The first step in making positive change is to create the mindset that one can achieve great things or surmount great challenges. I know we have seen enough evidence of this in recent months as the new U.S. administration seeks to assume a global leadership role, as well as fix the U.S. economic, energy, education and health care challenges. An Opinion article in the Wall Street Journal this week, “It’s Time to Fight the ‘PharmaScolds’”, made me wonder… Where is the Leadership to Fix Pharma?

In this article, Shaywitz and Stossel succinctly point out the classic challenges of drug discovery and development well-known to industry insiders: “Human biology is maddeningly complex, laboratory models are necessarily simplistic, and scientific understanding remains painfully limited. Discerning which ideas have value and capturing this value is extraordinarily challenging and has a depressingly high failure rate. The complexity of product development as well as the scientific sophistication, regulatory oversight, and manufacturing consistency required to pull this off are astounding. That any new useful medical products emerge at all is nearly miraculous.”

They then proceed to bemoan “…the disproportionate influence of a coterie of prominent critics we have previously dubbed “pharmascolds,” who routinely vilify the medical products industry and portray academics working with it as traitors and sellouts.”

But the comment that got me thinking and reaching for my keyboard was the following: “For the sake of the many patients whose diseases require innovative treatments — and for the medical philanthropists determined to make it happen — it’s time for the leaders of the medical products industry to take pride in their purpose and start fighting back.”

So, where are those leaders? And by the way, who are those leaders? I don’t think they are the CEOs of pharma companies whose words are mistrusted by most, from the lay public to the highly educated and experienced scientists at the lab benches of their own companies. (Sorry for this harsh judgment….but it has been a tough decade for pharma and few have gone unscathed!) And the industry organizations who represent pharma, including PhRMA and BIO, as well as many regional organizations, don’t seem to have been much more effective at addressing this very specific need to change perception. They are too busy lobbying for industry interests using traditional and well-meaning tactics to advance business interests.

So, who will lead the industry to a better day? We have so much to fix, from Discovery to Development to Distribution, but where are we looking for leadership? To suppliers or out-sourcing organizations whose incentive is to sell more into pharma? To management consultants who become attached like barnacles to ships floating gingerly in shallow waters, hoping not to sink or run aground? To the employees who have learned to stay out of trouble, rather than innovate…and who could blame them, these days? Or to the investment bankers who are richly rewarded for merging us into another cycle of gap-filling consolidation?

If you have read to the end of this commentary hoping for the answer, I am sorry to disappoint you. I simply do not have the answer and at this moment, I don’t think there is an answer. But I am ever hopeful that out of the self-examination of our health care system in the health care reform effort, leaders will emerge who “get it” and can fix some of the broken fundamentals that can lead to transformational change.

Where do you think leadership might emerge? Will industry scientists step up and lead in a bigger way, not just as product champions but as industry champions? Or are we waiting for patients to just love us? It could be a long wait. A few major breakthroughs in some serious diseases would certainly help, but these are unlikely to save the day in the short term. Perhaps education will provide the answer over time… glorification of the scientist and the R&D process in the mind of every child would go a long way to creating a new future for pharma and the nearly 7 billion patients waiting for those new products. Hollywood, where are you?

What do you think?