Speech: Building back better through innovation

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Speech: 73rd World Health Assembly: UK statement to Committee A

Most people have heard of Thomas Edison. Fewer people, I suspect, have heard of Joseph Swan.

A resident of Sunderland in the north-east of England, Swan made his first prototype of the lightbulb in 1850 although he didnt demonstrate it until almost 30 years later.

Swan is among 21 people who might reasonably have claimed to be the inventor of the lightbulb along with inventors from Belgium, Canada, Russia, Germany and many others.

But Edison gets all the credit. And in so many ways, its justified. Because he understood that the product the lightbulb was simply the first step. Its innovation that allows it to take off.

And at the heart of innovation is iteration. Edison used some 6,000 different materials, before eventually settling on Japanese bamboo fibres for his filament.

Innovation is very rarely about that eureka moment where everything just clicks into place.

Its a collective process of gradual and incremental improvement.

Much has changed in the 150 years since Edison and Swan.

Were now on the cusp of a fourth industrial revolution one that builds on our digital revolution, blurring the lines between the physical, the digital and the biological.

And few things reflect the spirit of this new age better than our life sciences sector which sits at the intersection of all 3.

But what hasnt changed for centuries is the role of iteration in innovation.

Im passionate about innovation. Not simply because I am, quite literally, the Minister for Innovation.

Its a personality trait. I am an optimist. For others the drabness of today for me the sunlit uplands of the future.

In my previous life, before becoming a Minister of Innovation, I ran the Ministry of Sound, a start-up before the words start-up were even invented.

We rode the tiger of the first great internet bubble of the 1990s, powered by the sound of house music. We had a great data business before Facebook and GDPR had been invented. NatWest told us we cleared the first online retail purchase in the country. And we were live to the global internet directly from the club each weekend, pioneers of internet broadcasting.

But what I experienced, here and in the United States, is that the businesses that really took off were the ones that could change direction on a dime.

When we launched our first album, it was enough to stick the famous portcullis club logo on the front cover to top the charts. There were loads of clubs Cream, Gatecrasher, Renaissance, even School Disco had an album. So the battle was for the big-name DJs Pete Tong, Carl Cox, Sasha and Digweed. They soon oversold themselves, and the competition came for tracks. And so it went on. The Ministry of Sound thrived because we were ahead of each consumer twist.

Iteration is the difference between your start-up succeeding or stumbling.

Clinical trials are no exception to this.

The Silicon Valley mantra fail fast, fail often, fail forward applies here too.

Its something my friend, the science and economics writer Matt Ridley, sets out in his fantastic book, How Innovation Works, where he argues in defence of incremental, iterative processes, noting that the Wright brothers succeeded because they didnt expect to build a flying machine at the first attempt.

But as well as the power of iteration in innovation, he argues that, for people like me in government, its the barriers to entry we have to watch out for.

Its my personal mission to ensure you have the right conditions to iterate, to innovate and, ultimately, to succeed and that means taking a hard look at those barriers to entry.

And, for me, a key part of that is to help you make clinical trials cheaper, faster and more accessible.

Clinical trials plus COVID

In normal times, this would be a challenging mission. But it feels especially challenging now, as we are still grappling with the biggest public health emergency in a generation and its impact on our life sciences sector something I wont shy away from.

There have, of course, been some amazing victories.

The pandemic has shown, beyond measure, the value of robust clinical trials, identifying vaccines, therapeutics and diagnostics that work and, crucially, ruling out the ones that dont.

Like the UKs RECOVERY trial, the largest of its kind anywhere in the world, with over 38,000 participants, which revealed the life-saving benefits of Dexamethasone something that has gone on to save countless lives, here and around the world.

Or the REMAP-CAP study, for which the UK has recruited 60% of trial patients globally, a study that showed how drugs ordinarily used for arthritis can also increase survival from COVID-19.

These are great achievements.

But theres no getting around the fact that the pressure on our health and care system this past year has been immense, with real consequences for non-COVID studies. Weve seen research programmes put on pause or even cancelled.

There are therapeutics that would have been developed in 2021 that simply havent materialised because of the pandemic.

Theres no question weve lost something and I share in that profound sense of loss.

So the question for people like me indeed, for people like all of us here is how do we catch up?

I want us to be able to look back in 5 years time and say we made up the ground.

Build back better

The first natural step is to restart what weve stopped.

Our Restart Framework that weve built with the NIHR has supported the recruitment of over 230,000 participants in non-urgent public health studies since last April.

It is heartening to see that 76% of paused commercial studies have now reopened.

We know the challenges facing these studies continue to be great, and we are exploring strategies to better enable the full recovery of our non-urgent public health studies.

And now, with the success of our vaccine roll-out, and our roadmap out of lockdown, the sector can realistically look to the future.

But that future cannot simply be business as usual.

So our second step must be bigger and bolder.

The only way we can truly hope to catch up is to take a totally new approach, by reducing the barriers to entry, dramatically increasing the velocity of innovation in the sector, and building back better.

Not only will this help us catch up, but it can also help us tackle some of those seemingly intractable challenges, like treatments for Alzheimers and dementia that have eluded us for so long.

And, for me, there are 3 ways we can do that.

1. Making trials more accessible

First, by making trials more accessible. Fundamentally, we have to centre our studies around patients.

Like the RELIEVE IBS-D study, which used new tech and virtual trial designs to enable rapid recruitment and safe participation from home.

At a single NIHR site in Newcastle, for example, where they used a virtual approach, recruitment was 67% faster, compared to the 28 sites using a traditional approach.

Clearly thats the way forward.

We can also make trials more accessible if we continue to embed research within the NHS and local care pathways, so research and trials are not a burden but an essential pillar of effective patient care.

And Im delighted our 5 NIHR national patient recruitment centres are already making it quicker and easier for life science companies to deliver late-phase clinical research at scale and at pace through the NHS.

2. Internationally competitive and collaborative

Second, we need to be both internationally competitive and collaborative.

Now, that might sound like a contradiction in terms, but heres what I mean by that:

We can be more competitive, by using our newfound regulatory freedom, now weve left the EU, to embrace new opportunities something weve seen so brilliantly through the pandemic as our regulatory system has got innovative trials off the ground in record time.

I want us to attract more research to these shores and get more UK patients to the front of the queue for new treatments.

But equally, we have to stay collaborative.

Just imagine what Edison could have achieved if he worked with the other 20 people around the world who were also developing light bulbs!

While there are many successful trials, not enough are set up in a way that can benefit the whole world.

Its frustrating when the clinical trials in different countries arent recognised, because data and insights cant be properly integrated across national boundaries.

We need to be more co-ordinated about how our trials are set up.

And we know thats possible.

For example, at the start of the pandemic, there were no international assay standards for vaccines.

It made it harder to compare results from vaccine trials and meant that work was sometimes duplicated or worse, unusable.

One of the reasons the UK was the first country in the world to vaccinate is because our regulator worked so hard to overcome some of these challenges.

We must continue to strengthen the frameworks that underpin clinical trials, with shared standards, so the creation and delivery of clinical trials can be as seamless as possible arou



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