The Chavis Chronicles
Dr. James Hildreth, Meharry Medical College, FDA vaccine review board and President's COVID-19 Health Equity Task Force
Season 2 Episode 218 | 26m 5sVideo has Closed Captions
Dr. James Hildreth, Meharry Medical College discusses health equity and vaccine safety
Dr. James E.K. Hildreth, President and CEO of Meharry Medical College, who sits on the FDA's vaccine advisory review board discusses the development and distribution of vaccines. Hildreth was also appointed to President Biden's COVID-19 Health Equity Task Force. He gives insights regarding the on-going distrust among many African Americans about the safety of the vaccines.
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The Chavis Chronicles is presented by your local public television station.
Distributed nationally by American Public Television
The Chavis Chronicles
Dr. James Hildreth, Meharry Medical College, FDA vaccine review board and President's COVID-19 Health Equity Task Force
Season 2 Episode 218 | 26m 5sVideo has Closed Captions
Dr. James E.K. Hildreth, President and CEO of Meharry Medical College, who sits on the FDA's vaccine advisory review board discusses the development and distribution of vaccines. Hildreth was also appointed to President Biden's COVID-19 Health Equity Task Force. He gives insights regarding the on-going distrust among many African Americans about the safety of the vaccines.
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Learn Moreabout PBS online sponsorship♪ ♪ ♪ >> Dr. James Hildreth, the distinguished president of Meharry Medical College in Nashville, Tennessee.
We share views on the global pandemic next on "The Chavis Chronicles."
>> Major funding for "The Chavis Chronicles" is provided by... Reynolds American, dedicated to building a better tomorrow for our employees and communities.
Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.
American Petroleum Institute -- through the core elements of API's Energy Excellence Program, our members are committed to accelerating safety, environmental and sustainability progress throughout the natural-gas and oil industry in the U.S. and around the world.
You can learn more at api.org/apiEnergyExcellence.
Over the next 10 years, Comcast is committing $1 billion to reach 50 million low-income Americans with the tools and resources they need to be ready for anything.
♪ ♪ ♪ >> Dr. James Hildreth, welcome to "The Chavis Chronicles."
>> Dr. Chavis, thank you for having me, I'm so happy to be here with you today.
>> Dr. Hildreth, you're from the great state of Arkansas.
>> That's correct.
>> Tell us about your family.
How did your upbringing lead you into the field of medicine?
>> So, Dr. Chavis, I'm the youngest of seven children, and when I was 10 years old my father got really sick.
He worked at the paper mill, and when he -- I was 11 years old, he got even more incapacitated, and he died.
>> This is in Camden, Arkansas?
>> Camden, Arkansas.
And because we were poor and Black, my father didn't get much medical attention.
So an 11 year old, I didn't understand why there's a hospital with doctors in it, why did not my father get the kind of care he needed?
So, I was real angry about that.
That was in January 1968.
In April 1968, that also was event that changed my life, when Martin Luther King was assassinated.
>> Yes.
>> Dr. King had become my personal superhero.
Because of him, I believed I could do so many things.
So to lose my father and then to lose Martin Luther King, Jr. within a four-month span was just too much for me.
And I went into a... A kind of an internal rage.
But my mother prayed me out and challenged me to do something about my anger, so I decided I was gonna become a doctor, despite the fact that I'd never seen a Black physician, didn't even know if you could become a physician if you were Black, that was decision.
And that's what prompted me to want to be a doctor, is my personal experience with my father's illness.
>> And today, you're not only the president of the historic Meharry Medical College, but you serve on the FDA committee that approves the vaccines for COVID-19.
Share with our audience, what is the mission of Meharry Medical College?
>> So, our mission, Dr. Chavis, is to train minority individuals in health care professions, but also to give opportunities to get health care to people who otherwise would not get it.
And it goes all the way back to our founding in 1876.
