So this is a picture of my dad and me, at the beach in Far Rockaway, or actually Rockaway Park. I'm the one with the blond hair. My dad's the guy with the cigarette. It was the 60's. A lot of people smoked back then. In the summer of 2009, my dad was diagnosed with lung cancer. Cancer is one of those things that actually touches everybody. If you're a man in the US, you've got about a one in two chance of being diagnosed with cancer during your lifetime. If you're a woman, you've got about a one in three chance of being diagnosed with cancer. Everybody knows somebody who's been diagnosed with cancer.
這是一張我和我父親的合照 在Far Rockaway海灘上 那裡叫做Rockaway公園。 我是金髮的那個。 我父親是拿著香菸的那個。 當時正值60年代, 那時候很多人抽煙。 2009年夏天, 我父親被診斷出罹患肺癌。 癌症是是和人人都有關係的東西。 如果你是一個男性的美國人, 你這一生將會有一半的機會被診斷出癌症。 你這一生將會有一半的機會被診斷出癌症。 如果你是女性, 你會有三分之一的機會被診斷出癌症。 每個人都會認識一些被診斷出癌症的人。 每個人都會認識一些被診斷出癌症的人。
Now, my dad's doing better today, and part of the reason for that is that he was able to participate in the trial of an experimental new drug that happened to be specially formulated and very good for his particular kind of cancer. There are over 200 kinds of cancer. And what I want to talk about today is how we can help more people like my dad, because we have to change the way we think about raising money to fund cancer research.
好,我父親現在好多了。 有一部分的原因是他可以參與 一種實驗性新藥的測試 有一部分的原因是他可以參與 一種實驗性新藥的測試。 有一部分的原因是他可以參與 一種實驗性新藥的測試。 這種藥對於他所得的特定癌症非常有效。 這種藥對於他所得的特定癌症非常有效。 癌症有超過200種。 我今天所要說的是 我們如何能幫助更多像我父親一樣的人。 我今天所要說的是 我們如何能幫助更多像我父親一樣的人。 因為我們必須要改變我們對於 癌症研究募款的想法。 因為我們必須要改變我們對於 癌症研究募款的想法。
So a while after my dad was diagnosed, I was having coffee with my friend Andrew Lo. He's the head of the Laboratory for Financial Engineering at MIT, where I also have a position, and we were talking about cancer. And Andrew had been doing his own bits of research, and one of the things that he had been told and that he'd learned from studying the literature was that there's actually a big bottleneck. It's very difficult to develop new drugs, and the reason it's difficult to develop new drugs is because in the early stages of drug development, the drugs are very risky, and they're very expensive. So Andrew asked me if I'd want to maybe work with him a bit, work on some of the math and the analytics and see if we could figure out something we could do.
我父親被診斷出後不久, 我和我的朋友Andrew Lo一起喝了杯咖啡。 他是麻省理工學院財務工程實驗室的負責人 而我也是這個實驗室的其中一員。 我們談論著癌症, Andrew也做了他的研究: 有人告訴他 並且他也從閱讀文獻得知, 現在有個很大的瓶頸 -- 新藥很難研發出來, 而此原因在於研發的早期階段 而此原因在於研發的早期階段 研發的藥物風險很大, 也很昂貴。 所以Andrew問我是否有意願跟他合作, 所以Andrew問我是否有意願跟他合作, 在數學以及分析上面著手 看看我們能否找到我們能改變什麼。
Now I'm not a scientist. You know, I don't know how to build a drug. And none of my coauthors, Andrew Lo or Jose-Maria Fernandez or David Fagnan -- none of those guys are scientists either. We don't know the first thing about how to make a cancer drug. But we know a little bit about risk mitigation and a little bit about financial engineering, and so we started thinking, what could we do? I'm going to tell you about some work we've been doing over the last couple years that we think could fundamentally change the way research for cancer and lots of other things gets done. We want to let the research drive the funding, not the other way around.
