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Working Differently To Cure Duchenne | Debra Miller | TEDxSageHillSchool


[Applause]

hello thank you very much it’s wonderful

to be back at stage and I appreciate the

opportunity to talk to you about

something that is very near and dear and

I’m very passionate about cure duchene

tradition has been acknowledged over the

last couple of years for creating a

unique nonprofit business model the

reality is I’d like to say that we set

out to do this purposely but basically

we just applied logic and common sense

to a problem so a little bit of

background I was raised in just a normal

household I had an older brother and

sister my mom used to always call me the

pragmatists in the family and I because

it was my mom telling me that I never

bothered looking up the word to figure

out what it meant and so many years

later and I guess she would she would

tell me that I was always able to shift

from Planet a plan B pretty quickly

without a lot of stress or anxiety and

so I was also very rebellious when I was

young I was especially my teenage years

I was pretty much a rebel looking for a

cause and I would go through very

intense stages of whether it was horses

or rock and roll or travel or whatever

it was I was completely focused on what

i was doing to the point that when I was

in college my friend started calling me

saying that I had monomania and I did

look this word up and I wasn’t real

pleased with the first definition about

mental illness so I like to think that I

attended more towards number two which

was excessive concentration on a single

subject and so we basically ended up

having a huge huge problem our son

Hawkin was born in 1997 when he was five

years old he was diagnosed with Duchenne

muscular dystrophy we had never heard of

this word before and we really didn’t

know what to do and there was a problem

in my life that I honestly did not have

a

Lucien for and it was huge Duchenne

muscular dystrophy is the most common

form of muscular muscular dystrophy it

affects boys it’s an excellent

chromosome disease they’re usually

diagnosed between three and five years

old usually by the time they’re twelve

years old they stop walking confined to

a wheelchair later in teen years they

need ventilation to breathe they’re

unable to move their arms or even use a

keyboard on a computer this is a

terrible prognosis we researched we went

to all the doctors we were basically

told we’re told that there’s nothing you

can do go home and love your child this

disease affects all parts of the body it

affects the brain there’s a lack of

dystrophin which is a protein that’s in

muscles and also in your brain so

there’s cognitive issues many times of

these kids your heart is a muscle and

basically the primary cause of death is

cardiac failure usually with with boys

young men in their early to late 20s so

it was a very serious problem we were

basically told that our son we were

going to lose him as most most parents

were seeing their their sons graduate

from high school so Dan pilota who

actually was a TED talk several years

ago that I heard and really inspired me

I had already been running a non-profit

for a few years and trying to grapple

with just the regulation of the way

things were done there were a couple

muscular dystrophy organizations and

Duchenne organizations and we tried to

work with them and we really had no

intention of going out and starting our

own organization but what we heard was

when we would come up with new ideas new

ways of doing things that’s not the way

we do things here and so we looked at

this and thought well they don’t have a

cure yet for a disease and they’re

really not very far along so maybe we

shouldn’t be doing it their way and so

that was why we created the business

model and started moving forward so Dan

pilota was very articulate and talking

about the dysfunction of how charities

are

and help what the public expects from a

charity it seems that charities are

supposed to operate with very little

money and get big results and he felt

and said basically that it’s it’s

unrealistic to expect that that

frugality is is a measure of success and

morality when in essence we should be

thinking big we should be thinking about

problem solving and having setting and

being rewarded for our accomplishments

and for setting high goals and achieving

them and not worrying about our expense

ratio it’s like any business if you have

to operate on an eighty-five percent

profit margin you’re going to have a

tough time and that’s what nonprofits

are expected to do so he basically said

let’s change the way we think about

changing the world so here to Shen you

know I think a lot of it has to do with

the fact that both my husband and I came

out of business and we started looking

at traditional nonprofits and basically

what you had is we would you know a

non-profit goes out and works really

really hard to raise money from people

like you to to donate in in medical

research what this means is you give a

donation in the form of a grant to an

academic institution and the scientists

there you work on a sponsored research

program and and you know if the if the

science is successful and it’s promising

a biotech or pharmaceutical company may

come in and license that technology and

if that drug is developed and it’s

commercially successful then the biotech

and the pharmaceutical company make a

lot of money and you the nonprofit go

back to your donors and ask for more

money to do it all over again it’s very

very hard raising money so what cured of

shin did is we created what’s called the

venture philanthropy model and actually

we didn’t we didn’t create it it was was

kind of an unknown phrase when we

started this organization but a few

organizations had already had successful

business models

namely actually one cystic fibrosis have

done a fantastic job with this so

basically here to shen we take our

donations and we work with biotech and

pharmaceutical companies as much as we

can the difference between these two

