Decoupling From Animal Testing and Making Medical Research Human-Specific: A Conversation With Aysha Akhtar
Interview by Ivan Duran
HHPR Senior Editor Ivan Duran interviewed Aysha Akhtar, M.D., M.P.H. She is the Co-founder, President, and CEO of the Center for Contemporary Sciences, which is pioneering the transition to replace the use of animals in experimentation with superior human-based testing methods. A U.S veteran, she is a double-board certified neurologist and preventive medicine specialist, with a background in public health.
Ivan Duran (ID): Double-board certified physician, Deputy Director in the U.S. Army, Commander in the U.S. Commissioned Corps, Medical Officer at the FDA, and now a Co-Founder and CEO of your nonprofit organization. At first glance they might seem like very different careers, but they all have something in common: selfless service for the greater good. What inspired you to pursue these careers at the individual level?
Aysha Akhtar (AA): Rather than focusing on health at an individual level, I really wanted to effect positive change among larger groups–that is why public health is so appealing to me. At the FDA, I led studies on vaccine safety and helped with the world’s public health response to the 2009 pandemic. I am a neurologist so I especially focused on the neurological side effects of certain vaccines. I also helped prepare for future pandemics and public health threats. At the Army I helped create prevention and treatment strategies for head injury in soldiers. In the Commissioned Corps I deployed to help with public health threats like Ebola and floods. In all of the organizations I worked for, including now the Center for Contemporary Sciences, I got to work at the macro-level of health, which is immensely rewarding for me.
ID: May you tell us about your nonprofit Center for Contemporary Sciences (CCS) and the work that you do?
AA: We work on replacing animal experimentation with more effective (and kinder) methods of research and testing that are based on human biology. We do this through education, policy, and scientific partnerships.
ID: How do you think that your past myriad of experiences has helped you with your overarching goal at CCS?
AA: As a neurologist I can’t tell you how hard it is to tell someone they have Parkinson’s disease, or that their mother has Alzheimer’s. That’s because we have no effective treatments for these and most neurological illnesses. In fact, for most diseases, there is no approved treatment–let alone effective treatments that actually make a difference in people's lives (there are many approved drugs that barely have an impact). At the Army I saw how, despite the Army putting hundreds of millions of dollars every year into creating head injuries in animals for research, we have not a single treatment for head injury. All we can do is help alleviate some of the symptoms of head injury, but we have nothing that actually treats the injury itself.
And during my ten years at the FDA, I saw promising drugs come through the pipeline again and again–drugs which worked and were safe in animals–only for the majority to fail when tried in humans. In fact, 90–95% of drugs and vaccines that are found safe and effective in animal tests fail during clinical trials. Can you imagine hopping on a plane and the pilot announcing: “strap in everyone because we have less than 5% chance of landing safely at our destination?” We would demand an overhaul of the entire airline industry. Yet we accept this dismal failure rate every day when it comes to the safety and effectiveness of our drugs and vaccines. The other major concern is that drugs and vaccines that would have worked and been safe in humans were abandoned because of misleading animal tests. We have plenty of examples to support that we likely threw away really good treatments and maybe even cures because they just didn’t work in the animals.
All of these experiences solidified for me that we need a new approach to medical science. On top of that, I love animals. I care deeply about how we treat them, and I know we can do better. We can improve human health better without hurting little animals. No matter what the similarities are between humans and other animals, we are now working at the molecular level of biochemistry, physiology and genetics and at this level there are too many differences between species. We need to get back to studying human biology, not the biology of a mouse, cat, dog, or monkey. Replacing animal experimentation is a win-win for humans and animals.
ID: To that end, why should researchers transition from non-human animal experimentation toward human-specific medical research?
AA: The future lies in research based on human biology. First, the failure rate in animal testing says it all–we need a new paradigm in medical research. We need to stop trying to artificially create animal “models” of human diseases that are never the same diseases as what occurs naturally in humans. We need to embrace newer technologies that allow us to study human biology and human diseases. Such technologies include machine learning, virtual humans, the human body on a chip, 3D printed organoids, and many more. I truly believe that these technologies will revolutionize medicine and human health.
Second, the public is increasingly disapproving of animal experimentation. The Gallup poll, which tracks this yearly, has found a steady rise in public disapproval since 2001. With climate change, environmental destruction and the pandemic, we are being reminded daily now how our practices impact the lives of animals. The younger generations want a change: a new ethic and worldview that embraces compassion for animals. We conducted a pilot study of biomedical students and overwhelmingly found that they preferred to train in human-specific medical research rather than do animal testing. The biggest reason they cited was concern for animal suffering. So this (albeit pilot) study and the Gallup poll suggests that future scientists will more likely work in techniques other than animal testing. Market analysis also shows that the CAGR for human-relevant testing is growing at a much faster rate than for animal testing. The future job market will be in human-biology based research.
