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Transformative Innovation Policy

Professor Fred Steward PhD

 

Fred Steward: So I was one of the first generation of academics to get into studying innovation several decades ago. I've got a bit of an interdisciplinary background from natural and social sciences. I spent many years teaching innovation to MBA students in business schools. But I became less satisfied with simply looking at it from the perspective of one firm beating the opposition, and became increasingly interested in how innovation can address contemporary social challenges, whether it's to do with the environment or to do with health. So I'm going to share some of my thoughts on this with you today.

My broad topic is transformative innovation policy. By this, I mean a new domain of policy in many governments across the world, which I think we can explain by the political appeal of innovation as a solution to societal problems. The simplest and broadest definition of innovation is novelty, translation into practice. It's not just a new idea but it's when an idea actually changes either a product that we consume, or the way we run our organizations or systems more generally. Clearly from a politician's perspective the prospect of being able to transform things without unleashing the rather disruptive processes, a wider societal change and revolutionary upheaval has a lot of appeal. And so as governments have become confronted with some big, persistent societal challenge, such as climate change, global health or social inclusion, innovation becomes appealing as a route to try and change things in order to address some of those problems. I've done a lot of work on climate change, and I'll refer to that a bit. But I've also increasingly looked at health issues and I'll also use some examples there. The broad context, I think, is a shift in what are seen as the broad aims and goals of governments.

In recent years, I think it is fair to say that in the 20th century, particularly the last half of the twentieth century following the more secure context after the Second World War, national competitiveness was the overriding goal perceived by most national governments. By the 21st century we've actually seen that these have been in many ways supplanted by what can conveniently be summarized as the United Nations sustainable development goals, which of course present governments with a much bigger range of goals, from big environmental and ecological challenges at a global level, through to basis economic and social welfare issues which is still a challenge for many countries throughout the world, and weaving these together into a more plausible, sustainable development trajectory which commands broad popular consent.

So, we've seen a shift in the terrain of what we have perceived as the headline national goals for innovation policy. And what I'm going to talk about today is how this attempt to develop that type of transformative innovation policy immediately has to confront the fact that we have contrasting models of what innovation is. What is the process whereby innovation is successfully achieved and happens? One presenting a simplified framework which is grounded in the more complicated academic literature in the area, and I contrast too broad, different approaches to understanding innovation. The one I label the pipeline model. This essentially views innovation as a science-driven process. Ideas emerge in the lab they get pushed through a variety of stages to try and interpret their feasibility to work out their practicality to implement those ideas in practice. It's very often portrayed as a stage model, a pipeline going from scientific discovery, passing through inventory, engineering, and manufacturing activities and ending with the marketing given you product or process. 

In contrast with that, we can identify a model of innovation which is much more of a network model of innovation. Instead of seeing new science as the trigger for innovation, it sees it as shaped by a variety of social actors, who have to interact with each other in order to make innovation happen. So, the network model of innovation sees it as a complex and pluralistic pattern of interactions, exchanges and relationships between actors participating in that process. So, if you follow any policy discussion on innovation, or any economics or business-oriented discussion and innovation, you'll tend to find references to these implicit models, these different models of how innovation may be understood. If we delve down into the academic literature more deeply over the years, which, of course, is the academics’ favorite pursuit, we can actually trace the roots of the pipeline and the network model in the contrasting economic approach to innovation and the sociological approach to innovation. The most prominent economist of innovation is Joseph Schumpeter. He really pioneered the notion that innovation could be seen as the engine of economic growth. His focus is on innovation within the business organization - the focus is on economic development. He draws a strict line separating innovation from processes of innovation, of invention, creativity, or imitation simply diffusing and existing innovation into the wider society and economy. He's been very much upon a pioneer of evolutionary economics, and so the evolutionary economic model of innovation is that you have firms creating variety of different possible innovations, and a process of selection favoring some of these and killing off the others. The term creative destruction of course, is a widely known term to symbolize that process of creating novelty and new firms rising and displacing old firms in that process. It's very technologically oriented so I tend to call this a techno-scientific approach to innovation.

