North Carolina Research Triangle's Biopharmaceutical Manufacturing and Innovation Hub

Good afternoon uh and welcome to today's uh program spotlighting the North Carolina research triangle biofarmaceutical manufacturing and innovation hub. Quite a mouthful if you uh but it's also a very uh contentful afternoon so perhaps just as fitting. Uh my name is Sujesh Shivakumar. I'm a senior fellow at the center for strategic and international studies. Uh where I direct the innovation uh program. Uh really delighted to be here at Duke University and uh really grateful to the folks at Duke uh for help working with us to pull this program together. Uh unfortunately Jeffrey Ferrante, senior vice president and chief digital officer here at Duke uh had an family emergency. So he is not able to join us to welcome this group but um I'm sure that I wish him well and uh I uh we can I think u you know thank uh thank our hosts here very fulsomely uh and uh maybe get on with with our with our mission here. So uh just a quick word about CSIS. We are here at Duke so perhaps Duke doesn't require as much of an introduction. Uh, CSIS is a bipartisan nonprofit policy research organizations, otherwise known as a think tank in Washington DC focused on developing practical ideas to address major national security and economic challenges. Our work brings together frequently leaders from government, industry, academia, and the research community to inform policy choices that strengthen US national security and national competitiveness. Our program, the Renewing American Innovation Program, was founded about uh six years ago and one of our co-founders, Walt Walt Copan is here with us today uh senior adviser to our program and this program really focuses on the institutions, partnerships and capabilities that sustain uh our nation's leadership in science uh technology, manufacturing and national security. We look at the innovation system as a as in in in its entirety. Research, commercialization, manufacturing, workforce, capital, standards, intellectual property, and the glue that often ties these many pieces together. Public, private, collaboration, partnerships. Uh it's I think really important that we see it as a system because the system as a whole is actually a national security asset. We don't think about our innovation system in those terms. But having a program at a national security think tank I think helps us to establish just why it's why it's so important that all the pieces are are are understood. We understand how they connect them. We make sure that we have policies that encourage each piece as well as make sure that the pieces connect with each other. Uh and so this means that we need to talk about universities, startups, manufacturing capacity, regional talent pipelines and enabling policies not only as as engines of economic growth but also assets in our strategic competition. Major part of our of our work has been on indeed on regional outreach on innovation clusters across the countries. We have been examining how local ecosystems connect research institutions, entrepreneurs, manufacturers, investors, workforce organizations, and public agencies into durable engines of technological progress. We've had events uh from uh you know looking at the workforce challenge in Syracuse, New York. We've been looking at the semiconductor design ecosystem in San Diego, California. We were in Texas earlier this year looking at how that state is putting together a an ecosystem to support the packaging industry in in semiconductors. Uh we were in Colorado uh working with the vault there looking at the growth of a uh of a quantum cluster in in Colorado and in the mountain west region. We were also uh recently in u in Chicago with a very different model of how Illinois and Colorado are putting together you know their versions of a quantum cluster and also more more recently in our own backyard back in DC in in Maryland which is the other um third major quantum cluster. This is our first event looking at the bio pharma bio technology um cluster. And what is so remarkable about this region is that there's a deliberate attempt to make sure that manufacturing is a integral part of the growth of this cl of this this culture of this cluster. So uh you know this you know our delighted again to be back at the research triangle which is has been and continues to be one of the nation's leading center for innovation and uh biotechnology biioharmaceutical innovation and advanced manufacturing. You know the triangle is widely uh stouted as a success story but the question before us really is are we prepared is the region prepared for the demands of the 21st century which are very different from the success factors that made it uh so internationally recognized to to to today. Uh so there is multiple uh as aspects to the challenge that we have today. One is that state and regional policy makers increasingly recognize that they're competing not with the next state or the next county but they're competing with the re leading uh you know innovation clusters around the world. Ohio isn't competing with Indiana. It's competing with Shenzen. It's competing with Helsinki. It's competing with Tel Aviv. Uh and so that reality is now uh well understood by state as well as regional leaders. uh and so they are now having to step up their game. They are not dealing uh you know purely in terms of local priorities but they're they have to show global leadership uh and they need to understand issues of strategy, investment, partnerships, institutional coordination uh if they want to stay in the game. Uh there's also a regional shift is occurring. At the same time the federal innovation policy landscape is also changing. uh there's less of an emphasis today on on the core focus of our innovation system which has been on uh R&D and much more on manufacturing and one of the themes that we hope to explore today is whether you can do one or the other uh you know the the the uh focus purely on R&D was not balanced a focus too much on manufacturing will also not be balanced so how do you capture a balance between the two of them and then finally you know look we want to look at programs focused on regional technology hubs translational research, manufacturing readiness, workforce development to reflect the growing recognition that US technological leadership really depends on strong connected regional ecosystems. So it's you know the strategic uh competition is also occurring in a more challenged challenging global environment. uh you know uh it's difficult to have an uh conversation like this without mentioning China uh which has emerged as a technological pure competitor that is investing heavily in R&D it is uh investing in research universities it is now creating intellectual property so that it's its focus is now turning from uh collecting intellectual property to actually protecting its own intellectual property and it's China is also a innovation system that really places manufacturing at the very heart of its innovation system. Uh this is something that we uh we took for granted in the United States but we have sort of allowed manufacturing to go offshore over a number of decades. Belatedly now we recognize the the gap that we have in our innovation system. We're trying to bring manufacturing back. But one of the things that we also got off the hook for a few decades when we didn't invest in manufacturing we also didn't have to invest in the workforce. We also didn't have to invest in the standards. we also didn't have to invest in the infrastructure and so now all those chickens are coming home to roost and so if we want to make sure that we have a robust uh you know innovation system that is centered with manufacturing here in the United States we need to address a whole lot of things a whole lot of challenges and do it almost uh simultaneously and in a hurry so uh so this is why uh you know we come back to the the region here uh the research triangle uh region offers an opportunity to examine on how a successful regional ecosystem can continue to adapt, compete and contribute to US economic strength and health and innovation and national security. So that is sort of the the the idea behind this meeting. Uh Representative Deborah Ross is here. I just wanted to also mention that we had a uh an event in Washington at CSIS headquarters in March of this year. one of our annual major conference looking at the issue of IP and uh you know I met uh representative Ross in the green room before she was about to give her keynote and I told her about this sort of this this road trip that we've been having looking at these critical innovation clusters that are growing and connecting across our nation and she said you have to come to you know to North Carolina and and uh so then we worked with her staff who are extremely proactive and so here we are so thank you for giving us that uh that impet And uh if you if you will a kick in the pants to come over here and do this uh important important event. Uh we have uh uh we uh we uh we have a really excellent program ahead of you today. Uh I think the we will start with uh Senator Senator Tillis who could not be here but we have uh u uh her his uh assistant uh um uh Mr. Osborne Anna Osborne here to give his his remarks in hisstead. So thank you Good afternoon. I'm Anna Osborne with Senator Tillis's office. I'm excited to be here today um and hear all about this. I know the senator hates that he's missing um this. This is right up his alley. Um but I just wanted to read a short statement that he had prepared. Uh North Carolina has a proud tradition of supporting our nation's military and as home to seven military installations, we understand that America's strength depends on continued investments in technology and innovation. That same commitment has made the research triangle a global hub for biioharmaceutical research and advanced manufacturing. Powered by a world-class workforce, strong public partnership and commitment to scientific excellence. It is uniquely positioned and qualified to partner with our great military and with specialized area of industry. I am proud to support these efforts and look forward to continuing our work to expand workforce opportunities, accelerate innovation, and keep North Carolina and the United States at the forefront of industries that will define our future. Thank you. Thank you. Can I now invite state representative Zack Hawkins to come and say a few words, please? >> Good afternoon. Good afternoon, everyone. Thank you for allowing me to be here. Uh my name is Zach Hawkins. is a state representative for House District 31, which is uh all of uh parts of downtown, all of RTP and all of East Durham. And so um I have been talking about AI all day. I just left the other side of town um where North Carolina Central has just um uh broken ground um and had a ribbon cutting actually for their AI institute. And so I have uh the privilege of also being the co-chair of the AI uh bipartisan bicameal legislative caucus in the general assembly. And so we are working and trying to make sure that we keep uh this particular um you know this particular substance and topic um front of mind but also bipartisan. I also want to recognize uh Congressman Deborah Ross um and I thank her for her continued uh leadership uh to and service to North Carolina. I see my colleague Donna White, one of my favorite colleagues in the general assembly. Um, also want to recognize Secretary of Commerce, uh, Lee Liy, and thank him for his leadership in strengthening our state's economy and innovation um, on our innovation ecosystem. I want to thank CSIS and Duke University for bringing us together um, at Duke for such an important conversation. North Carolina has established itself as a national and global leader in research, biotechnology, pharmaceutical manufacturing, and emerging technologies. That success is the result of decades of investment in our universities, our workforce, businesses, our research institutions, and strong partnerships uh both public and private. And the research strangle park RTP is an incredible example of what is possible when those pieces come together. As I say in the general assembly, and I get a few eye rolls when I when I say this, uh, Congressman uh, Ross, um, poundfor pound, there's no other place that can compete with RTP in the country. Um, and there there are few that are jealous. That's okay, though. Uh, as we look forward, uh, to the future, we must utilize innovation to improve the lives of the people that we serve. Technology should help the primary care provider spend less time navigating an electronic health record and more time educating and caring for patients. It should help researchers analyze information faster so they can spend more time developing the next life-saving treatment. It should help manufacturers operate more safely and efficiently while creating new opportunities for skilled workforce. And it should help businesses, educators, and public servants solve problems so that people can spend more time focusing on their talents, relationships, and responsibilities that cannot be replaced by technology. That is what excites me about North Carolina's positioning at this moment. We have the research institutions, universities, businesses, entrepreneurs, and workforce to lead the generation of American innovation. And as the ecosystem continues to grow, the workforce must grow alongside it. We we should continue creating pathways that connect North Carolinians to these opportunities from K12 to our community colleges to our HB.CU to our universities both public and private and particularly workforce development programs. I'm especially encouraged that companies and organizations represented here today to um I'm uh especially encouraged the companies and organizations represented here today to encourage themselves to help make sure that students are early in the process. Create opportunities for internships, apprenticeships, mentorships, job training, and hands-on learning. Give all young people an opportunity to serve the work, see the work happen, and more importantly, help them see themselves doing the work one day. If we want North Carolina to remain a leader, the leader for the next generation, we have to invest in them. Today, innovation is strongest when it benefits every part of our community. Our responsibility is to continue supporting the research partnerships, people, and institutions that have made North Carolina a leader while ensuring uh we are prepared for what's next to come. So, thank you for allowing me to come. I see my uh partner uh Senator Murdoch walking in the door. I look forward to the conversations today and continuing to work on making North Carolina a place where innovation can grow, businesses can thrive, and people and communities can benefit from the technologies shaping the future. Thank you and have a great conference. >> All right. Good afternoon. Um, honored to be preceded by my colleague um, in Durham, Representative um, Zack Caukins, State Senator Natalie Murdoch. Honored to be here with all of you today. And I don't know if it was in his remarks since I'm just arriving, but um, we both were just leaving an event where um, North Carolina Central University will be the first H.B.CU in the nation to have their own AI institute. And I lead with that because as we're talking about international issues and really looking at a global economy, we're going to have to do everything to make sure our students and our local communities are prepared for the jobs of tomorrow, jobs that we can't even fathom, jobs that don't even exist yet. And so we're honored to be here um and particularly as a part of a bipartisan um uh collaboration because I know I believe what US uh Senator Tillis will be speaking today. I see Congresswoman um Deborah Ross and know that we'll have other um electives here, Representative Donna White in the House because for North Carolina to remain number one in business, that's only going to happen if we're having these sorts of critical conversations making sure all of our institutions public and private um Durham Tech as well with our community colleges um that we all have to work collectively together. Years ago, um I was an economic developer. It was on the beginning of the recession of 2008. So I got some great advice to get into a field that was a little more stable. So ended up in transportation planning um but full circle Google was at the previous event and um they were doing work in Lenor um back then to make sure that not only are we prepared for these opportunities but spread them across the state. I know folks like Representative White is in a fast growing county. Um we're thrilled to have all the success we're having in Durham County. Um but we've got to do this across the entire state. So, um, we're honored to to be here to be a part of the conversation, um, as we go back to session next year. These are the sorts of conversations that we should be having as someone that represents the research triangle park. Um, we had a ribbon cutting with a bio biio manufacturing company and uh, they're based in Switzerland and that ambassador took the time to fly from Switzerland to be a part of that ribbon cutting. So um to show the the type of success we're having in the region and we know that that would not happen without partners um such as Duke University. So um thank you all again um for being here. Looking forward to learning. I'm looking forward to the conversation again as we make sure um that North Carolina remains number one in business. That will not happen without innovation. Thank you. Thank you rep uh rep uh Representative Hawkins for uh making the point that innovation has to be broad-based and uh Senator Murdo for pointing out that regional innovation is really important for to make sure that uh North Carolina has its place in the world and I think those are complimentary points that we need to be uh holding on to as the today's discussion goes goes on. Now, it's my special uh pleasure to uh bring to the dis here uh representative Deborah Ross and Walt Gopan to conduct a nice fireside a cozy fireside chat in the absence of a fire. It's on. >> Terrific. Thank you so much for joining with us in this important conversation. Um I'm Walt Copen uh with the Center for Strategic and International Studies and also formerly the under secretary of commerce and director of NIS, the National Institute of Standards and Technology. Um, and I'd just like to take a moment to introduce somebody who needs no introduction to this audience. Um, uh, Representative, uh, Deborah Ross. Um, as Suj Shiva mentioned, uh, she had been a keynote speaker at the leadership conference in Washington. And uh that's really led to this gathering as we look at the importance of innovation ecosystems across the nation and the very special role uh that North Carolina and the research triangle have. Um Congresswoman Deborah Ross um is a lawyer. She's a champion for clean energy and technology and innovation. A proud North Carolinian indeed. um and uh uh is uh in her third term at for the House of Representatives uh that started in uh January of 2025. Um she's not directly here in Durham, but in the region, right, and of course represents uh this uh this region uh nationally. Um and um Congresswoman uh Ro uh woman Ross serves on the House Judiciary Committee. Um and uh and of course um it's incredibly important as we look at our innovation ecosystem as SUJ mentioned um all the underpinning structures that we have for US innovation and intellectual property um and standards and and investment and the rule of law uh for the future of our nation. Um, she also serves on the House Committee on Space, Science, and Technology. And so I was really thrilled as NIS director to have the opportunity to uh interact with Congresswoman Ross in in that very important role. Um, and uh for the House Democratic leadership team, she is the chief deputy whip on the U and also on the steering and policy committee. Um, an area that Congresswoman and Ross has really focused on um is also um legal immigration and we all know um whether you're at a university, at a corporation, in the federal government, the role that immigrants play in our nation's um economic system and our innovation economy. Um and so we're really just thrilled for her uh focus on on those aspects um as well as the importance of the fundamentals of US innovation and in particular as we look at our bioeconomy and the unique strengths here um in North Carolina. She didn't graduate from Duke, but she did go to law school at UNC Chapel Hill and uh uh and and really kicked off uh her career in public service going back to 2002 uh when she ran for and and won a seat representing Wake County here in the House of Representatives. And we've got folks in the audience who know a little bit about that uh role in in serving the state. So, we are really thrilled to have you here, Deborah Ross. Um, it's my honor to be together on the same uh podium as you and also to have the chance uh to uh engage in a fireside chat. Um, and um I want you to be thinking about questions that are important to you for Representative Ross uh because we hope to have some time toward the end of our conversation for you to ask your questions. So, uh, let me turn it over to you for any remarks you'd like to share on opening. >> Well, the first thing I'm thrilled that we have bipartisan representation here because that is the only way this state is going to continue to thrive. Senator Tillis and I do a tremendous amount of work on intellectual property issues together. As a matter of fact, we got a very important law passed called the Unleashing American Innovators Act that helps firsttime patent holders. and we are working very hard to get one of the um technical assistance offices put here in North Carolina so that our firsttime patent holders and our amazing students, our amazing veterans, our amazing farmers who come up with these ideas will be able to secure their rights, be able to monetize them, them and ultimately manufacture and distribute them. So, I wanted to say that on the Duke University front, I did teach at Duke Law School for 11 years, so I do have that connection. And starting a week from now, my niece will be coming uh to Duke to do her graduate work in physics. And I am thrilled, thrilled, thrilled. She went to Davidson undergrad and she's going to be at Duke for that work. So, I will be back on campus quite a lot. That those are my opening remarks. >> All right. Fantastic. Well, you're definitely playing to the home crowd here and I'm delighted that there are other universities from across North Carolina who are participating in our conversation here together. Um, so let me just kick off with a question about what are the factors that made North Carolina's research triangle one of the nation's leading hubs and in particular what are the strengths that have brought together life sciences innovation? Um, and back to our opening uh discussion, how can this region maintain competitive advantage in the decades to come? Well, most of you here know the history of the research triangle park. Um that it was really the brainchild of Terry Sanford and then fully implemented through um best governor in the entire world Jim Hunt. Um as and it was it was conceived to retain the talent that was coming from our institutions of higher education. So, um, 50 years ago, these smart people who graduated from Duke and NC Central and NC State and and Chapel Hill, they'd all go to New York or Chicago or LA. And the idea was to keep them home and to attract the people who came to these amazing universities and keep them here and help the economy of of this region. And so the idea of course was Terry Samfords along with business and education leaders, but it was really Jim Hunt who kind of nabbed all these companies, these international companies from Switzerland or England or wherever or you know New York City um or New York State because IBM was one of the anchor folks here. Terry Sanford was the one who got the EPA headquarters here because of his relationship with John F. Kennedy Jr. And so that kind of vision and wanting to make sure that the best and the brightest want to live here is what started the research triangle. But then, just like me, because I moved here um almost 40 years ago, once you got here, you want to stay, right? I'm I'm a North Carolinian because I got here as fast as I could. Once you come, once you meet the people, once you have these opportunities, once you have the quality of life you want to stay, we also have a wonderful history of um that international recruitment that being open as as you talked about in the beginning to having people from all over the world feel welcome in the research triangle. to the to the point that Kerry which barely existed. It was like 10,000 people when RTP started but that's where all the IBM moved Kerry now one quarter of its population was born in another country. Morrisville is 40% South Asian and these are the bedroom communities of the research triangle. So how do we sustain this? We are we've been number one or number two for business um for quite some time and we have done that by investing in higher education. I would argue that we need to invest more in K through 12 education so that we prepare everybody for these opportunities. Um we have probably the best community college system in the entire country. Um, I too worked on business recruitment. Every business who gets recruited to this state through our department of commerce is paired up with a community college because they're going to need to get their workers there. And so I know that the the pharmaceutical manufacturers are actually having classes taught in the adjacent community colleges. Isn't that right, Representative White? in Johnston County, which has been a hub. For some reason, all the Spanish companies want to go to Johnston County. All the German companies want to go to Wilson County. And then we have Novosymes, which is of course from Denmark in both Johnston and Franklin counties. But I remember visiting the community college up um that you that serves Franklin County and they developed a curriculum just for Novos. >> Yeah. just for Novos. That is how you maintain that leadership. Unfortunately, and then I'll let you ask another question. Um and and this was alluded to in the original remarks. Yes, we are attracting all of this manufacturing here in this area and we're thrilled to have it, but the investment in R&D, which is what got us on the map to begin with, has diminished. and it has diminished precipitously under this administration. And as anybody who knows anything about um innovation knows that you only have the right to manufacture the thing as long as your patent is around. So if you don't have a new idea, then you may end up with a manufacturing facility that is of no use to you anymore. And I have talked to pharmaceutical manufacturers who have closed facilities in this state because the patent ran out and now the generics are happening and the Chinese are producing things. And so it might seem good in the short term to just focus on the manufacturing, but if you do not have the innovation, there's going the life cycle of the manufacturing is going to drop off and then we're going to be in the same situation that we were with the textile industry and the tobacco industry and everything else. So we have got to continue to invest in that innovation so that we can have those new discoveries, the new uh pharmaceuticals and biioarma products that will be manufactured by these amazing companies in this area. And um I see Laura from NC Bio, she's in my office all the time. We're talking about this all the time. Um but we got to do both. We've got to do both. >> Yeah. Well, uh, thank you for that, uh, uh, great picture that you've shared with us. And I just want to unpack some of these points a little bit. You started off by talking about North Carolina being the best environment for business in the nation. Um, so how do we maintain that and what does that mean in the decades to come? >> Well, a lot of people would um that that's always a an issue of debate and sometimes it's not as bipartisan. Some people think you're best for business if you just have low taxes. But if you have low taxes but you don't have an educated workforce, then you can't be best for