ID: Despite the “increasing evidence of the ineffectiveness” of non-human animal experimentation today, why is it still used by researchers in major institutions including the NIH and FDA?
AA: Because they are bureaucracies! We know how slow the government is to change. There is a cultural mindset that is entrenched in the biomedical community that cannot look beyond animal testing. During my time at FDA I can’t tell you how many internal conversations there were in which my colleagues admitted that animal testing is so non-predictive of human outcomes, but they still cling to it and I believe that is in large part because animal testing is what they know. It’s what they are comfortable with–no matter how problematic it is.
ID: Do you believe that non-human animal experimentation should be altogether banned or just be made not legally mandatory? In other words, should it remain as a viable option for research and testing for human purposes?
AA: There will be a day when we will no longer be using other animals for experimentation. And that is the right direction–scientifically, medically, and ethically. Of course sometimes what we find in another animal is also what we find in humans and I think many still cling to animal experimentation because of those times when there are similarities. But there is an immense problem with this viewpoint. To give an analogy, it’s like you are standing outside a gambling casino and every few months someone steps out of the casino and announces how much money she won. From your vantage point, you would think that gambling is a sure ticket to make money. But what you are not seeing is all the many, many more people still in the casino losing money–failing–day after day.
To judge the effectiveness of animal testing, we have to look at it as a whole, systematically. When systematic studies are conducted, they overwhelmingly show the ineffectiveness of animal experimentation to inform human health. Billions of our tax dollars are basically being thrown down the drain for a very shaky practice. Think how much further ahead we would be if instead, we used those billions and the bright scientific minds to focus on human biology?
ID: Should such a transition happen overnight or gradually but firmly? Are institutions and researchers equipped for it? If not, how can they be supported?
AA: Practically, it will be a transition. Many academic centers and companies are focusing on the newer technologies that I mentioned above for research. So by and by, the transition is happening.
ID: What are some caveats of not conducting non-human animal experimentation? What are the risks of conducting it, both for humans and non-human animals?
AA: There is no downside. By putting our resources into human-relevant research methods we will have methods that better predict if a drug will be safe and effective in humans, better help us understand the pathology of human diseases, and better help us prevent and treat the diseases that afflict us. And, we will do this in a kinder way.
ID: May you tell us about the efforts and success of CCS in helping introduce the bipartisan FDA Modernization Act of 2021? What is its purpose and how confident do you feel about the Act becoming a law?
AA: We are the scientific lead behind the FDA Modernization Act. We have been creating a consortium of scientific groups which support this bill. The bill was introduced in the House in spring of 2021 and then in the Senate in October 2021, with bipartisan support–which, you can imagine, is a rarity nowadays!
President Franklin Delano Roosevelt, A.B. 1904, signing the FFDCA into law on June 25, 1938.
The bill amends the Federal Food, Drug, and Cosmetic Act (FFDCA) of 1938. Currently, the FFDCA specifies animal testing to be used for assessing the safety and efficacy of new drugs prior to clinical trials. However, the science of biomedical research has been substantially transformed since the FFDCA was enacted during the Great Depression and now includes a variety of advanced testing methods that are based on human biology and that can predict better than animal tests how humans will respond to drugs. Amending and updating the FFDCA will broaden options for drug sponsors to use test methods that are most predictive of safety and efficacy in humans. Because the bill has widespread bipartisan support, we have great confidence that it will pass. Every representative I’ve spoken with understands why the FFDCA needs updating. It just makes sense.
ID: What kind of support have you received both in and out of the research field? What about the backlash?
AA: There will always be haters. Those stuck in their ways who will try to fight us. Frankly, I’m not interested in these folks or institutions. We at CCS work with those who can envision a better science–those looking to the future, not the past. And each day there is another academic group, company, or scientist who has the courage to stand up and say we need better science. We need to move away from animal testing. Because of our approach at CCS, we have no shortage of institutions who want to work with us in creating a new paradigm in medical science.
ID: In addition to CCS “pioneering a paradigm shift…that replaces animal testing”, what other areas would CCS consider working on and advocating for?
AA: Ask me this question two years from now. We are looking into options… That’s all I can say for now!
Ryan was a remarkable member of our HUHPR community, known for his kindness, advocacy, and passion for important policy issues like environmentalism and human rights.