#346 - Scaling biotech and improving global health: lessons from an extraordinary career in medicine | Susan Desmond-Hellmann, M.D., M.P.H.

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Susan Desmond-Hellmann is a physician and scientist whose remarkable career has spanned clinical medicine, oncology, biotech innovation, and global health leadership. In this episode, Susan shares insights from her journey training in internal medicine during the early AIDS crisis, treating HIV-related cancers in Uganda, and developing groundbreaking cancer therapies like Herceptin and Avastin. She reflects on her leadership roles at UCSF and the Bill and Melinda Gates Foundation, offering lessons on guiding large-scale health initiatives, navigating uncertainty, and fostering scientific innovation. The conversation explores the promise of precision medicine, the integration of patient care and policy, and the evolving role of artificial intelligence in transforming diagnostics, drug development, and global access to care.

We discuss:

• Susan’s medical training, the start of the AIDS epidemic, and the transformative experiences that shaped her career [3:00];
• Susan’s experience working on the frontlines of the HIV/AIDS crisis in Uganda [12:30];
• Susan’s time working in general oncology and her transition to biotech where she helped develop taxol—a top-selling cancer drug [26:30];
• Genentech’s origins, and its groundbreaking use of recombinant DNA to develop biologic drugs [33:45];
• Susan’s move to Genentech, and her pivotal role in the development and success of Herceptin as a groundbreaking therapy in targeted oncology [44:00];
• The rise of antibody-based cancer therapies: the development of Rituxan and Avastin [52:15];
• The step-by-step drug development process and the scientific and strategic challenges involved [1:01:30];
• The ethical and economic controversy surrounding Avastin’s high cost and limited survival benefit [1:12:30];
• Susan’s tenure as chancellor at UCSF: leading during a financially strained period, and her strategic approach to fundraising and institutional development [1:14:45];
• What Susan learned as CEO of the Bill and Melinda Gates Foundation: strategic processes and decision-making frameworks [1:26:00];
• Susan’s philosophy of leadership and how she sought to build an empowering, values-driven culture at the Gates Foundation [1:35:15];
• The erosion of public trust in science during COVID, the communication failures around controversial treatments like ivermectin, and the need for better public health engagement and transparency [1:39:30];
• The role of AI in transforming medicine: from drug development to cancer detection and beyond [1:53:00]; and
• More.

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