by Charlotte Kilpatrick | May 10, 2024 | Global Health
Our next interview from The World Vaccine Congress in Washington this April is with Dr Michael C Caldwell of Meharry Medical College, who joined us to chair the Clinical Trials sessions. Dr Caldwell an internal medicine physician with a background in preventative medicine and public health, and his official title is Associate Vice-President for Vaccine Research and Education!
Clinical trials: key concerns
As Dr Caldwell was Chair of the Clinical Trials track, we asked about some of the key themes or concerns that he was expecting to see during this. He explains that the two-day “experience” provided a “comprehensive” exploration of clinical trials, from how to conduct trials effectively to fine-tuning and tailoring trials. It’s encouraging to hear that Dr Caldwell was looking forward to meeting attendees so that he could learn from their work!
Diversity matters
We hear from many among our community that clinical trials must be improved to more adequately and appropriately reflect and serve key populations. We asked about Dr Caldwell’s perspectives on this, and how his team is advancing efforts here. He explains the process behind trials, from protocols to recruitment.
“Oftentimes there’s biases in who you go to reach out to…so we have ignored a lot of diverse communities because we don’t think that they’re reliable and that is just biases that have been built in.”
Not only do we need greater participant diversity, but the scientists behind these trials can be more diverse.
“So you really need to make a substantial investment in thought, in process, and in monetary compensation.”
Dr Caldwell offers us a simple illustration of the effect of current biases, where protocol would prevent replacing an unreliable cohort of men with more women.
“I challenge all of us in the clinical trials space to say ‘why don’t we do that’ with racial and ethnic diversity…if it costs more, that’s the cost of doing business.”
The emphasis for Dr Caldwell is on putting diversity into the operationalisation of studies: “or we’re not going to achieve it”. This brings us to the idea of workforce diversity, the “root cause” for Dr Caldwell.
“I believe the root cause is fundamentally connected to who’s doing the studies.”
Dr Caldwell gives us a bit of historical context to the work that he and his team are doing at Meharry Medical College, which was “born out the civil war” and the need to provide care to black veterans who were unable to seek treatment and support. This “spirit” is strong today, and Dr Caldwell shares that Meharry’s new School of Global Health is advancing the “mission”.
“We’ve made progress, but it’s still too slow, and we’d like to accelerate that.”
With this in mind, Dr Caldwell was keen to share that his team is working on a national and global Center for Clinical Trial Diversity.
“We want the workforce to be representative of who we recruit.”
Improving the experience
Another key concern for many people at the Congress was the experience of participants and workforce, which has a role in shaping the outcomes of clinical trials. We asked about efforts to improve this experience.
“What we’re trying to do is engage our students…they may not realise what it takes to run a clinical research trial. And similarly, we’re trying to get the community to understand what it takes to do clinical research studies.”
Dr Caldwell highlights that, when a community understands this “in a way that is meaningful to them”, they are more comfortable and engaged in the process. This involves educating them about the many steps in approving medical interventions and, following that, the ways that we “keep making sure we didn’t miss something”.
“It’s important that we let people know that ‘we want you; we need you’.”
Why WVC?
Finally, we ask about Dr Caldwell’s expectations of the event. He shares that he wants to learn!
“The World Vaccine Congress is now a standard, it’s not just a nice conference to go to; you really have to go to it!”
He reflects that the event also provides opportunities to reflect on the past, both recent and more historical.
“Things are changing constantly… we don’t know what’s ahead.”
Dr Caldwell considers the COVID-19 pandemic an example of a “success” in vaccine development: “we did save countless lives”. His experience in Nashville during the COVID-19 pandemic as Nashville’s Metro Public Health Director, navigating the “twists and turns” of public health, has led him to his current position:
“We want everyone to participate, because, without everybody trying to understand, to learn, to work together, for us to also be able to understand diverse points of view, and to know that we can’t change everyone’s mind…We’ve got to just keep using science the best way we can and the most compassionate way we can.”
It was great to hear Dr Caldwell’s insights, and we hope that you enjoy the conversation!
To follow Dr Caldwell on social media:
This article was originally published by vaccinenation.org on May 10, 2024. Please check out the original article at this link: https://vaccinenation.org/global-health/representative-recruitment-is-key-for-dr-michael-caldwell/
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