رونوشت کامل The Target

Indeed, it's flying, Shanoor. 00:02:52.139 --> 00:02:54.860 And good to have the pool of our regular listeners 00:02:54.860 --> 00:02:58.099 growing. Hello to all of you. In our first series 00:02:58.099 --> 00:03:01.900 in June, The Rise and Rise of Elderly, we briefly 00:03:01.900 --> 00:03:05.039 touched upon biopharmaceuticals in the episode 00:03:05.039 --> 00:03:09.090 titled, The Biopharma Balancing Act. This episode 00:03:09.090 --> 00:03:13.650 is available on ideas .org .es. But we will take 00:03:13.650 --> 00:03:16.530 a deep dive on this topic today, in our first 00:03:16.530 --> 00:03:20.930 episode of the Molecular Pipeline. Later in the 00:03:20.930 --> 00:03:23.930 show, we hear the dispatch by Dr. Bilal Zafar, 00:03:24.330 --> 00:03:26.669 a practicing physician and friend of the show. 00:03:27.689 --> 00:03:30.289 This is a segment in which we send him a question 00:03:30.289 --> 00:03:33.810 and he answers through a recorded audio. So stay 00:03:33.810 --> 00:03:36.889 tuned to hear from an expert on how to differentiate 00:03:36.889 --> 00:03:40.629 between ordinary tiredness and occupational fatigue. 00:03:41.810 --> 00:03:44.710 Shenor, the dialogue between a Himalayan lion 00:03:44.710 --> 00:03:48.330 and the biochemist is quite rare, and what you 00:03:48.330 --> 00:03:51.650 narrated earlier is extraordinary, especially 00:03:51.650 --> 00:03:54.569 that this conversation is happening within the 00:03:54.569 --> 00:03:58.110 lion's own territory. I'm super curious now. 00:03:59.560 --> 00:04:01.400 You'd be listening to a rare dialogue, Erin. 00:04:01.680 --> 00:04:04.979 That's for sure. The biochemist explains what 00:04:04.979 --> 00:04:08.650 he has learned. At the earliest stage, the search 00:04:08.650 --> 00:04:12.860 for a target? The science is brutal. A target 00:04:12.860 --> 00:04:16.810 is a lock in the body, usually a protein. Some 00:04:16.810 --> 00:04:20.589 locks are enzymes. Some are receptors. Some are 00:04:20.589 --> 00:04:25.180 genes. The key must match the lock, or the body 00:04:25.180 --> 00:04:29.069 pays the price. Plants and fungi evolved their 00:04:29.069 --> 00:04:32.879 chemistry to survive. That chemistry sometimes 00:04:32.879 --> 00:04:35.199 fits human locks better than anything designed 00:04:35.199 --> 00:04:38.870 from scratch. But the lock must be chosen first. 00:04:39.350 --> 00:04:43.379 And choosing is excluding. The targets that get 00:04:43.379 --> 00:04:46.449 studied are the ones someone can afford to study. 00:04:46.730 --> 00:04:49.230 Rare diseases in poor countries wait longest. 00:04:50.800 --> 00:04:53.199 I have sent 90 molecules towards the clinic, 00:04:53.540 --> 00:04:58.660 the biochemist says. Nine reached it. Preclinical 00:04:58.660 --> 00:05:03.459 means before humans. Cells, animals, simulations. 00:05:04.769 --> 00:05:08.500 Most molecules die there. The industry calls 00:05:08.500 --> 00:05:13.899 it the valley of death. The lion listens. And 00:05:13.899 --> 00:05:18.779 the ones you make in the lab? Synthetic biochemicals, 00:05:18.920 --> 00:05:22.660 gene therapies, monoclonal antibodies. The failure 00:05:22.660 --> 00:05:26.220 rates remain high. Phase 2 is the graveyard. 00:05:27.529 --> 00:05:30.410 The model was wrong. The animal did not predict 00:05:30.410 --> 00:05:35.310 the human. The lion looks towards the road. And 00:05:35.310 --> 00:05:39.550 the smaller labs? The pipeline rewards scale. 00:05:40.550 --> 00:05:42.569 If you cannot afford the failure, you cannot 00:05:42.569 --> 00:05:45.699 afford the cure. Even when we find something. 00:05:46.029 --> 00:05:49.850 The patents close behind us. Patent analysts 00:05:49.850 --> 00:05:52.310 report that biologic drugs average more than 00:05:52.310 --> 00:05:56.180 20 patents each. Some carry walls of over 100. 