我並不是一名科學家, 所以,我並不了解怎麼做出一種藥。 我的任何一位同事,Andrew Lo, Jose Maria Fernandez,或是David Fagnan-- 沒有任何人--是科學家。 我們不知道製造癌症藥物的第一步是什麼, 但是我們知道些許和降低風險有關的事, 還有一點點財務工程。 然後我們開始思考, 我們究竟能做些什麼? 我將告訴你們我們過去數年在做的事 -- 我將告訴你們我們過去數年在做的事 -- 我們相信這會在根本上 改變癌症研究以及很多其他事情的做法。 我們相信這會在根本上 改變癌症研究以及很多其他事情的做法。 我們想讓研究主導資金, 而不是反過來。
So in order to get started, let me tell you how you get a drug financed. Imagine that you're in your lab -- you're a scientist, you're not like me -- and you've developed a new compound that you think might be therapeutic for somebody with cancer. Well, what you do is, you test in animals, you test in test tubes, but there's this notion of going from the bench to the bedside, and in order to get from the bench, the lab, to the bedside, to the patients, you've got to get the drug tested. And the way the drug gets tested is through a series of, basically, experiments, through these large, they're called trials, that they do to determine whether the drug is safe and whether it works and all these things. So the FDA has a very specific protocol. In the first phase of this testing, which is called testing for toxicity, it's called Phase I. In the first phase, you give the drug to healthy people and you see if it actually makes them sick. In other words, are the side effects just so severe that no matter how much good it does, it's not going to be worth it? Does it cause heart attacks, kill people, liver failure? And it turns out, that's a pretty high hurdle. About a third of all drugs drop out at that point. In the next phase, you test to see if the drug's effective, and you give it to people with cancer and you see if it makes them better. And that's also a higher hurdle. People drop out. And in the third phase, you test it on a very large sample, and you're trying to determine what the right dose is, is it better than what's available today? If not, then why build it? When you're done with all that, what you have is a very small percentage of drugs that start the process actually come out the other side. So those blue bottles -- those blue bottles save lives, and they're also worth billions, sometimes billions a year.
首先,讓我告訴你們如何幫一種藥籌措資金。 首先,讓我告訴你們如何幫一種藥籌措資金。 想像你在一間實驗室裡-- 跟我不一樣的是,你是一名科學家-- 你是科學家,而你研發出了 一種你認為能夠治療癌症病患的新物質。 一種你認為能夠治療癌症病患的新物質。 嗯,你所要做的,就是在動物身上測試, 在試管裡測試, 但是有個從實驗桌到臨床的概念: 但是有個從實驗桌到臨床的概念: 而為了從實驗桌、實驗室,到臨床、給病人使用, 而為了從實驗桌、實驗室,到臨床、給病人使用, 你必須要測試這種藥。 藥物測試基本上就是一系列的實驗。 藥物測試基本上就是一系列的實驗。 透過這些被稱之為臨床證驗的大型實驗, 來決定這種藥是否安全或有效等等。 來決定這種藥是否安全或有效等等。 因此美國食品藥物管理局有一套特定的準則。 在這個測試的第一階段, 稱為毒性測試, 叫做第一期。 在第一期中,會給健康的人用這些藥, 看是否會讓他們不適。 換句話說,不論藥物帶來多少好處 副作用都可能讓這種藥物要失去它的價值。 副作用都可能讓這種藥物要失去它的價值。 它會引發心臟病嗎?會致命嗎? 會引發肝衰竭嗎?會引發類似問題嗎? 事實證明,這是個頗高的障礙。 大約有三分之一的藥跨不過這道障礙。 在下一期, 測試的是這種藥的效能。 你要做的是讓癌症病患使用這種藥, 看是否能讓他們好些。 這又是另一道更高的牆, 很多會被淘汰 第三期你將會在很多的樣本上做測試, 目的是確認正確的劑量。 同時 同時確認它是否比現存的藥物好。 如果沒有,那為什麼要生產它呢? 當這些事情都做完了以後, 只有一小部分的藥物能通過整個程序。 只有一小部分的藥物能通過整個程序。 這些藍色小瓶子能夠救人一命 同時,它們價值數十億, 有時候一年就能賺進數十億。
So now here's a question: if I were to ask you, for example, to make a one-time investment of, say, 200 million dollars to buy one of those bottles, so 200 million dollars up front, one time, to buy one of those bottles, I won't tell you which one it is, and in 10 years, I'll tell you whether you have one of the blue ones. Does that sound like a good deal for anybody? No. No, right? And of course, it's a very, very risky trial position, and that's why it's very hard to get funding, but to a first approximation, that's actually the proposal. You have to fund these things from the early stages on. It takes a long time.