business. And if you just reduce your taxes, you can't pay for the educated workforce which comes from K through 12 or community colleges and investment in higher education. And if you ask these companies that come, they largely come because of the talent. They come for the talent. They come for the quality of life. They come for the quality of the public schools. I mean, the fact that people will come to the United come to the research triangle from all over the world and send their kids to our public schools, that says something about the quality of those public schools, right? And then of course people have to feel welcome here. And you know we've seen how culture wars have driven major sports activities and companies and the film industry away from this state. But if if we make people feel welcome, comfortable, they can buy a home, it's going to be safe. We have the infrastructure to support these manufacturing facilities. And I know in Johnston County, water issues are enormous. They're enormous. So, we've got to make those investments as well. So, I would say ask the people who are coming here, >> what makes you what makes you want to be in North Carolina rather than somewhere else. And almost always they will talk about that talent pipeline. They'll talk about the quality of life. They'll talk about feeling welcome. and they'll talk about infrastructure, infrastructure, infrastructure. >> Great. Thank you. Um, you you mentioned the importance of uh of R&D and sustained investment uh and growing investment for the future of uh research in the pipelines for manufacturing. Um, a lot of that comes from our universities and our research institutions, of course, and how can universities and research institutes continue to balance their mission of open scientific discovery with the need to protect intellectual property and of course enables the commercialization that attracts investment and and that builds uh product outcomes. How can universities and research institutes keep the right balance? Well, I think that universities and research institutes have done a pretty good job, particularly here. What is unfortunate is that there's less government investment in that research. Fewer of those amazing graduate students having those opportunities. Um, my niece feels extremely fortunate that she was accepted into a graduate program at Duke and is getting some funding for it. But those opportunities are drying up and with that will be that innovation. The other thing to talk about intellectual property, one of my favorite things is um the fact that we have a pretty good structure um under by Dole which is that partnership between universities and the private sector and how intellectual property is rewarded and how the uh benefits of that can be shared. But there are threats to that that we also see from the federal government. Um I don't know how much you guys know about intellectual property, but there have been something called marchin rights where if um a a an innovation or a a patent isn't used um in quickly enough, monetized quickly enough, there is a process for the federal government to be able to take over that patent. It is so rarely used. But as we all know in this room, turning an turning innovation into a a commodity that's sold takes a long time. And I would argue in this time when the words communism and socialism are being thrown around, if you take somebody's innovation away from them when they're working on turning it into something incredible, that's what this administration's trying to do. That's what this administration's trying to do. And that is why I'm opposed to exercising marching rights except for under extreme circumstances. >> Well, thank you for for that. And and just to clarify, um, federal marching rights have never been exercised and, uh, and and, uh, I'm really glad that you continue to advocate, uh, for that not to happen in the future, that we need to ensure that our innovators have the kind of support and the kind of runway that they need, recognizing that the federal government does not pay for commercialization, does not pay for intellectual property protections. That's on the shoulders of our universities and a and and our investors and we have a great investor ecosystem here but when there isn't that R&D investment and when things are going elsewhere you know they invest to make a profit right so they're not going to invest in something that they don't think will come to fruition and we have got to create that environment because again that's what makes us number one in business is that we have that kind of connection among the universities, our local government, our state government and then of course um people who can commercialize these amazing innovations. >> Yeah. Uh so you alluded to this the long path and the risks that are associated with taking a promising discovery and actually bringing it to market. From your perspective, what do you see are the barriers and the largest barriers that researchers and the organizations that they're part of are facing in moving a promising discovery from lab to the marketplace? And as we look to the future, uh what role should universities, industry, investors, and government play in helping to overcome those barriers and making it even easier in the future to drive technology uh innovation to the market? >> Yeah. Well, as we've just discussed, obviously you need that patient capital. You need people who are going to believe in what's going on and and be willing to wait, you know, more than just two quarters to see a return on their investment. The other thing that we need, and this is something that has been very frustrating, I know I've talked to NC Bio and other folks about this, is we need qualified regulators who at the FDA um in all these different capacities who understand the areas where they're doing the regulation and I would say can move expeditiously while protecting public safety and because that is so so important and what we're seeing is rather than having and retaining that those quality folks um there are many of them are being pushed out. Many of them were dozed out and now they're basically the federal government is picking winners and losers and we're seeing that particularly for weight loss drugs. For those of you I'm sure you're aware of this whole compounding issue for weight loss drugs and whether the patent will be enough or whether compounders will be able to do it. And we've got a bunch of people who aren't experts in this area again picking winners and losers. And what we really need are highly educated, committed public servants who understand, who have that technical expertise and want to advance innovation while keeping public safety front of mind. And um we've got to be able to do that at the same time that we attract that capital for that innovation. And so that's that's what I think we need to do. I also think it helps and this is to your point about clusters. Being in a cluster is so so important because there are people who are moving from one company to another, from one institution of higher education to another, and it's just like a bee be pollinating on these flowers, right? And so we have to encourage people to move around um and in that way you know not have non-disclosure agreements that are ownorous not um try to wed people to a particular place I completely understand trade secrets that's another part of intellectual property but the more people can share their innovation um and and have that experience and then um share it with their new colleagues colleagues, the more cool things are going to happen. Um, and we need to we need to foster that. >> Yeah. Um, and just to follow up on that, um, the university is under special pressure right now. um funding, uh concerns about overhead rates and uh and and in this type of environment, um how should universities across North Carolina be thinking about and responding to this environment of change and and how can they navigate that successfully? >> Well, I get asked this question a lot. I just did this for engineering deans all over um the country with um with Kevin Howell who has taken over NC State University. Um >> I think universities have not had to advocate for themselves and the value that they provide to the communities where they're where they are. They haven't had to do that because they've been well taken care of by the general assembly or by Congress. That is now at stake. And I think that universities need to talk about how they are economic engines for their regions and for the state. >> If there was not the research triangle, North Carolina would be a backwater. It would be a back. It was a backwater. And we have got to put quantify that show people even and even for our smaller colleges and universities where many of those like my my niece who was in Davidson not you know particularly it's right outside of Charlotte but not particularly it's a cute little college town. If Davidson College was not in where it w where it is there would be nothing there. I mean there might be a coffee shop and then there would be agriculture. >> Yeah. >> That is an economic engine and it is producing the folks who are going to go on to graduate schools in all these different places. And we have colleges and universities in rural areas of this state that are the biggest employers. the biggest employers in those areas, particularly in western North Carolina, which is suffering, colleges and universities. Yes, they they should have a moral high ground about educating the next generation. They need to talk about how valuable they are, how valuable they are to the communities and the states that they serve. >> Yeah, thank you for that. I mean the the power of storytelling and the data behind that is uh is absolutely essential at this time. Um I want to move us back to the intellectual property topic which is near and dear to I think all of our our hearts and you've been a co-sponsor. Thank you for co-sponsoring the prevail act. It's a bipartisan piece of legislation the promoting and respecting economically vital American innovation leadership act uh prevail. Uh so it's about strengthening intellectual property protections for our US innovators and and you've mentioned now several times what we see here in the research triangle area about the importance of intellectual property protections and what happens when they go away. So how does strong intellectual property protections influence investment decisions in biotechnology and bio innovation more broadly and what risks arise if those protections are weakened? So um basically it is the intellectual property that investors are investing in. They are investing if it's a say if it's a patent in you know the exclusive right to produce whatever that pharmaceutical is or biologic is for a period of time. And the way I and I'm always going to rem remind people every single place I go, the right to intellectual property is in our constitution. It was put in the Constitution before the Bill of Rights. Why? Benjamin Franklin and Thomas Jefferson were innovators. They invented a bunch of stuff and they didn't like that when we were colonies, England would take their intellectual property away from them. So they put it in, but only for a period of time. So you should be able to monetize your idea for a relatively short period of time and then your idea goes out to everybody and that's where we get generic drugs. That's where we get the opportunity to use Mickey Mouse however we want and copyright. But for a short period of time, the reward that you get for your innovation is being able to monetize it. Nobody is going to invest in your idea if everybody else is going to be able to use it whenever they want, however they want immediately. They're not going to. And so we need to have that short period of time. Now there are people who abuse their patents and I will go after them because that is wrong. But for that short period of time people need to be able to monetize. That is something unique about the United States and it is why we are the place that everybody wants to come to. So as that intellect as those intellectual property rights are diminished so will be innovation. Um and I our AI experts are here. It's also happening with singers and songwriters. I have a bill to protect them from AI um and let them collectively bargain for their rights. It's happening with movies. It's happening. Our newspapers are having to sue AI because AI is taking their content and monetizing it. And so again, limited period of time, not forever, limited period of time. People need to be able to monetize it. Otherwise, because our government doesn't pay for everything through the whole lifespan of bringing an idea into market, you're not going to get that private sector investment. You're simply not going to get it because they're not going to give their money for somebody else to take away the idea. >> Yeah. Yeah. Um and and thanks for that and thank you for your focus on these issues. And in addition to the legislation that you co-sponsored, the prevail uh act um are there certain other things that we can be doing now as a nation to strengthen the US intellectual property and innovation system? >> Yeah, I I love that you asked that question because I'm going to go back to immigration. Disproportionately, immigrants in this country have invented things. Disproportionately, those patents in the United States, those ideas came from immigrants. The reason why I and and Senator Tillis cared so much about the Unleashing American Innovators Act is because a lot of firsttime patent applicants, you know, they're not in a university. They're a farmer who figured something out >> and wants to be able to create this better way of farming. I mean, and let's just be honest. Most of the farming innovation in this country, the key African-American farmers. Why? They didn't have a whole bunch of other people working for them. They had to figure out a better way to do it. And they deserve to get a patent on what they do. >> Yeah. And so we have to look beyond just our research institutions and our big companies and understand that you know necessity right. >> Yeah. >> Creates innovation and we have to nurture that everywhere it is. And that means it's in the rural areas. It means it's on our military bases. It is in our immigrant communities. It is everywhere. And when we say that only certain people are going to have access to higher education or to different things, we are basically saying that the people who are most likely to be scrappy and innovative aren't invited to the table >> and we're all going to lose. And I'll close that with this. I am um co-chair of the congressional study group on India and have a huge Indian population in my district and I went to India um three summers ago. They have the largest incubator and fab in the entire world in Hyderrobot. And where do they get the people to go there? Not all from their universities, from all over the country. People who have tried to solve problems with irrigation or with health care. I mean, some of the things that I saw in that fab were entirely born of necessity in rural areas. We have got to have the same approach here. Innovation is not something that is only for elite people. It is something for people who need to solve a problem. >> Yeah. Well, as a first generation American, as an inventor and as an entrepreneur myself, I really appreciate those comments and thank you for your uh efforts there. Um so we we had this wonderful success an amazing governor here. um the success of the research triangle area and the bioinnovation power that's been developed. Um but not all parts of North Carolina are enjoying the same kind of uh benefits and um uh and innovation outcomes. So how do we replicate these models? How do we take what's been successful here and allow other parts of the state and really other parts of the nation to flourish? So we have seen um and back to the comments that I made about you know manufacturing that has gone away. We have seen um clusters kind of reinvent themselves and attract this innovation. And Wilson, how many people have been to Wilson lately? I was there like last week. You know Wilson was just pretty much a tobacco town. right now. Everywhere you look, there's they're putting in there's like Merc highway or Merc, you know, I'm like, what is going on? Here I am on 64 and I could take a right on to Merc highway. And then Fenius, I think Forcenius was one of the first that was there. So um we're also seeing that in Canapapolis where they lost um the textile industry and they've brought in um innovation in in terms of food um research. So you have it does help to be near the institutions of higher education, right? It does help Wilson that it's near Wake County. It helps Johnston County that it was near Wake County when the Spanish um manufact drug manufacturers wanted to go. But we also have seen places where that community college and the and the workforce that's being produced from that community college can make the difference as well. So I think showing that you've got that workforce is the most important thing. Thank you. Um before I open it up to um uh a question or two from the audience, uh you mentioned this earlier on and I just wanted to double down on this question about the United States and our competitive position visa v China. Uh we have allowed our uh investment position to be overtaken in basic R&D um as a nation. I I've testified both before your committee as well as a couple weeks ago before the Senate Commerce Committee on this topic too. Um is is Congress taking this seriously enough? >> No. Are are we willing to allow China just to run over us? >> No, Congress is not taking this seriously. It is actually something that is very bipartisan on the science committee um and on the intellectual property subcommittee. Um we if anybody I mean the the the happiest government right now other than what's going on in the street of Hormuz is the Chinese government because we are seeding things to them >> that would be so easy to develop here and um the pharmaceutical industry is a perfect example. >> The mo the majority of pharmaceuticals are made in China period. They are and as we have less and less of that share they are the ones that are taking it over. I mean India is taking some over but not in the way that China is. And so every time we don't make the investment we are basically just dealing another card to China. and and and we make that point every single solitary time we can in both the judiciary committee and in the um in the science committee. And my my amazing dis district director Nadia here told me I only have five minutes because I've got to be at the governor's mansion no later than 2:30, which is 35 minutes away. >> All right. Um thank you. Thank you for that. Do you have time for one question? Maybe. >> Um, if there's somebody who has a question, please come forward. CEO had five companies as fast as >> now China we are all absolutely necessary when we're in phase so we're having more risk because Yeah. So, we um we just have to be smarter about how we protect our innovators, how we protect that capital. Um, and uh, we need, and I'll turn it over to some of my colleagues who are doing even more work on AI, but we have got to make sure that AI cannot steal intellectual property. And it is so infuriating that AI calls the theft of intellectual property fair use. Fair use is when a teacher shows a movie in a classroom and doesn't have to pay a license fee. Fair use is not when you take something that anybody else would have to pay a license for, use it, and then make money off of it. >> Yeah. >> The minute you're making money off of somebody else's intellectual property, it is not fair use. That's I mean it's just really not complicated. But AI, you know, they want to be the Cowboys. They think that everything they're doing is better than everybody else. Well, guess what? It's not complicated to do a license. >> Anthropic learned about that the hard way. It is not complicated. But Congress has got to flex its muscles and protect intellectual property or else we are not just going to lose to China. We're going to lose the next generation of innovators to people all over the world. >> Yeah. >> So, thank you, >> Congressman Ross. Thank you so much. We really are grateful for your comments today. Thank you. Perfect. Perfect. Can I invite uh the first panel to come to the DAS please? These are the hardest chairs. Yeah. So, wow, that was an energetic talk, wasn't it? That was just just amazing. I haven't been that proud to be an immigrant in a very long time. So, that nice talk and a really nice overview of the success of of North Carolina as well. So, we've got a great set of panelists here for the next discussion. Um, you know, we often use the word innovation, we often use the word ecosystem. We've combined them here together. Um, and we're going to give some a lot of, you know, details, um, about what that innovation ecosystem looks like here in North Carolina, it successes, and what's going to happen next as well. Um, I'm going to just quickly let the group introduce themselves. I think what's nice is that we've got kind of a continuum here. We've got, you know, Robin here who works in academia, uh, the early friend of R&D. We've got Mike who's who's an innovator. Uh and then we've got um Jesse who's done who's built things but also now is an investor as well. So maybe just quick introductions um for yourselves and then I'll get into some questions as well and I'm going to have actually Mike do a little bit of um level set of some of the numbers that we have here in North Carolina as well. So Robin uh >> so I'm Robin Racer. I'm associate vice president for translation and commercialization which is a fancy way of saying I manage the tech transfer office at Duke. Hey >> everybody, great to see you today. I'm Mike KS. I lead the emerging company development program at NC Biotech and we provide funding to early stage companies to help them attract and raise follow on capital and grow here in North Carolina and look forward to the discussion and things. >> You're you're you started companies yourself though as well, right? >> No. >> No. Oh, I thought you Okay. >> No, we we seed companies. Uh good afternoon everybody. Uh Jess Shore um with First Flight Venture Center. I help run ecosystem develop as well as strategic strategic init uh initiatives. Um just I'm like three weeks in over here. Uh so um uh I'll try not to get fired in week four um by saying anything. But before this I was actually at uh Department of Commerce here in the state um helping with working with John Harden over in the office of science technology innovation. Before that a couple years in defense and before that I was a professor at NC State. kind of bringing like a kind of a broad background uh which is um which allows me to talk forever and not uh and u let's see well yeah when I was at NC State I felt like I was like I could talk forever because I that's the that's the attribute you learned as a professor and then in defense you get to add a layer of BS but a layer of formality at the same time and then state government you just are trying to prevent risk for your boss um and then you leverage stats that's what I learned from John um so anyways I'm not sure what how today's going to go now and now I'm in this new role. >> Well, we'll find out. So, but just to level set ourselves with some numbers about um the the triangle. Maybe you can just uh give give a bit of an overview here. >> Sure. Sure. So, um you know, Representative Ross, I think, gave a really nice historic background on North Carolina and how we got to where we are, right? Starting with the the the recognition of the economic engine that could be from our universities. And so you know formation of those early anchoring companies and then uh bro's welcome of moving into the region um the innovation that began to occur and really recognition of North Carolina as a great place with with a strong reputation and a in a in a talented workforce. Those were the beginnings, right? And over the the years we've continued to grow from that point. um we saw a period of time where the CRO industry was fledged here in the state. So this is the birthplace of of the the CRO uh industry with Dennis Gilling starting quintiles. Um and then as time went on, we saw the emergence of of a strategy to become the global leader in biio manufacturing. And so we we saw the state really create policy and and and and workforce development programs intended to help us be the the place the destination for biommanufacturing and we saw that through uh you know dozens of companies located in into the state. Um another u big step I think in the 80s was the creation of the biotech center. Um I'm I'm biased because I do indeed work at the biotech center, but I think it's been everyone would agree it's been an amazing resource for for an economic engine for North Carolina. The the program that I lead provides funding to early stage companies. Uh we've invested over $70 million over the lifetime of the program and those companies have gone on to raise over $8 billion in capital if you can believe it. and just the last quarter we funded our 300th company through the program since 1989. So great milestone for us. Um and then we've only seen more and more success around biio manufacturing over the last few years. So um a lot to really be proud of. But I think the important thing to remember is this doesn't just just happen, right? This was 60 years of of workforce development and strategy that got us to where they are to where we are today. But it also doesn't mean that that the future is a surefire thing, right? We've got to continue to to to innovate and to um compete in a global in ever more global work workplace. And so those are all things that we think about and keep us up up at night. But I I would like to give just a couple to your original question and then I'll stop talking. But uh did want to kind of level set with where we are. But just to give some some statistics and some ideas, we've been doing a project that's trying to quantify our our ecosystem and our R&D ecosystem. So I want to just throw some stats out there for you. So we have across all sectors 860 life science companies in North Carolina that employ over 76,000 people if you can imagine um from from the the 50s when we were a second poorest state in the country and in a farming. It's actually >> Yeah, >> there were only 49 states when RTP was actually put up. So, we're actually the poorest state. >> Yeah, we were we were right there, right? Yeah. No Alaska, no Hawaii at the time. Uh we we also now have um this three-part three parts of our bio therapeutic ecosystem. So, hello. Yep. Sorry. So, the first part being research and development. So currently we have over 490 R&D companies here. Um when it comes to therapeutics there are 147 companies that are pre-clinical and six we have now 61 clinical stage companies in North Carolina. 