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What Happens When Medical Affairs Intersects with Politics?

What Happens When Medical Affairs Intersects with Politics?

In any pandemic, political narratives tend to emerge.

Often, these narratives seek to assign blame to political enemies, or to deflect blame from those in power. That’s why the 1918 H1N1 flu was dubbed the “Spanish flu” and why some people have tried to get purchase with “China virus” in response to COVID-19.

Other contexts feed those narratives, as well. Anti-vax conspiracies, for example, present a hurdle in treating COVID-19.

For medical science liaisons, trying to share scientific information during such political currents can feel like shouting into the wind. But that’s become part of the work for medical affairs.

Below, we will explore some tips and strategies MA teams can deploy to ensure medical information cuts through the political noise.

First, though, it’s worth diagnosing the problem at a political level.

The Politicization of Medical and Clinical Information 

In August 2020, President Donald Trump criticized the FDA by dubiously alleging that the organization was dragging its feet on approving a COVID-19 vaccine until after the November 2020 elections, Jill Wechsler reported for Applied Clinical Trials.

“The entire research community acknowledges that sponsors and public health authorities are moving at record speed to test potential vaccines, enabling several sponsors to launch phase III trials for promising products,” Wechsler reported.

The frustration from members of that research community has been clear. In late September 2020, Pfizer CEO Albert Bourla sent out a memo to employees expressing his disappointment at how politicized COVID-19 vaccine development had been in the run-up to the election.

He urged staff not to give into that political pressure but instead to think of “the billions of people, millions of businesses and hundreds of government officials that are depending on us.”

Already, there have been instances of clinical trials being compromised by political narratives. Dr. Jon Giles at Columbia University tells NPR about how he had scheduled a trial in April 2020 to see whether hydroxychloroquine could help prevent COVID-19.

The previous month, however, President Trump had blithely promoted the drug as a potential treatment for COVID-19. Shortly thereafter, the FDA warned consumers not to take the drug without strict medical supervision.

That was enough to put off potential patients for Giles’ trial. “Pretty much everybody said, 'Well that's the drug that's dangerous to your heart,' or, 'I talked to my friends and they said don't take it,' or that 'I saw on TV it's dangerous,'" Giles told NPR.

That’s the power of political narratives. They can sway groups of people on questions of actual science, even before the research has been undertaken.

Meanwhile, researcher and advocate Els Torreele cautions that too few conversations are happening at a political level regarding what a COVID-19 vaccine could or should look like. What is the minimum threshold for efficacy, she asks, and would the vaccine protect against infection or simply mitigate the severity of the disease?

“Unfortunately, these nuances are largely lost in the bidding war for approving the first vaccines, touted as magic bullets that will promptly bring our lives back to normal,” Torreele writes.

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The MSL’s Task: Transparency and Setting Expectations Against This Backdrop

Torreele’s points have not gone unheard in the research community. Right now, pharmaceutical companies are working hard simply to pump the brakes on people's expectations for what having a COVID-19 vaccine would mean.

One recent example: Boston-based Monderna said in early October 2020 that data from its COVID-19 vaccine trial — which has 25,000 enrolled participants — wouldn’t be ready until perhaps December 2020, the Financial Times’ Hannah Kuchler reports.

Certainly, some stakeholders will want to know whether it’s possible to have data before the election. Moderna’s medical science liaisons may have to engage scientific conversations on that basis.

When a vaccine does become available, there will be major public-health questions about handling the suspicions of some members of the public. Anti-vaxxer sentiment plus election-year emotions could make public engagement a real challenge for medical affairs.

"It's going to be hard to convince people to get these vaccines,” Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia, tells MedPage Today. “People generally don't trust the government, they don't trust the government about this virus. It's just not a government you can trust with science."

Cutting Through the Noise: 4 Practical Tips for MSLs

Of course, MSLs have a diverse variety of stakeholders they engage, not only people concerned with political outcomes.

Nevertheless, conversations with healthcare providers, KOLs, patient advocates and the media all happen within this politicized context, so it’s important to be mindful of that.