00:05:57.379 --> 00:05:59.720 Small labs cannot litigate their way through 00:05:59.720 --> 00:06:04.170 that. And the biosimilars? The copies that should 00:06:04.170 --> 00:06:07.430 widen access face hurdles the originators never 00:06:07.430 --> 00:06:13.189 did. Biologics are biology. Cells, proteins, 00:06:14.110 --> 00:06:18.699 antibodies. Small molecules are chemistry. The 00:06:18.699 --> 00:06:21.540 pipeline treats them differently and the rules 00:06:21.540 --> 00:06:26.230 are harder for the second kind. And the regulators? 00:06:27.810 --> 00:06:30.029 The biochemist pulls a four -lit page from his 00:06:30.029 --> 00:06:35.139 bag and clears his throat. They move at different 00:06:35.139 --> 00:06:39.170 speeds. Regulators report that the Food and Drug 00:06:39.170 --> 00:06:42.389 Administration or FDA's median review is about 00:06:42.389 --> 00:06:47.959 300 days. The European Medicines Agency or EMAs 00:06:47.959 --> 00:06:52.810 is over 400. China's approval lag for drugs already 00:06:52.810 --> 00:06:55.290 cleared by the FDA in the United States fell 00:06:55.290 --> 00:07:00.069 from nearly 1700 days to 600. But it still lags 00:07:00.069 --> 00:07:03.589 behind Japan and Europe. A drug approved in one 00:07:03.589 --> 00:07:07.670 country may take years to reach another. So the 00:07:07.670 --> 00:07:10.709 pipeline is not one pipeline, the biochemist 00:07:10.709 --> 00:07:16.129 explains. It is many. With different gates. Different 00:07:16.129 --> 00:07:21.259 guards. Different speeds. The line nods slowly. 00:07:21.970 --> 00:07:24.410 And we're not the ones who choose which gate 00:07:24.410 --> 00:07:29.550 opens." The lion hears the vehicles. He remembers 00:07:29.550 --> 00:07:33.269 a plant the old healers used for pain. One he 00:07:33.269 --> 00:07:36.689 once saw made into rope and cloth, carried across 00:07:36.689 --> 00:07:41.230 valleys, even rigged to sails on ships. He hasn't 00:07:41.230 --> 00:07:43.910 seen it in that abundance for decades and wonders 00:07:43.910 --> 00:07:48.519 quietly why. The biochemist once told him that 00:07:48.519 --> 00:07:50.720 natural

products have been the inspiration for 00:07:50.720 --> 00:07:54.540 over half of approved anti -cancer. anti -infective, 00:07:54.920 --> 00:07:59.839 and anti -diabetic drugs. But the forest is thinning, 00:08:00.120 --> 00:08:03.680 and the ocean is emptying. The biochemist's bag 00:08:03.680 --> 00:08:07.399 holds fewer specimens each year. The population 00:08:07.399 --> 00:08:12.360 grows, the lion says. The diseases change, the 00:08:12.360 --> 00:08:15.180 burden increases, and your discoveries slow. 00:08:15.939 --> 00:08:19.180 That is the paradox. We need nature more than 00:08:19.180 --> 00:08:22.139 ever, but we are destroying it faster than we 00:08:22.139 --> 00:08:26.089 can study it. The lion sniffs the diesel -laced 00:08:26.089 --> 00:08:30.810 air. Your species chose speed. Now the diseases 00:08:30.810 --> 00:08:34.419 travel faster than the cures. The biochemist 00:08:34.419 --> 00:08:37.950 does not argue. He thinks of a child in his village, 00:08:38.669 --> 00:08:42.409 a fever that a local root once treated, now waiting 00:08:42.409 --> 00:08:45.820 for a foreign drug that may never arrive. The 00:08:45.820 --> 00:08:50.240 plant is gone. The knowledge is fading. Dependence 00:08:50.240 --> 00:08:54.330 is a kind of erasure. The Himalayan lion rises. 00:08:55.509 --> 00:08:59.940 Then we agree. Prevention, not just treatment. 00:09:01.179 --> 00:09:04.279 If the planet sickens, the target is not only 00:09:04.279 --> 00:09:07.480 the molecule, it is the world that makes us sick. 00:09:08.309 --> 00:09:13.429 You in your lab, me in my kingdom. The biochemist 00:09:13.429 --> 00:09:18.629 looks at his bag. Planetary prevention. The molecule 00:09:18.629 --> 00:09:22.350 is only the beginning. Then the testing. The 00:09:22.350 --> 00:09:27.490 cells. The animals. The stand -ins. The lion 00:09:27.490 --> 00:09:32.200 growls softly. The target, he understands now. 00:09:33.080 --> 00:09:36.419 The target is never just a molecule. It's a decision. 