61 companies those are actively enrolling patients in clinical trials. Um our CRO industry to give you a snapshot of where that is it went from the birthplace back in the 80s. Now we have 160 companies in contract research with 24,000 employees. And on the manufacturing side, we have 34,000 people doing biommanufacturing across a number of of companies with an additional $6.1 billion in investment announced over the last um the last year on top of a record year before that. So really um great place to be. But again, um, it's not without challenges and I think it's important that we keep our eye on comp competitors and what what we need to do to continue to grow this ecosystem. >> So, so that's great in terms of level setting us. Um, we had a really energetic um, uh, panel prep session as well. So, uh, I'm going to hand it over to Robin. I think, you know, as a as a preface to that and say, um, you know, who's the poet or playright? He said, put put some people into a room and we're going to stop being polite and start getting real. So talk a little bit about the the challenges um that you know we've we've done so well in in this triangle park. What do we need to do next? What are some challenges that that we're facing some headwinds? >> I promise that I would be um I would be political not political. Um I did want to give you a little bit of level set because I think you you know you've been talking about ma all you've heard this mostly this morning is manufacturing and companies and workforce but you know there is how successful is it been so Duke is very fortunate we have seven drugs on the market that means that the research that happened at Duke over the last 20 years has made it through the FDA process and is also making it on the market Our revenue last year was well over hund00 million which says that the market believes in the technologies that are coming out of Duke. That's the good news. And we have uh well over a hundred companies in which we have equity. Um we have last year uh probably close to 300 million in investment into those companies which is not as good as we'd like. Um, we've had IPOs and we've had acquisitions, but we haven't had IPOs in the last four or five years. We have had acquisitions in the last four or five years, but they haven't all been spectacularly good acquisitions. So, it's sort of the good and the bad news. I think the important thing that's sort of the bad news is if you look across, and I'm just going to focus on UNC and Duke because we're really talking about life sciences. No offense to NC State, but they do do some life sciences. But when we're really talking about therapeutics, we're really thinking about UNCC and Duke. Um, our research funding for across those two universities over the last three years is essentially flat. Duke's at about 1.3 billion. UNCC's at about 1 billion, and it's been about the same for the last three or four years. You know, that's the engine that funds the the research. The numbers of disclosures have been flat more or less with the two universities. Our startups at least at Duke are down. Startups at UNCC I think are also down. I think that's a function of you know the research. So all this is great about having manufacturing and all CRO and all this kind of thing but if we don't have the basic research and the inventions we don't have anything to manufacture or anything to develop. So I think Deb was was you talked a little bit about that and I think that's what we worry about the most is the pipeline. I mean, it's been really great to have these drugs make it into the clinic and onto the market and having many startups and, you know, we really depend on NC NC Bio does invest in a lot of the Duke companies, but we really worry about what's going to happen in the next five years in terms of, you know, new inventions, news, new ideas. >> Let me just ask you, >> can I say one thing real quick? So I you know I think this is an interesting trend um where as Robin said there's been this a decline in the number of of startups. This isn't a unique trend here in North Carolina. This is something that has been seen across all ecosystems all the major biotech ecosystems across the country. Uh if you look at the data it it it's pretty strong in suggesting that there are um fewer startup companies overall. And again, I think part of this is is driven by the the the the mature group of clinical stage companies that have arisen out of the maybe out of the the the pandemic the the time 2020 2021. There were so many companies created and those that have have gone on are now clinical stage companies and I think the investor risk tolerance is has moved to a little bit later stage in in picking more being more selective around those clinical stage um uh clinical stage companies. In North Carolina last year, we actually had a record year in the amount of venture capital funding that came into our state for life sciences. Um, including over a billion dollars for for um therapeutics companies with several major companies raising over hund00 million in financing last year. So, it it's it's kind of a tale of two worlds at this current time. And that's an important thing to understand. >> Well, we should also point out that it's also a little bit of a tale of two worlds, too. It's not that we're not busy in the engineering side of things. It is very busy at Duke. So we have lots of startups happening in engineering, sensors, drones, satellite technology. No problem there. And also and unfortunately you didn't get to hear Dr. Ferrante this morning. We are also very very busy in the whole AI health digital health. So investors, you know, this is sort of there are cycles over what investors are interested in funding and so those kinds of companies are, you know, are are doing just fine and we are very very busy with those kinds of agreements. So this could also be a little bit of a >> Yeah. I I mean I just add I founded a company in 2021 and at that time it was a heyday investing in lifestyle. I got very lucky. You can't be good be lucky, right? And you know, we got $50 million of of early stage funding. Then we got an additional $35 million from the DoD as well to really accelerate us. And so we ended up going from from co-founding the company to exiting at $250 million. We did really well. Um so I think it is a bit and so I think there's a reckoning now, right? The money was slashing around. It's it's kind of um in a downturn, but I think it's coming back up again, especially when you look at AI and early drug development and AI and healthcare as well. I mean, if you just look at like what's going on with like the most recent AI, SpaceX, OpenAI, all that's going to be flooding the market back into a lot of angel investors, family funds, and that that should help out the smaller the smaller checks or writing the smaller checks for companies. I think that life science is going to uh life science should have a a positive impact on that. >> Let me just follow up with you in terms of the tech transfer office. you know what do you see as kind of the successes of you know why you were perhaps better a tech transfer if you were right than other uh universities around the nation >> uh small and very flexible so we we've been very fortunate that we have really good faculty and good research but we've been fortunate enough that we can be you know as quick as possible we can be pretty flexible with the kinds of deals that we do we have a fair amount of support from admin administration to let us do these kinds of things. Thank you to my boss over there. Um I I you know we have very much focused on trying to get the deals done and help our faculty. We're small enough that we're very team oriented. So we we have a venture group. We have an angel group. Um you know but I would say in the triangle NC State has also been very aggressive and very you know they're not huge either. very good at doing um startups and and more in engineering. UNCC is going through some transition so I can't really speak to where they're going. So um I think most of the tech transfer offices across the country we all and Steve will you'll hear from Steve later today a lot of because we have a professional association we can get together and talk about best practices and better ways of doing deals. I think it's I'd like to say it's not the tech transfer offices that hold up things. It's more trying to find the investment and also keeping your faculty happy. We are going through some changes where faculty are moving you know faculty can go wherever they want in many cases if they have funding and so maintaining the faculty group that you have sometimes is a challenge. >> Yeah. you know, so used to be a professor and transition technologies out and there's this it's a double-edged sword when you're a faculty um and you probably see this every day. You want your faculty the return on investment that a university has in their faculty is bringing in more R&D funds, getting more graduate students, teaching classes, and your main product to university is students overall. But when you're starting when you're going out and trying to transition a a company out or a technology out, you're just like, "Okay, well, I can start a company." Well, that's not as easy as it looks. And also, does the universities actually provide you all the necessary resources into doing this? Um, that I mean it so it's a it it take so when you start a company, it starts taking away the resources that you have for going out and building R&D infrastructure and kind of doing that sort of like university mission sometimes. And so, you know, every university kind of has to find a way to grapple with this. I think our local universities have done pretty good on this, but are they creating a founder ecosystem around those faculty so that they can retain the R&D infrastructure and still get that technology out, I think is one of the things that maybe sort of like could be improved over time uh or has the opportunity to pro to improve the whole ecosystem. >> So, so let's dig in that a little bit further. Um, so what so we look at technology hubs, life science hubs, you know, you got Boston, you got San Francisco, maybe San Diego, uh, you got Maryland, where where I'm from. What's that? >> Paloto. >> Palo Alto. Exact. So what makes So, you know, earlier we talked about educated people here. You know, we talked about the great universities, but that's what those other ecosystems have as well. What makes North Carolina this view because you've been around here for a while. >> What makes North Carolina actually unique other than maybe it being cheap? Uh so what makes uh North Carolina >> what's unique about North Carolina success that is that is not that other hubs don't have I guess >> I think it is the you get a lot of the when you start going and doing customer discovery as a as you bring a technology along with all of our manufacturing presence around here I think that that's the thing you can create a high quality product that can be transitioned out because you have that ability uh to look at that. >> No I I think that's great. Yeah. And I, you know, I I look at this in kind of three three buckets. So the first bucket is that that RTP in North Carolina is an a mature R&D ecosystem. We have assets in every category across the board. We have, you know, an a local investment community that does a very good job of syndicating investment and bringing dollars into the state alongside programs like NC Biotech. Um but if you look at our infrastructure, if you look at the workforce, I think sometimes our R&D e what we have as an R&D ecosystem is sometimes overshadowed a bit by the amazing biommanufacturing that we have here, which is awesome, but I think we really do have the the the one two punch when it comes to uh both R&D and manu manufacturing. So I think the mature ecosystem assets, that's part one. Part two is this is a really it is a capital efficient place to do business. The you know the average R&D biotech wage in North Carolina is about half of what it is in in the Bay Area as well as the the the Cambridge Boston area. And that's from um some statistics from um the Department of Labor. So uh much much more affordable. the uh lease for space is about half the price as well. So there's a lot of there are a lot of reasons this is a capital efficient place to do business and then and then lastly, you know, it's been alluded to, but the quality of life here. There's a lot to a lot to really like about the the area and why people that come here don't want to leave. >> Yeah. But I love this. Not just cheap, it's the one-two punch, as you said. I I love that. >> Yeah. So >> those of us who live here know it's not as cheap as it used to be. Um so let's just remind ourselves about how much our taxes have gone up in the last especially last couple years a cheap as it used to be. >> Yeah. So Mike brings up a really good point. So there's you know a lot of times like uh you know Congress or Congressman Ross brought this up is like our region does biio manufacturing and pharma really really well at like highcale manufacturing. Um lots of investment from international companies. they they move here and then they continue into invest in here. I mean, just look at Amgen for example or Biogen. I mean, it's unbelievable. Um, but at the same time, you know, we also have this high high quality of R&D that's coming out. Um, so you you're thinking that that's going to create a both a balanced manufacturing and innovation economy, but because of where we started out as a state, which is a historic manufacturing state, it's kind of hard to kind of like gain the extra label of being innovative at the same time. Um, and so you can look at that at the salary u discrepancies. I think that that's like the most telling stat around this. Um so just let you know the in knowledge and technology industries uh which is put out by the national science foundation uh and and other groups in the federal government we are 85% of the US average wage that has increased since 20 I think it's 2021 to 2022 that has increased 29% on the US average and only 26% in North Carolina. So if you just look at that, you're saying like we're just not translating into those KTI types of jobs as much as we are in the manufacturing jobs. So we're not seeing the benefit of having the private manufacturing in at the startup stage coming from universities. >> We'll talk more about that. So we you got the large you know u multinationals doing manufacturing over here. You got nent startups starting the university. Are you saying there's there's a gap in between for >> I think that there's a translational gap that could be that that could be for that could be there. Um but I you live it every day. Robin, what are your thoughts on that? >> Well, I I do think we should be careful about holding on to our laurels and the park is so special and all that. We are being eaten up by the PaloAlto and the Bostons of the world because the state is not investing in the park. the state. You know, we could have a whole vibrant discussion on NC innovation and how the state is not focusing on the on the triangle and just assuming it's going to stay here forever and it everything's going to be roses and it's not. Now, we do have the advantage um having lived here now for 10 years to watch how RDU has grown. We do get investors coming. It's easy to fly here from Boston. It's easy to fly here from New York. So, a good number of our startups now, the management is in Boston and then they keep on funding. They fund it here. Um, but they're not moving their companies to the park necessarily. I mean, yeah, maybe we're cheap, but we're not that cheap. And so, that's where a lot of the talent is. And so I worry that the state is is talking about western Carolina and all the instead of focusing on hey we have the we had I think had we had the opportunity to really be competitive with Boston and PaloAlto but because we're not focusing on the park we're going to lose that edge. >> It's peanut buttering a little bit across the state. Is that >> Yeah. >> Yeah. I think there are important examples to highlight. uh in our state for example Korea Therapeutics. So you know Korea has moved in their entire operating uh presence here to North Carolina now and and that's a really unique story of a company who who was doing R&D in gene therapy and has now primarily uh established its operations here in manufacturing. And so they were able to take advantage of of our R&D employment but also really grow into a new stage in their business which was around biommanufacturing. And so I think that's a really interesting case that we can all learn from. And in in addition they raised 300 over 300 million last year. Um and so I think there are some some very unique uh opportunities there and and uh we you know at NC Biotech does a lot of company recruitment as well and and and it and it's no um it has been articulated that it's important to some of the biommanufacturing companies that there's also the opportunity for R&D here in the state and so I think there's that really interesting you know there's that really interesting crosspollination that happens between manufacturing and R&D and that's the I think that's a huge opportunity. Uh we're already starting to see that with some of our some companies that are doing next generation R&D in biio manufacturing and AI and um uh I think you know that is a that's a a a big opportunity where we have a lot of really smart people and companies that are interested in pulling those technologies into their businesses here. I mean that specialization specialization is interesting. I was just out at an investor conference um in in Berkeley and they're really focused on AI and life sciences right Boston is known for its clinical with all the great hospitals they kind of spoke focus on clinical specialization. So I like the idea about manufacturing you know back to you Robin you said the state should be doing more. What should they be doing and what area should be they should be focusing on? Well, we were still we were trying to kind of get away from the ma I mean I think manufacturing is great and everything but the whole translational side. How do you get the early stage technology to a point where somebody actually wants to invest in it and also eventually manufacturing and I came from and some people have heard me whine about this for 10 years. I came from a state, Michigan. Michigan has a program called MTRA and Michigan it's it's sort of a joint between the universities and um the government and basically instead of trying to have every university from NCCU to UNCC Greensboro have a tech transfer office instead pick the the major universities that already have the infrastructure the translational dollars and focus on those universities and then let those universities help the smaller universities IES so in other words fund University of Michigan and then it helps Western Michigan for the 10 disclosures it gets a year and and it's also a translational fund so they have a major translational funding for agriculture for uh therapeutics of course for automotive um and I think for u maybe for manufacturing I can't remember and and to have something like that where you're really trying to you're helping across the state but You're building on the strength that you already have in the existing universities. And then you're doing a partnership with the universities. For every dollar the state puts in translational funding, the universities also put in it. And it's a great program. It was based on the culture program that a lot of universities have. You know, I would I it'll probably never happen. I would have loved to have seen something like that. That's what I was hoping NC innovation would be in that kind of a structure. Go ahead. >> Yeah. you know, so that's the state state funding and state initiatives, but I think it's also important to think about on the federal side uh what's what's available for early stage companies and in particular the importance of uh the SBIR program on the federal level as many of you may know that in in recent times about uh back in September the program lapsed for the first time since its creation and it took some time to get the program back on track about eight months and we within our portfolio companies we have a a portfolio of over a hundred companies right now in the triangle that we've funded and and it and some of those are reliant on SBIR capital um you know again North Carolina is not not an ecosystem like Boston where there is as much venture funding so these the SPR program is is very important and and this isn't um you know for for companies that are just doing research. These are companies that have raised venture financing and are also sub supplementing their venture financing with SBIR capital. So it's it's a it's very important program and and we've seen this gap has already created some pretty significant issues where we probably will have some companies that go out of business. Um the uh the second thing that we've been seeing and I think this is really important to note for for you know for uh policy makers and and folks in the room just to understand what's happening right now. Um uh last week I got an email from one of our portfolio companies who they informed me that they were denied funding because of um foreign risk that had been assessed on their SBIR. And this was after they had already uh been notified that they were likely to be funded. U but the the final audit flagged them for for foreign risk. This is a problem that we saw last year. Uh about nine companies that we know of here in in North Carolina were affected by it. Uh losing about $15 million in funding and and u last year before the reauthorization companies weren't giving given any feedback as to what the foreign risk was. And this was a big issue for for a number of companies that are very good companies that we work with. Um, fast forward in the reauthorization for the SBIR program, there was language that was added to that bill that was that that that required u more detail to be provided to companies about what the foreign risk is. Unfortunately, um it's it's kind of vague in terms of how much detail has to be provided and and what we've been seeing is um the the first company that it took a few months to get everybody back into the system, get applications in and get get notice from the agencies, but we're starting to get awards from the new the new reauthorization. and uh and one of the companies it it was it was denied and and the rationale for that was very very vague like six sent sixword sentence didn't even make make any sense I don't I don't know what it means nor does the company nor do they have a chance to to to learn and so I I fear that this foreign risk issue is going to become a big killer of innovation for our early stage companies the the other the other other thing that I did following up to that was reached out to you know, to a an organization that does grant funding and and supports companies with grant funding. And so they they interact with a lot of SBI companies. And I asked them, are you seeing an issue with this as well? And they informed me that 20% of the companies that have been notified of award have then been have have been then denied due to foreign risk. And so it seems that after this reauthorization that there's going to be more of this happening than we've ever seen before. >> So a little bit of a little bit extra context on that. Um from I think it was like from 2021 to 2024 every single award that had So when you when you submit an application for federal funding, you fill out a you fill out a sheet, you check boxes around foreign influence stuff. And so that's what the government agencies use to evaluate whether or not there's foreign risk or if they should go in and have further investigation on this. Um NIH uh so just give you just u DoD um if they see that they will negate out 25% of their awards on average um if they if they see any boxes checked. NIH 100% negated between those between that span. So I think it's actually interesting that now all the agencies are actually having to develop these methods uh in order to assess foreign influence. And I think that what we're going to see is a little bit more of a I I think it's going to be more of like a P curve a little bit. There's going to be some there's everybody will figure this out. But at least they're kind of they're telling the agencies, hey, actually put together a plan. I think we're going to start seeing this, but right now we're sort of like wild wild west and it's not helping our companies. >> Yeah, I think everybody can agree that, you know, if there's foreign risk, we need to know about it. And if if companies have foreign influencers, we we we definitely want to know about that. Uh but I think it's it's just important that that um companies receive the feedback that they need. Yeah. Totally. So that >> Yeah. But NIH historically had just never provided any feedback and just negated everybody out as well. >> And a lot of it's got to do with the data transfer as well. I think at least when I was the White House, we're worried about companies doing maybe clinical trials and then transferring those to to China. was that's okay except all the data would flow there as well about US citizens and about their personal data and and you know that was that was a concern. So I think I think it was derived by actual activities that were occurring again wholesale data that's genomic epigenetic you know omic data just wholesale being transferred over so I think there were concerns but I think we have to drill down to be like to your point like what does what are the actual risks how do you mitigate those risks often it's a lot easier rather than saying you're denied funding say how do you mitigate those those those security risks so >> agreed >> um >> and I and I'll say if you if you have any doubt on the value of the SBI program. There was a study that showed that between 1997 and 2020, I think um 12% of the drugs that were approved across the board were at one point those companies were funded by SBIS. >> Can you all talk a little bit about just general federal funding? So, I'll be kind of incendiary. RP pouring a lot of money. You know, NIH has got more funding than than than ever before. Looks like money's sloshing around. Um, so what are you what are you guys doing with all the money that's flowing from the federal government? >> Well, we do we we are fortunate enough that we have two right now A R A R A R A R A R A R A R A R A R A RP grants and I will tell you they are uh exhausting but it's really an interesting program. It's a lot of money but it's run in a way that um you know if you're a university you gota you got to really uh think like your industry. I mean the great thing about ARPA is that's it. It's translational. You're working as fast as you can. Um the project managers for the two RPH grids I'm familiar with are are really um good at management because they have to be. And so I think it's a it's a throwing a lot of money at something but saying if you don't meet the target milestones, you're out. And I think university faculty often are working on faculty time and not industry time. And so it's really um it takes different kind of faculty to do that. So I think the RPH programs are wonderful and so we're seeing those and I don't know how much if you have any data about how much RPH money is flowing into the other institutions. I only I know about Duke. So those have been great. There's some other um interesting programs that have come out more out of um DOW and stuff that it's still a little early. Clearly, they're focused on translational and I think really they're meant to be outside of the university and really try to move things quick, but I wouldn't say that we're we're loaded with all sorts of federal funding. I mean, the SBIR and the ST are are coming back, so we're seeing a lot of faculty with that. We're seeing, interestingly, and I I think Ed was here, we're seeing more big pharma showing up with some of the programs, which is nice. I mean, I wouldn't say that we're drowning in it, but they're they're definitely coming back and looking at things. Um, you know, it's but it's definitely flat. It's not like um it's going way up. >> Yeah, it seems that there are new new models, right? Like >> u innovators have more options in terms of how they start companies and how they fund those companies. uh you know the the venture creation model for the venture funds has become a major trend uh where uh you know the the orbimemed the RA capitals uh of the world are are putting large investments into innovation and building teams around that and and then growing those companies and taking them to the clinic that way as opposed to kind of the traditional founder startup model. So there there are a lot of new opportunities uh and um tools in the toolkit if you will but it's still very important um that you know in my opinion for organizations like NC biotech to be able to provide support to early stage companies to bridge that gap between university and you know venture capital larger rounds of venture capital funding in most cases. um also important for SBIR to play that role as well. And so I think it's important to to to understand that there is there are some changes in funding models, but um the the the support that the government provides is extremely important to early stage innovators. And if if you look at countries like China, you know, they're they're putting tremendous amount of capital into into their com into their ecosystem as well. And so you can see how the the the role of of policy and things make a difference. >> Yeah, I kind of feel like federal government is reducing risk on managing