We can contrast Schumpeter’s economic take with Gabriel Tarde’s sociological take. Tarde probably was the earliest pioneer of attempts to try and understand innovation. Back in the nineteenth century, he drew a much broader definition of innovation, involving novelty and all spheres of social life - not just the economic, not just the technological, but also the social, the cultural, and the artistic. Tarde didn't distinguish between the creative aspects of invention or the more mundane processes of diffusing new innovations he bundled them all together as an intersection of innovation in these different activities.

He saw conflict and contradiction, dialectical processes essential to the pros of innovation and clearly network building was part of the way to achieve successful innovation. This can best be described as a socio-technical approach to innovation, in contrast to the techno-scientific approach. If we take those 2 broad frameworks, the goals and aims of innovation, and the process models of innovation itself, we can broadly see a range of different paradigms of innovation policy which can be seen in the past decades. If we still start in the bottom left and corner of this matrix, we see a narrow pipeline model of innovation apply to narrow goals of national competitiveness.

This was very much the big science innovation paradigm of the 1950 to 1970s. This broadens its model of innovation into the 1980s and 90s to a wider network model, but it remains pretty occupied with the narrow social goals of national competitiveness.

If we then move to the more recent past, we see a shift towards these global challenges that I've talked about. But again we see some of the approaches which I call a mission-oriented approach still tending to be more pipeline techno-scientific in focus.

What I call the systems transitions approach adopts a wider, interactive socio-technical network perspective. So the period of the 1950s-1970s was marked very much by the big State, led science driven projects. It started with atoms for peace, the development of civil nuclear power. It included projects like concord to try and apply supersonic transport to civil travel. But of course, its outstanding exemplar was the Apollo moonshot program. So all of these programs pursued some sort of national competitiveness. There was an argument about the degree to which economic competitiveness or security competitiveness dominate, and this actually became quite an important issue subsequently. So it's not difficult to understand the background to that period of the 50s to the 70s. It was the aftermath of the Second World War, where science had been seen to play a key role in the final outcome of that war. Whether it was atomic weapons as used in Japan at the end of the war, or even discoveries of medicine, such as penicillin, which contributed to the overall war effort. At the time there was growing concern as to whether the narrow focus on security and economic performance was justified.
And certainly, there was a lot of soul searching after the success of the Apollo Missions and the Moon landing, and they developed a strong lobby, particularly in the United States, to apply that big science model to big social problems to health such as cancer of course, which was the area that received a lot of promotion as the prime candidate to apply this model of innovation policy to. So Sidney Farber argued that we only lack the will and the money and the comprehensive planning that went into putting a man on the moon to try and find a cure for cancer. And so, in response to this, President Nixon did launch what subsequently become not known as the War on Cancer, which was a decade long program of investments in an attempt to apply a moonshot model to the problem of cancer. I think it's fair to say this is this is not an argument about whether or not the investment in cancer research in the 70s delivered anything of any value or not, the issue is whether it delivered the promised goal which was a breakthrough equivalent to the Apollo moon shots, and I think by consensus the agreement would be that it was not possible to replicate that type of mission in the field of cancer.

