← James Reed: all about business
James Reed: all about business
24. Responding to a crisis: The force behind getting life-saving vaccines to the public | Dame Kate Bingham
00:53:41
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- [00:00]
A
Welcome to All About Business with me, James Reed, the podcast that covers everything about business management and leadership. Every episode, I sit down with different guests who bootstrapped companies, masterminded investment models or built a business empire. They're leaders in their field and they're here to give you top insights and actionable advice so that you can apply their ideas to your own career or business venture. In 2022, the life science sector generated over £100 billion in turnover. But with more and more companies entering the space, how can new businesses secure investment in an industry plagued by politics? Today's guest, Dame Kate Bingham, is the Managing Partner at SV Health Investors. She's been investing in the healthcare industry for over 30 years, and in 2020, the led the UK's Vaccine Task Force in the fight against Covid. As 90% of drugs fail their trials. We discuss in this episode how investors decide where to put their money, the women taking the industry by storm, and what the COVID Vaccine Task Force taught Kate about leadership. Well, this afternoon I'm really delighted to welcome Kate Bingham to the All About Business Studio. And full disclosure, Kate and I have been friends for a very long time and Kate actually introduced me to my wife, Nicholas. I'm already hugely grateful to Kate for that. Kate, I want to start. You've just told me that you've been in the same job since you left business school back in 1991, you started the company that is now SV Health Investors. What drew you to that line of work and why have you stayed in it so long?
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B
I mean, it's fantastic to be here. James, thank you for having me and thank you for your great pink picture that goes with my pink coat. So I joined Schroeder Ventures as It was in 91, because I'd been working in a biotech company in Cambridge, Massachusetts, that had been venture capital backed. And so when I got a call out of the blue to say, did I want to join a venture capital company? I thought that was pretty interesting opportunity because one of the key things I was interested to do as part of doing my MBA was to bring back those skills back to the UK to really help drive the growth of what was then a very nascent biotech sector in the uk. So I thought it was a great opportunity to do that. And I came in right at the beginning. So I've basically seen the growth of this sector into something that now is bigger than any other European country, and not obviously as big as the us, but absolutely the second major sector part of the sector in the biotech area.
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A
You're a scientist, aren't you? You studied biochemistry.
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B
I think I did. I can pronounce the words. I wouldn't say I'm a deep scientist because I've not done a drug discovery per se, but I, I know the basics.
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A
You are a scientist, so you studied science and you got into this sector right at the beginning and it's, and it's been an incredible journey. And now the uk as you say, is world leading in this space.
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B
Correct. And we've been able. If you think about where innovations come from, they come out of academia. So there is a relatively linear relationship between academic research funding and patents and innovations and know how that comes out of that. So sitting here in London, which is the golden triangle, London, Oxford, Cambridge, we are in a very rich place for brilliant minds to be coming up with great new inventions. So that's why we're so lucky to be based here as part of setting up biotech companies.
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A
So the way this works, as I understand it, SV Health Ventures, you, you raise a fund of money from investors and then you go and look for companies to invest in on their behalf.
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B
Yes. So these are standard venture capital funds. So 10 year funds, you invest over up to five years, but by the end of 10 years you will. The goal is to have returned cash back to the investors because it's in a liquid fund, as in once you've committed, you can't get out at all easily. We have to deliver returns which are materially better than any than other investments in the stock market. So that is the promise that we make. And so we are completely performance driven. If we don't make money for investors, they're not going to give us money again because we are at the extreme risk end of the investment. So that's. And we raise money from, you know, pension funds, insurance companies, family offices, you know, public and private pensions. I mean all, all over.
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A
Just for the benefit of our listeners, how big is one of these funds?
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B
$500 million.
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A
$500 million. A substantial amount of money. And then you look for these academic sort of geniuses in Oxford, Cambridge, elsewhere, coming up with new ideas to treat people with conditions.
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B
Exactly. So what we're interested in finding is are there some interesting biological insights that tells us about what is the cause of a particular disease in groups of people? And are there new ways, better way, halt the progression of that disease so that you can actually either treat or potentially cure the patient? So when I first started 30 years ago, the sorts of drugs we were developing were very much addressing the symptoms of disease, but not getting into the underlying cause of the disease itself. And now we understand so much more about biology. We had the human genome sequenced in 2000 and we now have much, much greater tools to really understand what's going on. I mean, still the science has moved on a lot. Science moved on hugely. I mean, we're still a sort of fraction of the iceberg. I mean there's a lot more to do. But being able to actually identify the drivers of disease and work out which patients have diseases caused in that mechanism then enables us to develop drugs which are very precise. So it's precision medicine to get to the cause of the disease. So that you are trying to, trying to develop disease modifying drugs, not symptomatic.
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A
So is there an example of an investment journey that you could share that you know a company you started investing in, that's then.
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B
Well, the most recent big success we've had has been in a company called Ibio, which is a company we formed. So we worked with a entrepreneur that we'd backed twice before, actually an American physician who'd been hugely successful. And he created the first class of drugs to treat macular degeneration. That's an eye disease, that's a, that's an age related eye disease. And what happens is you get blood vessels that grow behind the back of the eye and then they leak fluid into the back of the eye and it's that fluid that forms cysts at the back of the, the eye that causes the blindness. And so we'd worked with him twice before. Each time actually led to an approved drug. And he called us again and said he'd like to do it a third time. So we said, fantastic, this is great. And so we identified a particular pathway which is a regenerative medicine pathway, which we thought was a very plausible basis for developing a new drug to treat blindness. We licensed that in actually from California. We found an entrepreneur there and we then recruited the team, put the business plan together, built the budgets, put the financing together. So we then raised. That was we. So we invested about $6 million to seed it to basically get to a point for series a. Then early 22, we raised $65 million from US and European investors, but also crucially the corporate venture arm of Merck, the US pharmaceutical company. And that funding was to generate the initial clinical data on the lead asset, but also to bring in one or possibly two other assets. And you know, sometimes everything goes right. And in this case everything went right.