programs um and getting the technology out there. So, and what I mean by that is typically when you'd work with somebody like the Department of Defense, they'd have program managers that you work with. Um you look at like Department of Education is a really good example of this where they've per per I mean for the most part defunded Department of Education, but now they're moving, you know, the anticipation is that they're going to be moving a lot of this to like state uh efforts to just let the states manage the risk on this. So, you kind of think about this is like how does this impact industry or technology clusters? You're going to start seeing a lot more folks like the North Carolina Biotechnology Centers, which are, you know, they bring together a community. Uh you're start seeing a lot of incubators. You actually start seeing this already where incubators are g being asked to hey utilize how your entrepreneur support organizations or structure can go and support the new R&D efforts. So I think you're start seeing a lot of push towards those types of places. Um and then it's up to those organizations to then figure out the best ways in which they can leverage the university infrastructures in terms of building out the economy, providing testing services, providing the educational portfolios to get those technologies out to maturity >> and then just broadly are you seeing um money flowing to very specific areas? So we talk about manufactur platform but are Yeah. So >> well I I but that's not new I don't think. I mean, I think there's trends. I mean, I've been doing this for a long time, and you know, I'm I'm old enough to remember gene therapy was hot, then it wasn't, then it was hot, and now it's back to not being. I mean, it just it all these technologies kind of come and go. And also, you know, I was around when the first software and now we're in AI Health. So I I if you're like you say if you're lucky and I have faculty are like oh they're they happen to be right there in the middle of it at the right time versus some research that it passed them by. So I mean I think it's trying to be nimble enough on the research that you've got or the technology areas that you've got that happen to be hot at the right time. um you know and and helping our faculty also not be too greedy in the sense of no no let's let's move this way but don't expect that you're going to make10 billion dollars just because you're the first AI whatever >> but let me ask that another way is there an perhaps an area of excellence that Duke North Carolina you know has in a in a specific disease area platform that's kind of emerging or has emerged over time >> well we've certainly been good in in genans gene therapy, gene editing, epigenomic editing, RNA. I mean, we have and cell therapy. In those areas, we've been, you know, very strong in the in the life sciences. Duke has some special air, you know, we're we're pretty good in some of the orphan diseases and some of the pediatric diseases. And of course, we have the Tish Brain Tumor Center. So, we're also very much in in GBS and those kinds of things. I can only speak for the really specific things, Duke. So in the in some of the therapeutic areas, we we've definitely got a beach head here in those areas. >> Another one to throw in there is regenerative medicine. So a large regen medicine cluster in the in the triad area >> and now the longevity now all this stuff with longevity and orthopedics and regenerative medicine. I mean I think that's important. Vaccine technology has been an area. Now, who knows what's going, you know, vaccines can be good and bad depending on >> and I know we're not it's not the topic of today, but our medtech ecosystem I feel has been very strong uh lately for a while now, but I I really feel like there's a lot of value pent up in our in our medtech ecosystem and you can see that by investor interest from out of state. >> And why are those areas so hot that you mentioned? Is it bringing in some sort of Nobel Laura? Is it an anchor company? Is it a biotech that has succeeded? So you mentioned all those different areas. >> Regenerative medicine, you can look at the NSF engine on regenerative medicine that's out of Wake Forest University. Federal government has put in $30 million on that NSF engine so far. And they've gotten another I think it was like $266 million in other funding from private organizations as well as other federal funding sources. And that's had so far a $300 million economic impact on the Triad. >> And why did they invest it here else? uh they invested here because they brought in the right faculty to run that that is well connected and I'll also bring up the fact that so Tony Atalo if you don't know Tony um at Wake Forest Regenerative Medicine Institute the guy is probably one of the top scientists in the state I mean the he's he's amazing um he knows how to get it done he's been working on this for like 15 years and he had a couple really good shots on goal about 10 years ago and then he you know three years ago he got the NSF engine funding And now I mean and he had already built a really good ecosystem uh and cluster around that. So it kind of like it took that one person to understand how does it build how do you build a cluster who are the right people and create strategic pipelines out to other areas within the US. And so it just doesn't look like it's you know North Carolina and North Carolina only the borders are closed but it looks like North Carolina is a facilitator for economic growth in other parts of the country. And now we're gonna go and get more more of that investment. >> That's a great case study, >> I think. Okay. Um >> I agree. Yeah. >> Um and then when you look at the externalities now, we look at, you know, India, China, um how are those impacting North Carolina? >> Well, it's funny. We do hear a lot of our spinouts who are going to China to do their CRL work, and it's because it's cheaper. It's just cheaper. You know, when we talk about, oh, this is horrible. Well, it's because we pay our employees in the US a whole lot more than they pay them in India and China. You know, what are you going to do? So, that is a struggle too for trying to keep a lot of the drug discovery even in the US. So, the spinouts that don't have federal money are still going to China to do a lot of the drug discovery, but they're maintaining ownership here. So, you know, they're and most of our spinouts are doing their early clinical trials outside of the US. Cheaper to do your clinical, you know, in gene therapy, they're doing it in New Zealand and Australia now and they're still so that's also a struggle. We have a big clinical research institute at Duke and I don't know and they're not how much they're suffering from a lot of the clinical trials being done overseas, but this is mostly just a cost thing. It has nothing to do with anything other than money. >> Yeah. And I I think it's a it's a really interesting time, right? Um the you know the other side of the coin is we've we've seen startups here in North Carolina who have licensed innovation from China and built companies. Um a good example of that is Slate Medicine that was formed and now is uh based in in in Raleigh. Um it was a RA Capital startup. It started with a $120 million seed investment. Uh and they're growing building here. They've found access to the executive talent they needed right here in North Carolina, but are now a great success story of of how you can get innovation from wherever it is in the world and and do good business here in the state. >> Tell me a little bit more why did they come here then? Why did they invest here? Was it you said talent people? Yeah, it was it was talent. Um yeah, we're being told to shut off, but um you know, part of it was the the the uh president of the company was already here and um and then was able to assemble a team to take it and run with it from from here. And it's a it's a migraine asset out of a Chinese company. >> I mean I mean that's a good way to close out. I think you had that ecosystem, you know, you come here for the talent, had the leadership as well. So, it's kind of a nice story there as well. >> Yeah. >> And and a good place to end. So, >> sounds good. Thank you. All right, without further ado, let's bring our uh second panel up to the front, please. my picture. >> All right, everyone has a chair. Everyone has a microphone. Wonderful. Thank you all and uh what a great afternoon. And what a wonderful set of conversations that we've been enjoying and I'm really thrilled about this amazing panel um as we talk about the journey from discovery to commercialization and build on some of the themes that we've been talking about today looking at the aspects of research intellectual property and investment across the pipeline. I'm I'm Walt Copan with the Center for Strategic and International Studies. And uh what I'd like to do is to pass it along in turn to our our uh panel members to briefly introduce themselves um uh and uh really provide us just kind of some opening framing remarks uh on this broad topic. Let's dig deeply into disco discovery to commercialization starting with Steve Susulka. Steve, >> thanks Walt and thanks everybody for being here. My name is Steve Susala. I'm the CEO of Autumn. Autumn is a nonprofit association focused on growing and advancing technology transfer worldwide. So we work with people like Robin and uh people like that around the country that are responsible for taking early stage innovations and turning them into the products and services of tomorrow. So, you might have heard the term technology transfer a couple times here, but I guarantee you each of you have experienced it. From the retractable seat belts that you have in your car today, came out of the University of Minnesota to those N95 masks that you wore during COVID, came out of um University of Tennessee to over 200 drugs that are on the market. Those all arose out of academic or hospital or federal lab research and are uh products and services you use every day to make your life better. >> Great. >> Hi, I'm Nick Sharpless. I'm a medical oncologist by training. I was faculty at the University of North Carolina for a couple of years. Um during that time I was an academic who kind of ran a lab. I uh started a company at my lab called G1 Therapeutics that was uh uh led to a marketed FDA approved product called Cosella. The company eventually went public and got acquired. Hatteris was our first investor. My second investor, my mom was our first investor. Uh I uh left academia in 2017 to go work in the federal government. I ran the National Cancer Institute in the Trump and Bid Trump one and Biden administrations. I had two years of pandemic time as a federal official, which is very interesting. I also had a stint in the middle as acting commissioner of food and drugs at the US FDA. I left government in 2022 and came back to uh Chapel Hill where I live now again and now I run an incubator called Jupyter Bio Ventures that invests in early stage biotech companies. And maybe my framing remark is that I suspect we're going to complain about some stuff. That's the nature of the game. But uh it's actually a really great time to be an early stage biotech. There's more cool ideas. There's great science. There's people brilliant ideas. China is both an opportunity and a challenge and has made some things easier and some some things harder. But I I have never been more encouraged about the prospects of curing cancer, the thing I care the most about than now. >> Fantastic. Dan, to you next. >> Hi everybody. >> Hi everybody. I'm Dan Dardani. Um I work in the tech transfer office at Duke. So my boss was just up here a minute ago, Robin. Um so anything I say that's dumb is my fault and not of course uh Robin's uh or Duke's. So um I have been working in tech transfer for over 20 years. And to me tech transfer is really where um possibilities and realities kind of overlap. And uh tech transfer is the farmers market where you should get up and your innovators and your entrepreneurs should get up early on the weekends and go farming for fresh ideas. Literally produce right the noun and the verb. Uh I also am involved with the autumn organization with Steve to my left. I'm the incoming chair. So, I should probably also say that anything I say that's dumb is not Autumn's fault, but mine as well. Um, but basically there's there's there's there's a lot that goes in between sort of saving patients lives and fresh ideas that come out of a lab and there's a lot of risk in between and my job is to try and facilitate that transition as smoothly and effectively as possible. Um, we often have a phrase in my business saying it's about the impact, not the income. And I think that's still mostly true because at the end of the day, you have to keep your poll star and your poll stars about how do we make sure that really interesting ideas that are generated by academics don't just become papers or uh PhD dissertations, but can somehow become life-saving medications that become services uh or seat belts that can save lives. And so my job is to try and remember that every day and not get too beat down by uh sort of the daily grind. >> Awesome. Thanks, Jennifer. Over to you. >> Uh, hi. Uh, I'm Jenny Lodge and I'm the, uh, vice president for research and innovation here at, uh, Duke University. And I've been had the pleasure of being the senior research officer at two different, uh, institutions, uh, including Duke and, uh, Washington University in St. Louis. Um, both of these institutions had very strong uh, biomedical research. Um, that was really the majority of their portfolios. Um and um I think that also both institutions have a commitment to uh thinking about uh and and committing to uh that we uh are a recipient of federal funds and we have an obligation to ensure that the benefits of our research actually reach the public uh and uh provide that benefit that public good as well as economic development. Um, and I've had the pleasure of uh working for uh Holden Thorp, who is now the he was the provost at Washington University and is now the chief uh editor of the science magazine. Uh, and uh at Washington University, we were very focused on improving the ecosystem, reducing barriers. Um, and now I'm working with Alec Gallammore here at at Duke who's the provost. And his vision is that we really amp up our translational ability uh and that we uh embibe that into the culture of our faculty um and uh make sure that people are thinking about the translational potential of their research um at the beginning uh rather than the end as well as providing the resources that are needed uh and reducing barriers to get them uh to translation. But also um a big part of this also is going to be uh changing the culture within our administration being much much more flexible uh being much more uh able to take on new challenges things that we've never done before and uh I think as Robin uh indicated we've been doing that over the past uh year or so and it's really been challenging uh and fun and exciting. >> Great batting cleanup David. >> Thank you Walt. Um, I'm David Ridley. I'm also at Duke. This is kind of the Duke side. Maybe that's the Carolina side or or mixed mixed over there, but >> I work over at I work over the business school. Um, Congresswoman Ross uh gave some wonderful remarks about the importance of intellectual property protection. Spoke very eloquently about patents. But patent protection doesn't work for all drugs, doesn't work for all diseases. So consider, for example, a doctor at Duke working on an ultra rare pediatric disease, a disease that tragically kills about 20 babies a year, but you can't afford to pay all the R&D costs if you're selling to 20 customers a year. Uh, conversely, consider GSK, which has a local presence. Uh, some dogooders at GSK were interested in malaria. You can't make money in malaria. It's tremendous suffering. thousand children die every day from malaria. But if you invest all this in R&D and get a product to market, you're not going to make any money. You're probably going to give away the drug. So, how can we help that doctor at Duke working on the ultra rare disease? How can we help that local pharmace kind of pseudoloc pharmaceutical company working on malaria? How can we help United Therapeutics here also working on a rare pediatric disease? Well, three of us faculty here in the triangle came up with an idea. We published a paper 20 years ago in health affairs. It became law the following year. We worked with Senator Sam Brownback and Senator Shared Brown and it was part of the next uh prescription drug user fee act reauthorization. And both of these have been able to and so both that doctor at Duke, GSK, United Therapeutics have all benefited from this program. That doctor at Duke was able to get investors because of this program. GSK was able to rationalize to investors why the heck they're working on malaria when it's surely not going to be profitable. So, we're able to provide support all of these through this program we came up with here in the triangle 20 years ago. And uh I'll tell you about it later if time permits. >> Awesome. Thank you so much. Um what what a great uh set of opening remarks that we've heard. Before we go any further, I'd like any of you to respond to what you've already heard. I mean, Dave, that was just fantastic. Just what a no what a what a wonderful set of examples. And um and and Ned, you've been through u this sort of seeing it from the lens of of multiple perspectives, including the National Cancer Institute leadership. Um what what would you respond already to what you've heard? I I think I'd respond to Dan and his remarks about how important the impact is. And I think that actually feeds exactly into what you were talking about. It's not about money. It's about impact and changing people's lives. >> So, Jen, but let's pull on that, right? I mean, what are faculty incentivized to do? What are their promotion and tenure guidelines looking like? And how do we how do we close that gap, right? because they're not really incentivized uh to be the innovators. They love to teach. They love to do research. How do we build a bridge? How do we close the gap? >> So, I think a lot of our faculty actually do want to make a difference in the world. I I think about RTI and they had a gold's uh a north star of change of imp positive impact for was it 1 billion or 10 billion Christie I'm looking over 10 yeah uh and you know I think a lot of our faculty actually feel that way uh they get into education and into research because they do want to make a difference uh and so I I think it's not that hard in terms of how to pull on them it is a little challenging to make sure that they are rewarded for doing those things. >> Yeah, Dan, what do you think? >> I was going to add um and there's some data that backs that up because when we did some polling about what was motivating our faculty to turn in invention disclosures or try and file patents, yeah, there was a direct incentive. You get a sort of royalty check if it works out, that's not too bad. But there was also this spirit of what their sort of life's work were what they were really doing their whole careers. Seeing that sort of have a tangible like you know aspect of it in the real world really was one of the things that like shot up and spiked in terms of like the the so so there is that element of it having that impact. The other thing is they don't have to be the CEO they don't have to be the COO not every academic is born to run a company and in my experience most of them are not. But the point is is that we provide tools and resources for that idea or that IP to enter into the pipeline even if they themselves do not follow it. Sure, they can advise, they could be on the board, they're getting their founders equity, but they're not necessarily forced to do something that they're not like in their DNA good at doing. So, >> yeah. And so, this is we're taking a left turn here, but I think it's a really important and that is um uh that of incentives. And so we talked about the importance of promotion and tenure and really IP invention disclosures patents they just don't fit into the classic academic model. Now I think you're seeing a change. One of the things I urge any of you that are interested Autumn is very supportive of an organization called PIA promotion and tenure in innovation and entrepreneurship. Their website is pi.org and they actually are pulling together universities across the country on identifying what should that model be. It doesn't mean you have to uh file an invention disclosure or pursue a patent to get tenure. However, it should be used against you and it actually probably should give you a little step up. Um so that's an interesting resource that uh we're seeing more and more universities around the country um pursuing. >> Ned, um you're more excited than ever about cures for cancer. Tell us a little bit more. Oh, I mean I think um you know the uh the decades of investment in biomedical research in basic fundamental NIH funded biomedical research at institutions like Duke and UNCC have led to this understanding of cancer biology and and I I I would argue that kind of a lot of stuff that happens in biomedical research starts in cancer and moves to other therapeutic areas. And the immunologists are very frank about this. they're like we're just ripping off oncology, you know, so so so I think that there's a very strong trickle down effect of understanding biology for therapeutic inter in interdiction in oncology and then it moves to other fields and and that you know 30 years of you know NIH and NCI funding has really paid off and now we have this understanding of cancer biology that is so much more sophisticated than when I started in this business you know back in the 1990s and so every year I mean every week practically I see a good idea from faculty at one of these institutions saying I have this idea video on how to treat or diagnose or you know prevent cancer or related disease and that capitalizes on some new you know science paper I am about to publish or I just published hopefully the former and not the latter we can talk about that later visa v China and IP risk but in any event uh I I think that you know that the the the pace of biome discovery is just sort of hard to explain to people and so >> you know if you told when I was a fellow in oncology at the data far uh you know we used to kind sit around and pick like what's the worst cancer, you know, and you know, if you told me that like the majority of patients with metastatic melanoma were going to be cured, big C cured, cancer go away, never come back with metastatic disease like Jimmy Carter, uh, 20 years later, I would have never believed that it was 9% 5-year survival back then. It was grim and terrible. And now it's a disease where most people with metastatic disease can expect to get cured. So, I think the uh progress has been really great. It's still a long way to go. a lot of lot of progress to be made, but it all started with like NIH investment in basic science. >> Um Dave, I'm going to close this first round by asking you there's something that you really wanted to tell us and you were not sure if you're going to have the time. Tell us. >> Oh, thank you. So, um so we're working with so we came up with the priority review voucher program 20 years ago. Uh more recently, we have a couple of uh projects in the works. So they all they have the same spirit of trying to promote innovation but through different mechanisms. Uh we hope that lightning will strike twice. So lightning struck once, one of our papers became law. We're hoping that we can get some traction on this. These are just working papers, but they're under review at journals. We hope once they come out, we might be able to get some traction with um uh some people on the hill. So uh one of the proposals was about the accelerated approval program at the FDA. I want to talk to Ned about this. Okay. So that's been very much in so many of you um won't be familiar with it, but for some people on the hill it's been in the news because it's been quite controversial with different FDA leadership having very different views about it. The key question is if there's a drug with some promise and some evidence but not enough, should patients get access to it? Should that should that drug reach the market now and uh while we're waiting for some follow-up studies? We've got a surrogate endpoint saying, "Hey, this drug may this drug shrinks the cancer tumor, but we don't yet have data on whether it extends life." So, should that drug come on the market now while it's still collecting evidence? And for the most part, the FDA has been very supportive of this. Um, a a recent uh leader at the FDA who was there briefly and then fired and then back and then fired um had different views on it. He he was more of a stickler for the evidence. let's see the proof before we let these drugs on the market. One of the points of this paper is not only are those patients really eager for access to the drug. And that's the reason he got fired the first time and the second time is because patient advocates were saying we want these drugs. Okay, that's number one. But number two, on the incentive front, another advantage is those drug makers start making money earlier. And if this is a drug for an ultra rare disease, it's just not going to be profitable. the sooner they can start making money, it's going to give them some liquidity, give them a better return on investment and the potential for this pro uh to to get this uh accelerated approval also drives some investments. Okay, so the argument here is we need to think about this as buying an option on a drug and that's a very different way to think about. We usually think about let's let's get this out to patients but let's think of this as buying an option on a drug that might not work out. Most drugs in development don't work out. It's not the end of the world if it doesn't work out. As assuming the drug is safe and the question is whether the drug works. Number two, we need to think carefully about the final approval threshold. Maybe even give some leniency to keep that drug going. Drug makers should be very happy about those things I've said so far. Here's the thing they won't like. The third part of this is in some cases it may be sufficient to give partial approval. Partial maybe a narrower label or maybe a lower price. Maybe during this accelerated approval phase your price might be lower. We have to be careful with that. If we make it less lucrative, we may get less investment. We certainly don't want to turn that off. But that's that's a paper we have conditionally accepted at management science. We're business school faculty. So that's where we send it eventually. But maybe this is my way to let some people in the real world know about it. And then we have another paper working with the Gates Foundation. I can tell people offline about that's a different incentive model I can talk about later if people want. >> Great. Well, we will have a break after this and we will also have a reception. Great opportunity to follow up on on all those points. Yeah, Ned. >> So, um I'm a huge fan of the PRV program. I think it's really been important. It's tremendously important for pediatric disease and tropical health. Uh I think you can see how important it is now that papa the pandemic and all hands preparedness act has lapsed. Papa has a PRV program in it. That PRV program does not exist at the moment and that has caused a hell of a mess for anybody developing bio defense and medical countermeasures at the moment. So PRV is is tremendous. It's not totally popular at the FDA because it causes some problems with the reviewers, but it's a really great thing. I think uh accelerated approval I I agree with everything you said and I'm I'm glad to hear you're a fan of sort of preserving and improving it. uh you know it's 85% of accelerate approvals are in oncology so it's been very important to cancer patients um but I would disagree with one thing which is the push back in accelerate approval antidates this administration it really started in the Biden administration so it was adjome if you remember the Alzheimer's drug that got approved through acceler and I watched that happen because when I was there accelerate approval was still in