. Having recently attended the diversity summit, I was curious to get their take on the diversity issue. I was surprised to find that many executives either don’t see diversity in clinical trials as being an issue, or is an issue which they believe has already been adequately addressed. Personally, I think that if you want more diversity in clinical trials in the United States, you need to get more minorities like me involved.