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A
You saw the company's mug. I Think it's worth saying for $3 billion.
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B
$3 billion. Not all up front. So we got.
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A
But it's a big number.
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B
Yes, it was 100 up front. 1.3 billion up front.
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A
From an initial investment of 6 million.
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B
From initial seed of 6 million. Yeah. No, no.
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A
I mean, it's obviously an amazing drug. I mean, because a lot of people are. Suffer from diabetes and.
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B
Yes.
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A
And all of us are aging, so it's going to help.
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B
And it will treat macular degeneration too. So we saw. We saw efficacy there. So Merck are particularly interested in this area because they've got one of their big cancer drugs, comes off patent in 2028 and that is. Has sales of something like 30 billion right now. So Ibio is one of their bets as to how can they make up that lost revenue. And so if it all pans out, they should be launching the drug at the same time as Keytruda comes off patent. So that is the strategic bet from Merck. And they took the whole team, so they don't have an ophthalmology franchise. And so they basically said to David and the team, we want you to deliver these clinical trials, get the drug registered. And then.
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A
So David's the original entrepreneur.
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B
Yeah, yeah, he's the physician.
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A
So you've lost him now. He's on a comeback a fourth time.
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B
Time. You never say never. I think. I think there's a good shot. We did. We didn't think you'd necessarily come back a third time.
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A
No, no, you never say never.
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B
That's very good advice. Phenomenal entrepreneur. And this was an interesting company because we actually set it up as a UK company, even though David is. Is based in New York, because we led manufacturing and operations and finance out of here, because there's a lot we can do that's really good. And we were able to basically build a transatlantic company, taking the best out of each different region and a pretty virtual company.
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A
That's the way you. You run your business. Is it sort of transatlantic, a sort of leg in both places?
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B
Is it? We. We do because we see it from the UK perspective. When, when our companies grow up, it's very helpful to have somebody from the U.S. bringing that U.S. perspective, because fundamentally we're always going to raise money in the States. So we will list our companies on nasdaq and obviously there's much greater sources of funding in the state. So we want our companies to have a view to the US and so my partners can help with that, but equally want it the other way around. Where we can take US companies and bring them to the UK or to Europe to run clinical trials, to partner with different strategics. In the uk, we've got fantastic big data sets, whether it's Biobank, Genomics, England, our future health, we've got data sets that are vastly better than anywhere else in the world. And those are the sorts of things we can help our U.S. company, well, all our companies tap into.
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A
It's good to hear you being so positive about the UK because, you know, it's had a bad couple of years.
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B
I suppose less so in our sector. I mean, I think we.
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A
This is a growth. So for young people listening, this is a good sector to join young people.
- [10:55]
B
Listening, do science degrees, get your heads down, learn something and start businesses. It is a fantastic sector to be in. Can't imagine how I could be in the same job after 30 something years if it wasn't interesting. So if you think about the sort of the macro level, most diseases are not cured. We've got faster rate of scientific innovation than we've ever seen in the world and we've now got an explosion of new tools that allow us to basically interrogate what's going on, including obviously AI. And that is just a fantastic place. So whether or not you're interested in the wet lab, the computational side, the clinical trial side, the commercial side, working with patients, I mean, there is a very broad range of areas for people to get excited about. And then you think about, well, what about prevention and diagnosis and actually just stopping these diseases because we don't want to wait till people are highly symptomatic with cancer or dementia and then you start treating them. We want to stop those diseases from even happening. And maybe not all diseases, but a large portion of diseases are where your immune system isn't working properly. So cancer is an example where your immune system is not picking up the fact you've got these mutant cells floating around and dividing. And so we've got immuno oncology, which is about, how do you provoke your immune system to actually specifically take out those cancer cells? You've got the same with the brain. So the same idea of stimulating your immune system in the brain to again, clear plaques, clear all the stuff out there that shouldn't be there. But, you know, could you do that with vaccination? Could we all be vaccinated in our Middle ages? You know, go into boots at age 40, they take a, they take a blood test, they say, well, you got some circulating tumor, you know, colorectal, and they zap you With a, with a vaccine and you get Alzheimer vaccines. I mean, there'll be lots of exciting things.
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A
Boots would do well if you could do that, wouldn't they?
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B
Well, I think, but so would, so would the taxpayer. Because you, you know, healthcare as it currently is, is becoming increasingly impossible to, to pay for. And you only need to look at America. I mean, our health outcomes in many cases are as good as America and yet they're paying more than twice as much for it. So it's not just spending more money, doesn't, isn't necessarily the solution, it's being smart about it.
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A
You mentioned dementia. I believe you've developed a whole new range of drugs in that space as well, is that right?