vogue and you people like Rick Pazer were still selling accelerate approval is the way to go for cancer and then agile helm happened and you couldn't find anybody in Congress on either side of the aisle who thought it was a good idea so the political uh you know winds changed when uh this calculation of what it would cost Medicare was done and uh you know Medicare raised all our rates. That was I think how it happened. >> Yeah. Great. Um so Steve, I'd really like you to now kind of ground us in this world of technology transfer and commercialization. Um some of us are familiar with it, some of us have lived it. Um, but some in the audience may not really have a feel for how this thing works. Uh, just give us some insights here and and you're a North Carolinian as well. Um, and I'd like to hear more about your perspectives on our North Carolina bio innovation ecosystem, specifically protect transfer. >> All right, there were like four questions in there, but okay. All right, I got it. I got it. All right, so um All right, let's boil down what technology transfer is. uh all um uh please forgive me Dan and Robin and any other tech transfer people. I'm going to summarize what they do which is incredibly complicated um into just a couple of words and that is they evaluate inventions that come from their uh faculty. They protect those inventions generally with patents could be other types of intellectual property protection. Hence the importance of a strong intellectual property system that uh Representative Ross spoke about. And then they ultimately commercialize those innovations by licensing them to companies that'll actually take those early stage highly risky inventions to market. That's kind of the three steps of tech transfer. There's a whole lot of other stuff they do in a very um uh dealmaking environment in an otherwise fairly rigid academic environment. So So that is what it is. So now let's kind of dive into why North Carolina is particularly well poised for this and why they've been successful over the years. So let's start from the beginning. I mentioned inventions. Where do the inventions come from? Uh Representative Ross said it very well. They're concentrated within those universities and we have some incredibly strong universities across the entire um uh state. So um those uh inventors come up with inventions. Turns out there is a straight line. If I showed you a graph of it, you would see two parallel lines. First parallel line, the amount of research funding. The second parallel line, the number of invention disclosures. In fact, we can calculate it. For every $4 million you do of research on average, you're going to generate an invention. So, most important thing, have as much research as possible. It's as many shots on goal. Okay? So, we do a very good job of that. We mentioned a couple of institutions over a billion dollars in research. Do the math on that. That is a lot of invention disclosures. Again, that the four million is an average, but it's a good way to look at it's a a direct relationship. So, that's uh the inventions. Okay. So, now you got the inventions. Now, you want to protect them. And again, with representatives uh like uh representative Ross strengthening the IP system that's really been very supportive. Then ultimately, you have to license those to companies. And so, you're coming to those companies with a very early stage technology. Might not work. might kill cancer cells in a petri dish. That might not be something a company wants to invest a significant amount of money. And that's where the tech transfer offices, especially in North Carolina, have done a really great job of derisking those technologies. They bring those as far as they can in the academic environment to make them attractive to companies. Now, when we so again, evaluate, protect, and now commercialize. When you then commercialize to companies, you have two avenues. Avenue number one, you go to an existing company, GSK, um, and you say, "Hey, this is the technology. This is as far as I've gotten. I have world-class scientists, um, that have started this." Great. So, that's one route. The other route is a startup company. Many times the technology is so advanced there is literally no industry to license to. Take the crisper therapeutics, if you guys remember that, gene editing. Uh, when that invention was created, what do you do? You market to gene editing companies. Well, turns out there are no gene editing companies because there's no gene editing technology. That's happening every day in the United States with these in inventions that just don't have a market. So, where do they go? They either die on the shelves or published in a paper never to be seen again or they could be advanced through startup companies. At Autumn, we show about a thousand startups arise out of universities every year. Um, 195 last year. um those each of those companies can take that early stage innovation and advance that. And so this is again an area where North Carolina is really strong. One, you have really strong scientists that generate the inventions. Two, you have great companies in the area that can inlicens. And three, you have lots of talented scientists and business people that are willing to start take the risk and start their own companies to develop those technologies into those products and services of tomorrow. >> It's a it's a great summary. Um uh but one of the gaps that we spoke about earlier is the u access to capital. Um and so what's happening here in North Carolina with respect to the early stage investment, the venture capital community? >> Yeah. So um again, if you start up a company, I I think you kind of need three things, right? You need the idea, you need the people, you need the money. Those are the three things you need. Um the ideas, they are plentiful throughout North Carolina with the great scientists that we have. Um the people and uh uh Representative Ross talked about a really strong community college system. We've got the resources to help support those. You're right, funding has been a challenge, although we're starting to see more and more funding opportunities. And I want to mention something else, and that is the importance of long-term long horizon investment and leadership in innovation. In the absence of that, innovation timeline does not equal an administration timeline. Whether that's at the federal government, whether that's at your university, it is a long-term development. These inventions will take 10 years to get to market in many cases. So, it's really important to have that again strength of North Carolina RTP that is the envy of the world in terms of research parks. And I think that's hopefully been attracting more and more capital. Some of my other colleagues might uh know better in terms of the industry, but I think there is a great opportunity here in North Carolina. Teric. Um, so Dan, let me turn it over to you uh because you live this every day and uh you're a transplant here to North Carolina and have had some great uh perspective on this whole journey of technology commercialization. Uh what uh what would you add to Steve's comments so far? Uh, I would add that um they're definitely, you know, we talk about sort of these clusters and I came from the Boston cluster and Boston's obviously pretty healthy and coming to North Carolina I see a lot of the same ingredients that Boston had uh and the Bay Area, but I have seen uh a trend that I think Massachusetts and California seem to for the most part be bucking and that is the continued reinvestment in innovation. Yes, we do have RTP. Yes, we do have, you know, wonderful individual universities with really smart people. Uh, yes, we do have a VC community. It could be better, but there seems to be access to capital. They're certainly willing to fly in if the idea is good enough. But I I would love to just see more more of all. If I think we had more of all, we would really see acceleration on all levels. That'd be the only small uh thing I'd add to what Steve was saying. I'm an optimist, so I still think at the end of the day, you know, we have to focus on the impact, not but the reality is is that the money is going to allow for that patient long-term gains in our innovation. And I think we North Carolina should hopefully see that and really lean into that instead of just saying it's good enough, you guys can figure it out. We're going to go focus on other parts or other problems. >> Great. Uh and and so Dan, let me let me stay with you. um because the topic of artificial intelligence has come up several times here and we live with it um every day and we see the investment uh parameters that are affected by AI opportunities and risks. So how do you see artificial intelligence affecting the health care sector um and in particular the research and commercial opportunities in bio innovation? Um what insights can you share? >> Yeah, there's there's enormous attention on AI right now. Obviously, there's the promise, there's the hype, is it a bubble? Um, you know, all those corporate executives getting booed at the commencement speeches for bringing it up. Um, so, so you know, what's weed and what's chaff? We have to, you know, so the area I focus on at Duke, by the way, is more the engineering and the AI side, less so the life sciences and impact. What brought me here to Duke from MIT was the ability for Duke sort of to be centrally located and somewhat level playing ground where you could go from a really interesting AI model at the school of engineering and almost literally walk a few steps over to the medical school and then have access to the hospital. So you'd have all the sort of ingredients between the science sort of the validation and then the patient data all under one roof. Could not do that at MIT. you'd have to sort of, you know, go talk to one of the Boston area hospitals. Good luck trying to get a deal for their data and how that was going to grind everything to a halt. So, there's enormous opportunity for Duke to lead and I would argue also for Chapel Hill because of the way they're situated in their health system. So, I think North Carolina uh particularly can be a spike in AI health care. Um, more specifically, the the thing that's really interesting these days in AI, it's not so much the models, it's not so much the algorithms. those change so quickly that filing patents seems almost archaic. Um, but there's other ways of thinking about collecting the assets and protecting them as a whole that's going to sweep in things like software and copyright, maybe even a little bit of knowhow. But data is really one of the more interesting things that's emerging as a gamecher. And data means many things to many different people. But in a sense like data, particularly patient data, particularly the data that a a Duke or a Chapel Hill can bring in terms of experts that can validate models and sort of add longitudinal clinical EHR records to that to back it up is really where we see a lot of exciting deals being spun and a lot of demand from industry that wants access to what universities have. There's two examples that I could talk about specifically. Duke partnered with a company called a bridge. And a bridge had an interesting technology that basically just somewhat observes, sits and listens, you know, in your whenever you're at your doctor and having a conversation. And it just basically records and writes notes so that your doctor doesn't have to spend time typing away at a keyboard and can actually talk to you like a human being. Um, and so that technology now is actually implemented across Duke. If anyone that's seen their doctor at Duke knows what I'm talking about. Um, I can't tell you how many doctors came up to me because we were sort of involved in bringing that and thanked me and said, "This is rejuvenated. This has taken years off my life because I can actually focus on what I remember loving about being a doctor and not all the minutia and all the epic like nonsense." So, um, so those kinds of things are really heartwarming. Now what's interesting is now that we have these tools, we can start partnering with them to think about how to do really innovative things with those tools to really expand it. So like they're interested in Duke and some of the unique data sets that we bring to the table in order to expand their offerings. There's another company that we partnered with called Trace which is operated out of a group called Redell. Very similarly, they are actually doing AI agents. So they're now not just what the can the AI learn from looking at a record but what can the AI do for you in terms of making your life easier and so they're looking at all the different sort of ways you know from clinical otherwise to they're working with Duke Health I mean cardia cardiology right now but it's really an exciting time to think about AI impacting Duke healthcare and I guess the last thing I'll say as a cautionary note is we understand that when we're dealing with data you know not all data is equal and some people would take offense to how universities might you know collect monetize data. But I, you know, would just make sure that you understand that like just like they say data is the new oil. That may be true, but you know, crude oil is not that um effective on its own either. It takes a lot of refining. And so there is a lot of refinement of data that does happen behind the scenes. deidentification, all these other extra steps to make sure that like, you know, consent forms, things of that nature go into whether or not how this data is being used to have impact. And I think that's part of our process to make sure it passes the sniff test when there is an opportunity to commercialize it. And Duke has all these other controls and committees that help with that, but I'm not going to get into that right now. >> No. And and obviously we uh we have limited time here. Uh and so I'm excited about the chance for u our continued conversation uh later on in the day and at the break time. Uh so um uh David, we heard uh uh from you a little bit earlier on and um maybe just briefly share uh some insights into something that you've been really passionate about is uh looking at the FDA's priority review voucher program and what you would add about uh that program as as an accelerator for uh for drug approval. >> Uh I appreciate what Ned said about it a moment ago. Ed was uh sorry Ned was former FDA commissioner and it's required some of the reviewers to work faster as he alluded to but overall we really appreciate the support of the FDA on this. Ned also mentioned though that one of the three parts of the voucher program sunset so the medical counter measures portion and so um so members of Congress might consider bringing back the medical counter measure. >> I they better I mean it'd be very surprising if they don't. It's it's like one of the few bills everybody agrees on, but you know, it's been lapsed for more than a year, and if you're one of these companies making an MCM, it's a bad time for this program to lapse. And I I think it's caused ambiguity. I am certain it will come back or 99%. It's hard to think of anything more popular than pandemic preparedness in the government, but uh you know, it's it's uh interesting that it's been gone for so long. Like the it's sort of what the SB program went through something similar where it kind of a very popular program that kind of died for a while for non-lear reasons. and eventually got resurrected. >> And the other thing I'd say about Ned is it's remarkable that that you guys who organized this got two former FDA commissioners. So, uh, so Mark Mlen will be here later and Ned is here now. You could have gotten Rob Kaleiff. You could have had three. >> Rob's somewhere around playing golf or something. I'm sure we >> and beside three be way too many. But isn't it remarkable that when we want a leader of the FDA, we're plucking talent from here in the triangle and that they're coming back here. So, it's great to come up with a a great new technology that has potential, but you've got to navigate the regulatory environment and who knows better about that than someone who's been at the FDA. So, we're very fortunate in the triangle. >> Yeah. Fantastic. A wonderful tribute. >> I I would point out when I when I went around and just started meeting people at the FDA and NIH, I was struck by how many feds are UNCC and Duke grads. I mean, there really a ton of them. the Duke Law School, the business school, the medical school, and uh and we have lousy train service to DC. There one thing we could do for this region, I think if we could get the rail, the Amtrak between RDU and DC, uh it would be really good for this region in terms of federal uh employment. >> Oh, great. Uh so, uh Jennifer, let me turn it over to you. who you're managing in some challenging times and um uh just as we look at this kind of connectivity between the research enterprise commercialization and what we all seek is impact right as as you've uh uh emphasized uh what are the implications of uh the changes that you're seeing for bio innovation here in North Carolina. So, I'll I'll echo some of the things that uh Steve talked about is that the the disclosures, the innovations come from the uh the federal funding that we obtain um based on the creativity of our faculty um and others. Um and it is definitely under threat um at this point uh in time. We've seen a decrease in the amount of federal funds that are being awarded to universities. We see a big uh emphasis on translation which is it's good to emphasize that but at the same time it's at the expense of the fundamental research which is really the foundation of the creativity of the ideas that can then be um innovated upon. Um, and so I think it's really important to think about the whole life cycle as uh Deborah Ross talked about this morning. Um, and Robin mentioned about uh how important the pipeline is in order to get those ideas out. Um I think another uh area that's very challenging is that right now um I don't know if people have paid attention to the uh office of management and budget and their their uh their proposed changes to uniform guidance but a lot of that has to do with making decisions um not on merit of of awards but rather on uh political decisions or geographical decisions. And we really strongly believe that it's very important to keep merit at the top of the decision making uh in terms of uh what kind of awards come out because uh if you do that then you're going to be getting the best ideas. You're going to be uh using federal funds to to really fuel uh the best ideas in the country. Um, another area that's been fairly challenging, um, and, uh, this is implied in some of the uniform guidance changes is the, uh, the attack on indirect costs. Um, which I won't get into explaining what indirect costs are, but they are real. We do need them. Uh, the proposal that was floated last year to restrict indirect costs to 15% would have cost uh, Duke University over $200 million. uh and uh we would have had to shrink our research mission in order to uh pay for that and you know that would have if we had shrunk our research mission that shrinks the number of people who are engaged in the research and who have those great ideas. Um and so we really need to be working with Congress uh and others to make sure that we uh still can uh have the long partnership that universities have had with uh the federal government that has been so incredibly successful uh for the last uh many many decades uh and has has made the United States the envy of the world in terms of its research uh ecosystem. Uh but uh we are in danger of losing that. >> Yeah. Um so Ned, let's wrap it up with >> I got to respond to this for a second. I >> I know >> these are my favorite topics and I >> but and I agree with almost everything you said and obviously 15. Yeah. But I will just point out that that the simple narrative confuse something and there's there's an uncomfortable fact I think we have to say out loud. The simple narrative is this administration is dismaling science. It hates science. It's cutting the NIH. Y it's just not true. The NIH budget went up actually $400 million this year in 26 and certainly many institutions have seen a significant decline in their funding but not all of them. So for most institutions of Texas have seen a nice bump. So while it's true Duke and UNCC have gotten cut not flat cut at the NIH in terms of the NIH that is not true at every academic institution. And I think we have to ask so it's lumpy as to who's experienced the effects of the NIH uh uh stuff. And I think, you know, when I was in government and Richard Burr was in the Senate and he called my office, I picked up the phone. Yeah. >> Right. I think we need to get our we need a muscular legislature that understands how to tell the NIH and the FDA and the CDC what to do. With Tom Tillis retiring, with Burr now gone, I just don't think we have that kind of leadership on either side of the aisle right now in North Carolina. And we need it back. And this does not come at the extremes. Something like the NIH lives in moderate land. You have to have moderate politicians who like the NIH and are going to tell it how to spend its money and they're going to say, "Stop cutting North Carolina and stop giving all the money to Texas and Oklahoma." And I think we need to uh be aware that is happening and it's hundreds of millions of dollars for our state. >> Yeah. Yeah. And and um um would you just wrap us up on the US China? Um >> Oh, yeah. We can knock that out in like two minutes. Uh so you know again it's the same thing I think is the simple narratives confuse a much more interesting situation. I it is very true that there's some really bad behavior. So when I was NCI director we had a bunch of foreign influence you know force tech transfer really bad stuff happen that's sort of at the behest of the Chinese government that that really damaged US scientists. So I think that is real that is a valid concern. Anyone who tells you that's not happening is naive and or like you know there was a science article on how the NIH was uh you know doing racial profiling against Chinese scientists a story that I think was just completely untrue. So but at the same time it's also important to say the US ecosystem is completely dependent on China. These great posttos and scientists are vital that they come over here. They staff all our labs. They do a lot of the CRO work for early stage companies. They are really really important. And so I think the interplay between US and China in order to benefit patients is really really important. So I think heavy-handed things that like you can't use any company that has uh the word China in their name or you know stuff like that. Those are not a good ideas. I think things that prevent those students trainee from coming to the United States are not good ideas. But I think also we can't just pretend like there are no problems and we should be naive about it. So I think that's the uh simple most of the stuff I see in Congress right now feels very simple and naive to me. >> Yeah. Well, um, we have a lot more conversation, uh, to continue. Um, what an amazing panel. Thank you so much. Let's thank them, please. And we now have the opportunity for a break. Um, that's going to take us to 3:35 and we will resume with our third panel right back here at 3:35. Thanks, Sure. >> I know. Really nice that. If you succeed, they succeed. Thank you. One I would just That was I wish we would. Got a lot of good shout outs. Beautiful. How's the online So, we're not We'll see. Hallelujah. They were like You don't want to talk to them. The All right. I lost That means you have to Yeah. God bless. I don't know where Can can we uh take our seats, please? We need Can I invite the next panel onto the dis and can we take our seats please? Thank you. Two roses. you know the sign of a successful event is whether people stick around after the break and I think uh we've passed that test. So thank you for for staying and thank you for being uh so attentive. I think you know even by CSI standards this is actually one of the really superb events that we've held in terms of the content and the you know the level of the conversation. So uh really appreciate uh the uh your participation and engagement in all of this. Uh so just a quick uh again uh I said hello to you at the beginning of this proceeding but Sujay Shivakumar I'm a senior fellow at CSIS direct the renewing American innovation program. uh and um what we've been hearing uh through the day is just how interconnected the different parts of the the innovation the regional innovation ecosystem is. Uh if I always like to think of it like a you know oldfashioned Swiss watch with all the gears inside and each gear has to work well and each gear has to connect with the others because if one part of the way one gear sticks every the all the rest of the parts of the watch also don't work very well. So you have uh you know the the IP system, you have the the the uh the federal policym system, you have the state policym system, you have uh you know uh uh the R&D system, you have the education system and what we're going to be talking about is the workforce system in this uh in this round. uh so uh and and of course the next uh panel is we'll be we're looking at industry perspectives in terms of manufacturing uh what I think was observed earlier in the conversation is that uh you know manufacturing and workforce are really two sides of the same coin uh it was mentioned that uh you know when manufacturers look for a location the first thing that they look for actually is the workforce uh and uh so uh you know the the the the connection between workforce and manufacturing is very strong. The connection between manufacturing and innovation is very strong. If you don't have manufacturing, you don't have a vibrant innovation system. If you don't have a vibrant innovation system, you're not going to be globally competitive economically and you're not going to be producing the technologies that drive our nation's uh leadership in national security and and uh economic competitiveness. So it all comes down to how well we include uh our population and as well as the the the talent around the world and to bring them into our own uh innovation ecosystems. But where that all happens is on the ground and that h and that ground is rooted in our uh in our respective uh uh regional uh communities. So this conversation is in a way really pivotal to understanding how uh the the region uh can succeed and ergo you know the the broader impact on our nation's competitiveness and security. So uh just to get the conversation started uh uh we should just introduce ourselves perhaps if you could just go down the the the the row here. If you could just quickly introduce yourself and if you have some sort of a top level message that you would like to get out before the conversation starts that's also very welcome. >> Good afternoon Alex Murray work for Biogen. Um I have the pleasure to run one of the two manufacturing sites we have here. So Biogen's been in the region for about for just over 30 years now. We celebrated 30 years last year and so as we evolve through the conversation there's there'll be an interesting conversation or like origination like teamwork growth maturity continuation of like where this is going to go in the future. Um for a bit of reference budget's got about 1200 people that come to work every day in the region. Um it is primarily manufacturing although we do have what we refer to as technical development. So it's kind of that bridge between innovation like discovery of a molecule to be able to figure out like how actually do you take that molecule and then make it and then once you figure out how to make it and and discover that move through clinical trials and then long-term commercial production in the facility here. Um so I look forward to the conversation. Thank you. >> I'm Mary Kman, executive vice president for health affairs at Duke University, chief academic officer for Duke Health and dean of the medical school. You know, so when we think of workforce, we're talking about several aspects. We're talking certainly about our health workforce, which you know, doesn't take a lot to know that that has been under stress just in terms of the demographics of an aging population and the and the workforce needed