In 1826, a young, white, teenage boy named Samuel Meharry was driving his wagon in the back woods of Kentucky, it got stuck in the mud, and it was late in the day, and he'd knocked on the door of a modest cabin in the distance, and was greeted by a Black family.
And they took him in, gave him some food to eat.
The next morning, they help him get on his way.
And he made a promise to that family, that if he ever had the means, he was gonna do something for Black people.
So, in 1876, 50 years later, true to his word, Sam Meharry and his four brothers gave $30,000 to Central Tennessee College to start a medical department, and that's how Meharry Medical College was founded.
>> So, the incident happened before the Civil War, but after the Civil War -- >> That's exactly right.
>> He donates, 50 years later, the money to start -- >> That's exactly right.
>> A school here in Tennessee.
>> It was an act of kindness that prompted an act of grace.
But we have, as part of our mission, part of our legacy, part of our founding, to give opportunities to people who otherwise wouldn't have 'em.
'Cause you might imagine, in 1876, there was nowhere in the South where African Americans could get training in medicine.
So Meharry was that opportunity for them to do so.
>> And for many years in the Deep South, no Jewish American would be accepted to an American university in the South.
>> That's right.
>> And here's Meharry.
>> That's right.
>> Open its doors to Jewish students.
>> That's right.
>> Who also studied med-- Tell us a little bit about that, 'cause I think our audience needs to know this history.
>> Well, you know, the racial bias against Jews in the South was pretty profound in the '40s, '50s, and '60s.
So in the late '50s, early '60s, if you're a white Jewish student applying to medical school, or any other professional school in the South, you were not gonna get in, even though you were white.
Many of those students came to Meharry; we welcomed them, we opened our doors.
So there are many Jewish dentists and physicians from that era who got there training at Meharry Medical College.
The point is, we are there to give opportunities to whatever disadvantaged people there are.
We don't really care what your color is, we just care what your story is.
That's why I love being the leader of that amazing institution, because of that legacy.
>> Now, you've been the president of Meharry Medical College seven years -- what have you seen over the last seven years in terms of progress of the school here in Nashville, Tennessee?
>> So, I'm really proud to have led a team that's done some amazing things.
The most recent thing that we did, which I think is very -- kind of contributes significantly to our success in the future, we started a new school.
It's our first new school in 80 years.
Let me back up and tell you what the other three schools are.
We have a school of medicine, school of dentistry, and the school of graduate studies.
And in the school of graduate studies, we've trained more Black biomedical scientists than probably any other institution in the country, going back many, many decades.
We have a school of dentistry that's been around for many decades.
And many people may not know this, but 40% of all the Black dentists in the United States of America were trained at Meharry Medical College.
>> 40%?!
>> 40%, even though there's 68 schools of dentistry in the country.
So I like to say we box above our weight class every single day, in terms of health care in the country.
And of course, we have a medical school, and we train 110 students per class in the medical school.
And we've added a school of applied computational sciences that's gonna offer biomedical data science and data science degrees.
And the reason why I did that is because, as you probably can appreciate, Dr. Chavis, going forward, data's going to be important to almost everything we do.
>> Yes.
>> Especially the use of artificial intelligence to make critical decisions in medicine, business, otherwise.
I want to make sure that some of those individuals who are developing those algorithms who are involved in our artificial intelligence look like me, because what we're finding is, currently the algorithms have the same biases in them as the people who created them.
>> Yeah, for the sake of our audience, people who program -- >> Correct.
>> They're -- inherently invest their own biases in the programming, in the development of algorithms.
>> That's correct.
And the other problem is, if your data set does not include data from people of color, they may not be as effective for people of color as they would be for the white population.
So we need people who look like us developing the algorithms, and we got to make sure the data sets include data from people of color.
And that's why we thought it was so very important to have a school of applied computational sciences, so we could actually contribute to that solution.
>> So, artificial intelligence needs to be broadened to make sure that the intelligence itself is not biased.