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B
Yes, we have two funds, so two classic venture capital funds called the Dementia Discovery Funds, and they are designed to do what it says on the tin, as in new ways of treating different forms of dementia. So at the moment we have two approved drugs which are antibody based drugs. And what they do are clear the plaque. So if you've got amyloid plaque in the brain, they're very good at clearing the plaque and there is a very close genetic correlation between a certain genetic pattern and the likelihood of getting amyloid plaques. The challenge has been that even though these drugs are very good at clearing the plaque, they have a relatively modest effect on cognition. So you're intervening in the disease too late and by that point you've got severe neuronal loss. So this is not, this does not replace, does not renew your neurons. So what we've been looking at is not dissimilar to sort of the cancer playbook, but trying to identify the different paths or the different causes of different types of dementia. So we don't talk about breast cancer anymore. We'll talk about her two positive or triple negative breast cancer. We'll talk about the causes and the drivers of the different diseases. And so therefore there were different kinds of cancer, which we still talk about Alzheimer's. And Alzheimer's obviously is caused by a whole range of different biological mechanisms going wrong, but we haven't really yet teased those out. So we have two funds that are trying to start teasing out some of those different mechanisms for the different types of dementia. So some of them are rare genetic dementias and some of them are more broad. But we're looking at different cell types, different drug types, obviously different targets and mechanisms. I think we've got 13 different clinical trials running right now, so I'm hoping that some will be in time for me and you, that there will see.
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A
So am I listening to this? This sounds very positive.
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B
We'll see some effects. But the fact that there are two drugs approved now is a big step forward because up until then we'd had nothing but failure. So billions and billions of dollars has been spent in this space which has all failed. So the fact that there are two, two drugs now which, which are not approved by NICE here. So they're not available in the UK but are available elsewhere and they're working to an extent. Yeah. I mean it slows down cognitive impairment, but for a short period. And it's not a significant. It's. It's statistically significant, but it's not hugely clinically significant.
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A
Right. So there's masses to do, masses today. So could you just. These are fascinating examples, but could you give me a sort of sense of bringing the science from a university into a business context and building a team? There's quite a lot of interesting components here that don't necessarily sit together normally.
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B
Yeah. So the most recent company we've set up is in precision psychiatry. So of course mental health, severe mental health is still a massive clinical need. Treatment resistant depression, psychosis, schizophrenia and they hit young people. And so we have just set up a business with science coming out of Cardiff and really exciting. It's still in stealth, so you won't. There's no website. It's named in Welsh after the Welsh dragon.
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A
What's that in Welsh? You know, draig dry. Okay, well look out for this.
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B
Yeah. And what done here is backed two key academic founders who had actually spent their life in industry. So one out of Merck Neuroscience and one out of GSK Neuro. Each of Merck and GSK closed down their Neuro divisions and those two came together and carried on doing basically the work they'd been doing in pharma, but in an academic setting being funded by grants. And they worked very closely with one of my venture partners, Ruth McKernan, who is a genius. And they basically. Ruth was talking to them and agreed that actually rather than trying to license out individual assets, they'd be much better setting up a company de novo, putting the different new lead molecules that they'd been developing, of which the most advanced had just gone into the clinic. But they've got a range of different.
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A
Potentially, what will this do, this drug? Potentially.
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B
So this will.
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A
So it sounds like a stable of drugs.
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B
There's a whole bunch. The lead is looking at treatment resistant depression and it will basically improve the cognitive impairment that you otherwise see in long term treatment depression. But that is an example. We have these two fantastic academic founders. The first thing we do is to do the due diligence to make sure we really understand what is the data sets they've got, which are basically lab based tests to understand what is the secret source, what is the innovative science that they've been developing and how does that sit relative to all the other different approaches that are out there from companies, academia, pharma and everything. We look at the IP so the patents and understand have they actually secured protective rights so that we can actually build drugs around these? And then we get to work which is putting together Gantt charts to say, well, what are the key value inflection points that, that will show us that these particular interventions are likely to be safe and effective. What does it cost us to get there? What, you know, how many people do we need? What does an org chart look like? So all the things you do build up. Yeah, build up the C suite, build up the key capabilities. And so there's, you know, they're sitting in our office around the corner so. And we're just closing a big series A round now to run a series of larger clinical trials.
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A
I was thinking the trials is the next stage.
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B
So our companies are loss making R D companies and our assets are clinical data and preclinical data and patents. So that's what we go out and sell. And it's those companies only will become profitable or even revenues once you've got a registered drug.
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A
But that's the years in the making though.
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B
Yeah, probably, you know, 12, 13 years on average. And the bit that makes it hard is 90% of drugs that go into clinical trials will fail. So we've got to be very smart about how we back those companies to make sure you double down on the winners and you don't back the losers for too long. So picking winners, picking winners is critical. And you know, you need to focus on, you know, the lemons ripen before the plum. So you want to kill the lemons quickly and then double down on the plums.
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A
That's an interesting. So, so you might make a start on something and think that's enough. Yeah, yeah.
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B
Oh yeah. So we will, we will as part of our.
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A
So you call them lemons and plums.
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B
Yes. Although we, we don't, we don't tell the companies which category they've been put in.
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A
Well, you might be a plum one minute and eleven the next.
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B
That's the trouble. Well, no, absolutely, absolutely. So but what we do do is have very, very explicit conversations about what are the key data sets which give you confidence that this is an approach that's working. Because ultimately you don't know if it's working until you've done your pivotal studies and you've got a regulator to say, yes, we will approve this. I mean, that's the end game. But you've got plenty of steps along the way. And if you take cancer, for example, the ultimate test is, do you improve survival? Now, you can't do survival tests right at the beginning of a company's life because they take too long. So we have to use what's called biomarkers, so other surrogates of efficacy to give us a sense both of safety as well as efficacy. And so it's those, those milestones that we need to, to achieve, to give us confidence to carry on putting money in.
