OUR PURPOSE PIONEERING SCIENCE PATIENTS OUR PEOPLE ENVIRONMENT COMMUNITY REPORTING 46 ADVANCING HEALTH ACCESS AND EQUITY BIOGEN 2021 YEAR IN REVIEW FEATURE Striving to achieve health equity Wanda Castro-Borrero grew up in Puerto Rico in a family of modest means, went to medical school to become a neurologist, and practiced for seven years in Texas and Connecticut. As a practicing physician, she saw the challenges in receiving care faced by people from racial and ethnic minority groups, especially those with limited English proficiency. “I understood very quickly that the patient experience was not the same for everybody, and we have to do better,” said Wanda. She joined Biogen in 2019 to do just that. Her first job at Biogen was to improve MS outcomes for patient groups that have historically faced barriers to accessing quality care. Biogen’s Corporate Health Equity Initiative was an outgrowth of this work. Now Global Head of Biogen’s MS Franchise, Wanda has an opportunity to drive health equity on an even larger scale. In a recent journal article she co-wrote in Neurology Reviews, Wanda reviewed the disparate impact of MS on different populations. “Women are three times more likely to be diagnosed with MS than men,” she wrote. “[N]ew statistics regarding the prevalence, progression and treatment response of MS in minority groups are more concerning than once thought. African Americans appear to suffer a quicker progression of the disease with a blunted response to disease-modifying therapies, while Hispanic Americans of Caribbean descent are often diagnosed at a younger age and have greater mobility impairment [...]. African Americans who served in the Gulf War [...] have an increased incidence compared to residents of their ancestral countries, indicating that environment plays a nondiscriminatory role in MS onset.” Wanda takes an expansive view of the term underserved and underrepresented population, viewing health equity through a broad lens. For example, she once treated a patient with aggressive MS. He was a 21-year-old male with private insurance, which most people would not consider part of an underrepresented population. But Wanda saw it differently. “In MS, men are an underrepresented population,” she noted. “To be able to have a high-efficacy therapy, which is what he needed, I had to send a 40- page report every three months to his insurance company. It was not easy doing the report because our clinic at the state hospital lacked resources. But it needed to be done to ensure that this patient did not become disabled at a young age and could instead have a better quality of life.” To Wanda, inclusive care is not just about expanding access to care for ethnic minorities, it’s about making sure therapies work on the broadest patient populations. She has worked to challenge how the healthcare system views health equity in disease-specific areas and is working toward more inclusive clinical trial enrollment. Wanda noted, “I’m so passionate about health equity because I know what it’s like to not be heard. I want to give a voice to those who are in that same place.” I’m so passionate about health equity because I know what it’s like to not be heard. I want to give a voice to those who are in that same place.” Wanda Castro-Borrero M.D., Director, U.S. Medical MS Franchise at Biogen