問題來了: 例如我問你是否願意做個一次性的投資, 例如我問你是否願意做個一次性的投資, 例如說,兩億 來買這些瓶子的其中之一, 先一次性的付兩億, 來買某個瓶子, 我不會告訴你你買的是哪一個-- 十年之後,我再告訴你是哪一個。 對你們來說是筆好生意嗎? 不是。不是,對嗎? 這當然是個風險非常、非常大的情況, 而這也就是為什麼融資如此困難。 但是大致上來說, 提案就是這樣子。 在一開始你就得為這些事情籌錢, 這會花很多時間。 在一開始你就得為這些事情籌錢, 這會花很多時間。
So Andrew said to me, he said, "What if we stop thinking about these as drugs? What if we start thinking about them as financial assets?" They've got really weird payoff structures and all that, but let's throw everything we know about financial engineering at them. Let's see if we can use all the tricks of the trade to figure out how to make these drugs work as financial assets.
所以Andrew對我說: 「如果我們別把它們看作藥呢? 如果我們把他們當做資產呢?」 它們有著很詭異的報酬結構, 但就把它們放進我們所知的財務工程裡吧! 但就把它們放進我們所知的財務工程裡吧! 來瞧瞧我們是否能用交易的把戲 來把這些藥物變成資產? 來瞧瞧我們是否能用交易的把戲 來把這些藥物變成資產? 來瞧瞧我們是否能用交易的把戲 來把這些藥物變成資產?
Let's create a giant fund. In finance, we know what to do with assets that are risky. You put them in a portfolio and you try to smooth out the returns. So we did some math, and it turned out you could make this work, but in order to make it work, you need about 80 to 150 drugs.
讓我們創造一筆巨額資金, 在金融界,我們知道要如何處理高風險資產: 在金融界,我們知道要如何處理高風險資產: 把他們當做投資組合, 然後試著讓所得趨於平緩。 因此我們做了點運算,結果是可行的。 但是為了讓它可行, 你需要80到150種藥。
Now the good news is, there's plenty of drugs that are waiting to be tested. We've been told that there's a backlog of about 20 years of drugs that are waiting to be tested but can't be funded. In fact, that early stage of the funding process, that Phase I and preclinical stuff, that's actually, in the industry, called the Valley of Death because it's where drugs go to die. It's very hard to for them to get through there, and of course, if you can't get through there, you can't get to the later stages.
好消息是,有很多的藥正等著被測試。 好消息是,有很多的藥正等著被測試。 有人告訴我們有積壓了20年的藥等著被測試, 但是卻找不到資金。 有人告訴我們有積壓了20年的藥等著被測試, 但是卻找不到資金。 有人告訴我們有累積了20年的藥等著被測試, 但是卻找不到資金。 事實上,融資的早期階段 也就是第一期測試還有臨床前測試, 在業界被稱之為死亡幽谷。 因為這是許多藥物的葬身之地。 要跨過這道障礙非常困難, 當然,跨不過這道障礙也就無法前進到下一階段。 我們做了運算,找出了,好
So we did this math, and we figured out, OK, well, you need about 80 to, say, 150, or something like that, drugs. And then we did a little more math, and we said, OK, well, that's a fund of about three to 15 billion dollars. So we kind of created a new problem by solving the old one. We got rid of the risk, but now we need a lot of capital, and you can only get that kind of capital in the capital markets. Venture capitalists and philanthropies don't have it. But we have to figure out how to get people in the capital markets, who traditionally don't invest in this, to want to invest in this stuff. So again, financial engineering was helpful here. Imagine the megafund starts empty, and what it does is it issues some debt and some equity, and that generates cash flow. That cash flow is used, then, to buy that big portfolio of drugs that you need, and those drugs start working their way through that approval process, and each time they go through a phase of approval, they gain value. Most of them don't make it, but a few of them do, and with the ones that gain value, you can sell some, and when you sell them, you have money to pay the interest on those bonds, but also to fund the next round of trials. It's almost self-funding. You do that for the course of the transaction, and when you're done, you liquidate the portfolio, pay back the bonds, and you can give the equity holders a nice return.