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A
So 90% of drugs don't succeed at.
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B
Trial and, and those ones, once they're launched, there will be a decent fraction that never return.
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A
Succeed in business.
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B
Yeah.
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A
So this is a tough game.
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B
It is a very tough game, but.
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A
You'Re good at it. We're still in business in the game.
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B
We're still in business, which means we've returned some money to our investors.
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A
So about your approach, your sort of mental approach, do you think that has made you still stay in the game this long? You have to, you're talking Kate Bingham now. What is it?
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B
You, you have to have Teflon skin.
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A
Right.
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B
Because it is, you know, you're going to have a lot of losers. And if, if every investment you make is, is one of your children, it is really difficult. And so getting to a point where clearly we're close to our, you know, if we're building the companies, we're very close to the teams that we're putting together.
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A
Sure.
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B
So being able to have incredibly well understood plans that if you're clearly not going to meet the plan and it's not about you, you know, you've just missed it because we want these companies to succeed. So if it's a matter of a, of a, you know, some extra money or a bit of a pivot, actually, all that is fine. But if fundamentally it's not going to work, we need to make sure that that is not a confrontational process because that's understood from, from the beginning that we are trying to do the same thing. And, you know, we invest personally in our funds so that every investment I make has got my money in it. And we have our management teams and our founders all have equity in the company. So we want them to make money through actually. So we want to be on the same side.
- [23:03]
A
SV Health Investors, you know, was one of the, if not the very first biotech investor in the UK. You've been doing this for 30 years plus. You've broken a lot of records and shown some endurance in the sector, much more than other competing firms, I think it's fair to say. What's the secret to this success? What is it? What makes you different? Why is it that you have been able to sustain that?
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B
Well, I think not being an asshole is helpful. So what really matters, and I don't mean that entirely facetiously, what I mean is working with scientists and entrepreneurs and innovators in a constructive way in a space which is really difficult. So we're going to have failures and we're going to have bumps. And so actually to be constructive and helpful, to find solutions to the different challenges we're going to face actually really matters and to treat people well. So there'll be times when we have to turn the lights off in our companies. You want to make sure that people leave with their head held high, pleased about the experience, not pleased obviously that we've not achieved the drug we were hoping to achieve, but nonetheless recognizing that we've done good work and they don't regret it. And so actually the way we behave as venture capitalists really matters. It's not like Dragon's Den where you're just sort of, you know, negotiating as to who's going to give you the best valuation and the most money. It's much more a long term marriage and making sure you perform well in that marriage is what is our secret.
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A
Not being an asshole is quite good in marriage as well to stress, but that. So yeah, not like Dragon's Den because that is the popular perception of sort of venture capital is sort of, you know, Wheeler dealer. Yeah. And so you're saying the reality is not like that, it's much more long term and it's much more of a relationship that should be positive and engaged.
- [24:54]
B
It has to be because it's such a. We're dealing with very large amounts of money. So we, millions to hundreds of millions of dollars will we will invest in collectively into these companies before we get clinical data to show these drugs are safe and effective. So the stakes are incredibly high and the risks are huge. So there are so many opportunities to fail that we need to be absolutely joined at the hip with our management team. And that doesn't mean that we won't fire people. I mean if they're not performing. And it's clear that they're not a good fit in the organization. Of course we will remove management, but by and large we need to do that in a constructive way so that people realize why we're behaving like that and recognize that and that goes around. This is a small industry and if you behave badly with one company, others will know about it. Because the best, our best new deals are word of mouth where people will say, you know, you've got this great idea, go and talk to Kate.
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A
Yeah, it's so important because all industries in the end are quite small. I mean, people sort of know each other, don't they? And especially these days with networks.
- [26:05]
B
And it's small and international. So it's, yes, it's small here in the uk, but we are also dependent. So my UK companies will still have us academic founders of a, of a UK company. So it's all highly connected. So behave badly once and it'll get around.
- [26:23]
A
Your use of the word failure is interesting. I spoke to my father, Alec Reid, on this podcast a few weeks ago and he was talking about failure just being an indication that you need to find another direction, almost like a signpost. And so with, with these drugs that don't succeed, it's. It's not like that's the end of the road, is it? It's going to have a, let's have a look for the next one.
- [26:44]
B
Or yes, it slightly depends on the company. So it may be that you've developed a new platform that generates lots of different drug candidates, in which case maybe the first or one of the candidates that comes out is toxic or it doesn't actually have the clinical effects, or maybe it does bind in the mechanism that you were planning on targeting, but that actually doesn't affect the disease. I mean, there are lots of reasons why things might fail, but the way we think about investing is you've got to allow for all those different contingencies. And if you come to the end of the road and you've tried everything, you've pivoted, you've looked at new approaches to doing things. If it's still not going to work, then you close up shop, because there's no point continuing to put money into something that you just don't think is going to work.
- [27:34]
A
You don't put good money into after bad. But there's a sense of aggressive trial and error here. You're trying things all the time and failure is a big part of success.
- [27:42]
B
Intelligent failure is part of our business making the same Dumbass mistakes repeatedly is not a good thing to do. But that is the nature of. We are, we are empirical experimentalists in, in what, what our products ultimately are and no one can do this perfectly. That's why we have an industry and that's why we still have disease. And at some point we will get better at it and then we can intervene better.
