Stem Cell Leadership Summit

Remarks by Prof. Lawrence H. Summers

Boston, MA

October 13, 2006

Thank you very much for those kind words, Brock [Reeve]. Thank you all for being here for something that is profoundly important. Before I say anything else, I want to say something about Doug Melton and David Scadden. People who have more capacity than I to evaluate the details of scientific worth tell me that they are remarkable scientists. What I can tell you from my own observation is that they are remarkable leaders of extraordinary energy, imagination, determination, and courage in what they are pursuing. We and the world are fortunate to have them leading the Harvard Stem Cell Institute.

I first met Doug around five years ago, on about my third day as the president of Harvard. He arrived in my office with an agenda to change the University’s approach to science and suggested, fundamentally, that it had to be scrapped and transformed. He emphasized one thing that day that stayed with me through all my time as president – he insisted that we must empower the brilliant young investigators who were going to see the future – and that is something he is certainly doing at the Stem Cell Institute. One of the most difficult things to do in an academic community is to assure that younger scholars have access to resources, have the leverage, to carry out their visions, because that was where the future was going to come from. He was right then, he continues to be right, and he has been right about almost everything else he has said over the last five years.

I first met David Scadden in a very different way, and in a way that makes this all very real for me. When I was being treated some 22 years ago for a life-threatening condition at the Brigham hospital, David was the Fellow on my case. He was a terrific physician then. After I had recovered to some degree and could handle it, I remember asking him about the science supporting my therapy, and he explained it to me in various ways.

Then I asked him how many years ago those therapies were developed. At that time, he said about 15 years ago, if you lived in Boston, and about 10 years ago, if you lived in most places in the rest of the country. That gave me a very clear and personal sense of the importance of accelerating the progress of biomedical science, and how important a commitment that is for us as a country.

I am not a scientist, but I have spent a certain amount of time over the last five years talking to some of the greatest minds in the biological sciences. As I am not currently constrained by the caution they have to exercise, I will make this prediction: Three of the following four things will happen in the next decade.

- Personalized medicine, based on a patient’s genomic information, will become routine, and will lead to an entirely different approach to the prescription of drugs and other therapeutic agents, including an approach to cancer that is no longer based on the site of the cancer in the body, but is instead based on the biomarker of the cancerous cells.

- Small molecule chemistry will lead to major revolutions in the way in which we prevent cardiovascular disease.

- Approaches based on progress in the life sciences will have had a transformational impact on the energy industry or another major non-biomedical sector of our economy.

- And most relevant for our discussions today, stem cell therapies will be in routine use for cancer, diabetes, or neurological disease. David told me that I needed to stress that that was an “or” between those diseases, rather than an “and”.

If you think about it, and if I am even close to being right, that is quite a revolutionary thing for humanity. One way of considering the stakes in all of this that resonates for an economist like me is hearing the answers given to the following question, which scientists have studied: Which would you prefer, if you could only have one? All the economic progress that has been made in raising standards of living, creating flat-screen TVs, providing bigger houses, providing safer cars, having better highways – all that has taken place since 1950 – but with the standard of medical care we had in 1950, or the living standards we had in 1950 and all the medical progress that we have had since that time?

Most people answer that they would rather have had the medical progress of today, with the 1950 standards of living. If you think about it, for a sector that accounts for much less than 1% of all the money that our economy spends each year – that is, the biomedical research sector – to have as much value for human beings as what comes from all the other growth in the economy is quite a remarkable achievement.

So many of you have heard me say it before, and I will say it again: I am convinced that when the history of our time is written 300 years from now, there will not be a whole lot that anybody will define clearly and link to our quarter century. But I am convinced that the revolution underway in the life sciences will be something important that they will see. Now, that is an enormously positive vision of great potential. It is one that, as I will talk about in more detail in a few minutes, we see in Boston, and we see in the United States. But we are not along in seeing it.

The stakes here are very high: the stakes in where those treatments will come first, as mine came to Boston some time before it came to other places; the stakes in where leadership will come from in a world that looks to leaders; and the stakes in the vast wealth creation that will be associated with all of this progress. So make no mistake, there will be brutal competition. But there is much to take satisfaction in. I will add more about that later.

None of us should lose sight of some things that have been underway for a number of years and are matters of great concern. After a period of major and rapid growth in our nation’s commitment to biomedical research, that growth has stalled. Currently, and for the first time since 1970, the NIH budget, in nominal dollars, is in decline. The average age at which a Ph.D. investigator gets his or her first grant is now 42, up from the mid-thirties a generation ago. Worse still, these trends do not appear to be moving in a positive direction.

At a time when the life sciences are increasingly central to everything, from finding cures to disease, to finding substitutes for petroleum, to understanding the effects of global warming on the ecology, to gaining a better insight into many aspects of human behavior, we see that one-third of high school biology teachers in the United States do not believe in the theory of evolution. When the American people are asked what they think about the theory of evolution, forty percent say it is right, forty percent prefer an alternative Biblical account, and twenty percent say they do not know.

In Japan, ninety-five percent of the population believes in the theory of evolution, and the fraction in every other industrial country is substantially greater than it is in the United States. The President of the United States has contributed to this debate by urging that we discuss evolution and alternative theories on an equal basis, because they are both theories which should be considered in American high schools.

We are right to weigh and to balance and to consider with enormous care all of the equities involved in carrying out research in new areas, to recognize the role of commercial institutions, but also to recognize the very, very great dangers of the market as well as the important ethical and moral considerations that play an important role.