models and what what defines success is

for an academic institution success

means getting a paper published success

for a pharmaceutical or biotech company

means having a drug that’s working so

cure Duchene knows that drug companies

make drugs and so why not partner with

them so we started partnering early with

with drug companies where we would

actually invest and and if there was

commercial success then part of that

return would come back to cure duchene

that we could go and reinvest in further

research and so we still have to go back

to donors because as you’ll see in just

a minute you know weary deploy the funds

and if we’re going to move on to more

projects we do need to continue to raise

money but it’s not a one-way street this

is a case study that actually is a very

successful case study in 2004 cure

duchene and over a couple years invested

two million dollars into a little tiny

biotech company called presenza and the

netherlands and we went through ups and

downs with with their drug development

program and finally in 2015 a larger

biotech company in northern california

bought them called BioMarin and when

that transaction happened are two

million dollars we were able to get back

about seven million dollars from that

which we then redeployed into five

additional research projects four of

them being biotech companies one of them

being an academic institution bamboo

therapeutics is a gene therapy company

that potentially has a cure by

correcting the DNA and we invested money

into that in two thousand

January 2016 august 2016 Pfizer bought

them in the future if that is successful

and hopefully it will be you know at

some point cure edition will be able to

take those funds that we get from that

and reinvested Capricorn era più tix

has the heart stem-cell exosomes it’s

delivered directly to the cardiac and it

is in a phase 12 again we’re awaiting

results for that miles Eric’s resurrect

small companies that cure edition was

the initial funder resurrects was right

out of USC that we created a startup

company and license at technology so

it’s it’s really exciting to see that

one one investment that started with

people like you in the room here by

trusting in an organization that cares

so much about a disease and we have the

best experts in the world you can see

how it’s that the funds that donors give

us are leveraged and able to grow so

this is this is a business model that we

would like to to work with we basically

find the best science areas and another

thing that sets cure edition apart from

the traditional nonprofits most

traditional nonprofits that fund medical

research have you know very very expert

Board of Advisors with the scientists

and they once a year get together and

they do a call for proposals and they

meet and they score and it’s you know

it’s a very high level meeting and they

find the best science well that’s great

but what if what if there’s certain

parts of this disease that aren’t being

addressed by the proposals that they

happen to get and so we take a top-down

view where we basically look at this

disease and we realize that it’s cardiac

its diaphragm muscles failure it’s

brittle bones it’s inflammation and

fibrosis and you know gene replacement

and correcting the gene and all these

different things that have to be taken

care of so we look at it like from the

top down like we have to impose our will

on the science

and so we basically go out and set the

targets that we want to address and we

find the best people to work on that and

if nobody’s doing it we create that and

it’s worked out to be very successful

something else that distinguishes cure

dash in from I think at least at the

nonprofit’s that I’m familiar with in

the muscular dystrophy space is when it

came time to hire our team I did not go

to academic institutions if drug

companies make drugs then I wanted to

hire a professional from the

pharmaceutical business which we did

with 30 we hired a scientist with 30

years biotech and pharmaceutical

experience who can actually help us

through the drug development process we

hired somebody out of a venture capital

firm who is in a Stanford trade Stanford

trained and B that can help us design

these deals and really work with the

biotech companies and so we find the

projects we find the best projects we

fund them and we also foster them by

offering our expertise the patient

access the key opinion leaders and we’re

able to foster these all the way through

to the hopefully commercialization so

venture philanthropy I I believe in my

opinion is the way that nonprofits

should be run if possible they’re

self-sustaining again raising money is

really really hard and will never stop

raising money through our galas and our

fundraising and that’s really the core

but we are able to tell our donors that

we’re going to leverage the money that

you give us and grow it by being smart

without money it’s replicable I’m on

several panels talking to other

nonprofit organizations especially in

the rare disease space trying to help

them understand you know different

financing models whether its equity

convertible notes royalties licensing

agreements there’s a lot to learn and

taken us will taking me personally a

long time to learn that

and and I think this is a model that is

starting to be replicated a lot in

nonprofits it’s it’s a way to

revolutionize the the medical research

and for me the most important part is

this is a way to get meaningful funds

and I’m not talking you know ten twenty

thousand dollar grants we’re talking

million or two million dollars where we

can actually see the project and make it

happen quickly so meaningful funds that

come back to the people that care the

most about what they’re going to do with

the money so we care more than anybody

we care more than the pharmaceutical or

the biotech companies about the success

of that particular drug and so when we

have control over it and we have the say

it goes a lot faster and again back to

Dan pilotis point it’s like let’s let’s