- [28:06]
A
How can you tell how good a scientist is?
- [28:09]
B
I hire some fantastic scientists in my team.
- [28:12]
A
So you get scientists?
- [28:13]
B
Absolutely. I'm not the one who's going to be judging the.
- [28:16]
A
Because it's, I mean, highly technical, isn't it? So you get other scientists.
- [28:19]
B
Oh, I've got a kick ass team who absolutely know what they're doing.
- [28:22]
A
So hiring the right team less thing everyone is really important.
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B
Yeah, yeah. And, and this is. So there's, there's two types. There's the technical expertise. You need to really not understand the, not just understand the basic academic science of what is the new insight or whatever, but how do you actually turn that into a drug? So the drug discovery skills take some time. I mean that is an important, valuable deep experience we need. And then you've got the venture skills which is all about, well, how do you turn that into a business so that you're not in the lemon category and you make sure that you're back in the plums. And that's an apprenticeship business. So that is one where you know, you, you start in the business but it's, you don't know how good you're going to be for a long time because it takes a long time to build the companies to see whether or not they're going to be financially successful. And so you may be backing some fantastic science, but if you can't make an investment return, your investor's not going to come back and then you're out of, out of business.
- [29:26]
A
Quiet. I can see that it's got to work commercially and scientifically and medically which is a, a unique combination. So Kate, thank you, thank you for that overview of SV Health investors. I mean one of the standout moments of your career has also been the vaccine task force which you chaired in 2020. And I think it's generally seen as a great success, the work you did there. But it was pretty challenging, wasn't it? And you had a tough time sort of from the press at points in time and you've just said you need to be. Yeah, resilient, resilient.
- [30:02]
B
So it was a great challenge actually because I joined in May 2020 and committed to do six months, because we just raised a new fund. So actually that was the core driver for why I didn't want to do longer is because I had to go back and do a day job.
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A
And it's worth saying you joined on a pro bono basis. No one was paying you anything. No, no. I think that's worth stressing, yeah. As a volunteer.
- [30:24]
B
Yeah, yeah. And it was the right thing to do also. And so I was. Everything went well. One of my CEOs called me up, literally the day I was called by the government and said, I think you need a deputy and I think I can be that deputy. And he's called Clive Dix and he's brilliant. And I'd backed him twice as CEO. He used to run research for Glaxo as it was. So he knew everything cold. We knew each other incredibly well. And so I was thrilled and said, absolutely, come and help. And so the way it worked in the Vaccine Task Force is the conditions I set, which I did with Jesse, my husband, which actually were the defining moments of getting that job right, was setting out the basis on which I'd do it. So the first was to report to Boris. So anything political. I'd not done political stuff before, but what you know is that is what politics is. It's people sort of trying to kill each other and take credit. And so actually being able to report.
- [31:28]
A
Boris Johnson you're talking about, he's the.
- [31:29]
B
Prime Minister, he's the boss in 2020. So being able to report to Boris, we thought would help get rid of the sort of political side, which undoubtedly did. It was incredibly helpful. And then the second one was that I got to recruit my own people. Again, incredibly helpful. So what they wanted from me was the expertise in our sector, knowledge of the vaccine companies, and then to work out, just like venture capital does, which are the ones we want to invest in. So being able to recruit my own people was very helpful. Wanted a budget, wanted them to make quick decisions, and then it was a six month term. So setting that out as the criteria on which I would take the role probably was the.
- [32:13]
A
And that was all agreed, was it? That the.
- [32:15]
B
Yeah.
- [32:15]
A
So they said, fine, that's the way we're going to do it.
- [32:17]
B
Yeah.
- [32:18]
A
And then what was the brief? What did Boris say to you?
- [32:20]
B
Boris said to me again, he had the right instinct, which was, we've got people dying every day. We want you to do this as quickly as you can, because speed matters. And so this wasn't about getting into some sort of bureaucratic, making things perfect. But it was get work quickly. We didn't talk about, you know, make sure this is as cheap as possible. We didn't talk about cost at all. Actually, as it turned out, we all roughly paid the same amount. There wasn't any, There wasn't a huge amount difference between what we paid, what the Americans paid, what the Europeans paid. It was all. And the vaccines were cost between sort of three and $30 a shot.
- [33:03]
A
You did achieve the sort of vaccine roll out faster than any other country, didn't you?
- [33:07]
B
Yeah, we, we were the first to get. So my, my job was to procure vaccines for the uk, for the rest of the world, and then to help with planning for, to prepare for the next pandemic. The UK was the first to get the first registered vaccine. And so that wasn't, you know, that wasn't me, that wasn't. That was your.
- [33:26]
A
You and your team.
- [33:27]
B
The team, but also the regulator. So we've got our regulator, our medicines regulators, called mhra, and they are a globally recognized, very brilliant regulator and they, they just pulled a complete blinder. So they basically moved from being, as June Rain calls it, a policeman to an air traffic controller. So basically working collaboratively with the vaccine companies to help them get their vaccines regulated now, to show they've obviously got to show they're safe and effective. But instead of saying, well, give me your data when it's all ready, they were saying, give us the data as you're going along and then we can look at it, we can give you feedback, we can tell you if we need more. And then when you've got the final data sets, we will be ready to go.
- [34:15]
A
I mean, there are people who say some of these vaccines have had negative impacts on people or cause, well, blood clots and heart issues and things. I mean, is that, is there any truth in that?