In a sense it was disappointment in the inability to extend the big science model to some other societal challenges as well as serious questions about the economic benefit of those science based big projects; as you know for many years there were arguments about whether civil nuclear power or supersonic civil aviation actually were successful in economic terms, I think the general agreement was they were not very successful. So by the 1980s you actually had an about turn in the focus of government policy for innovation, and really a rejection of that big project - moonshot mission approach. So instead, an approach was promoted which we can generally regard as a market failure of innovation policy approach. What was the significance of this? Well, it was quite deliberately to get the Government and the State out of trying to do innovation. The term “picking winners”, was the criticism that was leveled at the old-style big projects, and it was argued that the only organizations who were fit for pursuing innovation were business organizations and the firm. Government had a role in setting the framework conditions in which those firms operated such framework conditions might include investment in basic scientific research rather than commercial scientific research, encouraging an interface between the academic world of science and the business world of innovation, promoting a regulatory environment which gave more freedom to businesses to pursue the innovation pathways that they wanted. So from the early eighties onwards we see this abrupt shift in the focus of government, innovation, policy to a more market-led approach. And this was the heyday of the rise of innovation, management of innovation programs on MBA courses, books on innovation, and the theory of the firm and managing innovation. So, in other words, not government policy is the focus, but business strategy is the new focus for innovation policy. And I couldn't resist putting a picture of Boris Johnson leaving downing street at a lunch time today, he has argued quite strongly that innovation is the job of business, not of the State, and memorably put it that only capitalism can cure cancer and use this as a stick to beat the labor party's support for investment in public research. 

Strangely enough, although this big change occurred from a big science mission, moonshot approach to this market-led, business-based model of innovation. It's about the time that this more markets-oriented approach was taking off, rumblings began to emerge about a new global challenge of climate change. And oddly enough, it was really by the 2000s, so after the market led model had been up and running for 20 to 30 years that Nicholas Stern, a leading global economist argued that if you wanted to address climate change, you needed to acknowledge that this was a market failure. In fact, he called it the widest ranging market failure ever seen. His argument was that this required a new era of public policy to try and address this newly emerging global challenge. And the way he formulated it was managing the transition to a low carbon economy. So, this was a big change, really in policy focus, because it's suggested that you couldn't really just rely on mainstream business innovation activities as normal, even though some companies were quite active in pursuing more environmentally sustainable innovations. What they were doing was simply not enough to deal with the global challenge of climate change, and that arguments that we simply needed to move to a no growth economy and radically change our lifestyle and attitude to prosperity was seen as politically unrealistic. And so this is what led to a new focus on an innovation policy, oriented towards a transition to a low carbon economy. And, interestingly enough, it very soon led to a revival of the moonshot notion of mission-oriented innovation. A variety of leading scientists from across the world launched a global Apollo program to combat climate change. A network called mission innovation was established, and this was a quite deliberate proposal to replicate the huge R&D investment of over 25 billion dollars at the time, which is estimated to be about $250 billion in 2020 to, As Martin Reese president of the Royal Society put it, an ambitious public investment in more R&D for new, far from the market energy technologies. So this was a program of techno-scientific mission investment through a big program of research and development.

At the same time others argued for something a bit different to a moonshot-type mission. Their model was much more the Roosevelt type, New Deal of the 1930s, where the proposal for a much wider social transition which would involve a whole diversity of types of innovation, would involve multiple systems - not just how you made electricity within the power sector, but how you used it in your transport system, how you created greenhouse gases in your food and agriculture system, how you using energy within buildings and your domestic residences. And so it suggested you needed to address and use demand as well as supply side innovations. And this was articulated even more clearly in the European Green Deal several years later, which basically says, we need to transform a variety of systems in transport buildings, food, energy, and industry. In order to address global environmental issues, including climate change. 

It's fairly clear that these policy responses like the global challenge of climate change which used the terms missions and transitions were themselves reflecting this contrast between these fundamentally different models of how innovation occurred - its dynamics and how it should be managed and steered. Missions were drawing on this economic science through a pipeline model, while transitions were drawing on a sociological made by actors, network model.

They were different models of innovation, though they both shared what we could call a transformative turn. They were both saying that innovation policy needed to address these new, global challenges. If we look at the way in which they are articulated by the advocates, we can see that they share some similarities with the past, but they're also different. Certainly, the mission-oriented innovation policy does seek to be more systemic, in nature rather than driven simply by scientific discovery. Yet, It still tends to follow a pipeline stage-based process from strategic orientation through policy coordination to policy implementation. The OECD has probably been promoting this model of a new mission-oriented innovation policy approach. 

