Fly on the Wall: The human side of health research

At first blush, biomedical science and cultural studies couldn’t be more different; however, Matthew Miller, an associate professor in McMaster’s Department of Biochemistry and Biomedical Sciences, and Chandrima Chakraborty, a professor in the Department of English & Cultural Studies, say that the fields are in some ways two sides of the same coin.

Indeed, Miller and Chakraborty agree that both fields play an equal role in keeping our communities safe — bioscience generates critical health innovations, and cultural experts help ensure those innovations are better trusted, accepted, and used by society.

Developing novel health solutions and building trust at the community level are both core mandates for McMaster’s Global Nexus, where Miller is executive director and Chakraborty is an executive committee member. Miller and Chakraborty sat down to discuss how Global Nexus is fostering collaborative work efforts to bring new health products to market while also addressing gaps in efficiency, access, and equity.

Start by sharing a bit about Global Nexus and its mandates.

Miller: Global Nexus is attempting to re-think the way that the university works with partners from outside the university in order to transform health. We’re focused on translating innovation into real-world impact. A lot of what stifles impact is a lack of coordination with other sectors — with groups like government, where our regulatory bodies are housed; or public health, who are responsible for policy and implementation; and with industry, which is the motor that drives the commercialization of new drugs, devices, and vaccines.

In addition to bringing those groups together to help academics more effectively translate their research, the other thing that we want to do is serve as a better receptor for those outside groups to use academia as a resource. We think about innovation as something that starts in the lab and that we move out into the world, but we are home to immense brain trust in various subjects and we also have unparalleled access to state-of-the-art resources, and so we want to have community partners, or industry partners, or government come to us with challenges that they have and that we can help them solve in a more effective way.

One of the initiatives Global Nexus is currently undertaking is advancing equitable and inclusive vaccine science. Can you explain some of the issues around equity when it comes to vaccines?

Chakraborty: With COVID-19, we were able to push out vaccines, and we know that vaccines can play an enormous role in terms of lowering or alleviating the burden of disease. But, at the same time, we also know that these vaccines were not equitably distributed, there wasn’t access globally, and there were all kinds of barriers that stopped people from accessing vaccines. Wherever COVID-19 had time to linger, new variants developed and affected people all around. So, questions around vaccine equity are in our self-interest — in everybody’s self-interest! It’s not about philanthropy. It’s not about kindness. The dictum should be that we are only safe if everyone is safe.

The other thing I would say is that, even where populations had access to vaccines, like Canada, there were particular groups who were very resistant to those vaccines. This means we also have to understand why people are resistant, and one of the reasons, of course, is that they — Black and Indigenous communities, in particular — have a very difficult and long relationship to science. There is a long history of healthcare inequities written into vaccine and healthcare practices. We have to take into account, for both global issues as well as local issues, what are the histories? What are the relationships with health that people have ingrained in them as members of particular religious groups or racial groups that prevent them from trusting something that is going to benefit them?

Miller: Yeah, and as someone who does a lot of science communication, I have learned that I’m not always going to be the right person to communicate things to certain communities. I think that really underscores why having diverse voices engaged in all aspects of vaccine research — from development through to implementation — is so important. People from different communities bring a lens that those of us who haven’t experienced those historical inequities can’t possibly bring to the field.

The recently announced Pfizer Fellowship Program, which you were both involved in, seems like a good step toward addressing some of these issues. 

Miller: One thing that I was really excited about with the Pfizer Program is that it addresses what I see as two major gaps. With the Pfizer gift, we were able to — at the same time — support the representation of individuals from underrepresented groups in vaccinology, while also supporting science focused on addressing vaccination issues that are specific to vulnerable populations. Sometimes, the easy or obvious thing to do is focus on the representation piece, which is critically important; but then we don’t always close the circle and ensure that our research missions actually address these issues too.

Chakraborty: I completely agree. This is an amazing initiative that writes equity into research, into innovation, and into manufacturing so that you are training and mentoring a new group of scholars who can go into different communities and find out what the gaps are. You don’t need to rebuild trust if trust is written into vaccine research.

Global Nexus has two Humanities professors on its executive committee. Why is it important to have Humanities researchers working alongside health researchers on initiatives like this?

Miller: In the biomedical sciences, we often start so far away from the end-user that we can forget to build them into the early phase of development. This causes a whole bunch of inefficiencies, and it unintentionally builds in inequities because we don’t always have diverse voices represented in that process. It doesn’t matter if you have the best drug in the world for something if no one will take it, so I think biomedical scientists who work on the basic side of developing new drugs can’t ignore — even from the conceptual phase — the realities of what the research will look like for different communities. We can’t think, ‘oh, that’s not our job — our job is to get the drug designed and we let other people worry about getting it out into communities.’

Chakraborty: Humanities researchers can’t make vaccines, like you can; but we can ensure optimal uptake of vaccines. We can make sure that communications reach their target audience. We can make sure that you have a better understanding of the context — the assumptions or perceptions around illness, around health, around disease. Around what works for particular groups based on age, based on race, based on the communities that they come from. With Humanities researchers, given that many of us work in such interdisciplinary fields, we bring multidisciplinary perspectives. We have a larger, broader, holistic concept in our mind. We don’t start with just a small question. We are always aware of the context — the histories, languages, culture, assumptions, etcetera. So, you start with the cell, not really quite thinking of the human. We start with the human. It’s a very different starting point.

Miller: No single person can have all of the competencies needed to make transformational change, so we have to work together and leverage our collective strengths in a unified way.

There are a lot of examples of how you are working to address these gaps right now — the Pfizer Program, the BBS Summer Scholars Program — but what is the long-term outlook for Global Nexus?

Miller: If we were to look back in 10 or 15 years to evaluate whether Global Nexus has been successful, what we would want to see is that we haven’t just paid lip-service to doing things differently — that we’ve actually done things differently. And that we are truly, meaningfully engaged outside of the academy with partners in all other spaces, whether they be other communities or other sectors like government, industry, or public health, and that we can show the rest of the world the benefits that wouldn’t have happened were we not operating in this unique way.

In the wake of COVID-19, especially, there has been a lot of questioning of the value of academic institutions and a lot of distrust in experts overall; but I think if we’re more community-facing, it will create more trust. Because those people who are distrusting don’t see themselves as part of the academic community. So, we need to make the academy into a resource and a benefit to those who are not just our students, staff, and faculty.

Chakraborty: I think something that Global Nexus will perhaps also do is reach out to communities within campus. We work in silos, but there is lots of amazing research happening in Humanities and Social Sciences and there has to be a greater, proactive effort to leverage the knowledge that exists among our researchers. We need to create an ecosystem where we complement each other’s expertise. It doesn’t have to be publishing a paper — it can be sharing knowledge and brainstorming ideas, or it can be leaning on our community partners to further the work that we want to do.

This Q&A is an excerpt from a longer conversation hosted in partnership with the Faculty of Humanities.