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Darwin's Medicine blog

Professor Brian D Smith is an authority on the pharmaceutical industry and works at SDA Bocconi University and Hertfordshire Business School.

Covidian selection

COVID-19 will trigger a spurt of change in the life sciences industry and, perhaps, a brighter future

Although evolution is often used as a synonym for gradual change, not all evolutionary change is slow. We may think about the evolution of complex organisms, like us, over millennia but microbes can evolve over hours and days. And cultural evolution is staggeringly fast. I’m in my 50s and I’m both amazed and delighted by how much our society has evolved, in my adult life, with respect to racism, sexism and other social norms. And since the life sciences industry is ultimately an artefact of our culture then its evolution is cultural, with the implication that it can and does change quickly. This is especially relevant when a major event, like COVID-19, emerges from the environment. Allow me my usual digression into the science before I return to the practical implications.

Perhaps the first law of evolution is the Hardy-Weinburg principle that a population remains stable unless it is disturbed by some selection pressure. So, if we want to understand evolutionary change, we need to understand how the selection pressures are changing. We also need to understand Eliot Sober’s important distinction between selection of interactors (eg organisms or firms) and selection for their replicators (eg genes or organisational routines). In biology, selection pressures change the distribution of genes but in industries they change the distribution of organisational routines, those little subprocesses that drive how we do everything from ordering stationery to executing strategy. Sometimes selection pressures work slowly, sometimes they work quickly. Daniel Lieberman’s excellent book, ‘The Story of the Human Body’ gives, for example, a fascinating description of how the human genome is the result of both slow climate change and fast cultural evolution.

How can evolutionary theory help us to understand, and perhaps anticipate, how COVID-19 will change the industry? Well, let’s think about how it will change the industry’s environment and therefore its selection pressures. Some smaller things seem obvious. For example, our pre-COVID environment was one that took infectious diseases quite lightly. That environment selected for certain routines that we took for granted, such as big meetings with large numbers of people shaking hands and kissing each other’s cheeks in greeting. In that infection-complacent environment, the balance of selection pressures favoured routines such as office working over home working and personal selling over digital channels. Even once the current threat is over, the magnitude of COVID-19 means that blasé world is probably gone forever. While I don’t predict permanent self-isolation, I do expect that firms that don’t change their routines to make significant allowance for infection control concerns will not be able to attract employees, customers or partners. The industry’s routines will shift significantly towards more remote working and less physical contact. As an introverted, stand-offish Englishman, I won’t mind that at all.

But Covidian selection pressures will have a more fundamental effect than fist-bumping and Zoom conferences. The old environment was one that favoured, in the evolutionary sense, healthcare systems with little slack, the politically motivated starvation of the World Health Organization, the severe pruning of the Centers for Disease Control (and its equivalents) and the primacy of talking up the stock market over being open about the threats of disease. Our new, disease-aware environment favours rapid global responses, coordinated by governmental and non-governmental institutions, political openness and the promotion of scientific rigour over spin. Again, it would be naïve to predict a world where governments didn’t try to spend as little as possible and scientific advice was never tempered by political-economic concerns. But the institutions with which the life sciences industry works – governments, regulatory bodies, healthcare systems – will change because the new environment will select for new routines. And if our institutional environment changes, we’ll need to change accordingly. This will be most obvious with respect to infectious diseases but it will have a wider effect too. Remember, for instance, that while the thalidomide tragedy changed our environment and selected for new routines in drug safety, those changes also spread to far greater regulation of manufacturing, marketing and the rest of the industry value chain.

Evolution is a powerful theory to explain things but it is not a good predictive theory because we are dealing with a complex, adaptive system with a behaviour can’t be simply extrapolated. That said, by understanding how COVID-19 changes the environment, we can anticipate how the selection pressures – both small and large – will act on the industry and its institutional framework. This perspective – Generalised Darwinism to give it its academic name – tells us to get used to doing more remote working and spending less time kissing colleagues. More fundamentally, it tells us to anticipate a world where we are less complacent about infectious diseases, the science is taken more seriously, our institutions are better resourced and, who knows, the life sciences industry is more valued. If nothing else, that is a hopeful thought at a time when we all need something to look forward to.

Professor Brian D Smith is an authority on the pharmaceutical industry and works at SDA Bocconi University and Hertfordshire Business School

Article by
Professor Brian D Smith

27th April 2020

From: Healthcare


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