- [34:25]
B
Yes, of course there's truth in that.
- [34:26]
A
So what's the downside?
- [34:28]
B
I suppose so the challenge is where there are. The world has never done a vaccination campaign of how many billion. I think 11 billion doses of vaccine have been given, or some enormous number. And of course that scale of dosing anything has never been done before. So even though the clinical trials were much larger than have ever been done in any, any time before, and if you have events that are very rare, that, and say the trials were up to 50,000 people, if the event is less frequent than one in every 50,000, you're not going to pick it up in the clinical trials. So you'll only pick that up when you start to deploy. And then the question is, can you then identify who might be getting that, that rare event? And the trouble is, you can't tell that when you're conducting mass vaccinations. We've all got. Everyone will have different genetic backgrounds and different environmental inputs. And so it's very difficult to be able to predict what all the potential harms will be. But I think you have to be open that there could be harms, which is why you focus on those who are most vulnerable. So there's no question that the people who are Vulnerable, the groups 1 through 9, irrespective of blood clots, will have been safer having taken the vaccine than not taking the vaccine, because the consequence of severe disease with COVID is blood clots that are way worse and potential death.
- [36:06]
A
So I think you've written a case study about making difficult decisions, you know, looking at this story, is that right?
- [36:12]
B
I haven't written it.
- [36:13]
A
No, no, there is a case.
- [36:14]
B
HBS wrote it.
- [36:15]
A
And it's a business school.
- [36:16]
B
Yeah. And they wrote a good case.
- [36:18]
A
Yeah. So what, so what were the decision points that you found? Well, you had to really think about that. You know, students at Harvard Business School would be discussing, you know, if they put themselves in your shoes, that what would I do here? It's not a decision making so important in business. You know, good decisions, you're talking about good investment decisions. But here, what were the sort of difficult decisions?
- [36:38]
B
So it's not a classic HBS case, because normally you'll, you'll have your protagonist and then they come to a crossroads and the question is, do they go right or do they go left? And then you debate, you know, which way the main decision that the case focused on is should I take the job? Right. Which is. And interesting hearing, hearing the students talk about it, when they come up with a catalog of reasons why you shouldn't take the job, you kind of think, you know, anybody's there.
- [37:07]
A
Kate.
- [37:08]
B
I'm very pleased. I hadn't heard them talk about it.
- [37:10]
A
All right, okay.
- [37:11]
B
So that was one of them. And then it was more about decision making, sort of in a vacuum. So, you know, we didn't know really what this virus was doing. We didn't know if any of these vaccines were going to work.
- [37:24]
A
How'd you know? With such limited knowledge, it's difficult making. So we have to make decisions with limited knowledge. Also time. But when it's so new and so unknown.
- [37:31]
B
Yes. So what we did is try to put processes in place so that we least had a framework for how we would as and when we had knowledge. For example, you know, we started off with I think nearly 200 potential vaccine candidates. And so as we started whittling them down, we started refining more and more as to what were the criteria for deciding which ones would go into our shortlist to really drill into. And then we would then start thinking about, well, for the manufacturing, what are the different things we need to put in place. So for example, manufacturing in many ways much harder than the clinical trials. The clinical was straightforward because we've done that lots and lots. But manufacturing typically to get to population scale will take years and years. So speeding that up was something that's never really been done. So we had the best experts making great judgments. But even so that was the rate limiting step and so not knowing which vaccines we were going to use. We knew though that some were going to need a cold chain. So that was something we could do. We could say, okay, go out and buy minus 70 degree fridges. We're not sure what we're going to put in it yet, but there's a good shot that some of the vaccines are going to need that cold chain. So that's an example. Then you've got the process of manufacturing the actual vaccine itself and there are lots of different formats that we funded. But then you've actually got to put them in a vial so that somebody, some healthcare professional can then give them the job. And so again, that's another bottleneck. So we bought two years worth of, it's called fill finish. So basically putting the, putting the vaccine into a, into a vial, we didn't know what we were going to put into it, but we knew that having that capability was going to be important. So those are sorts of sort of planning decisions that you can make before you actually know what it is you're going to do because you need to make sure that you've, you've covered all the bases.
- [39:28]
A
Okay, that's interesting. So I'm thinking listening to you, that you know, you're through and through a scientist, business person. But through this process you had to deal with the press and you had to deal with government and public servants, which are people we don't typically deal with.
- [39:42]
B
No.
- [39:43]
A
And, and, and so let's, let's take what each individual turn. So the press, you were given a pretty hard time I think by the Guardian newspaper.
- [39:50]
B
Oh yeah, definitely.
- [39:51]
A
What did they do? And I mean it would upset me, but I remember reading it and thinking that's not fair. They're not being fair about Kate you know, during. At the time.
- [39:59]
B
Yeah. So luckily all of that started in November. So had all of that started right at the beginning of my appointment in May? It may well have derailed the whole thing because.
- [40:11]
A
What were they saying?
- [40:13]
B
They were. No, three things. I'm corrupt, incompetent and a crony. So those were the.
- [40:17]
A
That's what we're calling you.
- [40:18]
B
Those are the.
- [40:19]
A
Those are the corrupting, confident crony.
- [40:20]
B
Yeah, those are the.
- [40:21]
A
Let's put the record straight.
- [40:22]
B
Yeah, exactly. Not corrupt.
- [40:24]
A
No, absolutely.
- [40:25]
B
I think I'm not incompetent. And then the crony aspect is the fact that I'm married to an mp.