Here are four ways MSLs can ensure scientific insights — not political red herrings — drive medical decisions.

1. Promote Transparency and Data Sharing

More and more organizations are beginning to embrace data sharing. Still, it’s not yet the norm.

As a result, some medical information remains opaque, and not just to patients who are left to Google symptoms or share experiences in online forums.

Transparency is achieved when the insights derived from clinical research are made freely available. At the organizational level, that does require a strategic plan for authenticating and shepherding data.

The alternative, however, is more confusion and more knowledge gaps for people to prey upon for political goals.

2. Make Data Sharing and Data Collection a Dynamic Process, and Engage Stakeholders Along the Way

Don’t imagine data sharing as a linear process.

Instead, imagine the medical affairs network as an ecosystem that’s evolving in real time. HCPs are collecting and sharing information, as are patient advocates, as are clinical researchers.

The role of an MSL in this network, then, is to facilitate that evolution by making sure insights flow freely. Data collection happens within this network, as does data sharing.

Transparency, listening closely and having empathy for everyone in that ecosystem are the keys to making this model work.

3. Communicate Across Channels With the Same Dynamism

Each stakeholder has their own preferred communication channels, which means an integrated communication approach is necessary to connect individual people, or organizations, with the insights they need.

“Looking beyond simple tactical implementation of brand strategy, an integrated communications approach should be developed from a thorough understanding of your audience (both internal and external) and the role that different communication platforms can play,” writes Alison Washer, group director of client services at Porterhouse Medical.

“... An integrated approach must use an appropriate lexicon for the target audience and employ the most appropriate channels, such as face-to-face communication, digital platforms (something that we’ve all embraced because of COVID-19) and social media.”

4. Make Media Education a Core Component of Your Strategy

The way a story is reported shapes the narrative around it. The better a reporter understands the science behind a story, the more likely it will be that a narrative remains rooted in facts.

The best reporters are committed to the same principle. Jonathan Corum, Sui-Lee Wee and Carl Zimmer at The New York Times, for example, have built an excellent tracker that lets readers visualize each potential COVID-19 vaccine’s stage of development. MSLs at the companies developing these vaccines would want to keep the NYT’s team up to speed on developments as they happen.

Media education is seldom so cut-and-dried, however. Most medical stories require deeper explanation, which is why some companies “[have invested] in fast, snappy online tutorials for generalist health media which are either conducted live in a group setting or pre-recorded as bite-sized modules,” writes Con Franklin, managing director of health communications at Ketchum UK.

“By tailoring this type of exclusive content for journalists, you’ll not only be supplying useful fact-based guidance, but building individual media relationships for the future.”

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When the Science Is Unclear, Political Conjecture Thrives

In May 2020, Ron Waksman, editor-in-chief of the journal Cardiovascular Revascularization Medicine and associate director of the Division of Cardiology at MedStar Heart Institute in Washington, D.C., published an editorial in which he stressed the importance of keeping medicine and politics separate.

Waksman cited the confusion surrounding both remdesivir and hydroxychloroquine, and noted how the voices of medical professionals got drowned out by speculators, “rented pseudo experts” and politicians.

“The truth of the matter is that when the science is weak, false statements, even by respected individuals, play into the hand of the politicians and the media to serve their special interest and add more confusion, anxiety, and polarization,” Waksman wrote.

Four months later, in September 2020, a participant in one of the COVID-19 vaccine trials, a public information specialist named Ian Haydon, published an op-ed in The Washington Post that made a similar request.

“Science does not happen on a fixed schedule,” Haydon wrote. “It takes time to get things right. Interfering with that process for political purposes would not only be dangerous, but it would also be an insult to the tens of thousands of vaccine volunteers like me who have already taken on personal risk on behalf of others.”

Sometimes, getting scientific insights into the public domain can indeed feel like shouting in the wind.

Other times, however, the combined efforts of an entire stakeholder network — from trial participant to specialist HCP to pharmaceutical CEO to the MSLs who connect them — can push back against the political currents that seek to overwhelm true scientific inquiry.

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