In Good Company with Nicolai Tangen - GSK CEO: Drug Discovery, AI in Pharma, and Changing Company Culture

Episode Date: April 2, 2025

How is the pharmaceutical industry evolving to meet the world’s biggest health challenges? In this episode, Nicolai Tangen sits down with Emma Walmsley, CEO of GSK, for an insightful conversation about the future of pharmaceuticals. They discuss GSK’s latest advances in cancer treatments, HIV therapies, and respiratory medicine, as well as the role of AI in speeding up drug discovery. Emma also shares her thoughts on navigating change, transforming company culture, and the role of curiosity in staying motivated. Tune in!In Good Company is hosted by Nicolai Tangen, CEO of Norges Bank Investment Management. New full episodes every Wednesday, and don't miss our Highlight episodes every Friday.The production team for this episode includes Isabelle Karlsson and PLAN-B's Niklas Figenschau Johansen, Sebastian Langvik-Hansen and Pål Huuse. Background research was conducted by Isabelle Karlsson.Watch the episode on YouTube: Norges Bank Investment Management - YouTubeWant to learn more about the fund? The fund | Norges Bank Investment Management (nbim.no)Follow Nicolai Tangen on LinkedIn: Nicolai Tangen | LinkedInFollow NBIM on LinkedIn: Norges Bank Investment Management: Administrator for bedriftsside | LinkedInFollow NBIM on Instagram: Explore Norges Bank Investment Management on Instagram Hosted on Acast. See acast.com/privacy for more information.

Hi, everyone. I'm Nicolai Tangin, the CEO of the Norwegian Sovereign Wealth Fund. And today I'm in really good company with Emma Walmsley, the CEO of GSK, one of the global leaders in pharmaceuticals. Now, we own 1.7% of GSK, valued at 1.3 billion US dollars. Emma, great to have you here. Wonderful to be here. Thanks for having me. I believe this is the second podcast ever in your life. The second ever. Wow. Looking forward very much to the conversation.

Now which areas of research excites you the most just now? Well, I'm excited about a lot of the ways that research, both in science and technology, are advancing, particularly those two things together. I mean, it is literally the point of our company is to innovate, and that's where we allocate most of our capital. So in fact, since I've been in this job, I think we've nearly doubled our R&D spend organically, and then of course, opened up a huge amount of partnerships that we do externally in business development to supplement the pipeline.

What excites me most is when we can innovate in a way that has real impact at scale for patients around the world. So I'm incredibly excited about five new approvals for new drugs and vaccines that we're expecting to get this year, one down and another four to go. And that's the first wave of a cohort of, we think, 14 scale medicines and vaccines, each with a potential of more than £2 billion worth of sales that we expect to launch this decade. And that includes in areas of oncology, in infectious diseases, in respiratory immunology, in HIV. And some of these, what's really exciting is when you have totally new technology platforms in pharmaceuticals. So for example, in multiple myeloma, very nasty blood cancer that where there are 180,000 new diagnoses every year. We have a new technology platform, something called antibody drug conjugates.

And you have to think of these as like kind of biological missiles that have precision targeting for cancer, which means they can bring greater efficacy, but also with less side effects. So we hopefully have a new multiple myeloma drug that has data that proves it extends life expectancy by three years. That's a very big deal for these patients in terms of overall survival. In that new platform technology,

another example of something totally new in emerging sciences in a field called oligonucleotides. You have to think of these as a kind of spell check for RNA expression to correct the way disease develops. And there we may have a new functional cure for a horrible disease, hepatitis B, which impacts 250 million people around the world. So these are examples of new near-term assets. You are both in vaccines and in medicines,

and how do these areas complement each other? Well, vaccines are there fundamentally to prevent disease before it starts. And at GSK, we say we combine science, tech and talent to get ahead of disease. There is no better return on investment than vaccine technology. In fact, in healthcare, perhaps except for clean water, it really is, you know, a very powerful solution, mainly in infectious diseases.