We are right to have that kind of emphasis. But it sometimes seems that every ethical claimant has a major capacity in our discussions, except of course the grandmother who may or may not get to know their grandchild depending on whether a therapy is be found sooner or found later, or the patients who never know what they have at stake in whether research is carried on rapidly or slowly, but whose lives will be shaped by that degree of success.

I can tell you that this idea that there are other priorities so important that government support for research can safely be cut back; that somehow science, and specifically biological science, can be a matter of taste, conviction, and faith, rather than experiment and empirical reason; that the constituency represented by the future, by the goals of the most ambitious investigators, can be as subordinate as it is in the United States today are not the attitudes that are shared around the world.

Around the world, there is a clear recognition of the importance of biological research, and a clear determination to move aggressively forward. The competition is ruthless. That is sometimes not obvious. This is because the competitive dynamics in an area like research, in an area like higher education, or in an area like the provision of medical care are very different than they are in most other areas. If I produce a better tennis racket than any tennis racket that exists right now, I will have a very high market share in tennis rackets within a very small number of years, and I will emerge as a dominant producer of tennis rackets, and the existing leaders will fall by the wayside. That is because if there is a better tennis racket, people will buy a better tennis racket. So it is with most other products.

A research community, a university, is a very different thing. Why do people come to Harvard and to the Harvard-affiliated hospitals? Not, I would suggest, for the Boston weather. Not even, I would suggest, for the quality of our laboratory buildings. Not, I can tell you from experience now as a faculty member, for the high salaries. They come for each other. They come for the colleagues they will have an opportunity to work with. They come for the students they will have an opportunity to teach.

The students come for the faculty from whom they will have an opportunity to learn. New faculty members come because they see all of that. What that means is that when you have a leadership position, inertia will maintain that position for a very long time, no matter how well you do. Think about competition in the hotel industry, and suppose that the main reason people went to a hotel was to meet other people in the lobby. If you were a leading hotel, you would stay a leading hotel for a very long time.

So in an industry such as this one, in a setting such as this one, it is of the utmost importance that we resist complacency; that we are prepared to compete aggressively; and that we not confuse a moment of leadership with enduring competitive strength. That movie has been seen before. Think of the role of some of the great British and European universities had in advancing the sciences a half a century ago, and think of their role in recent decades. In recent years, our national effort has lagged in the important areas of investment in science, in life-sciences, and in competing effectively. But it is my conviction – and has been my conviction – that massive, determined, and focused investments in these areas deliver an inordinately high return.

I believe there is no place better suited to the kind of commitment to stem cell research that is being described today than Boston. I believe there is no institution better positioned to lead such a commitment than Harvard. Why do I say that? For a couple reasons: We start from a base that is unmatched around the world. The NIH has various kinds of lists of the largest grant recipient institutions. Now, there is a certain amount of ambiguity with regards to the composition of those institutions. Some question whether Harvard and Mass General comprise the same institution or are different institutions, for example. There is some question as to what the NIH means with those numbers.

But in at least one way those numbers are frequently presented, all of the five leading institutions in the United States, in terms of receiving NIH money, are located within five miles of where I am standing. If you look at the number of published scientific papers in the biomedical sciences, if you look at the number of citations given to published scientific papers, if you look at the number of award-winning investigators – or any other measure – this area stands out uniquely. Strength begets strength.

There is the old saying, of course, which goes as follows: Add the eleventh farmer to a field that already has ten and he will be less productive than the first ten farmers were. That is what we teach in economics. It is called the law of diminishing returns.

Only in science, it is not actually true. Add the eleventh scientist to a set of other scientists with complementary expertise and she will be more productive the first ten scientists were. In the sciences, strength begets strength. We are in a leadership position. That is the first reason why it is our obligation to do this. The second is that Harvard University and the Harvard allied institutions are enormously fortunate in their resources and in their friends. Everyone who cares about the future of Harvard should think about this.

The extraordinary performance of the university’s endowment over the past few years has generated more than $7 billion above and beyond what any reasonable expectation of returns was. That is more than the total endowment of all but three other universities in the world. We have the resources to invest in a major way. But because even those resources will not be enough, we have a network of people who see the power of what is happening in Boston and whose lives have been touched, whose lives have been transformed by what has happened in one of our major hospitals or what has happened in some part of our great university, who see the power of biomedical research, and see the power of stem cells to change the world. We have remarkable people, remarkable resources, and a platform and an extent to which we are observed that is second to none.

Because, believe me, I have good occasion to know – both in ways that were positive and ways that sometimes were not – Harvard is a city on a hill. People watch what happens here. People emulate what happens here. People are influenced by what happens here. If we are able to show the way in the biomedical sciences over the next two decades, the impact will be felt far beyond what we are able to do here.

If we are able to demonstrate, not with rhetoric and with brochures, but with concrete accomplishment coming out of physical buildings, what happens when scientists with very different perspectives have the opportunities to work in the same laboratory together, the impact will be felt around the world for a very, very long time to come.

So this effort is now strongly underway. But I am convinced that with Dave’s and Doug’s leadership, with all the support they are receiving from the people here and many others in leadership positions at all the great institutions in Boston, that the best days are yet to come.

I am convinced of this, as well: If we choose wisely, Boston and its surrounding area will not be the richest city there has ever been. It will not be the most powerful city there has ever been. It will, however, be, as Florence was five centuries ago, the place that, through the human thought it catalyzed, cast the greatest and brightest light forward through history. Thank you very much.