嗯,你知道的,你需要大約80到150種藥, 嗯,你知道的,你需要大約80到150種藥, 然後我們再做了其它運算, 好,那大約需要30到150億的資金。 好,那大約需要30到150億的資金。 所以我們為了解決舊的問題, 似乎製造了另外一個問題: 所以我們為了解決舊的問題, 似乎製造了另外一個問題: 我們可以降低風險,但現在我們需要很大一筆資金。 只有一個地方能拿的到那麼多資金, 就是資本市場。 風險投資者沒有那麼多錢, 慈善家沒那麼多錢, 但是我們得想出辦法讓平常不投資 這類玩意的人們進入資本市場, 但是我們得想出辦法讓平常不投資 這類玩意的人們並進入資本市場, 並願意投資。 財務工程又再度派上用場了。 想像巨額資金從零開始, 它發出了一些債務以及一些產權, 它發出了一些債務以及一些產權, 而它們會讓現金流入。 流入的現金會被用來購買你所需要的巨型投資組合, 流入的現金會被用來購買 你所需要的巨型投資組合, 藥物也開始進行核准程序 藥物也開始進行核准程序 每次進到核准的下一階段, 藥物都會增值。 它們大部分撐不到最後, 但是有一些會, 而你可以賣掉一些增值的藥物, 你賣掉它們的同時, 就可以用這些錢來償還債券利息, 而且還有錢可以支付下一輪的試驗。 完全的自給自足。 你會在交易的過程中這麼做, 完成了之後你就可以清算這個投資組合, 清償債券,而你可以 給股東們一筆大回報。
That was the theory, and we talked about it, we did a bunch of experiments, and then we said, let's really try to test it. We spent the next two years doing research. We talked to hundreds of experts in drug financing and venture capital. We talked to people who have developed drugs. We talked to pharmaceutical companies. We actually looked at the data for drugs, over 2,000 drugs that had been approved or denied or withdrawn, and we also ran millions of simulations. And all that actually took a lot of time. But when we were done, we found something that was sort of surprising. It was feasible to structure that fund such that when you were done structuring it, you could actually produce low-risk bonds that would be attractive to bond holders, that would give you yields of about five to eight percent, and you could produce equity that would give equity holders about a 12 percent return. Now those returns aren't going to be attractive to a venture capitalist. They want to make those big bets and get those billion dollar payoffs. But it turns out there are lots of other folks that would be interested. That's right in the investment sweet spot of pension funds and 401(k) plans and all this other stuff.
以上就是這個理論,我們為此進行過一些討論, 我們做了一堆的實驗, 我們的結論是,實際測試看看吧。 我們花了接下來的兩年做研究。 我們和數百位藥物財務以及風險投資專家談過。 我們和數百位藥物財務以及風險投資專家談過。 我們和藥物研發人員談過。 我們和藥廠談過。 我們親自看過藥物的資料, 超過2000種被核准、拒絕或中途退出的藥, 超過2000種被核准、拒絕或中途退出的藥, 我們也跑過數百萬次的模擬。 這些全都要花很多時間。 但當我們完成的時候,發現了相當令人驚訝的事。 如此建構資金是可行的 -- 當你完成建構的同時, 你也就製造了會吸引持有人的低風險債券。 你也就製造了會吸引持有人的低風險債券。 你會得到5%到8%的收益, 你也會製造能夠給予股東大約12%回報的產權。 你也會製造能夠給予股東大約12%回報的產權。 這些回報不足以吸引風險投資人, 這些回報不足以吸引風險投資人, 風險投資人喜歡砸重本來獲取數十億的利潤。 風險投資人喜歡砸重本來獲取數十億的利潤。 但事實證明,還是有很多人很有興趣, 這完全命中養老基金、401(k)退休福利計劃 還有其他東西的甜蜜點。 這完全命中養老基金、401(k)退休福利計劃 還有其他東西的甜蜜點。 這完全命中養老基金、401(k)退休福利計劃 還有其他東西的甜蜜點。
So we published some articles in the academic press, in medical journals, in finance journals. But it wasn't until we actually got the popular press interested in this that we began to get some traction.
因此我們在學術媒體上發表了一些文章。 我們在醫學期刊上發表了文章, 在財金期刊上發表了文章, 但是在大眾媒體感興趣之前 我們並沒有得到太多的關注。 但是在大眾媒體感興趣之前 我們並沒有得到太多的關注。 但是在大眾媒體感興趣之前 我們並沒有得到太多的關注。
We wanted to do more than just make people aware of it. We wanted people to get involved. So we took all of our computer code and made that available online under an open-source license to anybody that wanted it. And you guys can download it today if you want to run your own experiments to see if this would work. And that was really effective, because people that didn't believe our assumptions could try their own and see how it would work.
畢竟我們想要做的並不只是讓人們察覺到, 我們想要人們參與其中。 我們所做的是,把所有的程式碼放到網路上, 我們所做的是,把所有的程式碼放到網路上, 任何想要的人都擁有這個原始碼的使用權。 任何想要的人都擁有這個原始碼的使用權。 如果你想實驗看看這是否可行的話, 你們今天就可以去下載。 這真的很有效,因為不相信我們的假設的人 可以試試他們自己的假設是否可行。 可以試試他們自己的假設是否可行。
Now there's an obvious problem, which is, is there enough money in the world to fund this? I've told you there's enough drugs, but is there enough money? There's 100 trillion dollars of capital currently invested in fixed-income securities. That's a hundred thousand billion. There's plenty of money.