But you talk about what's exciting in new science coming through. A couple of weeks ago, I was in Oxford looking with some part in a partnership we've developed there to look at pre-cancer cell biology. And that is potentially, and we're really looking on long-term horizons in terms of exciting science here to imagine what cancer vaccines could bring. And that's very exciting science. When you talk about the complementarity, obviously when you're in medicines, you tend to be more in the treatment space. But that can also be earlier intervention in disease to change its course, because what costs money for society and healthcare systems is hospitalization and spending on people being sick.

So intervening earlier is really important and that can be with long acting medicines that keep people out of hospital and we have lots in our pipeline, be it an HIV or a respiratory that's looking at that too. For the people who don't know GSK, what are your three bestselling products? Well, our biggest sellers are in HIV, in respiratory drugs, and in vaccines

today. So in respiratory, if you look at a drug called Trilogy, and that's for both asthma and COPD, chronic obstructive pulmonary disease. Perhaps many haven't heard of it, but it's the third leading cause of death in the world. So I think 300 million people living with that. And so we have an everyday inhaler for both COPD and asthma called Trelogy, because it's got three drugs in it. That's a huge one. In HIV, we have two drug regimens.

I mean, remember, an HIV diagnosis used to be a death sentence. Now it's something that you can live with as a chronic disease because we have these fantastic drugs that people can take and integrases, inhibitors, but we also now have been pioneering in long acting solutions in HIV. So that means an injection you can take six times a year. We're now looking at it being four times a year and eventually a couple of times a year.

That's an extraordinary solution. And then in vaccines, we really pioneered with an incredibly effective shingles vaccine. That's a multi-billion asset today. Gives 90% protection for at least 11 years, you know, one in three of us. So your camera woman or you or me, we're going to deal with shingles at some stage incredibly painful and we have a highly effective vaccines there. And then another example would be we had the world's first RSV vaccine that we launched last

year, still only in its very earliest days of global penetration. So those are the big ones today, but for the future, I think we're looking more and more towards cancer drugs as well. You've kind of overseen a major overhaul of your R&D approach since you became the CEO. So what are the biggest changes you made to that process? Well, I think this process is always ongoing, because as I said at the beginning, you know, the purpose of our company is to innovate. And we're one of the only industries

that has to literally replace itself every decade because of the patent model model which is in place. And the first thing to do was simply to say we want to prioritize it and put really organize ourselves to prioritize the allocation of capital to R&D. We had a radical overhaul of the key disease areas that we wanted to go into. So we explicitly said we're going to prioritize specialty medicines and vaccines within the portfolio and within that our key therapy areas. We bet back big in cancer, both through business development, acquisitions,

in licensing and homegrown innovation as well. I've been really excited to see that business more than double last year. It's still emerging. But I think when we look forward to the pipeline that's coming next, be it the multiple myeloma approval we hope to get this year, or a whole new portfolio of ADCs, these antibody body drug conjugates, which we think will open up solutions to new areas of cancer. I mean, this is, as you know, and you very kindly brought forward this recording because I'm going from this meeting to the funeral of a friend who died of pancreatic cancer. She was in her early 50s, mum of three. More and more, we're seeing diagnoses in younger people for cancer. And

although the science is advancing so fast here with new modalities, we've still got diseases like lung cancer, where even the biggest drugs in the world are only effective on 20% of the population. So I think there's a lot more work to do there. It's one of our areas of our portfolio. The other incredible transformation that is coming to R&D and our industry, and frankly, the healthcare industry writ large is what's going to be done with technology. Exactly.

And that's so exciting. And you are on the board on Microsoft. Correct, great privilege that that is, and I have been for six years. What are you taking from Microsoft into the processes? Well, first of all, just to reiterate, obviously my core job in accountability is the CEO of GSK.

Yeah, sure. But I mean, normally I'm a bit skeptical when people are on boards, right? This is hugely useful. But this, well, exactly. So here you can just on boards, right? This is hugely useful. But this, well, exactly. So here you can just see it, right? It should really enable you to bring in new technologies and be totally cutting edge.