Transitions policy adopted a much broader network, systemic approach. This diagram is very commonly used to express the transitions framework: it can best be seen as 3 levels, a top level of broad landscape conditions, a bottom level of niches, in which new innovations are developed by new entrance and entrepreneurial firms, and a Meso level - a middle layer - of the regimes in which our society and economy is currently embedded. In other words, that we're embedded in a high carbon regime in terms of the transport systems we have, the buildings we live in, the energy systems that we have. In order to innovate, to challenge that unsustainable regime, you need a mixture of bottom up novelty created by entrepreneurial actors, combined with broader top down policy landscape pressure to discourage the old regime and to make life more attractive for the new low-carbon net 0 sustainable alternatives. So it's a policy mix of encouraging bottom up entrepreneurship and innovation, and applying wider policy and regulatory and economic pressures to discourage the old unsustainable regimes and to facilitate and encourage new innovations to reconfigure that regime.

We see in climate change policy a persistent tension between the missions and the transitions approach as to which offers the best route to challenge the incumbent greenhouse gas regime. The mission approach tends to emphasize low carbon energy supply, driven innovation through renewables, hydrogen and carbon capture and storage. The transitions approach tends to favor and use some system reconfiguration around housing mobility and food. So it remains a pretty important policy debate.

As far as European innovation policy is concerned, the mission-oriented policy has become very popular, and was adopted as the new broad framework for research and innovation in EU and of particular interest to our group here, tonight, cancer was identified as one of the first missions to receive the attention of this new mission-oriented approach through the proposed mission of Conquering Cancer: Mission Possible. Although it aims at a broader systemic perspective, the moonshot still persists as the metaphor for transformation. And so, in some ways it echoes the cancer moonshots launched in the United States under the Obama Administration, put on the back burner during Trump, and now revived under Biden. But although the moonshot metaphor persists, I think it's unfair to simply regard the new cancer mission as simply reheating the old 1960s moonshot type of program. First of all, it is clearly much broader in the mission that it articulates. And so, the Conquering Cancer Mission and now also the US moonshot program clearly state that they seek to innovate in what they call the broad cancer continuum, ranging from prevention through detection and diagnosis right through to treatment and to care, so we'll ostensibly the aspiration is to pursue a much broader mission to address a whole range of targets as far as cancer care is concerned. 

Now the question I think this raises is whether the way that it is being articulated actually captures what I would call the broader transition perspective in order to enable such a broad set of missions to be achieved. The broader transitions perspective argues that you need to promote a much wider range of diversity in order to challenge lock-in to the present system. And so, in order to do that, you actually need to create new innovation ecosystems which will be different in their nature if they are going to facilitate innovation around prevention and detection for example, that you will need a much greater variety of niche actors and knowledge practices which go far beyond the specialisms within oncology and bioscience. And so you need to promote new regimes which offer different models for dealing with cancer.

So this is a big challenge. This is a different model to saying, there's an area of science which holds the promise of finding a solution to cancer, and it needs the same scale of endeavor as the moonshot did in order to make this happen. Instead, it requires to some extent to make life a bit more uncomfortable for the traditional approaches through landscape pressures, and you need to enable new entrance to thrive even if they are not powerful organizations, or very well endowed financially within the current system. In other words, you need a policy to enable a greater variety and diversity of innovation actors that may offer different approaches in fields such as prevention, detection, and care for example. 

There is an incumbent regime within the cancer innovation system, which is still very much basing its promise on the potential for innovation in terms of pharmacological innovations, and in some ways, having gone through the doldrums for several decades, the recent couple of decades, of course, have shown an upward trajectory in terms of the drug innovations actually entering the marketplace. So the question is whether the interpretation that this is a harbinger of a moonshot focus which could deliver results is well founded or not.