現在有個顯而易見的問題, 那就是全世界是否 有足夠的資金來支持這個玩意? 我已經告訴你們有足夠的藥, 但是有足夠的錢嗎? 有100兆的資本投資在固定收入證券上 有100兆的資本投資在固定收入證券上 那可是十萬個十億啊, 真多錢。
(Laughter)
(笑聲)
But we realized it's more than just money that's required. We had to get people motivated, involved, and get them to understand this. And we started thinking about all the different things that could go wrong. What are all the challenges that might get in the way? And we had a long list. We assigned a bunch of people, including ourselves, different pieces of this problem. And we said, could you start a work stream on credit risk? Could you start a work stream on the regulatory aspects? Could you start a work stream on how you would manage so many projects? And we had all these experts get together and do these different work streams, and then we held a conference. The conference was held over this past summer. It was an invitation-only conference. It was sponsored by the American Cancer Society and done in collaboration with the National Cancer Institute. We had experts from every field we thought would be important, including the government, and people that run research centers, and for two days they heard the reports from those five work streams, and talked about it. It was the first time the people who could make this happen sat across the table from each other and had these conversations.
但我們所了解到需要的不只是錢, 我們得讓人們有動機參與其中。 人們也須要了解這一點。 所以我們開始思考可能發生錯誤的每個環節。 做這件事情可能遭遇到的挑戰有哪些? 我們列了很長一串, 而我們所做的事把這些問題分配給一群人, 我們列了很長一串, 而我們所做的事把這些問題分配給一群人, 包括我們自己。 我們自問,能夠开始建立在信用風險的工作流嗎? 能夠建立法規相關事務的工作流嗎? 能夠建立管理眾多規劃的工作流嗎? 能夠管理眾多規劃的工作嗎? 所有的專家合作進行各種工作流, 所有的專家合作進行各種工作流, 然後我們進行了會議。 這場會議在夏天舉辦,今年夏天。 只有受邀者能參加, 會議是由美國癌症學會(American Cancer Society)贊助 以及和美國國家癌症研究所 (National Cancer Institute)合作。 以及和美國國家癌症研究所 (National Cancer Institute)合作。 我們有各個我們覺得重要的領域的專家, 包括政府,包括經營研究中心的人,以及其他種種, 包括政府,包括經營研究中心的人,以及其他種種, 在兩天之中,他們齊聚聽著這五個工作流報告 並加以討論。 在兩天之中,他們齊聚聽著這五個工作流報告 並加以討論。 那是第一次 人們把這變成了現實 -- 在桌邊面對面並進行這些對話, 在桌邊面對面並進行這些對話,
Now these conferences, it's typical to have a dinner, and at that dinner, you get to know each other, sort of like what we're doing here. I happened to look out the window, and hand on my heart, on the night of this conference -- it was the summertime -- and that's what I saw, a double rainbow. So I'd like to think it was a good sign.
現在這些會議通常會是晚餐會的形式, 在這頓晚餐裡, 你會認識彼此, 就像我們現在在這裡一樣。 我曾經看著窗外, 把手放在心前,我看著窗外 就在會議舉辦的當晚--那是夏天-- 這就是我看到的,我看到了兩道彩虹。 我認為那是個好兆頭,
Since the conference, we've got people working between Paris and San Francisco, lots of different folks working on this to try to see if we can really make it happen. We're not looking to start a fund, but we want somebody else to do this. Because, again, I'm not a scientist. I can't build a drug. I'm never going to have enough money to fund even one of those trials. But all of us together, with our 401(k)s, with our 529 plans, with our pension plans, all of us together can actually fund hundreds of trials and get paid well for doing it and save millions of lives like my dad.
自會議結束,來自巴黎以及舊金山的人們互相合作, 自會議結束,來自巴黎以及舊金山的人們互相合作, 很多人同心協力嘗試能否實現它。 很多人同心協力嘗試能否實現它。 我們並不是在融資, 這種事讓別人來做吧。 因為,再次說明,我不是科學家。 我沒辦法做出藥。 我永遠也不會有足夠的錢 來支付任何一個試驗。 但是只要我們合力,有了401(k)退休福利計劃、 529教育儲蓄計劃、退休計劃 就可以支付數百個試驗 並得到可觀的報酬, 然後拯救數百萬像我父親一樣的生命。
Thank you.
謝謝。
(Applause)
(掌聲)