I believe. We should all be on the board on Microsoft. I would love to. First of all, it's very interesting. The crossovers. What are they? What, the crossovers. What are they? What are the crossovers? Well, let's just, before you get into the obvious relevance

of the fact that technology, AI, now gen AI, are going to change every industry and society. And it's the most exciting time we can possibly imagine, especially when you consider a third of the world's data is related to healthcare. And healthcare is one of the biggest challenges in terms of its sustainability, its affordability, and the enormous amount of unmet need there is out there

when you think about aging populations. And the rest of the fact, there isn't a single tech company that doesn't think that the best case study for the possibilities of technology and its positive contribution to society is healthcare. Writ large. What is most exciting for GSK is our biggest challenge is the productivity of R&D. It is really, really hard to discover and develop a drug. 90% of, and this is industry writ large, 90% of the assets fail, which by this is

an important thing when you think about the economic model of our industry and having to cover the cost of failure. It takes a decade and it can cost billions. So capital allocation is a very, very important thing for us to do. But just imagine in this world of the explosion of data, genetics and genomics and healthcare systems provision and new tech, wearable tech, how every aspect of the value chain for us in R&D. And we think of that, if you looked at the traditional linear mode, you would say target selection, so biological target selection, molecule design, what we call CMC, so the transition of that into manufacturing, because that's often can be, you know, especially

with all these new technology platforms, it can be an area where you can get bottlenecks or a failure rate, and then you get into clinical trials where things get really expensive. And patient identification is a part of that. So we've traditionally gone through a linear mode and each one of those today, we are using AI and sometimes gene AI, whether it's to get more precision

around the probability of success about the original biological target. And then we're using genetic data as well. And we have examples of that. Whether it's about building completely industry-leading chemistry libraries to allow us to design molecules in silico. And again, that work is going on.

We're not, it's that famous quote about, the future here is here, but it's not scaled and evenly distributed yet. I would say we're still in the sort of early stages of doing these experiments. But there's a lot more. So when you see how you used technology and how you use AI, what has it done for you so far and how much more improvement will there be? Oh, I think, I think we've hardly scratched the surface.

We're already using it in the design of our clinical trials to predict outcomes, to be able to follow patterns of infectious diseases. So what do you think you will do, let's say over the next five years, what will you do and how will you measure it? Well, we will measure it in the performance of the discovery and development process.

It will reduce cost, reduce time, and ideally allow us to target labels for the medicines and vaccines that we have, so either the descriptions of their benefits, because we can design trials in a more precise way for patients that are specifically targeted, so you can get a disproportionate benefit. I give you two examples. I talked about three examples. I talked about hepatitis B, which is this huge disease that impacts 250 million people, but there are very different profiles within that. By being able to do much more precision profiling, phenotyping of patients. We're then able to design clinical

trials to show a disproportionate impact on a smaller cohort, not all of them, so that you can then get to what we call a functional cure, as in people can then live with the disease more normally. Our early trials are showing that. We're gonna have readouts of phase three as well. That would be one example. Another would be when you look at the biomarkers around different cancer types. So in colorectal cancer, from learnings we did in endometrial cancer actually,

we looked at a particular genetic marker called DMMR, which allowed us to be much more precise on the targeting in cancer and then have trials where we've had them in the early stages, 100% success rates, which will allow us to then go into at-risk phase three trials. Another example would be accelerated RRSV vaccine vaccine and this is a simpler one accelerated rrsv vaccine outcomes by two years because we were able to look at the infectious disease patterns in different parts of the globe and call the closure of clinical trials earlier and we've got a vaccine that has over 90 efficacy on on those that represent 90% of the hospitalization. So at the moment, these are spot examples.

Do you think it will improve the hit rate? Yes, without any doubt. With which you bring the early stage breakthroughs? Without any doubt. And that's the most important fact. In fact, I think what we're going to do, I think this five years, I'd say definitely within 10 years, and I hope we'll have more and more examples along that way. But instead of having this linear process,

we're going to move to more of a lab in a loop, which is an overused term. But you actually get into reverse translation, patient back rather than target out so that we can get to, frankly, faster, better outcomes with more precise targeting for patient cohorts. But Emma, aren't all pharmaceutical companies doing this? I hope so. Absolutely.

I mean, there's a lot more. I hope so too. I mean, if not, I think you need to be pretty thick. But the thing is that what is it going to do to the competitive landscape? Well, what I hope, I mean, Nicolai, let's just step back. In the end, our job is to meet the enormous amount of unmet need there is out there in the world.