reward success and what is success in

medical research it’s drugs that help

patients not papers that are published

in journals and so the whole venture

philanthropy rewards success by actual

results speaking of results last year we

actually had the first drug approval for

duchene it was a long and rocky road

getting there we learned a lot on the

way lots of mistakes and lots of ways

that we would do things differently in

the future but we do have one drug

approval so we know we can do this this

drug is not a cure we still have a long

way to go it doesn’t treat the primary

cause of death which is cardiac failure

and it only treats about thirteen

percent of the patients but it’s a start

and my husband always uses the Roger

Bannister the four-minute mile that

until Roger Bannister round the

four-minute mile nobody believed they

could do it and after he did that lots

of people made that record and so we

believe that we are so close to being on

the cusp of being able to treat many

more boys in a much more meaningful way

so these are few tiles of arns

estimates and it shows basically you

know a top-down view of treating the

whole disease whether it’s replacing the

dystrophin that’s missing treating the

cardiac failure we funded an initiative

to help companies better understand

clinical trials to accelerate the

process because the FDA was being very

very difficult and so we had to learn

how to work with the FDA to give them

the information that they need it in a

way that they would sign off on it

basically i’ll come back to X onyx and

these other these other ones I mentioned

so just recently this week in fact on

Monday we just announced the formation

of a new company called X onyx and I

don’t know if any of you have heard of

gene editing or crisper cast nine but

it’s taken to scientific world by storm

it’s a means of going in and almost like

using scissors to edit the gene and put

it back together the way you want it to

be and there is so much hope for this

technology to cure so many diseases and

make it not just a chronic issue where

you have to have ongoing treatments but

actually a cure and this is where we’re

moving towards so talk about problem

solving great opportunity the problem is

is that there are three companies three

public companies that are working on

Chris Burke as 9 technology their public

companies which means they’re their

responsibilities to the shareholders and

so they’re going to be working on the

low-hanging fruit first which means

they’re going to be working on diseases

where there’s like a single organ so

right now they’re working on for example

I issues when you look at muscle we have

a lot of muscle in our body and it

spread all over the place so just

looking at the expense of treating an

eyeball versus the muscle throughout

your body with a very very very

expensive delivery system and drug is

overwhelming not to mention how do you

get it throughout the body it’s one

thing to

inject a needle into a specific organ

and cure it it’s another thing to get it

throughout your body so great technology

big problem they don’t want to work on

dish in right now and what it’s like to

be a parent and to see a technology that

could cure your kid and nobody wants to

touch it because it doesn’t fit the

business model at this particular point

so what do you do you find a solution

and our solution was to form a company

called X onyx we licensed the technology

from UT Southwestern dr. Eric Olson is a

premier muscle biologist in in

Christopher technology and we just had

our announcement this week and we are

very very excited this is another

project that I’m extremely excited about

so a company that had a drug that failed

to get approval from the FDA and yet it

was shown to be effective in kids and so

here you’ve got a dichotomy between what

the FDA is seen on paper and what the

parents and the children are seen in

their lives where they’re responding

everywhere from stabilization of the of

the disease which is a good thing

stabilization is really good in duchene

as well as some of the kids actually

regaining function and having a better

lifestyle and riding bikes or they never

will be able to do that before and just

improve quality of life and then the

drug is told from them because the FDA

could not see what the parents saw so

this happened about nine months ago and

the parents have been devastated and I’m

very close with many of those and so we

we worked really hard and again here’s a

big problem a drug that works can’t get

it to the kid so to make a very very

long story short we created another

nonprofit called CD access and we’ve

negotiated with the company to transfer

drug to this non-profit and we are now

in the drug distribution and delivery

business there’s always a way and is

always a plan B

and I encourage all nonprofits to think

outside the box and figure it’s not

about running an organization it’s about

finding a cure so this is Hawkin he was

number 88 on the sage football team he

was talk about finding a solution he

loved he loved football always and when

he was diagnosed with Duchenne it was

just devastating he always had a ball in

his hand all the time when he was young

and so thanks to the coaches here it’s

aight ill and my husband being

persistent Hawkin was able to be part of

the football team and it’s been just a

tremendous tremendous story and stage

has been such a part of our life and

it’s extremely satisfying to be here

he’s now at USC in journalism and

writing up a storm so I would just like

to say thank you and I would like to if

possible inspire people here especially

the kids that if you have some quirks

that people comment on go with it

embrace it you know it’s God gives us

gifts and sometimes they’re not easy

ones and sometimes they make you feel

uncomfortable and and you don’t fit in

really well but there’s a reason why you

have a gift and my my advice to you is

let it let it play itself out and find a

way that you can use that to help other people thank you

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