When we think about what happens around us it all seems random, like a sequence of events that can evolve differently depending on the context. Yet, as Alessandro Baricco wrote, “Fate is never random; it is there, waiting for you in its own way. That means that sometimes fate is waiting specifically for you and it is not random that it looks like fate, it is destiny.”
For centuries scientists have been trying to understand what laws are followed by fate, in the attempt to foresee it and maybe even control it. Let’s think about genetics as an example: ever since Mendel genetics has been trying to comprehend and govern the transmission of hereditary characters, but there are always some elements escaping us. On the other hand Charles Darwin did elucidate how much other factors, particularly the environment, can impact and disrupt any law that attempts to predict and even control the random occurrence of events.
The virtuous cycle of discovery and progress
The history of clinical and pharmacological research is also impacted by the random occurrence of events. Today we call this “serendipity”, the random discovery of new drugs, phenomena and laws…The history of scientific research is full of examples of serendipity, starting from the well-known discovery of penicillin. In reality only one part (the beginning) of discoveries is the product of fate. The evolution of a discovery is the product of the constant commitment of researchers, who try to connect (associate) observations with events to understand and create new opportunities for discoveries. This is how research works in pharmaceutical companies too. The association between the pathology and the drug leads to the discovery of new pathologies, new drugs and new indications for drugs that are already on the market.
However, nowadays we know that a correct diagnosis and an effective treatment are not the only factors that determine medical outcomes. There are other factors that impact the success of a treatment and the most important among these is probably adherence: the doctors’ adherence to validated and researched protocols and the patients’ adherence to the prescribed treatment plan. Poor adherence to treatment is often the first cause of mortality and morbidity and is also the reason for the failure of the system that invests in care and of pharmaceutical companies that invested in the research of effective treatments.
This is such a relevant topic that the National Plan on Chronic Conditions published by the Ministry of Health in 2016 mentions several times the importance of adherence as a key factor to manage patients successfully. In 2009 the NICE published a clinical guidance on the topic of adherence [1] and, even before that, in 2003 the World Health Organisation wrote an “Evidence for action” report [2] on it.
The World Health Organisation identified five factors that impact adherence: the typology of healthcare system, socioeconomic factors and elements linked to the pathology, the patient and the treatment. It also indicated some areas for intervention that impact four main areas- the organisational, the economy, the social and the technological dimensions. Pharmaceutical companies, such as Servier, are moving precisely towards this direction, to develop technological solutions that would simplify the treatment plan, with suggestions that benefit the system in terms of economy, so that the efforts spent on the research of effective treatments can bring the most benefits to patients and to the sustainability of the healthcare system.
Directing events towards sustainable development
However, in this virtuous circuit of discoveries and progress natural resources are being exploited more and more and pollution is getting increasingly worse- factors that over time impact the health of the planet and of its inhabitants. Environmental changes happening globally are evidence of this and they are becoming a true priority that we need to act on. According to the last report by the United Nations Environment Programme [3], countries should triple their efforts to keep the temperature increase below 2°C. The pharmaceutical sector, whose mission is exactly prevention and health care, is committed to minimise the environmental impact of the drugs extraction, production and distribution chains and to make drug provision increasingly more sustainable in terms of social and environmental impact. This objective does not just emerge from the need to respect regulations but also from an increasingly greater attention and responsibility towards environmental sustainability, which in turn is linked to health.
Servier is aware of the interdependency between the economy, social and environmental dimensions so it set the objective to reduce by 25 per cent its carbon dioxide emissions by 2030. In order to achieve this ambitious goal it is working on multiple fronts: the implementation of actions to improve the energy efficiency of its branches and sites worldwide, choosing transport modalities with low carbon emissions and buying raw materials from providers that implement strategies to lower carbon dioxide emissions. For example, the Servier Paris-Saclay Institute of Interdisciplinary Research that is being built is trying to obtain the BiodiverCity® label and the double certification in Well and High Environmental Quality. Based on the requirements of the sustainability label it will be equipped with 5,000 square metres of gardens, 9,000 square meters of terraced green landscapes and 100 square metres of gardens for the community.
While the whole world is making efforts to contain the spread of the SARS-Cov-2, the complete stop of production activities and mobility has led to a dramatic decline in production and consumption but also a significant reduction of air pollution. In this way researchers are experiencing, thanks to this pandemic, an unprecedented opportunity to study and respond to one of the thorniest issues concerning the environment: the impact of aerosols on climate change. Nevertheless, we will also have to deal with the impact of tons of non-recyclable waste, such as the personal protective equipment that was utilised to prevent/manage the outbreak.
Serendipity brings along an opportunity to reflect on how we should look at the world around us- through the eyes of the child that is curious to discover new things, the eyes of the researcher that is wondering “why” and those of the innovator, who tries to find solutions to change or improve the state of things, while respecting the sustainable development linked to the environmental, economy and social dimensions.
References
[1] NICE. Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence. Clinical guidance [CG76], 28 January 2009.
[2] WHO. Adherence to long-term therapies. Evidence for action. Genève: World health organisation, 2003.
[3] United Nations Environment Programme (2019). Emissions gap Report 2019. Nairobi.
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