And most of what we do doesn't work. I think it is a wonderful thing if this industry that frankly has, you know, too many negative Netflix movies made out about it, is able to show the world what science and technology combined can do for good. We still have so many diseases that don't have solutions around the world. You know, one of the biggest ones, the most exciting area for science, I think, for the long term, where we don't have good solutions is in everything to do with neurodegeneration, dementia, and Alzheimer's. The trajectory of disease is going to change hugely, I think, over the next 10 or 20 years.

If you imagine that metabolic disorders that are going to be, I think, you know, and their sequelae because of what's going on in these amazing discoveries in the obesity drugs is going to be less of a burden, but we're going to have triple the number of over 80s in 20 years time than we have today. And, you know, I'm afraid like shingles, but with more- I'm going to be there soon, but- Well, no, but you're in our age group again. The probability for all the brains in the room, the probability of dementia or Alzheimer's, I'm afraid is again one in three. So we need solutions to that.

The introduction of increasing technologies into R&D and so on. Are the US companies going to be better positioned than the Europeans? I wouldn't say that. I mean, we have some great European-based pharma companies with proud histories and strong innovation. And I think- Are we held back by increased regulation and different ways of looking at technology AI and so on? I would say first of all, the American tech companies supply the world.

They don't only supply the US. I do think the question of regulation is important, and we need growth-focused regulation. But honestly, Nicola, I think it's really important that we have responsible regulation too on questions like quality, privacy, security. I think it's important that Europe opens up the possibilities because we have strong regulators in the EMA and the FDA and the MHRA here in the UK. We have to recognize the most important thing we do is bring trusted, safe, scale solutions and patients are waiting.

So- What are you now seeing coming out of China and India? A lot. safe, scale solutions and patients are waiting. What are you now seeing coming out of China and India? A lot. The share of first in class drugs developed in China, the pace of clinical development, the pace of innovation approval are all speeding up a lot. And we're doing quite a lot of business development finding great assets in China that you know want to

export their drugs to the world. Now in the medical sector there's always a trade-off between how you price your drugs and the availability and affordability. You don't think there is a trade-off? Well I think they're both, I think there's occasionally tensions but I don't... Has that tension changed? Is it tension changing in any way? Well I don't see these as an either or in any way. I think they are structurally, they have to be an ant because you're not innovating unless you do it at scale. At GSK, we say we want to reach two and a half billion people this decade. It's one of the things that differentiates us.

I think there is the scale of our impact relative to our size. I think there is a huge misunderstanding about the economics of our industry in terms of the pricing that is required to cover the cost of failure and the value that drugs and vaccines bring to a healthcare system. And remember, what's expensive is treating sick people and having them in hospital. We all know an earlier diagnosis is better, an earlier intervention is better. So we need to value the innovation and recognize that there are so many diseases that don't have solutions yet. But at the same time, we have a social responsibility, I believe, to drive access. And there are two billion people in the world that don't have access to the health care they need.

And it's not just a developing country agenda. By the way, GSK has been top of the access medicine or second to the of the access to medicines index, every single year since it was founded. And we're really proud of the work we do with GAVI to provide tiered pricing on vaccines with an HIV where of the 28 million people that are on these integrase inhibitors, 23 of them are million of them in the world, mainly in Sub-Saharan Africa, because we opened up our IP to provide those drugs there. So I think it's not an either or, it is an and,

but we have to do a better job of communicating also about the business model and the value that our industry brings and take these responsibilities extremely seriously. And it's not just a developing country issue, Nicola. I mean, in London, between East London and Southwest London, there's a 12 year difference between life expectancy. And in your beautiful country, you know,

access to medicines, I checked this and was just looking at it before coming here, but I think of the 278, I think it was, medicines, this is in 2022, that were centrally approved in Europe, 40% of them are not yet available in Norway. But I'm just saying that access is not simply a question of, you know, what we're familiar with talking in terms of aid to the poorest countries in the world, in the richest countries in the world, sometimes it's getting approvals on time. And this is where the US is definitely ahead. Definitely ahead.