00:09:37.450 --> 00:09:41.090 What to study? What to protect? What to leave 00:09:41.090 --> 00:09:45.730 behind? The forest was the first pharmacy. Do 00:09:45.730 --> 00:09:49.080 not let it become the last memory. The biochemist 00:09:49.080 --> 00:09:54.529 pulls a leaf from his bag. Small, green, still 00:09:54.529 --> 00:09:58.360 fragrant. You do not need a lab to protect the 00:09:58.360 --> 00:10:02.049 locks in your body, the lion says. Walk where 00:10:02.049 --> 00:10:06.299 the air is clean. Eat what grows nearby. Sleep 00:10:06.299 --> 00:10:10.299 when the dark comes. And maintain all of it as 00:10:10.299 --> 00:10:15.289 much as possible. The biochemist smiles. Small. 00:10:16.110 --> 00:10:23.899 Repeated. Local. Yes. Next week, we see guinea 00:10:23.899 --> 00:10:27.820 pigs approaching the pipeline. Shenor, please 00:10:27.820 --> 00:10:30.659 let me know if I can help either the lion or 00:10:30.659 --> 00:10:34.759 the biochemist. Sure, Aaron. I hope our listeners 00:10:34.759 --> 00:10:36.700 will be interested in helping them too because 00:10:36.700 --> 00:10:40.940 they both need it. And now it's time to hear 00:10:40.940 --> 00:10:44.500 the dispatch by Dr. Bilal Zafar. This is a segment 00:10:44.500 --> 00:10:47.340 in which he answers our question coming from 00:10:47.340 --> 00:10:51.000 last month's series. And because we toured the 00:10:51.000 --> 00:10:53.639 cognitive factory throughout last month, we asked 00:10:53.639 --> 00:10:56.809 the doctor. How does a clinician tell the difference 00:10:56.809 --> 00:10:59.850 between ordinary tiredness and something that 00:10:59.850 --> 00:11:03.090 needs clinical attention? What signs should a 00:11:03.090 --> 00:11:06.350 worker take seriously? Let's play the recording. 00:11:15.460 --> 00:11:18.600 I'm traveling right now. So Shanur, I think you 00:11:18.600 --> 00:11:21.000 may have raised a very valid point when you spoke 00:11:21.000 --> 00:11:23.440 about fatigue. Now, I think it's important to 00:11:23.440 --> 00:11:25.360 know when fatigue matters and when it doesn't 00:11:25.360 --> 00:11:27.840 matter. So we're just going to speak about some 00:11:27.840 --> 00:11:29.980 of the different population groups that can be 00:11:29.980 --> 00:11:33.629 at risk with this. So first of all, we're going 00:11:33.629 --> 00:11:36.730 to talk about our friends on the road. Now, this 00:11:36.730 --> 00:11:39.809 includes long distance truckers or everyday delivery 00:11:39.809 --> 00:11:43.460 drivers, couriers. When you're on the road, you're 00:11:43.460 --> 00:11:45.899 connected to your phone, you're taking orders, 00:11:46.440 --> 00:11:49.460 you have to be aware of your surrounding. Now 00:11:49.460 --> 00:11:53.159 all of that is very tiring in itself. All that 00:11:53.159 --> 00:11:55.580 fatigue and everything builds up can lead to 00:11:55.580 --> 00:11:58.179 a fatigue in decision making. It's essential 00:11:58.179 --> 00:12:00.539 to improve working conditions and it's essential 00:12:00.539 --> 00:12:03.899 to take breaks at intervals. Delivery drivers, 00:12:04.200 --> 00:12:07.019 truckers, anyone who's spending time on the road, 00:12:07.360 --> 00:12:10.250 they really have to take breaks. So now we're 00:12:10.250 --> 00:12:12.990 going to talk about all our workers who basically 00:12:12.990 --> 00:12:15.870 spend time in front of computer screens, long 00:12:15.870 --> 00:12:19.269 periods of time. It causes eye fatigue and that 00:12:19.269 --> 00:12:22.549 further on causes headaches. Now those headaches, 00:12:22.629 --> 00:12:25.070 they affect your overall ability to function 00:12:25.070 --> 00:12:28.049 and all of that is directly related to eye strain. 00:12:28.350 --> 00:12:30.370 You need to take breaks at regular intervals 00:12:30.370 --> 00:12:34.950 especially during these long shifts. And now 00:12:34.950 --> 00:12:37.250 we're going to talk about all those who need 00:12:37.250 --> 00:12:41.309 to be