- [40:32]
A
So Jesse.
- [40:33]
B
Jesse Norman. Who. Yes. And he was in the treasury at the time, and so he's actually. He was the financial secretary, so he was responsible for the furlough scheme team. And so the idea was that. That I rub shoulders with all these politicians all the time. The only reason I got the job was because of that. Now, the fact that I've never got into politics, I don't know any of them and politics is not my gig. Kind of missed the point. As far as the person, the Guardians.
- [40:59]
A
Have ever said, well, we got that wrong.
- [41:02]
B
No, they.
- [41:03]
A
I'm glad we make a note of it here, because they did get that wrong.
- [41:06]
B
They did. They made. It took months and months for them to make the occasional sort of word correction, but they never took anything down and they've never apologized. But anyway. But now I'm just fine about it. It's just it.
- [41:22]
A
But in hindsight, annoying, isn't it?
- [41:24]
B
I mean, massively annoying.
- [41:25]
A
It would annoy me.
- [41:26]
B
And, and, you know, there were lawsuits, you know, provoked by the Guardian, supporting claims against the government on my appointment. And so, you know, had to. The government had to spend a lot of money defending claims that this was a corrupt appointment, all of this sort of stuff. And actually, having defended it, having defended it, they, they, you know, the claim was dropped, but it's just a complete waste of time. And knowing what I know now, the government's scheme of how they manage the press is basically to give very defined lines. I wasn't allowed to respond to the press, so number 10 and the business department were. Their comms guys would determine what the response was. What I know now, which I wish I knew then, was you can just speak to the journalist off the record and say, these are the facts. You know, don't print stuff that says the opposite because you'll know that's not true. I wasn't allowed to do that because they Said you're not allowed to speak to anybody. But now I know that that's actually how you do it. It's much simpler, I think in politics.
- [42:28]
A
You know, if one side's doing something good, the other side still attacks them.
- [42:31]
B
Yeah.
- [42:32]
A
And vice versa. I think that's a sort of something I find slightly.
- [42:37]
B
Wrong. It's not good at all.
- [42:39]
A
It's just the nature of it.
- [42:40]
B
It is the nature of it. And again, another thing I would have done differently is I was not allowed to brief the opposition. And you know, I'm not doing a political job. And again, in hindsight, I should have laid in the tracks to say no, I need to make sure that anybody needs to know what it is we're doing. We tell them.
- [42:58]
A
And so then you were made a dame, Kate.
- [43:01]
B
Pantomime dame.
- [43:02]
A
Is that what you think it is.
- [43:04]
B
With all the bling?
- [43:05]
A
But you, you got it.
- [43:06]
B
You get an extra badge for being a girl. You get, you get, you get one, one thing that sort of goes on your brooch, on your chest and then you get one for your sash.
- [43:14]
A
Oh, very good. So. But that does show that you were formally recognized by.
- [43:19]
B
Oh yeah.
- [43:19]
A
Society for the work that you do. Did. And yeah, that's good. Congratulations on it.
- [43:25]
B
I feel uber recognized. And, and you know, the team was phenomenal. So that's the bit that's always slightly irksome is, is everyone always focuses on the person who's the sort of the, the lead face when actually, you know, as you know, this is all about having a great team, all of whom work incredibly well, who don't get that same level of recognition. So that's the bit that, that feels less comfortable.
- [43:48]
A
So. So it was for the team.
- [43:50]
B
Absolutely.
- [43:51]
A
Yeah. I think that's really important to stress. You can't do anything on your own. I mean, I find certainly you could.
- [43:56]
B
Be 100 meter runner, you know, that sort of thing.
- [43:58]
A
You may have pretty.
- [43:59]
B
They have coaches and stuff, good shoes and all that.
- [44:03]
A
So what about the, the other side of what we just mentioned? So dealing with officials, public servants. Because there's a very different culture between commerce and.
- [44:13]
B
Yeah.
- [44:13]
A
And government. Anything. I mean, any advice or you would share for people who are doing work across both sort of cultures or communities.
- [44:22]
B
Yeah, so I was again, I was very lucky in, during the vaccine task force because everything we were doing was remote. So I wasn't in that sort of white hole, you know, ecosystem. We had hand picked senior people working from government. Actually all the senior guys had all worked in the private sector as well. So that would be the main recommendation I would make is if you want to be going to civil service, make sure you have some experience outside government so that you understand what it is to actually be at the coal face to deliver something. And it's not just about writing policy papers and being super smart and at economics or whatever it is, but that you actually know whether it's selling something, buying things, building, creating running teams, but, but in a commercial setting, not just in government. So I was, I was frustrated that there was in the business department, there was precious little experience in business and actually reasonable, I mean, hostility may be too strong, but real nervousness about the motives of industry, which again, in the case of vaccines was nuts. We had AstraZeneca doing this for nonprofit, Sanofi doing this nonprofit J and J, gsk, all of these major pharma companies were providing vaccines for nonprofit. And so this sort of suspicion of motives I didn't like at all. That purveys Whitehall generally certainly pervades Department of Health. And so. And then you don't have in civil servants enough scientists. So there's 10% of. Of civil servants have stem degrees. And yet in a highly technological society doesn't make sense to me. So. So I think there needs to be a greater emphasis on actually having the skills that you need to function in this sort of society. So whether or not you're in government or engaging in government, there needs to be a better discussion between the two really, without each side feeling slightly suspicious of the other. So I'm reasonably optimistic that the government's support for life sciences is going to continue because we are a big revenue generator for the, for the UK. AZ is the AstraZeneca is the largest investor of R and D in this country. It's a hugely successful pharma company. GSK is smaller but doing great. So this is an important sector and if we can continue basically doing what we did in vaccines across all of drug discovery and development, the UK could be in a good place.