>> That's exactly right, Dr. Chavis, that's why we did it.
>> Very good.
Well, congratulations.
>> Thank you, we're excited about it.
>> In our society today, uh, part of our public believes in science, another part of the public does not believe in science.
Why is the American public divided on whether or not they believe in science?
>> Let me start by saying that every single American alive today benefits from science every single day.
There's no aspect of our life today that has not been touched by science.
The medicines that we take to treat our diseases, otherwise they'd be poisons, if we didn't have science to make sure that they're safe and do the things we want them to do.
We get inside of these aluminum tubes that are seven miles in the sky, and fly from one place to the other, taking for granted that we're safe -- that's the result of decades of science by engineers, by physicists, mathematicians.
So, my point is that we take advantage of science every day, and we express our belief in it by making the decisions we make, taking for granted that foods are safe and other things that we make decisions about.
And I also want to explain that science itself is not knowledge or facts; science is a process by which we derive new knowledge.
And when people say that science is evolving, it makes me cringe, because science is a process, the process may evolve, but as our tools get better, the knowledge we can get from those tools will get better.
For example, the reason why we were able to make a vaccine in less than a year, versus the shortest time before that is four years, is because the tools we had as scientists to work on this were so much more advanced, right?
The methods we use to do science may be the same, but the tools we have available to us are now so much better than they were before.
So people need to understand that we don't profess, as scientists, to be the harbingers of truth.
What we try to do is derive new knowledge, and let that knowledge be used for the betterment of the population.
And I'm really, really excited, as a scientist myself, the only way that we were going to solve the pandemic was through science, and science delivered.
Science delivered big time.
There are 20 vaccines that have been approved around the world, and as of last Friday, 8.6 billion shots have been given to people around the world.
>> That's quite an accomplishment.
>> It is.
>> What is the official name of the FDA committee that you are on?
>> It's called the Vaccines and Related Biological Products Advisory Committee -- VRBPAC.
>> And that committee enables the FDA to make a recommendation on what vaccines are approved.
>> Yes, so, the way the whole vaccine process works, there's several stages -- there's something called preclinical studies, where the pharmaceutical companies will take animals -- mice and monkeys -- and test the product in those animals first, just to make sure they elicit a response and that they're safe.
Once those studies are done, the preclinical studies are done, you do small studies in small numbers of humans.
Maybe 50 to 100 in Phase 1.
If those are successful and it seems to be safe, you move on to show that they're effective in eliciting immune responses, and those are the big trials we've heard about, with 30,000, 40,000 people.
So once the pharmaceutical companies have finished the trials, they put together a data package and send that to the FDA.
The FDA then convenes a panel of outside experts -- these are independent scientists and patient advocates -- who review the data from the drug companies and make a recommendation for approval.
>> In the African American community and other communities of color, there's some vaccination hesitation.
>> Mm-hmm.
>> Mainly because of misinformation and, uh, not getting the real truth.
How do you see the public being able to overcome misinformation, one, and two, hesitation for vaccinations?
>> From my perspective, trust or mistrust of medical research and the health care enterprise is a big problem in our community, and the way that I address that is to first acknowledge that we as a people have every reason to be doubtful and mistrusting of medical research.
We all know about the Tuskegee experiment with those 600 Black men who just were treated horribly and unethically by physicians hired by the United States government.
>> For many years.
>> For many years.
We know about the involuntary sterilization of Black and Brown women -- >> Called eugenics.
>> Eugenics, yes -- I can take you all the way back to 1619 and point out atrocities visited upon Black bodies in the service of research.
So we have every reason as a people to be reserved about this.
But the vaccine development for COVID-19 is very different.
At every stage and every step, there've been people of color involved.
There's a brilliant Black scientist, brilliant young woman named Kizzmekia Corbett.
>> Yes, Dr. Corbett.
>> Who was involved in the mRNA technology that was essential to getting these vaccines done.