As you all know, that optimism is contested by other clinical knowledge communities around the efficacy, or the relative efficacy of newly marketed medicines, and some of the techniques and methods used in clinical trials as well as the inherent scientific complexity of cancer as a condition. Yet the current policy, which very much emerges from that market led era of innovation policy is very favorably disposed towards that narrow incumbent regime. The global influence of the US health reimbursement system tends to be blind to price and so offers a global incentive to continue with expensive me-too drug introductions. The FDA has deliberately changed its regulatory system to favor regulatory approval for similar medicinal innovations. There is a curative culture within the medical system, which is shared by professionals and patients and post-genomics dominates the bioscience focus on personalized medical promises.

So the question is: are there any signs of more transition policy initiatives to try and enable a broader approach to transformative innovation policy? The Cancer Research UK Road Map on Early Detection and Diagnosis is one of the few examples which suggests a different type and a much more transitions-oriented approach.

It recognizes you need a new innovation ecosystem if you want to promote early detection and detection and you need different incentives and business models to facilitate early detection and diagnosis. So this recognizes that the current knowledge system has limits, and that if you want to encourage a variety of innovation, you need to change that system to some extent. And it does make proposals for that - it suggests social innovation as a newer health economic model. It suggests entrepreneurial incubators through organizational innovation and the new type of knowledge infrastructure platform for trials. It's got its weaknesses, but nevertheless, it indicates a different type of approach, and a more transitions-informed policy framework.

In conclusion, then, if these new policy mission aspirations are to be fulfilled, they need much more of a transition-oriented transformative innovation policy. Without that, a narrow mission will tend to be shaped by the dominant incumbents. New actors and new types of knowledge need to be actively supported and promoted system diversity. Some pressure needs to be put to limit the domination of incumbent players and this network model, what I would call an interactionist and socio-technical approach to innovation, needs to be drawn upon much more fully in order to fulfill this policy goal. 

Questions:

Leeza Osipenko: You talked a lot about the pathways and the environment that needs to be created. But the question is, how do we define innovation? And the reason I'm asking this question is because I think this is actually quite tricky, and the example I can give is from well, the only field I borderline know is UK innovation policy for healthcare. This became a very big political tool, and NICE is very active in this action to try to support innovation and one way or another, but it almost is kind of a humoral brand name for something which is hard to define, and especially in medicine, where, for the pharmaceutical company, they will tell you a new mode of action is innovation. Then it takes 20 years to see that this particular drug, having technically new mode of action, actually does not change anything clinically for the patient. On capitalizing on that innovation, collecting all the rewards associated with this innovation: financial, applause and everything, we actually don't have an innovation, and then something that let's say did not receive earlier approval over time may end up becoming a very important innovation. So where are we with definitions? And where are we with timelines, particularly in healthcare?

Fred Steward: I am firmly of the belief that innovation is a relative, not absolute concept. And if you try and get too deeply into “this is a real innovation, that isn't an innovation” one gets into quite complicated territory. There is a test of practice for innovation to be regarded as innovation so simply a new idea or something that claims to offer something, I don't think merits the term innovation. It needs to deliver some novelty in practice - seems to me that is the requirements of being recorded regarded as innovation. But then that covers an enormous spectrum from marginal practical impact to revolutionary impact. from local impact to global impact, but I think it's rather important to keep the spectrum on the agenda for policy.

And one of the reasons for this is that I do think there are different advocacy coalitions around the territory of innovation, because it's quite, as well as general social legitimacy, it has commercial currency in marketing terms, and it has policy currency in terms of receiving support from public policy and funds. So it's a contested territory and in many ways - the territory has tended to be captured by the science-based model of innovation in my view, to the exclusion, unfortunately, of areas of innovation that deserve more attention.