to care for that population. But we also think about the biomedical workforce. And historically, the model has worked very well with a a real partnership particularly between federal funding and academic institutions where the model is essentially um the workforce that is being trained is part of the workforce doing the the investigation on federal funding. And so that has trained um and been really I would say mutually beneficial. Um and then some of those types of partnerships also with commercial entities. And again it doesn't take a lot to uh know that that is under stress lately. One very important aspect of that workforce has been international um uh particularly pre and posttos in the biomedical space and there's some stresses there. So we we are seeing some major stresses and questions about how can we keep up with the workforce demands both in health and biomedical science and what those partnerships should look like going forward. >> All right. Good afternoon everybody. Andrew Gardner, associate vice president, workforce strategies. You all are here for the happy hour edition of the panel. So, thank you all for joining us. Drinks are in the back, right? No, not yet. >> So, uh I have the pleasure of providing support and guidance for our 58 community colleges in North Carolina. We are the third largest system in the nation. I also like to think that we played a major part in the reason North Carolina is number one in the workforce that we do. We have a diverse portfolio. We're the middle education system. We serve high school students that are trying to get their credentials or associates degree. We partner with transfer programs with the universities. We reach individuals that are looking for entry- level positions. We upskill the existing workforce. We have apprenticeship programs, customized training. So, we have a large portfolio that we serve our community and look forward to kind of talking about where the boots are on the ground. So, good afternoon. Kevin McLaclin with Duke Energy. Um, for those of you who were here when Representative Ross spoke, she left with three words. Infrastructure, infrastructure, infrastructure. You're looking at it. Um, at least part of the infrastructure system. My friends with water and transportation um couldn't make it. Uh so I think we'll talk about hopefully a little bit is the spirit of collaboration uh trying to find opportunities uh to build our workforce and the workforce of others that are helping to uh to power innovation and manufacturing uh here in this region. >> Thank you. In fact uh you know when um what what happened when we allowed manufacturing to offshore is that we also at least for a little while got off the hook from three things. One is uh having to train our workforce. Uh secondly, having to modernize our infrastructure and the third point was having to streamline our regulatory systems and what we are now faced with is an emergency operation to kind of get up to speed on all three simultaneously. It's quite it's quite a challenge. Um but uh I was wondering whether we could sort of split the the discussion into two sort of two two parts. And uh Dr. Clottman you mentioned a little bit more about the ski highskilled part of the equation. Perhaps we talk about that and then move on to the skilled technical workforce which also has connections to uh cooperation with universities. Uh you mentioned some of the stresses in the system. Uh could you elaborate a little bit on that? >> Yeah. So if you think of the highskilled um we're really talking about uh PhDs in biomedical science, MDs in in clinical. Um the stresses currently really are the dynamics between federally uh sponsored research and institutions that have been recipients. The model has been as that sponsored research grows there's the ability to train more PhD P-doal and post-doal uh trainees they're part of the workforce that actually does that science but that federal funding pays for that workforce. So with the uncertainties and sponsored research that creates anxieties at institutions and you saw it play out all over the country where most top institutions significantly cut their PhD um programs not knowing whether they were going to have enough uh federally funded labs to train those programs. That's a long-term commitment. It's at least a four to sixyear commitment. So that's one stress the uncertainty of knowing whether an institution is going to have enough federal funding to uh to support a training and the other as I mentioned international again there's no question that many of the top research intensive institutions have had access to an international work uh workforce development by bringing in international predocs and postocs and really had a look at what the talent is globally um that pathway way has gotten very strained by uncertainties about visa statuses etc. So those two things coming together have have led to a real shrinking of pipelines anywhere from 30 to 50%. Which is substantial. The problem is it's a creating a longer term problem because you start training now it's really talking about a workforce that's 5 to seven years down the road. So fixing it will also take some time. So that is a significant concern. >> Uh what what are the implications of not fixing it? I mean what >> well one would be um alternative revenue sources to support uh trainees you know and I think that's where commercial partnerships may play eventually a bigger role because PhDs that are trained in academic institutions many of them don't stay in academic institutions they go to industry >> and our our our biomedical pharmaceutical industry has really had a 50year growth um and success and if you look at the PhDs that now populate uh those commercial entities many of them trained at our top institutions. Um so looking for partnerships maybe in in the commercial space would be one potential solution. Alex, from your perspective from biogen, the uh the high skill binch that's going to be, you know, that gets projected out into the future, what are your what are your worries or >> Yeah, I think this has actually been a really interesting symposium, whatever the terminology will call over the last couple hours here because it's we spent a lot of time talking about that early innovation intellectual property conversation and then there's a reality where the world that we often live in here is like we're jumping five or seven years in product development, right? and you get into manufacturing and so maybe just a brief moment I'm like are the the RTP and maybe North Carolina collectively is I think there's the Dukes UNCC's NC states like all the institutions around here excellent at this initial innovation but there's almost like two donut holes right there's the donut hole around the like some of that like clinical research into like early phase phase and then there's a donut hole at the end of like corporate offices kind of conversation and so I think what where we spend a lot of time with the PhD folks folks um just predominately in the development labs those kind of pieces of conversation and if you do from a demographic perspective exactly as you shared like many of them do come from a different country and they find they're moving to the US as a change of life and really looking for opportunity here in the US and they provide that pathway through the PhD programs and they come in and so I think there's an endgame of the conversation we started of in theory if that dries up then the next generation there's a generational gap then coming through the scientific community within within university system um or sorry within the corporate system. I I do um I think on the corporate side though there there are times often though where a PhD is really nice to have but we can also just as much think about like the some of the skill sets and growth that we get in a PhD setting where you might take it straight through out of academia where you might come in and spend a lifelong learner and you and you learn those skills kind of over progress over the course of time. And so I think as we get other parts of the conversation, I think it's relevant to really get into this continuous learning mentality and continuous learning mindset because it's not always a onceanddone from an academic perspective. Oftentimes it's like how do we how how do you meld work, life, education all together to build a professional over the course of time and not just in the first seven years or eight years I guess it is after high school graduation. So the other aspect that has changed is uh you know not only our policy but what's happening in the rest of the world uh over the past few decades uh other countries uh have actually built up their R&D systems. They built up their research university capabilities. They built they're building their uh their regional and national innovation systems. uh to what extent is our our companies mobile in terms of in in the in the hunt for talent you know challenge for this region is to remain relevant if there's competition abroad uh just you know how how intense is that and what what should local policy and national policy makers understand about just how you know what this what the situation is >> yeah so R&D is an interesting topic right now because so much of it is happening like if you if If you look at a lot of the really big companies are actually starting to reduce their R&D budget from internal spend R&D and they end up procuring a lot of R&D in and when I say procuring it in it's either in licensing it's buying companies it's those kind of pieces and I think we can all probably have a conversation in terms of like why that's the case from a business benefit perspective and when you think about ROI in terms of dollar spent in research and your risk tolerance into new disease areas whether or not you take that risk tolerance internally or you just buy somebody's order to play through some of that some of the risk curve um >> I I think from when you look competition of talent. Uh I think it is it's really rooted in these partnerships. And so I think there's a there's definitely a piece of if your company's well known to Duke or UNC and you show up on campus, that brand recognition carries a really long way into that space. Um and when you go hunting for specific skill sets, capabilities, scientific knowhow, it's not just a university level, but obviously comes down to that specific professor or lab area, too. to like how you build relationships almost like department by department or like uh faculty by faculty to be able to fill that pipeline into the flow um from the manufacturing sites within the region we have here at Biogen it's not a dominance within the PhD comp community like we definitely hire a lot of PhD candidates or not just candidates I guess but post-docctoral folks um so I I it's I don't have a like a thousand% experience in in what it looks like from a struggle or in terms of where it sits in, but I knew there's strong partnerships through both local here and our R&D headquarters tends to be more in the Cambridge side. So, this is where like the Boston RTP conversation comes back into play again. Uh no it's it's interesting because uh these you have you know competition among US uh clusters and US universities as well as what's going on internationally and uh it's important as you mentioned to keep the brand uh you know uh the local brand which is a strong brand to make sure that you continue to invest in that going forward so that that brand in turns attracts students it attracts investment >> even free pizza doesn't get you >> this is true >> at all colleges so I think it's I think it's a matter of like you got to have the corporate brand and reputation in sciences to go tobacco. >> But there is a a real concern that that brand that has really built this the scientific infrastructure in this country is being tarnished a bit and as others globally really increase um their their focus on being competitive to attract some of the best scientists and so how much that will change the dynamics for the US market I think is an area of concern. This is really interesting because on one hand we are trying to uh reenter manufacturing in the middle of our innovation system but we need to make sure that we don't uh undermine that that strategy by uh I guess disinvesting or underinvesting in our R&D portfolio because one feeds into the other. These are compliments and not substitutes, right? Uh to sort of pivot into the skilled technical workforce, what used to be called the blueco collar workforce. Uh and uh you know the I when I was at the national academy of sciences, I directed a study looking at the skilled technical workforce. In fact, one of the key recommendations was to stop calling it the blue collar workforce uh and to refer to them uh in a more uh you know more respectful way in a sense. So part of the challenge there is in terms of students and workers to enhance their perception of what manufacturing is. Uh I was wondering whether one of you could speak to that uh that image problem and how do you get over uh the the even in in in high schools and so forth these the college track is seen as more is seen seen as higher social value higher more more preferred than sort of picking up uh technical skills. >> Yeah. So, I'll speak from a national level and state level. From a national level, community colleges are having a moment and especially in North Carolina. The investment and attention, people see the value proposition of what we bring to the table. So, not only did we see that in our state budget this year, but we're also coming up with a new innovative business model called PropellNC where we invest more dollars in those workforce sectors such as advanced manufacturing. Along with that, once we get additional funding, we're able to do increased outreach at the high school level. Interest and awareness gaps are going up. People know what the jobs look like. We're providing more on the job training, internships, apprenticeships. So again, the more we reach out to students, their parents, and the communities know what's in their backyard, it's helping shift that uh perception. I I I dare say that perception is slowly fading away and there's at this time more interest than our colleges can provide. So we have weight list of you know hundreds for certain programs and the technical trades because there's such demand. So this new business model and funding is going to help you know serve that need there in that talent pipeline. So we're really excited about the moment we're having in the community college space. So one of the challenges of uh you know developing vocational programs for industry uh is that they tend to be uh you know smaller classes, more qualified instructors, more expensive equipment. How do you how how benevolent or an environment is this to kind of provide the level of training that is required? >> Yeah, it's a multi-prong approach. You know, number one, have an industry at the table where they're going to co-create the curriculum. they're going to actually send their employees to be instructors in the classroom and that's a sneaky way for them to recruit the best talent, right? Because then they'll get to have a semester long uh interview with the students. So, that's a big approach, but we we really have seen the investment from the companies. Um Kevin, you you could talk about this a little bit, but our careers electric initiative, uh I know we're talking about a a different industry, but electricians, you know, spann multiple industries and we have a real exciting uh initiative with a careers electric. Kevin, >> it was a softball to me, but I also recognize Dr. Kloppman was about to say something a few seconds ago. So, please you you go first and I'll follow up. Well, just to build on that excitement of the pathways for non four-year college degrees is the um Bloomberg initiative between Durham Tech, Duke, and the community where Bloomberg provided $29 million to create a program jointly to meet the needs of the employers in the area, which is big health care needs, where the students are given both a a degree right out of high school that they can earn a real respect respectable living, but they also have pathways to go to advancement if they want. So, it gives them options and the options are stable employment, which is pretty attractive right now. >> Picking up on that and the careers electric piece. Um, so a couple of things. Look, the the line workers and the folks who are at our working our plants, making making sure there's power 247, 365, they're the best of our company. Absolutely. They best representatives of Duke Energy. Um, and there was a time when we really couldn't find line workers. And so what the company did was invest in 11 of our 58 community colleges, the great 58, uh, to start line worker programs. We were hoping we would need all those folks who graduated and they'd all come to work for Duke Energy. Well, they flocked in from across the country to come into these programs and have have have um spread across the region and we've been able to grab talented folks as have others. But that was a worthwhile investment to make sure. Now we talk about high school. So yes, we sponsor the STEM nights active engaging to folks to make sure they know what's possible for them and out there. But you bring alignment into a fifth or sixth grade or junior high classroom. Um and they explain what they do. Um and then they sort of kids get excited and they talk about being up in the bucket truck in tough weather at tough times. The kids are excited about it and then they say and I make about $100,000 a year. uh then everyone wants to get you know give their name and number at least their mothers and and fathers do uh to make sure they can get a chance. So that's where we were. >> You mentioned careers electric. What we have found now is with the amount of generation that we are building just two plants just north of here as we look to retire coal plants um and substations, transmission lines, etc. Uh we need more than just line workers. Um, we need pipe fitters, we need HVAC, we need more electrical, uh, skilled trades, some of the same folks who you need. >> Um, and we help recruit companies to come here. We don't want to then turn into be a competitor with them for their workforce. And so, Seammens deserves a lot of credit for initiating the careers electric initiative and helping fund it. And then other companies like us, ABB and others have helped to fund and support uh a rising tide lifting all boats to help those skilled trades in electricians especially. Um and what we hope to see is bounty for all of us. You can have the the skilled trades you need, we can get the skill trades we need. Um and then there's one other gap that's out there um that we saw and that comes back to my old days doing workforce development. and I saw it then folks who make the decision to to go to community college or to go to skil trade especially when they're not right out of high school when they're at their second career um it's a tough financial choice and some really smart folks came up with the idea of the forward fund to help make sure there's a zero interest loan to cover the expenses of going back to school otherwise wouldn't be covered by Pell Grant other programs and so it's a wonderful idea Duke Energyy's helped fund that for those bigger skil trades that we need and it'll be a revolving door. Um when folks go back into the workforce, they're going to pay their loan back and that seed capital will be ready for the next group coming through. So some really innovative ideas to help folks find the skill trades they need. >> So Kevin, uh your comments raised two issues. One is you mentioned seammens and EBB. Uh so what can we learn from the European models and what doesn't really what can't really be transplanted into US contexts. Uh the other one that you mentioned is just the sociological challenges. You know, you have students and workers often they have children or parents that they're trying to take care of. Uh how do you encourage them to you know to get over some of those uh those commitments to be able to rejoin the workforce and uh you know participate. So and and that I open that up to you and others as well. So >> sorry to leave it to others with more experience. I only have my experience dated back to 199495 um after NAFTA working with folks who were leaving the textile mills and the challenges they faced. I'm sure those challenges have only gotten harder. Um I certainly think it's going to require partnership between the private sector, our community college system, federal and state partners. I see Secretary Lily here, the Department of Commerce, their workforce programs are all part of the solution. Um and I guess we're still trying to figure out exactly what's going to be needed. There's probably a couple ads that'll play into this. So, I think you on the pre-call too, you asked about what's unique about North Carolina and I think it's come up across the panel already, but it's it's around partnerships. And so, the fact that I work for Biogen is important. The fact that I work for Biogen, but when I think about talent pipeline, support for community college, support for high school, STEM educations, etc., it's ubiquitous across all the companies that work locally. And so that I think there's a there's a really good and NC bio impact is the tagline on this, but like it's how companies work together. It's how companies work with the B tech center. It's how companies work with NC lifesize, how companies work with each other and academic institutions to not only shape and define what the curriculum looks like, but also help fund some of that curriculum. And then and then there's also like symbiotic customer supplier relationship. We're probably both customers and suppliers of each other in this space of of how that has to continue to evolve. And I think this is truly unique in this region compared to many parts of the country. And if that falls apart that that will really be a significant hindrance to all organizations be the technical trade, be it life science hands-on trade or the biowork certificate. Um and I think it's really a disservice to the community. And and what's a little bit crazy sitting in this room at Duke University, such a lauded institution, is something like 70% of the kids who go to high school in this town don't graduate high school. And only something like 40% of those graduate college in six years after they graduate high school or sorry 70% sorry it ends up being the 40% translation rate of people who start high school to get a college degree. That means there's 60% of that population we have an opportunity to serve because many of the jobs we're talking about locally don't require a college degree to the door to begin with. And I think that's the opportunity that a biotech sector, manufacturing sector, Duke Energy, like all of us provide that opportunity for students who who may have thought themselves missed opportunity. You can provide that pathway for opportunity. And once you're in the door, you're making money. You've got benefits. You've got the ability to continue education with whatever institution you want. So I think I think that's really the strength of RTP in the region locally is is how everybody's working together to advance this effort. And it's not just one team competing against another team being like, "Hey, colleges, do your thing and tell me when you're done. I'll do my part." And like I think that's really the advantage of the local ecosystem. >> And one additional thing I'll add is we've been very intentional in the past couple years about investing in success coaches. And these individuals aren't just counselors, but they help all students in their progression, ensure they have access to resources, are connected to the NC works career center so they can start building up their resume access. Say if an emergency pops up, there's something called a finish line grant where if that any emergency comes up that would keep them from going to school such as car having issues, there's funds out there to ensure that they continue their journey. These success coaches are there to motivate them and connect them to all the resources. So they're successful, you know, during their training and then they secure employment afterwards. So it's been a really good investment for our colleges. So the other uh part of the question that that your comment raised, Kevin, was uh the international competitors you were mentioning, you know, some of these German and Swedish companies. Uh how are how are those European models apt or not suitable for adaptation at the state level? I'll jump in there and say we're Thank you. >> We're looking at that playbook and trying to adapt it in in North Carolina. We have a very intentional vision of having more and more apprentices in our state. So, we're trying to embed all the best practice that we can that makes sense in in our in our state because one of the things that the Europeans do very early is they they put them on a track much earlier like either door left or door right where you're going to go. And so we're trying to do that to a certain extent. We're also trying to leave some room for creative freedom. But the number one thing we're doing is ensuring they have career plans. They know what uh opportunities arise or or available to them. And we're also investing in our apprenticeship program. We're putting millions in dollars into that. >> You you talked about the stigma perception whatever it is at community college over four-year colleges and how that's really evolving in the last handful of years. I think the same is true for apprentichips. Maybe to this the European model where if you go to a German factory like you you come out of secondary school, you go be an apprentice for a couple years and you work on the line and that's your career. That wasn't really a thing for a long time in the US. It is a thing again like and that's probably actually a really key point is this is maybe a little bit of PR side of the business but I think there's definitely a growing aptitude around this apprentichip um activity. So apprenticeships have often, you know, politically they're sort of this the uh the 50 cent solution to everything in terms of the workforce. But there are sort of two challenges with apprenticeships. One is uh you know if you're a big company in a small town then you can train the apprentice and uh you can bas you know they're not going to once you take the expense and time of training them they're not going to walk over to the your competitor across the street. Uh the other thing is of course you know for small and mediumsiz businesses it's very expensive to actually invest in providing the uh you're you're basically taking people off uh you know other productive activities to train and teach people. So how do you get get past some of those challenges in terms of getting apprenticeships and I think that sort of seg segus into a little bit of the partnership issue. How are you partnering with the community colleges to overcome some of those u those challenges? everywhere you can, you try to find the incentive, you know, where there's a financial incentive for a company to join, you know, tax write off. Um, for the student specifically, we have tuition waiverss, so there's no cost for them to get their related instruction through the community college. And we just keep keep showing them the return on investment. If they invest in their people over the long term, most of the time they're getting a 10-year plus employee. So, it pays dividends. It's for the long-term gain. So it's again continuing that message. >> For those who don't know of a biowork certificates, you should look take a look because that's actually a really when you talk about accelerator of apprentichips, that's where a lot of the training takes place. You walk into a community college and it looks just like a factory floor. You walk into the B tech center downtown at NC State, it looks just like a full manufacturing plant. And I think that's where the apprenticeship really gets accelerated is you get a certificate and and you walk in as an apprentice, but you're really probably 12 to 18 months down the road in a much shorter period of time because of the dedicated and talented instruction that's based. >> How does how do universities