Then once the trials start, there's something called a data safety monitoring board.
This is an independent group of scientists, patient advocates, who get to review the data in the trials in real time.
As a matter of fact, they're the only ones who know who got what.
The participants don't know if they got placebo or the vaccine; the physicians don't know that; the members of this board are the only ones who know that, and they have the power to stop the trial if something goes wrong, and people of color are part of all of those panels.
And then finally, when the data set is complete and you send it to the FDA, it e -- it convenes the VRBPAC.
And myself and one of my great colleagues, Dr. Fuller from University of Michigan, she's African American, we are part of that panel.
So, in the case of COVID-19 vaccines, it might have been an unprecedented level of participation by people of color throughout the whole process.
So I think that that should give people some reassurance that they've had representation in the process.
The other thing that I think is really important is having trusted messengers.
In order to engage the community and convince them, even to have them listen to you, you got to have a trusted messenger engaging them, and that's been one of the lessons, I think, we've learned, and I've been so proud to see national organizations, like the NMA, the Black church groups, the fraternity, sororities, I think with that collective effort, we've made a huge dent in this, and I'm very hopeful for the future going forward, that we're gonna get this solved.
>> I want to talk about the global context of the pandemic.
How important it is that we see the pandemic in its global dynamics as well as its local and national dynamics.
>> The origins of omicron, the latest SARS-CoV-2 variant, that variant tells us just how important it is to view this in a global context.
My understanding is that omicron arose in an immunocompromised patient in Botswana, and because that person -- >> Botswana's in southern Africa.
>> Yes.
And because that person was immunocompromised, the virus was able to replicate through many, many, many cycles of divisions, and with each division there's a small chance of a mutation.
And as a result of that, the omicron variant has more mutations than any variant we've had to deal with so far, including 32 mutations in the attachment protein.
If we have large segments of the population that's not vaccinated, a person in South America or Botswana or some other place could have a variant that is a threat to the whole -- the whole global population, as omicron has been.
And that's why it's really important that we take a global approach to this.
Or the best thing that we could do is to partner with the other rich countries -- Canada, Europe, you know, Japan and others -- to buy enough vaccines to give them to the countries that cannot afford them.
As a matter of fact, there are many, many countries that have vaccination rates less than 2% still.
I think overall, all the low-income countries together, only 6% of the people who live in those countries have even gotten one injection of a vaccine, and that's not gonna work for us -- 'cause we're in a race.
We are in a race with a biological pathogen that's been programmed in its DNA to keep changing and keep changing.
And some of my colleagues tell me that we're one or to mutations away from a variant of high consequence.
The delta and omicron are called "variants of concern," because they avoid the antibodies the vaccines make somewhat, and they spread more rapidly.
A variant of high consequence would be one that either had a higher fatality rate, or that the antibodies we have currently do not inhibit them, or work against those.
And that's determined by the sequence of the genome of the viruses.
So if we let the virus keep replicating in large numbers in people who are not vaccinated, all of us could be impacted, because a variant of high consequence could arise.
And that could be anywhere.
It could be in eastern Tennessee, it could be in Africa, it could be in Brazil.
The point is that, this can happen anywhere, and because we live in a global community, what happens in those places impacts us directly.
So, we need to do our part to get the rest of the world vaccinated as quickly as possible.
>> So we're in a race against time.
>> We are, and were it not for the astuteness and the abilities of these scientists to quickly do sequencing, we would not have known about this.
>> What is your view about the future of medicine, in terms of diversity, equity and inclusion?
Are you seeing more physicians, more nurses, more medical practitioners coming from communities of color?
>> Up to this point, it's been very disappointing to see such small numbers of African Americans in the health care professions.
Physician assistants, for example, only one out of 1,000 physician assistants are Black males.
In terms of doctors -- >> One in 1,000?
>> One in 1,000 are Black males.
Yes.
And even in the ranks of physicians, less than 6% of physicians are African American.