aware. of cognitive fatigue. And these 00:12:41.309 --> 00:12:44.269 are all the decision makers. They can be CEOs, 00:12:45.049 --> 00:12:47.610 they can be team leaders on the floor, senior 00:12:47.610 --> 00:12:50.649 doctors, anyone in senior positions, basically 00:12:50.649 --> 00:12:53.629 looking after your team and working in high stress 00:12:53.629 --> 00:12:56.730 situations. Now all of this high stress job, 00:12:56.950 --> 00:13:01.169 this all increases your risk of strokes, of high 00:13:01.169 --> 00:13:04.289 blood pressure, of diabetes, and it also has 00:13:04.289 --> 00:13:07.659 effects on... cognitive decline that's when you 00:13:07.659 --> 00:13:10.720 start getting slower with age so you all need 00:13:10.720 --> 00:13:13.139 to be getting your checkups done regularly you 00:13:13.139 --> 00:13:15.120 need to make sure your biochemical markers are 00:13:15.120 --> 00:13:18.139 all normal but you've also got to realize that 00:13:18.139 --> 00:13:19.919 all the time you're supposed to be asleep in 00:13:19.919 --> 00:13:22.220 bed that's the time when your body recovers and 00:13:22.220 --> 00:13:24.120 you're not getting that time for recovery so 00:13:24.120 --> 00:13:26.679 you have to take out your time and make sure 00:13:26.679 --> 00:13:28.740 you're getting that rest you've got to pay your 00:13:28.740 --> 00:13:32.179 sleep debt and that's it for the dispatch this 00:13:32.179 --> 00:13:35.629 month that's me Bilal With all the crickets all 00:13:35.629 --> 00:13:38.570 around me, I hope you're all doing well and have 00:13:38.570 --> 00:13:41.750 a good day. Thank you, Dr. Bilal. Our listeners 00:13:41.750 --> 00:13:44.570 can also participate in this segment. All they 00:13:44.570 --> 00:13:46.929 have to do is send their questions by email. 00:13:47.490 --> 00:13:50.389 But we clarify that this segment does not replace 00:13:50.389 --> 00:13:54.370 a physician's consultation. That's all for today. 00:13:54.629 --> 00:13:57.250 And until next week, I'm Erin Rogers signing 00:13:57.250 --> 00:14:04.080 off. Technical support for this show is provided 00:14:04.080 --> 00:14:07.039 by Vahab Shahid. Podcast logo, theme music, creative 00:14:07.039 --> 00:14:09.500 and production advice is given by Imran Babur. 00:14:09.720 --> 00:14:12.659 Aaron Rodgers is our editorial associate. Population 00:14:12.659 --> 00:14:14.879 Health Weekly is led by its listeners and they 00:14:14.879 --> 00:14:17.100 are invited to participate in any competent way 00:14:17.100 --> 00:14:20.460 they can. If interested, email us at info at 00:14:20.460 --> 00:14:26.570 ideas .org .es info at ideas .org .es Subscribe 00:14:26.570 --> 00:14:28.929 to our YouTube channel, Population Health Weekly, 00:14:29.509 --> 00:14:31.830 where you can also post your thoughts, comments, 00:14:32.169 --> 00:14:35.230 and imaginations. You can also subscribe to our 00:14:35.230 --> 00:14:38.590 monthly newsletter on our website, ideas .org 00:14:38.590 --> 00:14:42.289 .es. It's free. You can also donate to us through 00:14:42.289 --> 00:14:47.450 ideas .org .es and the hosting platform rss .com. 00:14:48.049 --> 00:14:50.470 All contributions will be dedicated to improving 00:14:50.470 --> 00:14:53.470 the quality of this show. The transcript of the 00:14:53.470 --> 00:14:55.870 show will be available as soon as it's posted 00:14:55.870 --> 00:15:00.210 via rss .com. If Population Health Weekly sounded 00:15:00.210 --> 00:15:03.570 interesting to you, then spread the word. Special 00:15:03.570 --> 00:15:05.970 thanks to Junta de Andalucía and Gobierno de 00:15:05.970 --> 00:15:09.470 España for their support to Autónomos that make 00:15:09.470 --> 00:15:10.789 this production possible.