collaborate with the community colleges to create the the instruction and the equipment and the expertise to train the train the skilled technical workforce? >> Well, I think you look for look for the win-win. I mean the the Bloomberg is such a win-win because we know that our workforce for Duke Health is really under strain and for the community it provides an infrastructure to train students. So you constantly looking for where's the need, where's the demand and how can we meet it. You know the PhD training is actually apprenticeship model. >> Yeah. Yeah. It is a high level apprenticeship where the the the young minds are coming in. They're learning a skill which is how to do science. And the benefit to the PI is you have a an incredible workforce. Um that model has worked. the uh the other the other issue is how do you sort of uh the the the role of the the state government in encouraging this uh you know the workforce in some regions of the country we won't mention which one but the the way in which uh community colleges are funded encourages them to sort of create what's called the the cafeteria model that is they are they are interested in u you know enrollment uh the funding and the and the assessment of community college performance is not so much based on placement. How is uh in in I mean how how do you rate uh North Carolina in that? U >> I'd say we're evolving. The top thing I brought up at the top of ours, our new business model and funding, whereas we are specifically focused on incentivizing training for these top tier workforce sectors, whether it's an accelerated format or a two-year degree. That's where our investment has been to ensure that we're aligning the labor market demand. And this is going to be dynamic where we're going to evaluate these workforce sectors every few years to ensure that the funding aligns with what the need and demand is. >> So we have uh somebody's phone is reminding me that okay mindful mindful of our uh panel coming to an end but uh uh I guess you know we've been talking about a lot of the what's been going on. There's a lot of positive uh synergies I think uh across the state. uh if you could just go down the the the row and if you could have you know your top policy ask of the state government and of the federal government what would they be? >> You'll have to convert this to policy for me. Um so I guess my my joke around this is >> I think the skill sets the like halflife of a skill set is reducing significantly as technology advances. And so we've talked a lot about community colleges, we've talked about universities that's still predicated in the fact that you come out of high school, you go to university and you leave and you go into the workforce. So from a policy and just practice perspective, like how do we keep up with that halfife of knowledge and capability and start to think about like the lifelong learning and reinject throughout a career just the advancement changes necessary to maintain momentum of mid-career and senior professionals to keep up with the technology in the world. So that model is all already changing. I mentioned the Bloomberg um initiative. You know what universities are really good at is education. So how do you incent >> institutions preferably with state as partnership to be part of the education initiative in a broader workforce. I mean when you think of AI right now we are really focused on how do we upskill everybody but but that platform can be extended outside the university there's no reason so you need to develop that incentive so that you can take advantage >> of the fact that you have an educational institution in Chapel Hill and Durham in Raleigh. >> So we talk a lot about return on investment and being able to tell our story. I think the top thing that we we could use is from a federal investment standpoint is invest more into our data infrastructure so we can, you know, better tell that story and align with student outcomes and things of that nature because that that system is lacking and there's accountability that's on the horizon as far as ensure that individuals that are participating in a particular program that they graduate and go into that specific field and they showcase that return on investment. the data infrastructure just is not there. So there needs to be better uh intergovernmental arrangements and agreements and and data sharing agreement. >> So just on that question, I mean there's a lot of missing information in terms from students and workers knowing what sort of skills they need to get into the jobs that companies like yours or or yours are asking for. Similarly, there's a lack of information from the potential from the viewpoint of of firms as to what sort of what sort of skills they can draw from in terms of the the population that's available. Uh to what extent can AI or other types of information technology solutions help bridge this information gap or is it something that will continue to exist? >> So, I think North K on the credentiing system uh for our employees. may not be AI that's needed to help with that other than the students and employers may not know about the backbone that exists in terms of our credentiing. A lot of work's gone into it to make sure that the community colleges are training folks for the right jobs that are needed and the employers say they need them. Um but if you pulled if you pulled my kid who's a senior going to be a senior in high school and asked him where to go look for the credentiing program, he probably wouldn't know where to go. So, if AI can help get the information to him, um maybe through his Instagram account or something, that'd be fantastic. Um so, I think that's that's an area of opportunity. I want to make my little plug real quick. Um real how many about how many employees do you have full-time at Biogen? >> About,200 locally here? >> Locally here? 1200. >> Yeah. Yeah. So that on this workforce panel, I hope we just keep that in mind as we are uh at Duke and working with our community partners and state partners to recruit companies to come to North Carolina to invest in manufacturing. Yes, it's not the headquarters necessarily. It's not the CEO. Um it may not be all the R&D, but gosh, 1,200 jobs impacting 1,200 families in this state. Um it is meaningful. It is generationally meaningful. And so my ask is that we continue that collaboration that's happening that ev that work as a team sport to try and bring these companies here. Um I'm hopeful that when the CEOs come down to visit and they take in a game at the Dean Dome or at Duke, um they're like, I want to live here. I want my family to be here. I want my kids to go to school here. and then we can we'll get those headquarters additional R&D. But keeping the focus on the cooperative nature of our economic development efforts and training efforts, I think are really important for so many families across North Carolina. >> Well said. And uh you know, as I mentioned, uh without workforce, there's no manufacturing. Without manufacturing, there's no innovation. Without innovation, there's no future. And so uh I think on that on that uh thoughtful note, we can leave uh this really fruitful discussion. Thank thanks thanks to all of you. >> Thank you. HELLO. OKAY, IT'S WORKING. >> All right. Good afternoon. Thank you all for being here. I I know it's been a lot of panels and um been a great afternoon. Um we are the last group keeping you all between here and uh some uh reception and networking. So um thank you for bearing with us. we'll uh I think uh have a pretty uh lively discussion and part of I think what our goal is to sort of bring this all home and um kind of tie it back together uh the the true North Carolina ecosystem from innovation um to manufacturing. So um I'm Laura Gunter. I'm the president of the North Carolina Life Sciences Organization. So we are the trade uh association or the the policy and advocacy group for the life sciences industry here in North Carolina. Um we've been around about 30 years. Um came into existence um about 10 years after the biotechnology center and I think you'll hear a little bit about that. Uh so really um excited to be here today and talk about uh some policies and and what we're getting right and what we can maybe do going forward. So with that, I think I just want to start with everyone kind of giving us uh a little bit of background, who you are, um what your sort of role in the the North Carolina broad ecosystem as well as sort of maybe the life sciences one. Um and then as we sort of said earlier over some of the conversations, tell us if there's something you any key points that you really want to start with and then we'll circle around with uh some questions. So I think we'll just go to uh to my right. Good. Good afternoon. Thank you, Laura. And I guess this means we have to be interesting since we're the last ones up here. I'm Lee Liy. I'm the Secretary of Commerce for the state of North Carolina. And I have the best job in all of state government because my job is I get to go out every day and sell this wonderful state to people who are already in it, who are thinking about coming to it, who are thinking about their future, their career, their investments, what they want to do with themselves and their enterprise. I say, "Come to North Carolina." And they say, "Why?" And I get to tell them exactly why. And it's a great job because it's a great product to sell. Uh the North Carolina Department of Commerce is the state's economic development and workforce development agency. We are not in the business of creating jobs, though we put out many press releases that t all the jobs that have been created under our watch. And since 2025, through the economic development team, we've announced 42,000 new jobs and 29 billion in capital investment in the state of North Carolina last year set a record to that effect. Uh but we don't create those jobs. private enterprises out there putting capital at risk and creating jobs. Our job at the Department of Commerce is to work with our partners and to work with commercial operators and help derisk those investments and through our investments in our talent through our partnerships through our work uh with sector partners and in infrastructure to cultivate conditions of prosperity in every corner of the state and that's what we spend our time doing. I can give you some details on that as we go through the discussion. But understand fundamentally that in a state like ours that's dynamic, that has so much to offer in terms of its talent and geographic and uh personnel diversity, we have a broad mandate that's been given to us by the general assembly to go out in every corner and create great jobs for people. And we work with the actual job creators to do that by trying to make their life maybe just a little bit easier. Thank you. Hi, I'm an Sha Walter and I have kind of a dual role at GSK. So, I'm a lawyer and part of my legal role is I have responsibility for digital and technology and also for manufacturing and supply chain, but I'm also a manufacturing and supply chain professional and a member of the GSK um global supply chain leadership team. And I think that gives me a bit of a unique perspective on how innovation and digital transformation and manufacturing all come together under the umbrella of the regulatory framework. Um, and for us it's helping us to deliver medicines and vaccines to patients. And as as many of you may know, GSK is a focused biioharmaceutical company. Um we develop, discover, deliver and manufacture both vaccines and medicines for patients and we aim to positively impact the health of 2.5 billion people in the next decade. Um North Carolina is extremely important to us at GSK. Um I think Kevin said in the last panel that we should all have our headquarters here. Well, we do have US headquarters here in North Carolina. um in Durham actually and we also have a manufacturing facility in Zebulon, North Carolina. U and we employ 2,000 people across the state. Um GSK is also really um involved in the community here and um with an aim to both help develop future talent but also to help um positively impact the health of North Carolinians. And one of my favorite programs that we're involved in is called science in the summer. And it's a program that helps grade school students learn about careers in STEM and also helps them to build the confidence to go for those careers. So linking into the last panel, that's something that we're really proud of. Um, yep. So with that, >> great. Thank thanks Ann. I'm Mark Mlullen. I'm the director of the Duke Margolus Institute for Health Policy here at Duke University. My own background is in a mixture of um a number of jobs in academia and in government, including having the privilege of leading uh FDA like uh uh NED um as well as CMS, the Center for Medicare and Medicaid Services and some work in the private sector as well. And Lee reminded me why I'm here is that North Carolina is really a great place to bring together several things that are very important for healthc care reform. Uh one of those is academic excellence. We've got some great um academic medical centers as well as expertise in a wide range of other disciplines. Duke, UNCC, other uh academic centers across the state and great feeder education programs to support all of that. Second is a vibrant private sector including in many aspects related to health and health care that includes uh uh leading academic medical centers but also innovative companies that are finding ways to keep people healthier using digital and AI and other types of technology. Obviously the life science uh companies both in terms of early stage more advanced larger scale companies doing um major manufacturing and and things like that. But also from a policy standpoint this is a purple state in a good way. We've got a very diverse population, Republicans, Democrats who don't always get along but seem to find ways to get it together on some of the most important issues like trying to address healthc care challenges. Lee, I think some of your colleagues in state government are having some difficulties with that right now, but that's the kind of thing that we work on at Duke Margolus. We're a universitywide program. We're actually located in the business school at Duke since virtually all of the solutions to make health care uh better at addressing unmet medical needs more affordable and available and accessible to people all across this diverse state. will require the public and private sector working together. exactly the kind of private investment that Lee was talking about and have been the subject of a lot of the work here today as well as aligned public policies to support education to create an environment where uh innovative approaches to health care can create sound business models protection for IP supporting um u early stage companies manufacturing is also maybe we'll get a chance to talk about a little bit advanced clinical development uh as well all part of getting um better access to more affordable um uh innovative treatments and doing it in a way that strengthens the economy in the state at the same time. >> Good afternoon. Thanks to all of you for still being here. That's good to see the crowd still around. Uh my name is Doug Etchton. I'm the president and CEO of the North Carolina Biotechnology Center. For those of you who don't know what we do, I'll just make it real simple. We focus only in the life sciences and we're a technologybased economic development organization. See, I made it simple. Our focus really is to make sure that North Carolina is a global life sciences leader. That's what our vision is for the state. And we do that by connecting the dots. We we connect programs. We try to find ways to put all the resources the state has on display whenever we have companies coming in looking to come into North Carolina. oftentimes we find them and explain to them why they need to come to North Carolina and slowly but surely we end up winning a few over and bring them in and we've had some really good years and so I think that uh through our creative programs creating workforce workforce development has been a huge piece of it because whenever we do talk to companies that's the first couple of questions they ask where will we find the people to work here having the great universities the great community college systems we're blessed to live been a state with so many firsts. First in Freedom, first public university, first community college system, first research park, first North Carolina biotechnology center, which is uh the only company like it in the in the United States. It was the first in the world like that. So anyway, there's a lot of f firsts out there, but I'll stop there and just say what a joy it is to get to do what I get to do, too. and I have a lot of fun and I get to see things that are being invented now that won't be on the market for 25 years or so. So, it's cool. >> Yeah. So, Doug, let me just stay with you for a minute. Um, because you talked a little bit about recruiting and the workforce and all the pieces, but the other really piece that you do is back to the very first conversation we had around innovation. >> Certainly. um because you know we we heard from Mike um about the funding of those small companies and that's been going on for since your inception. So you know you've really are in all parts and pieces of life every step along the way. If somebody has an idea in the lab and they want to develop it, we have a program to help you get a grant to help develop it further. So we make grants to universities. If you have a you're you're really doing well in that space and you want to create a company, we make loans to early stage life science companies in North Carolina and they're very favorable rates and we usually come in as Ned still right after your mother says no more. Right? So we get the next we give the next round and says okay the family doesn't want to see me anymore but the biotech center will help me out. And uh we have done that through since 1986 and the grants go back to 1984. So uh and then we do recruitment around the world. So >> and you know and and um Representative White is is just just leaving. She's she did tell me that she was going to have to to scoot, but she and the other legislators that are here. I think the important thing to recognize is that is something that has been bipartisanly supported since 1984. So the state since we're here kind of wrapping it up in terms of you know some policy pieces the state has supported innovation and then recruitment and the whole life sciences ecosystem since 1984. Um I think that's a very important piece to recognize. Um we can always ask for more and we do and there's certainly areas of unmet need but I think that is an important distinction. I I think without that that bipartisan support for 42 years now, um we would not see what we see in the state right now. Honestly, uh if you had drawn on the map, there are probably about five companies in the space in 1984 and now we have 860 companies in this space and they employ 76,000 people directly. About another quarter of a million are employed by companies that support the industry. So when you look at the $82 billion of annual economic impact, just this industry alone brings into the state with average salaries of about $121,000, you can see why it's so important to the growth and development of our economy. So >> absolutely um you know and then thinking about what's sort of happening and and what are the policy things that we need to be considering. Obviously, there's been a push whether it's the pandemic, whether it's the current administration, some combination thereof. We're seeing a lot of interest in that manufacturing front and not just the you know the companies that are making um you know very biologics and and kind of technologically advanced medicines but really bringing everything back and thinking about onshoring reshoring you know some of some shortages pointed out to us that maybe we need to be thinking about how we do that. So how is North Carolina addressing that? um in light of some of the the federal pieces that are coming down to us. >> So, I'll just start with Lee again. >> I'm I'm delighted to do that. The uh the thing that comes across to me, the sentiment that is most prevailing when I'm in recruitment conversations with large life sciences or even smaller life sciences companies that are looking to place manufacturing somewhere is speed, speed, speed, speed to market. how quickly can I get into this location, find an able and ready workforce, build or occupy a facility, and begin producing product? And I know that that seems obvious in some ways, but it's even more acute today than I think it was 5 years ago. And so most often what we are responding to in recruitment and recruitment as a as a representation of where the market is generally is can we meet those those core questions? Uh is there a site that's ready? Uh can we get Kevin's team to get power to the site? Can we get all the necessary permits? And then do we have the talent to do it? Now I list talent last but I actually think that is first. And I I think GSK would back me up on this. The talent question is really what matters the most. And one of the things that North Carolina has managed to do with success is to build our network of talent. And I know the previous panel spoke to this, but build our network of talent. First starting here in the research triangle and gradually expanding that network of talent broader and broader and concentric circles, if you will, around the center of the state as to where we now are able to able recruit these large life science manufacturing projects in almost every corner of the state. Maybe not every corner yet, but almost every corn every corner of the state. As we think about policy, what we want to do next, I'll list a couple things that I think really matter here. First is continued investment and public private partnership in workforce. Uh federal government, our money that's coming in for workforce programs is going down, guys. Uh I wish it wasn't, but it is. I'd love to say I'd love to get more money from the feds, but it's also an opportunity to rethink our paradigm on workforce development and it's driven by partnerships and those have been really successful partnerships and we can do more of them. Now, one place we are getting more money from the feds is the expansion of short-term certification PEL grants, workforce PEL, uh, which takes the PEL program and now makes short-term certification certifications like the biowork technician program eligible for PEL grants. As we think about how do we eliminate barriers for talented people to get into programs that are going to make them available and help answer this speed to market question, here's a good example of how we do it. Uh second, infrastructure, site readiness, and the infrastructure to get a a plant off the ground. Uh we've got a lot of infrastructure needs. We're the third fasting fastest growing state in the United States. A lot of people voting with their feet to come to North Carolina. That's on top of the fact that we have some aging infrastructure all around the state. Now, the Duke team is doing a great job of updating their generation transmission infrastructure all over the state, but that ship does not turn on a dime. So, it's going to take some time. The other place where we feel this most acutely is in water and wastewater infrastructure. And so our ability to find more partnerships and really to think about how we regionalize the concept of infrastructure with support from federal resources so that we can look at the future of where our growth will be and where we want to see uh more of this work happening and invest in that infrastructure. So again we can answer that speedtomarket question with confidence. Those are the two big policy pieces I would say. Uh building out those partnerships so that we are having uh more available resources to spread throughout our decentralized workforce development network on top of our public priv private partnerships and then second investing in infrastructure and uh concurrent to the investment is changes in regulatory structure so we can get it done faster. >> Yep. And I can talk a little bit about what GSK is doing. So we are um we already have the US as a really critical um hub for both innovation and manufacturing but we are increasing our footprint in the US and in 2025 we announced a $ 30 billion investment in the US including 1.2 two billion which is for advanced manufacturing and um AI enabled technologies. Um and a significant part of that investment is is in North Carolina where we're expanding our Zebulon facility to do um complex device assembly for auto injectors. And what that means for patients is that patients with an auto injector can take their medicine at home in less than five minutes instead of going to a clinic or to an infusion center which could take hours. So it's a really really critical both for patients but also for our um facilities and and people in North Carolina. Um, so I think that's really all I have to say about expans >> and just add sticking with manufacturing and advanced manufacturing and maybe a focus at the federal level since Lee you covered the the high importance of state policy already. Um, it's pretty obvious that biomed innovation and manufacturing is a high priority for the current administration. That's not just um uh President Trump and the team that's uh raised concerns about China and other issues, but that's a bipartisan area of interest in Congress and it's being translated into federal policy really throughout the government. Just a couple of examples. Um, the FDA has implemented a number of programs to complement steps like Lee was describing to help make it easier and faster to get through the regulatory processes. You know, not just following good manufacturing, traditional processes, but advanced manufacturing approaches that enable more continuous lower cost manufacturing. that can take a bit of upfront investment, but steps like we've talked about here, having a good a strong workforce, uh having uh the support available from Doug and and his programs, um really is a makes a great partnership for federal initiatives to foster faster progress. So whether it's around advanced biologics manufacturing cell therapies or um innovative approaches to bring down the cost increasing the productivity and competitiveness of more traditional drugs or even just um uh key starting materials and uh and and the active ingredients that are high on the list for many drugs just essential to have and have been subject to shortages in the in in the US. Uh there are a lot of opportunities for partnerships. Uh for example, the FDA has a pre-check program and I think Doug that um you know we we've been working with Doug Gone on this. We have a revamp program that focuses on manufacturing uh and manufacturing policies to um advance it. But I think something like three out of the seven, you know, inaugural class of this accelerated FDA support program were here in North Carolina in no small part due to like this kind of collaboration. Yeah. So that that process I think is only getting going now given all of the additional attention and potential financial support. You know this is an area where for um you know barta and other government support is increasing not not falling. So lots of opportunities for further progress. >> Agree and I I think that as we look at the uh shortages of certain supplies as you mentioned and supply chain opportunities in the state I think we'll continue to see growth coming into the state for companies looking to shorten that supply chain. We are still actively working with probably 19 companies right now, but probably another 35 in our little pipeline that we continuously hear things like, "We want to be in North Carolina. We think that will help us. We're in a geographically great spot. Mid-Atlantic, you're close to, you know, 80% of the US population. Uh, makes it pretty good." So, >> and you know, federally with the um National Security Commission on Emerging Biotechnology, some of their work um we've seen Senator Bud for instance um and I don't know if his rep is still around uh but they had um you know he sponsored the um center of excellence in biio manufacturing act and again back to Mark your point we