Drilling down on vaccines. Now you are a global leader in vaccines. What did we learn from COVID? Well, a lot. Top three things. Older adult vaccination is a really important contribution to healthcare and society. A lot of us are used to vaccinating our children and have been familiar with flu vaccines,

but you're seeing this opening up of vaccine technology for older adults. Supply chain security geopolitically is something that we all have to be thoughtful about. And certainly something that the GSK has invested in very aggressively in terms of regional supply chains, not just in vaccines, but also in medicines. Last year, we announced another in vaccines, but also in medicines. Last year we announced another 800 million that we're spending in both medicine and vaccine manufacturing in the US.

We also have strong European supply chains and we have partnerships in China for distribution of vaccines. And then I think the third thing, if I'm only allowed three, although I could make the list go on, is you know, we really have to watch out for the questions of vaccines hesitancy around the world. And there's been a bit of politicization of that specifically through COVID.

So, hold calm. I mean, vaccines got the world back on its feet and then now there is so much misinformation and vaccine hesitancy and anti-vax and so on. Just why is this? Let's remember, vaccines by definition are being given to healthy children or adults. It is preventative care. So you wake up in the morning, I can remember, I'm a mum of four. I remember taking my brand new babies, by the way, which were born in, I have experience of three different countries

of giving birth and you have different vaccine policies or it felt like you did. And you have these questions, I've got this precious newborn, what is this? What am I giving them? What's it mean? And you want to have information. Then I think obviously we went through

the global experience of COVID, which engendered huge pressure on the healthcare systems. I think a lot of national protectionism, tremendous energy around vaccines, and a focus on some brand new technologies that had never been developed in vaccines before. And people had questions about that. They had simultaneous fears about the risks involved

and the news that was coming every day. And then new technologies that they were being, they wanted to make sure that they could trust the communication about. So it does come back to these questions of trust and transparency. And what does GSK do here? Well, our answer is what it has always been, okay? Which is you start off by saying,

if you have the responsibility of, as we do today, frankly, vaccinating 40% of the world's children through our global programs, and a pipeline of new vaccines, of listening hard to people's questions, communicating transparently, underpinning everything with a 100% commitment to quality and safety and trust in our products.

And remembering shouting trust us, you know, as a, frankly, a company that is a public company with responsibilities to shareholders and that has to generate profits from these things, is not the most effective way. So we seek to partner with governments to provide the data and total transparency and to frankly go to where people are

with their questions, be it in the community, because that often is that as well, but also not to lose sight of the fact that, I mean, the US spends $9 billion a year on the hospitalization of people from vaccines preventable diseases. So, I think we're working through an age where people have questions and we just need to calmly

continue to underpin our work with the value set that we've been committed to for generations and keep answering people's questions in it. Bill Gates wrote a book about how the next pandemic could be handled better by spending, I think it's roughly a billion dollars a year. Yeah. But that's not happening.

So why are we not preparing ourselves better for the next pandemic? Well, I think we are actually, at least inside the industry, although I agree with you that, you know, memories feel a bit short, don't they? At the moment. And the challenges around this one is you're trying to keep capacity warm, if I can say that. Now, the reality is at GSK, we have contracts today with Europe, the US, Canada, around pandemic preparedness,

be it to be ready with our adjuvant or pre-pandemic assets. We have some prioritized reviews for pre- pandemic flu vaccines. And in fact, we're contracted also with the WHO to make sure that I think 10% of any ready supply would also be immediately available to some of the more underdeveloped countries in the world.

So I would say there is better preparation. We won't be able to stop another pandemic coming, but I hope the world will remember and that we will mobilize faster before so many lives are lost. But I'll tell you something else that we are really thoughtful about at GSK, which is a different kind of pandemic. And that's sometimes referred to as the slow one, which is antimicrobial

resistance, which will kill, I think it's 38 million people by 2050, unless we develop more antibiotics. And we have a very big portfolio and pipeline here. Last year, we invested, I think, 40 million with the Fleming work that's done, led out of the UK with Imperial as well to try and research. Because this is where the UK is very strong, right? Well, it's got a proud history in AMR. And I think this is killing people all over the world. It's a real challenge in antibiotics because obviously you're asking the industry to develop

drugs that you then don't want to be oversubscribed. So you know we've actually one of the five approvals I'm hoping to get this year is for a brand new antibiotic and you know the common, very common for women, UTI, uncomplicated UTI space. We haven't had a new antibiotic for 20 years so you know I'm hopeful we'll get that approved later this year. You mentioned that I was going to be 80 years old. Now... I didn't mention that yet.