So let me just give you an example from climate change there's still a fascination amongst many engineers with energy storage through new types of batteries, through trying to find new sources of carbon-free electricity, whereas, for example, the bicycle is seen as an innovation from the nineteenth century. Yet, the truth is if you go out, of your office onto the street, you will see a bicycle which is the same as the nineteenth century bicycle, but actually it's part of a digital platform where you don't have to own the bicycle to get on it and take a journey reducing greenhouse gas emissions and using a bicycle. So it's not novel in a scientific sense in old fashioned science sense, but it's very novel in terms of its impact.
Now I would say the same happens to some extent around health and cancer, that they clearly is scope for innovations around prevention which will draw upon a mix of big data and of modern insights of behavioral science. Yet they are still marginalized as far as being seen as central to the innovation policy agenda. So I'm a great fan of a broad, relative model of innovation to be more inclusive about a wider range of innovations that deserve attention and support.

Leeza Osipenko: Do you think this is like from Jack’s talks when he clearly presents data showing that it's becoming more and more difficult to find new drugs, becoming more difficult to innovate, and perhaps this is true, across a few areas, however, what's going to depend is how we define innovation. I think a bicycle example is a good one. But if we take this kind of packageable examples of amazing breakthrough drugs like penicillin, insulin; and we were getting fewer of these types of innovations. Do you think this is the reason why we need a policy around it? A framework, a catalyst, because, as I understand, firms and the government central structures for much of the innovation to happen now, because the real key for innovation is human creativity. This is our views on that. But the thing is it's not possible without platforms and the money in some fields. In some fields it's probably possible to lay your couch and advance something, but in others you really need this formal state or corporate support, to try to test your ideas, to bring this innovation, to life. Do you think the increase or the need for this policy became such because it's becoming harder to innovate or innovation moves into different domains? Or because actually, our productivity in innovation these days is so much more than it was in previous generations. Where are we with that?

Fred Steward: I don't know, is the answer. But what I do know is  pharma is like many other industrial sectors. Industrial sectors reflect success from the past. I mean that this is the fundamental contradiction facing governments with their policy on innovation. When they look around at the industrial landscape, the powerful organizations, the ones that are valued in billions of dollars, the ones that employ thousands and thousands of technically qualified staff, the movers and shapers of markets and systems, they're all based on the past. I mean Bill Gates still presents himself as an entrepreneur. I mean he's a corporate business tycoon whose entrepreneurship was when I was a student in the 1960s. There is a problem there because as you rightly say, you can’t say I don't care about the powerful incumbents. I mean that's not a viable policy you have to have something to say about them. Superficial writing them off is wrong. And they're likely to remain part of the future landscape. The real question is, are they going to lead the future? And there the answer is not clear, but it's certainly by no means obvious that they're going to lead the future - it's neither one thing or the other.
You can't say they're going to disappear next year, or the future is going to be shaped by them. They may or may not, and that's where judgment, which of course is what you have to do if you're a business manager, if you're a research director, if you're an investor, you have to make those judgments. Well so too if you're a policymaker, you've got to make the judgments about where is the future is likely to lie, and should I put all of my eggs in one basket, and my view on the likelihood of a second wave of pharmacological revolution, like the 1950s and 1960s I'd say is unlikely. No one could say it's not possible, But it's not likely. So if my job is to spend public money or pass public laws where the public want me to do in a way that could facilitate positive developments in the future to deal with illness such as cancer. Then I would say I can't justify just sticking with one basket, however powerful it is, or technically expert it is. It's a highly risky strategy and I would do research in both the climate and the health areas.

The climate area was like this 30 years ago, where basically everyone said oil companies rule the world, and anything else was treated as a joke and that has changed. I find the health area is lagging to some extent in that there is still an extraordinarily narrow focus and a hope, a gamble, on a certain promise, by all means invest in that promise no one's saying you shouldn't do that. But to invest your total policy effort, and in some ways some of the mission advocates are saying, increase the focus, is the solution, You've just got to put more resource into it - in my view it's misguided. 

