How Public/Private Collaborations Fuel Oral Health Innovation

By Jill Sirko, PhD

An Interview with Dr. Rena D’Souza

Rena D’Souza, DDS, MS, PhD arrived in Washington D.C. to take on the role of Director of the National Institute of Dental and Craniofacial Research on perhaps the worst possible day in recent history to be in Washington D.C. – January 6, 2021. It was the height of the COVID-19 pandemic, and the day of the attack on the U.S> Capital building. Dr. D’Souza said her friends questioned her decision to be in D.C. As she put it, “it was not a fun place to be at the time.”

Dr. D’Souza never thought when she started her job in a completely virtual environment after a cross-country move without the benefit of even meeting her new team in person that new collaborations and partnerships would drive much of the work that first year. However, she saw first-hand how productive working across silos can be, especially in driving new discoveries and innovations in science.

We invited Dr. D’Souza to join Forsyth dentech 2023 as a keynote speaker introducing the panel discussion “Public/Private Collaboration in Oral Health Innovation.” She was kind enough to meet with us ahead of the conference to discuss how crucial public/private collaboration was in addressing the COVID-19 pandemic. The lessons she learned during that crisis continue to inform her leadership at the NIDCR today.

Public/Private Partnerships Fuel Innovation

Even though Dr. D’Souza began her tenure at the NIDCR during a public health crisis, she said her move also symbolized joy and excitement:

“I came into a campus that truly was mobilized to handle the pandemic,” she said. “The principles that guided this mobilization of NIH were driven by innovation and creativity. I was thrust into the middle of discussions with Drs. Anthony Fauci and Bruce Tromberg, who was fairly new himself. These discussions were charged with creating the tests and making sure that the vaccine was available to distribute in different forms. It was a very exciting time to witness a real-life experience of having dedicated scientists, innovators, and creators of new knowledge, partnering with the private sector. It was truly a private-public partnership that I experienced in real time, and it was very, very invigorating.”

Out of necessity, public and private sectors worked together to accelerate solutions for diagnosing and treating COVID-19, and community organizations and connections became critical partners in disseminating information as it became available. These collaborations led to innovations and connections that otherwise might not have happened.

“I feel that when you have the unexpected, when you have serendipity hit you squarely in the face, leadership becomes essential. You have to be the kind of person who believes in the human process, who believes that connections are so important, and that communication means are critical,” Dr. D’Souza explained. COVID-19 was not the only crisis that influenced her communication across silos.

The Other Public Health Crisis

Dr. D’Souza’s first year at NIDCR was shaped by another monumental task – completing the Oral Health in America report, an enormous document of more than 700 pages, and over 400 authors. The report had originated in the Surgeon General’s office but became her charge as other national crises – the border crisis, mental health issues, gun issues etc. – claimed the Surgeon General’s attention.

“The report wasn’t what I thought an NIDCR director would do, but I realized the responsibility of informing all that we do by the status of oral health in this country,” she explained. The report revealed that health disparities highlighted by the pandemic extended into public oral health as well. As she began to think about the priorities of the institute through a post-COVID lens, she found herself reassessing strategy.

“I had to ask, why in the 20 years our science and technology have thrived for NIH, we have had some great discoveries, we understand the biology of disease much better, the world of microbiome research has flourished, and yet, our data show that four out of five children still have untreated decay? This question haunted me. I mean, it wasn’t something I just looked at and said ‘Hmm, it’s a problem. We got to solve it.’ I was haunted by it.”

This realization led Dr. D’Souza to question what was preventing progress. She concluded that there wasn’t enough focus on implementation science. “And then naturally I thought,” she continued, “are we putting patients at the center of all that we do? Is all that we do relevant to human health?”

“Because if you’re not doing science that has a beneficial benefit to humanity, then you have to question why.”

From Foundational Knowledge to Clinical Research: A Circle, not a Continuum

Working on the report raised important considerations that shifted priorities to implementation. Dr. D’Souza explained, in the past, “we kept the basic sciences of the foundational knowledge on one end, and we had the clinical research, which was very unexplored on the other end. We called all that was in between, translation. It was kind of a fuzzy zone where you did preclinical work, and then you tested on larger animal models. And then finally, you’d move to human trials and come up with a therapy or a cure or a device.”

“But today I view process not as a linear progression, but as a circular continuum. And circles to me are unifying elements. Mechanistic work feeds the circle. But how do we take what we know from the bench or from clinical work and make the clinician aware of this or make communities aware of it in terms of how we implement policies?”

“We must make community partnerships real, and mobilize leaders in the community, so that they understand and disseminate knowledge. They are an important part of the circle. Public health and population sciences, and public health policy-driven research can feed back into the foundational sciences in that total continuum. I think the message should be that every aspect of this circle counts. The patient is always in the center and that is what I would want to emphasize the most.”

With the patient at the center of the model, science and technology can find common ground to improve health care.

Public/Private Collaborations Accelerate Implementation

The COVID pandemic created a need for accelerating innovation and developing solutions. It forced people to think outside the box and form collaborations that didn’t exist before. “I definitely feel the importance of partnerships and collaborations, and of Shark Tank approaches.” Dr. D’Souza said. “Before COVID, we shied away from things that were high risk. We had to prove that we could do it first with preliminary data and publications.”

“And of course, we must keep some of that today. But we’re moving into a new era now, of challenging dental students early on to participate in bench to bedside innovation and challenging our research communities to create new ideas and come up with solutions.”

“This is an unprecedented time when science and technology continually intersect. For instance, if you have patient records through the electronic or combined electronic health record database, using data science, algorithms and machine learning tools you can now actually generate new science from technology. Forsyth dentech should capitalize on this unprecedented golden era of opportunity, where science and technology intersect, to come up with cures, therapies, new devices, and products.”

With members from both private and public sectors of the oral health ecosystem convening, Forsyth dentech 2023 is set to foster such discussions on the intersection of science and technology.

Forsyth dentech: Promoting Innovative Collaboration in Oral Health

Dr. D’Souza will join biotech startups, insurance providers, venture capitalists, and clinicians on stage at Forsyth dentech. The diverse makeup of oral health stakeholder groups at Forsyth dentech opens the door to unique and productive conversations. Dr. D’Souza explained why this is exciting to her:

“Forsyth dentech is blazing a trail. You are thought leaders and change agents right now. And at the center of all of that, I hope science will prevail. Keep science central. Corporations must look at the profit margins, otherwise they can’t exist.  They drive very fast towards product development, creation market analysis, Good Manufacturing Practices (GMP) facilities and all of that. I have done a little bit of that. On the science end, we are looking for the truth. And sometimes that is painstaking and slow.”

“Coming together allows us to incorporate both attitudes and values of both private and public sectors. Fabulous advances in Alzheimer’s, Parkinson’s, and schizophrenia all came about because of this type of partnership, of bringing two values together. You can’t say one value is better than the other. It’s a value, and they are both equally good, but we need to collaborate. You have the advantage of letting science fuel technology and having technology lean on science to be successful. That bi-directional process is very important.”

Dr. D’Souza sees tremendous advantages to this collaborative approach and hopes the upcoming conference provides new examples of how these values can work together to improve public health in a meaningful way.

We hope you will be able to join us to hear Dr. D’Souza speak at Forsyth dentech 2023.