have all the elements right to potentially be a prime location to put all of those things together and to further advance what manufacturing looks like and how we're going to develop, you know, in a faster way um and and through those regulatory processes. So, uh we we're I think really kind of sitting on the potential cusp of being able to do a lot of these things. So, um you know, what do you want to add to that or what do we do next to make sure that uh maybe those things um happen and we're able to take advantage of them? And that's kind of anybody. I'll I'll add one um thing that we think about when we're looking at where to expand. I think there's really three factors. A big one is talent. Um and that's been um talent. Where the people we go, where the talent is. And North Carolina is obviously a great place for talent with the universities and with the training programs and what the North Carolina um biotech is doing. Um we also look for innovation. So we go where the science is. Um, and again, obviously a great place here. And then we look for a businessfriendly and industryfriendly state. And I would say that North Carolina is both. Um, we have uh low corporate tax rates. Um, we have the connections of public and private partnerships that we've talked about are really important in uh in that space. So, I think that um North Carolina really does check all the boxes for um expansion for GSK and I think for similar companies that are thinking about it. I was say I think you know collaboration is sort of the other maybe secret sauce because you know as as you alluded to Lee you know who's in the room when you're talking to companies right all of the players that are there um I think you know to workforce and talent um was a little bit alluded to in the earlier uh workforce discussion but there's a group called NC bio impact it's been around for 23 years now which goes back to the formation of some of the training programs. Um, BTE at NC State, Brightite at NC Central, the community colleges um, biioet network program, you know, along with biowork that was separately put together by the biotech center. Um so all of those things and that NC bio impact the interesting thing about that is those you know educational components and NC lifesai and NC biotech have been in constant communication. So what they're being taught in those programs has evolved as the needs have changed for companies and we have those relationships. So they're well established. So when it comes to putting together other grants or other programs, we're all having conversations and and are and are in constant communication. So I think that's really a valuable component. >> Yeah. If I can speak just briefly to the partnership piece and it's already been mentioned on subsequent panels or or previous panels rather uh but it is crucial but to just give you a sense of how it looks for a given recruitment. We'll just pick any random company here that wants to come build uh a billion-dollar um life sciences production facility somewhere in North Carolina. The different groups that are going to have to work together and sing off the same hbook. I mean, it's at least 20, you know, it's going to be, of course, the Department of Commerce and our nonprofit uh front door, the economic development partnership. That's easy enough, but then the locals have to do the same thing. And the locals have to make sure that they've washed the windows and vacuumed the floors, so to speak, wherever they are, so everything looks real nice for company when they come over. And even within the locals, the local economic developers got to make sure they get along with the city manager and the county manager and the inspector and the county commissioners. And they all got to sing from the same handbook. And if it's life sciences, I'm going to be there with NC Biotech. So now we got more players in the room. And if we're talking about a plant that big, it means we're going to need some power. So I got to call Kevin, make sure his people are lined up. And I got to call DEEQ and make sure that they're lined up, make sure we've got all the the permitting lined in a way that's going to work. DOT might need to build a road out there. Uh, and then the general assembly, which we mentioned earlier, and Representative White was here, and it was referenced before, but one of the things that we're pretty fortunate to have in North Carolina. I think you see this in states that are succeeding in economic development is, yes, divided politics. Uh, Governor Stein, my boss, is a Democrat. The leadership of the General Assembly is Republican. uh the daggers go down when we start talking about economic development and that's been a big part of our success is that when we have sat at the table and said how do we actually make sure that this project in Wilson comes to success they say we are there to help you we will invest $30 million in a training facility for life sciences in Wilson North Carolina so that a J&J facility can be successful uh and I just use that as an example but the partnership element I do think makes us different and I talk to companies that choose us and I talk to companies that don't choose us and they all reference that point and I think that the way that that works is because we have a central organizing feature for this industry which is NC Biotechnology Center. NC Biotech, great idea in 1984 to create this facility. Not only because it was on the cutting edge of that commercialization of that technology, but also because it gave us a pretty safe nonpartisan space to come together around this and say we're going to have to have a lot of people line up to make these large big hairy projects work for us. That partnership element is a big differentiator for North Carolina frequently in these projects that we do. >> Absolutely. Mark, did you add? Well, I I just um build on all of this. Um we are facing some both challenges and opportunities for partnerships and we've spent a lot of time focusing on biommanufacturing and that is a critical part of the challenges today and the opportunities for economic growth and uh u leadership for more generally in in biomedical innovation which is the other part of manufacturing innovation hub here. Um what's also getting a lot of attention now Laura and I think this has also come up some today is sort of everything else that goes along with the development process. So it is hard and despite all of these efforts it is very time consuming and uncertain and you mentioned you know 25 years um which is uh a lot of time and a lot of time value of money and and risk involved in all of that and there is a ton of innovation going on now in not just the manufacturing but all steps in that innovation process starting with designing drugs assisted by um more advanced AI technology technologies and getting those drugs into human testing assisted by uh simulation capabilities also AI and incilicoass assisted which is a big focus of uh a lot of the research here and then um early stage first in human clinical trials which have historically been costly but it's been a major focus of recent FDA initiatives including their um u uh operation um trailblazer not trailblazer trials uh with uh a lot of public concern about those early stage trials shifting elsewhere because they're cheaper and the frankly the regulatory and the scientific capabilities elsewhere have have caught up a lot with where the US used to have leadership. um but a lot of opportunities for doing that here. And then North Carolina is also the home of some of the uh most experienced and advanced uh companies and academic organizations involved in conducting clinical trials. So the do clinical research institute Ned and colleagues at um uh at UNC private companies like IQIA and RTI. So, uh, opportunity here to make it easier and faster to do clinical trials, which has the added benefit of giving North Carolina residents earlier access to some of the cutting edge treatments that are being manufactured uh, right here, too. I think we still have some work to do in all of those areas, but for the same reasons that we've already been talked talking about today, plus a lot of opportunities for federal support, um, I think we can make more progress. Um uh you mentioned the you know the Democratic and Republican leadership uh the Governor Stein uh um your boss and the state treasurer Bradinry a Republican have come together along with the assembly to form a commission on access and affordability of health care because you know these these drugs medical treatments worldclass are great but boy they're quite expensive and this is the place that could figure out how to bring those treatments to patients more effectively at a lower cost. Uh innovative payment models, innovative ways of doing clinical trials. So we've got a lot of foundation to build on here in the state. We've started with manufacturing. We started with bringing more early stage companies here. I think there's a lot more opportunity in the near future that's going to be backed by a lot of these uh bipartisan federal priorities and by the the um openness to working together across parties to how do we get more affordable, accessible and highly innovative healthcare to go along with these um uh biomedical technology uh investments and developments. >> Yeah. Yeah. Because I mean certainly pricing whether it's marching rights was mentioned earlier whether it's price controls most favored nation I mean there's um sort of plenty of um you know maybe bad ideas on that front to go around but I think it is expensive for individuals when it comes to going to the pharmacy counter right and so I think to your point we have got to take cost out of the system we have got to be more efficient faster smarter um u because we know that small companies are looking elsewhere just from a price and speed standpoint. They're working on tight runways with meeting milestones. And so it is really important that we do that. And I think as you say we have some of those resources and we just need to really pull that together. And so what might that look like? I don't know if I mean again it has to be a public private. It's not going to be strictly done by um the state or the the federal um government, but you know, how can what what sort of maybe policy conversations should we be having um with our legislators um that maybe we are having or maybe we need to amplify? >> Great question. I I don't know the answer to that one. Let's see. But I would say when I think of what's happening in the form of convergence and how much tech sector we have existing in the state and how it can converge into the life sciences sector, there's going to be a lot of policy that's going to have to go into this. And and in order to do the clinical trials faster or at least the basic research faster, you're going to have to be able to allow people to find out whether or not that AI tool is universally acceptable or not. So I I would say I'm probably the least qualified to answer that one. So >> well, help Doug a little bit here. He's not the least qualified. They've got a great foundation for making these further steps possible. But um to to Doug's point, it has been expensive not just to and hard, not just to um manufacture drugs. And we're finding more efficient, effective ways through this kind of investment, workforce training, upskilling, AI, etc. to do that. Same thing for demonstrating whether these treatments really are safe and effective in people and then whether they can actually get access more broadly. So for early stage clinical development um there are a lot of innovative programs that startup companies here are involved with and that are um uh health care systems across the state are trying to advance. Um, uh, I just had a meeting recently with, um, administrator Oz at at CMS on how they could potentially find sites to support, um, earlier access for Medicare beneficiaries for cell therapies if they've got some confidence about, you know, whether that site can generate the evidence needed to show that it could be used more widely. It's an approach that um uh that Chinese academic medical centers and other regulatory agencies around the world are exploring now too. I mentioned this um affordability commission that the state um the governor, the treasurer, the assembly set up on a bipartisan basis. Um a lot of the discussions around affordability and they start with fingerpointing and and we definitely have a lot of inefficiencies and excess costs in the system. But the the initial meeting of that commission highlighted a lot of what the state has already done to build an infrastructure for helping to identify people who would benefit from earlier interventions. Um some of its behavior support that that AI tools and care management programs and uh and team-based approaches to care that include some of those same, you know, uh community college graduates that we were talking about earlier. um uh not just uh physicians but people working together to practice at the top of their license, identify health risks in the community and address them. Some of it is non-medical diet um food support, but some of it is medical using drugs that we know work but still don't reach a lot of pe people who can benefit from them done effectively. This can help reduce overall costs by finding those who can benefit and getting them into effective care programs. So I think more steps like that um building on this infrastructure that North Carolina public and private sectors working together can do. Um just to give an added boost to that um one of the areas where there is a lot of new funding coming into the state is around rural health care transformation. That's the name of the grant. 213 million per year this year in the next four years for uh the state of North Carolina because we actually have the the second largest rural population in the country. Pretty diverse state. So, a great place to to try out and scale uh more accessible AI technology um enabled models to help keep people healthy in the community and and not having to get those costly um uh complications that require hospital treatment. Um and also uh a lot of um potential additional funding related to innovative care models that the state has been uh part of uh advancing. And and so hopefully these will be um uh parts of this state response now to making healthc care more affordable and available the the North Carolina way which is about innovation and public private uh partnerships for the investment needed to um to accomplish the biggest challenges our state is facing and that includes healthcare affordability and biomedical leadership coming together. >> I want to add to that Mark. Um, so the Department of Commerce just completed its statewide strategic economic development plan. We do this every 5 years. Uh, uh, Doug talked about a state of firsts, so we always name it first in something. This time it's first in opportunity. But we went around the state, we got a lot of of input from local communities. Historically what we get in these conversations again this is an economic development strategic plan is a lot of what we talked about workforce readiness and training uh availability of sites natural gas lines etc. We still still get that but the thing we got uh most consistently from communities that they wanted for economic development success in the future was all about community development and well-being. housing availability and affordability, health care afford availability and affordability, child care availability and affordability. Those things came up. We did the bubble graph on them. They were like huge on those three. And uh so we put that in our strategic plan. You say, why is the Department of Commerce talking about uh healthc care access in rural North Carolina? Well, it's because Mark talked about it. We're the second largest rural state in the country. And if you look at the loss of hospital access over the last 15 years, it's all concentrated in rural North Carolina. Uh, and this is personal for me. I'm from eastern North Carolina, town of 5,000 people called Williamston, North Carolina. And we lost our hospital three years ago. And it's devastating for that community. It's devastating for its economic development prospects. It's nearly impossible for us to help them recruit great jobs to that area because a company shows up and says, "What do we have in an accident? Where am I going to send them?" Well, uh, the EMTs are going to drive you 45 minutes uh, down to Bowford or over to Greenville or up to Windsor. And, you know, you might make it, you might not, who knows? And, uh, but but more acutely, it's it's just a disaster for the public health of that region. Uh we think about also public health in the realms of having a great job is a pretty good indicator that you're going to have better overall public health. So these things are tied together for us. We're not a regulator here and we don't control control some of these uh cost questions that Mark and Governor Stein and Treasurer Briner are working on. But what we can help to do is work with our partners again to make the economic development case for availability of healthc care access in all forms across the state. I mean, you need it in in in lots of underserved parts of urban North Carolina as well, but the most acute need by far is in rural North Carolina, places where we want to see growth. Growth that can't happen unless you have affordable and available healthcare. >> Yeah. And I think that's um you know, to all of that, you know, we've been spending a lot of time talking about the research triangle and I think the research triangle park really puts North Carolina on the map in this space, but the reality is we're seeing opportunities across the state. It's no longer just an RTP centric thing. And that's really, I think, really important because that's what drives the legislature because they're thinking about their communities, right? And those of us that are from either different states or other parts of the of of the state, you know, we're concerned with what's happening at home. And so that's a really I think important driver of of what we're looking at and what you know we're we're trying to do and where we're trying to make sure that we bring good jobs and opportunities. Um so as we kind of wrap up because I think we've got about five minutes or so. Um any sort of touch points or things that we haven't covered that you want to to mention? I know that I had a note about you know federal funding. We've talked about its decline in some cases here and maybe in some cases like Texas that it's not. And so, you know, how do we maybe work to avail ourselves of of what is there? Um, any sort of particular thoughts on those fronts? >> I'll take it. Our our economic development success is tied to our investments in talent and in communities and building those partnerships that succeed. If we don't have the resources to invest in talent, and that's talent all the way through from pre-K child care all the way through postsecary, uh we're not going to succeed. We're not going to continue to be in the place where we are. And if we don't have the available resources and partnerships to invest in communities, healthcare accessibility, housing, infrastructure, similarly, we're going to start to see a decline in our ability to be an attractive place for investment. Those resources come from our federal partners, and I could ask more of our federal partners, but they also come from the state. And we do have a great working relationship in the state working on economic development. But we also are on a pathway for declining state revenue thanks to decisions that were made around our tax policy. Now we've got a really competitive tax policy right now today and it doesn't need to change because it's already competitive. But we're on a pathway to see our tax rates decline. And with that commensurately our available revenue and that revenue just means we're going to have to cover everything that's essential. means we're going to have to just do the basics and none of the things that we need to do to stay competitive in a really dynamic marketplace with a really fast growing dynamic population. So, I would just put a plug in for let's be smart about where we are for budgeting. That's not the most interesting topic, but resources are real. You got to have them. Can't have them if you don't have revenue. can't have revenue unless you have a competitive tax rate that that finds the sweet spot, the Goldilock spot between the taxes are are attractive, the tax rate is attractive, but it's still generating enough revenue for us to cover what we need to cover. Last plug I want to make here uh is we haven't really talked about our we've talked a little bit about uh pathways here, but we haven't talked as much about our innovation sector. North Carolina continues to be a place where we have all this talent emerging every day from places like Duke University and UNCC Chapel Hill and NC State beyond. Uh we're proud at the department of commerce and through the office of science, technology and innovation. We Dr. Jur used to lead that team before he went to first life venture center to run the 1NC small business program. I defy you to find another program grant program in in North Carolina that has a 250x return on investment for the lifetime of the program. 20 years plus running this program and it's 250x return on investment because it's making early stage investments grants for early stage companies. Uh the as you talked about Doug, mom says no more or they're actually going out to the federal government to get SBI and STR grants. We help them do that. We could do much more of that with more investment and we could work better with our partners in the innovation ecosystem to ensure that we are generating uh those big growth companies right here in North Carolina. >> Yeah, I have to agree on the one North Carolina small business fund. Um that's critically important and we will continue to to drive that point home. A few years ago we were actually able to secure recurring funds. So our conversation isn't about whether the program should exist, it's about how much should be in it and the answer is more. Um so we'll continue that that particular fight. Anybody else? Yeah, I think this is uh just a why health care and biopharm biioharmaceutical innovation is such a great topic today is on the one hand as we've talked about all afternoon uh the opportunities are just tremendous. the biomedical scientific possibilities have never been anything like they are today and in the years ahead for addressing you know it's not just heart disease it's it's neurodeenerative diseases it's obesity I it's cancer all kinds of unmet u medical needs but what's also clear is the way that we've been doing in the past is not going to work for the future it takes too long it's too costly uh it's too fragmented it's not easy and convenient you You got your app for, you know, exactly what your financial status is at every moment. In fact, too often it makes me nervous. But uh um you can't get that for your health care in terms of what you need to do to stay healthy um to prevent complications, to get the best treatments at the lowest cost. Um North Carolina has taken on a lot of challenges over the years. uh and it has done so through this successful approach that Lee and others have highlighted that you all are living which is public and private sectors, Republican Democratic parties coming together to find some common ground on public f private investmentbased solutions to the problem. So we've got a chance to do that. Now I was trying to come up with your next uh first in uh it's been you know first in biomedical innovation but so first in access to those biomedical innovations and first in health coming out as a result of all this. So it's a challenging environment but um it it's challenging everywhere around the world. Um and North Carolina is a place I think can help the US be part of the leadership for the future. If we could show companies the healthy population, that helps a lot when you're recruiting. We have other things besides health and pharmaceutical. I always worry about our agricultural sector. So, a biotech is a big deal for us. We spend a lot of time on there and it's a simple fact that we're running out of land to grow crops on in the world. Not just here, but in the world. So, it's a shrinking amount of land to grow food on for a growing world population. So using technology is the solution to getting better yields per acre. And so we have a lot of activity we do in the in the ACT tech space as well. And while there are not as many act companies here as there were, we're working really hard to bring them back. So I think that's another >> and the defense defense space as well. >> Yeah, defense space. And then u the other one is I'll put a plug in for it is workforce. We have some unique workforce programs that help people in rural North Carolina or not even in rural but right here in Durham who have been kind of in that space where uh they're not really making it in college and they don't have a job they can't afford for their family. So we worked with you know Maiden Durham to create this program called Bulls building up the local life sciences sector. It's a great program for helping to bring people together. just had a graduation the other night and out of that program most of those people who finish it in six months are hired within the first week of graduation. We do another program out in Greenville in one of the most rural parts of the state outside of right outside of Greenville and and it's our uh grads to work program and if you're graduating from high school you can take this class for two days and if you pass and get a certificate that we teach you how to press tablets and make capsules. Uh the companies in the area will offer you a job. Typically we have somewhere between 25 and 30 people go through the program and out of that group usually 22 to 23 get a job. So changes their life. They go from no possible college, no possible really meaningful career to making $45,000 a year a month after graduating high school. That's a pretty pretty impactful program when you multiply it over the lifetime of somebody. So I think those are the kinds of things we get excited about. >> Yeah. And I just building on that, I think from our perspective, AI is completely changing the way that we discover and develop and manufacture drugs. And what is really important is is linking those workforce training programs to the changing environment and to um digital fluency and AI innovation um so that we can help get people ready for the future which is actually already here. >> Yeah. >> Passing us by as we >> Exactly. Well, I think it is time for us to wrap up, but I will say of all the firsts, I think the bottom line because we talked about, you know, the Rs and the D's and coming together because I think first of all, we're North Carolinians and so that seems to be the guiding force and um so look forward to tackling some of these things with all of you and all of you in the room. And uh thank you very much. Um, I just wanted to thank a few people, thank some folk who uh really made today possible. First of all, thank you Laura for uh working so closely with us. Your connections across the research triangle uh innovation ecosystem uh were so invaluable in helping us bring together such an expert group of speakers today. Um, also want to thank Julie Rose and Melissa Wetterkine from the from Duke University for their partnership in helping to make today's program possible. particularly pleased to have two of our CSIS senior adviserss uh here for us uh at today's program, Walt Copan and Chanharjan, our newest senior adviser uh and uh really helped to enrich our our program uh and uh to understand just the complexity of what uh what is involved here. Finally, I just want to recognize uh my as my colleague CSIS fellow Alex Kirsten for doing the hard work of actually organizing the symposium. Alex has been the master of a thousand details uh without which a program of this complexity and depth and substance would not be possible. So thank you Alex uh with and finally thank you to all of you who have been uh who stuck it to the very bitter end. There is a reward and I think it's in the other room. So we will proceed there. Thank you again.