 

Sophia Carrera: I think it's about part of perhaps economics - I was particularly interested to see what you picture in this innovation policy pardons, then the choice between the process and the goals and how innovation is driven by different things, whether it's big science or led by the market, and I'm not sure I understood very well what you meant by system transitions. But I can see this big case for mission oriented innovation driven policy. I am, I think, like many of us, concerned that perhaps innovation nowadays has not really happened I mean by the needs of society much, but just driven by sort of technological advances which respond to market forces. But obviously we've got some sustainable goals which have been defined. We've got the anti-microbial leadership requirement really at our doors and many others. And I don't know whether this graph that you show us is something that is dynamic, can be dynamic. Can we alter how innovation may happen, driven by big science, or by other forces which are not just directly related to the offer and demand?

 

Fred Steward: Well, that's the that's the central question. Again, we know there are historical examples where policy has led and enabled innovation. But that doesn't tell, and there are many cases where innovation has occurred without any purpose, driven by policy or even by business.

I mean Strowger, who was the innovator of the modern telephone exchange, was driven by an obsessive anxiety that the telephone operators were listening to his telephone conversations. And so he was driven to develop an automatic system so the telephone girl couldn't listen into his conversation. So that's driven by individual idiosyncrasy. So I think this is my point that the reemergence of the mission, as society is trying to articulate goals that are important to it, and that we want innovation to address is a good thing, and it can deliver, but it doesn't necessarily deliver, and that's why the models that you have for the innovation process are then extremely important. Because if the model is simply the government will spend $250 billion dollars on the Apollo Moon Mission, now you take me into a room full of any scientist: bio scientists, energy scientists, I will show you 20 powerful, technically sophisticated advocates as to why government should spend 250 billion dollars on their area of expertise with that. So that is what the policymaker is confronted by a battleground of expert advocate, saying, I know the solution to cancer. I know the solution to climate change. You must just give me 250 billion dollars. To which the answer is, no, because you are simply an advocate, and no one knows which is going to be the successful route.

Therefore, as a policy maker I want to pursue the mission, but I need to ensure there's enough variety to make it feasible and realistic that there may be some success. There may not be, but it's got to be plausible. And that's why variety is so important. Now clearly, as soon as you have a system which you're all familiar with, big labs dominating the knowledge system, big companies dominating the industrial system. Well, if you want more variety, you have to ensure that business-oriented spaces, knowledge-oriented spaces, exists to enable this variety. And if you don't see and you need to make a judgment about it. And I would say the big pharma corporate structure is a bit monolithic. The new bio startups offered more variety, but most of them have entered a strong dependency relationship with the big companies, Jack's more an expert on this than I am. So you need to create what I call a new ecosystem; That means you enable new types of businesses and you how do you do that? You don't just bankroll them, but you might guarantee them a market for a period of time, or you might. You might provide an umbrella in which it's easier for small firms to pursue their own path.

So we know there are all sorts of models that we know about to enable this. You've got to say to the advocates no this isn't a competition about putting the moonshots on your favorite role of the dice, because that's what it is, even if it's even if it's well informed there is uncertainty and that's what your big question was, can we actually make policy to enable innovation? Yes, but we need some humility in the process and without the humility we just risk hubris and repetition of big mistakes which will then cause a pendulum swing again between the stakes, the solution, or the markets’ solution. we all know it's going to be some mixture and hybrid of what's going on in the private sector. What's going on in the knowledge sector and what's going on in the public sector. I mean that is what we know eventually will work and that's what we need to encourage, and it's become a bit unfashionable. For some reason I don't know why I mean in in my youth, or we were always bored by the mixed economy, whereas now it seems to be a revolutionary statement to suggest that there might be a role for something outside of the business sector. But certainly, I think climate change has definitely changed the perception on this, and I think health is going to be going along the same route as well.

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