The elderly need to get a lot of vaccines, right? Flu, Covid, shingles, pneumonia. When will we see a combination of all these things into one shot? There is ongoing work on combo vaccines from us and from others. We're used to having some combination vaccines with paediatric vaccines. I think the thing you have to think through is what is, well, it's not as simple as just adding them together, obviously. But you also have to think through what the durability of different vaccines is. So I'll give you the example, our RSV vaccine we now know has, that's a seasonal respiratory infection. We know we have protection probably, it probably at least three years, maybe it will

go up to five. And flu tends to be something that mutates obviously every single year. So you have to think about what the combinations would be when you're providing a solution that is required on an annual basis or more extended like that. So it's a bit more complicated. I think there are new technology platforms that will allow more combinations potentially. So mRNA is one that we and others are looking at. But the science here is quite complex. And again, you want to be in a place

where you're looking at both efficacy and reactogenicity as well to see whether that combination is going to be an effective solution, a remit of dramatically change the company. What are some of the dramatic changes you've done? Well, I don't know what the dramatic is the word that I'd want to use to describe it, but certainly very significant change in group strategy, structure, capital allocation, balance sheet, which was a major challenge when we came in, which is part of the reason why we did the de-merger of Halian.

I mean, I originally joined the SK. Yeah, I mean, my background was in consumer goods. I moved from China to London to build the consumer division of GSK. And we went through two massive global joint ventures, firstly with Novartis' portfolio and integrations, frankly, and then with Pfizer's. And then, you know, when I was CEO, it became very, very obvious that to me that to solve the business that we built up from, I don't know, four to 10 billion in sales was never going to be the primary recipient of capital allocation. And it was sort of locked up division inside GSK that I never got a single question on it quarterly results. And so it would be much better to set that business free. And I'm delighted to see how brilliantly they're doing

with that, but also use that to reset the balance sheet and of GSK and frankly, enable this fueling of growth and a step change in growth. How far are you into the, into your change plan now? Well, you know, I was really pleased at the beginning of this year to upgrade our 2031 outlook for the second time. And we've added another 7 billion to the outlook just in four years. That means we'll grow 17 billion this decade in sales, which when I started, we were only just over 20, so on the biopharm a bit. So I'm really pleased with the progress, but the work is never,

ever done on this because as I said, you know, in our industry, we have to reinvent ourselves every decade because of the rolling patent model. What's the biggest mentality change you have? Oh, well, this is my favorite question. Well, mine too, you see. So we should delete the rest of this podcast and just start here. Can we? I like the way you said mentality, by the way, because if you say what was the radical change that I wanted to drive for, I think culture is definitely one of the things that we've been working hard to change. What was the culture in the past?

Well, it's a company that's been around for over 300 years in a whole variety of forms. So it's got a long and proud history. But when I was asked to start, it was to change the performance trajectory of the company whilst retaining some things that have made it very special for a long time, including a commitment to global health, including a deeply collaborative culture. Because this is an industry where partnership and serendipity matter, because it's hard and because, you know, it's the clash of brains and ideas and created friction that can create good things.

But I think we'd become, for all the pride in our purpose, to change the course of disease and to provide access to medicine. So we'd lost our way in terms of performance edge, in terms of looking outside the company. This happens in a lot of big companies, by the way, that you get heavily matrixed. You think a day at work is doing good meeting and you're not agile enough. And you start to think that all good science is inside. So how do you change this?