- [47:02]
A
Well, thinking about the future, one of the things I remember you talking about at the time of the pandemic was that we should prepare for future pandemics and we have the opportunity to build up data. Has that happened? Is that happening? Or are you concerned that there's a.
- [47:15]
B
Sort of void I'm not close enough to it is the first answer. We've clearly got greater manufacturing capacity than we had before. We clearly have a understanding from government that working with industry cooperatively is a good idea, which is positive. And we've got national clinical trial capabilities. So all of that I think is better. What I would like to see more of which I haven't really seen is greater engagement between government and industry on the next generation of new vaccines. Because even though these vaccines were incredibly effective at preventing severe disease and death, they're still not great vaccines. I mean, you still have cold chains, they, they don't prevent transmission, they're not pan coronavirus. I mean, you still have different vaccines according to different strains, bit like flu, they delivered by needles. I mean there's lot, they're very short duration. So again, for the elderly, who are the ones who are most vulnerable, they have to keep being jabbed in order to provoke their immune response. So I would like to see a lot more innovation in that. So that, so that actually getting a vaccine is much more straightforward and much cheaper. So in. During my watch, according to the National Audit Office, it costs more to give the vaccine than it did to buy the vaccine. Now that is an expensive legacy. So we've got to get into a place where you have a patch, a pill or, you know, spray and you take your vaccine that way. Go into boots rather than all these injections.
- [48:48]
A
Yeah, so that's how things should hopefully.
- [48:50]
B
I think so. And that's what I'd like to see for greater resilience in the future.
- [48:55]
A
So one of the, one of the things I wanted to ask you about is about women in science. And there were a lot of women involved in the work around the vaccine, weren't there? Women scientists? And they don't get the sort of credit or the.
- [49:08]
B
Well, some are, well, necessarily. But.
- [49:12]
A
How do we encourage more women to go into science?
- [49:15]
B
I mean, it's very interesting. We women played a huge role in the pandemic. So obviously Sarah Gilbert is well known in terms of having designed the, the AstraZeneca or the Oxford vaccine. We have a regulator during rain that led MHRA and was the first to approve. And she's a physician, Oxford trained physician, public health, regulatory background, completely superb, practical, pragmatic and incredibly thoughtful. So making really good decisions. We had Emily Lawson, who did the rollout, PhD, geneticist, incredibly organized, who came in in November 2020 to basically absolutely take the bull by the horns and figure out how you're going to do the whole national rollout. I mean, work had been done before that, but she then came to spearhead it. Then we had people like Sharon Peacock who did created the database to look at all the different variants. So incredibly important to see how the, how the virus was mutating. So you can figure out whether or not the vaccines were still going to work and what we should be concerned about in terms of, remember the alpha beta gamma omicron variants? So there were lots. And I had women in my team, Divya on the clinical side, Ruth, who used to build submarines. So all our vaccine candidates were all named after submarines, code named after submarines, to disguise them. So we had a lot of important women who played critical roles.
- [50:54]
A
I think you might have a talk coming up on this theme of women in science, is that right?
- [50:59]
B
Yes. I've got a lecture at Imperial College called the Athena Lecture, which is all about women, and I'm going to talk about resilience and challenges and how our experiences leading into the pandemic actually helped the key women leaders in the, in the pandemic actually really respond and do a great job.
- [51:20]
A
So, looking back over your career, both in business and with this task force, what, what qualities have you sort of found most helpful to you? Or, you know, you talk about resilience that you might be encouraging others to try and develop. I suppose, you know, you, you have a position of perspective.
- [51:40]
B
Yeah, so. So my thought is, first of all, find something that you really like because actually it's really easy to get out of bed each morning if, if you're doing something that you know is fundamentally going to make a difference and that you're happy to talk to your mates about at dinner or whatever. So that is, that is one thing that I think is really important. And, you know, it's really hard when you're a young person to know what is it that's going to really excite you, in which case, try lots of things until you find something that you really like. So that for me is the first one. And second thing, and I think it especially matters for this new generation, is do something that you think is really going to make a difference. So we see lots of, of new businesses, obviously in biotech, thinking about new drugs, but also, I mean, with friends and colleagues and outside, you know, new climate initiatives and new energy, new ways of trying to address the challenges we face in the world. I mean, again, I think those are really important things to think about as you're building your career and where you want to go. And then my last one is work hard. You know, you're never going to get anywhere if you don't put the time in and be smart about what you're trying to achieve and do whatever you can to achieve it.
- [53:00]
A
I'm going to ask you a question related to this pink poster behind me, which is what gets you up on a Monday morning. This is from my interview book, my.
- [53:09]
B
Spin class at 7:30. So I find that if you have a massive hard workout, you get an endorphin kick at the beginning of the week that takes you through the rest of the week, the whole week.
- [53:20]
A
I'm going to try that spin class 7:30 Monday. That's a good tip. And my last question from, from my interview book again is, where do you see yourself in 5 years time?
- [53:32]
B
Exactly the same.
- [53:33]
A
Exactly the same.
- [53:34]
B
Yeah. I'm not going anywhere. It's. I don't. I can't get my head around the idea of retirement. I'm not sure what I'd do, so.