And the percent of those who are male is going way down.
As a matter of fact, between 1908 and 2008, the percent of physicians who are Black did not get above 3%.
It's only in the most recent years, most recent decades, that that number started to change.
>> For that 100-year period.
>> 100 years, it was 3% or less.
Which is really amazing to think that that's true, but it's true.
But I'm really hopeful and -- that the events of 2020, with the pandemic revealing this chasm in the health status of Black and Brown people versus white people, the murder of George Floyd, there was an epiphany of sorts among national organizations that race does matter.
But my great colleague Dr. David Williams at the Harvard Chen School of Public Health has done decades-long research providing objective data that race does matter.
And based on your race, your blood pressure, your life expectancy, your mental health and other objective things that we can measure, are impacted by racism and bias.
But the CDC has declared racism a public health crisis.
Dr. Francis Collins, who is the outgoing director of NIH has apologized publicly that racism has played a role in limiting the opportunities of Black people to get grants to do research.
So I think there's an awakening happening in our country that I hope we can leverage to the betterment of all of us, because when we promote the best health for all of us, everyone benefits from that, not just the minorities who are impacted by it, but the whole country will.
But I'm hopeful that going forward things will be different, and the interest in medical school among people of color, I know, is going up.
We normally get about 7,000 applications for 100 seats, this past year we got 10,000 applications.
>> 10,000 applications.
>> Yes.
>> For 500 seats.
>> For 100 seats.
>> 100 seats.
>> Yes.
So, I'm hopeful that that's a great sign that the pandemic has shown people just how important health care is, and science is, and research, and I think we're gonna leverage that opportunity to make sure you capture as many young people as possible into the fold.
>> Tell me what gives you hope.
>> Dr. Chavis, what gives me hope is the unprecedented collaboration among scientists in response to COVID-19.
It's hard to describe it to you just how extensive these collaborations are.
Last February of 2020, scientists working on Zika, HIV, many other things -- some of them not even working on viruses -- turned their attention to finding a solution to this.
What I really pray for, and what really gives me hope, is a lot of those individuals are young scientists who are like, early stage investigators, who recognize how powerful science can be in solving the problems that we face.
And you think about the problems that we're gonna be facing in terms of climate change, the growing population of the Earth and how we're going to feed all these people, have them have safe water, safe food -- it gives me hope to know that so many outstanding young people have now been focused, their attention has been focused on how powerful science can be to help solve some of the problems that we -- that we have.
And I'm hoping that some of them will emerge as true leaders in different fields, because, again, in a crisis of global proportions, we need leaders, and unfortunately, many times we're stuck with politicians.
And there's a big difference.
Sometimes they're one in the same, but oftentimes they're not the same.
And that's one of the things that gives me some concern, but my hope rest in the fact that some brilliant young people have stepped to the forefront of all this in helping us find solutions, and I'm excited about that -- including my kids, my students at Meharry.
They're right there with them.
>> Well, we share your hope, and I just want to say -- as we began the interview, I want to end the interview -- first of all, thanking your mother -- >> [ Laughs ] >> For praying you out of that situation.
>> Thank you.
>> And look how you've come now, not only one of the nation's leading physicians, but one of the world's leading physicians.
I think Meharry Medical College is in a good stead, having you as their president.
>> God bless you.
>> And of course our nation and FDA has benefited.
And I just want to say thank you.
>> Thank you.
>> Major funding for "The Chavis Chronicles" is provided by... Reynolds American, dedicated to building a better tomorrow for our employees and communities.
Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.
American Petroleum Institute -- through the core elements of API's Energy Excellence Program, our members are committed to accelerating safety, environmental and sustainability progress throughout the natural-gas and oil industry in the U.S. and around the world.
You can learn more at api.org/apiEnergyExcellence.
Over the next 10 years, Comcast is committing $1 billion to reach 50 million low-income Americans with the tools and resources they need to be ready for anything.
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