And you start to think that all good science is inside. So how do you change this? First of all, you say it's really important and you make it one of the stated priorities for the company. So I've been very aggressive since I started to say that we've got three priorities, which are innovation, performance and trust writ large. Obviously, we take our strategic direction in the therapy areas we're going to work in and specialty medicines and vaccines, but we underpin that and we power that by culture. So you say culture is the risk. It's not an HR issue. It's not something we write on the wall. It is literally the job of the leadership of the company, CEO first, by the way. And I think that is the secret source of everything. Because when you're running a company of, at the beginning it was 100,000 people, we're now 70 or so, you have to set an environment

that doesn't need constant oversight or inspection, it's just the way we work. So we spent a lot of time defining what we wanted that culture to be at a leadership level. And we say three simple things, ambitious for patients, because that's the point of everything. And there's a notion of ambition in there, which is delivering what matters better and faster.

Accountable for our impact. And that is about results, not process, which we needed to shift being a bit government department in the way we do things. A lot more individual accountability. But in the spirit of clear ownership, and I think that's what sometimes goes wrong in collaborative organisations is that there's a bit too much by committee. I'm a big believer in single point accountable decision making.

So clear ownership and a positive mindset of support to succeed and then doing the right thing. We have to do that. So this is all very good. So this is what you say and this is what your leader group say. But how do you get it through, how do you get it down through the permafrost level in your organization? Really simple. You define it and you just said that you get the message down there. You never stop talking about it.

You use a common language worldwide, worldwide. Every single country when I go and visit, I ask for a session on culture explicitly. You appoint for it. I've been very, I mean, the overhaul in talent in the company is one of the most radical things that we've done. And by the way, it's foundationally my philosophy of leadership is it's always about people,

and it's people that define culture. It's how they show up every day. It's the way you manage people. So you're incredibly intentional about your talent processes. I bet you are in orders as well. I mean, there's no way... Yeah, but you don't appoint people at level six and seven, right? No, not at six and seven, but there is a shadow of a leader principle. I spent a lot of time looking at succession planning. Two weeks ago, I spent three days with the next generation top 30, literally, and I am very planful, not on my

own because it's a team effort with the leadership team around their career development. This is purely three days of development on people and talking about culture is at the heart of it. You incentivize it, soft and hard incentives. So you will, I mean, we change the, I mean, literally down to the bonuses system for the organization. You promote for it and you fire for it. So you know, there's that, those famous matrices about the high performers with the bad culture. You know, when I've made mistakes on people, it's usually for cultural reasons.

So that's really important. And you measure it. And how do you screen how do you screen for attitude? So here I am, you're interviewing me, I'm applying now level five. I love to work in GSK. Now, how are you going to figure out whether I'm referencing? I'm a big fan of referencing as a system. Right, you're calling out my... Yeah, I mean, but also we do, we have, we do surveys and we also do something called 180s, which sounds a bit, you know, we're all familiar with the 360 thing.

180 is purely your team giving feedback on you, completely anonymously in this case. And we all do that. I have one on me as well. giving feedback on you completely anonymously in this case. And we all do that. I have one on me as well. And we look at the, and we spend time talking about that in our mid-year and our year-end reviews. So listen, here's what I would say.

The work is not done. And I am sure, in fact, I know there are still things that we've got room for a lot more improvement on. But my goodness, the culture of the organization has shifted. You also look at where you spend your time. I mean, I don't know how you work on this, but you know, if you want... I spend 55% of my time internally in the company because I tag every hour. But how do you work on culture specifically? All the time. I mean, every time I get the microphone, every time I meet people,

I'm a maniac about it. And we need to stay that way. And by the way, the other thing you have to remember is if you look at your workforce and if a third of it is new in the last three years, don't forget, don't believe for a microsecond that what you said in a town hall last time in the country has been heard. So you have to be relentless on it. Tell me about Emma Warmsley, 180. Well, I'm not sure I want to publish that completely, but listen, people know that I care deeply about the company and individuals' development.

And I'm hard driving on clarity of strategy and ownership of objectives. I could do a better job of saying thank you and well done, because I have a habit, which I'm sure is all sort of deeply rooted in my childhood of Looking up the mountain about you know, how much more we've got to do rather than sometimes occasionally enjoying the view so And I think all you know, we have to remember work as a human endeavor and everybody needs human endeavour and everybody needs to celebrate the wins along the way. So I could probably do a bit more of that.

Tell me how your childhood has informed your leadership. Only if you do the same for me. Come on, you. Well, I grew up in a military family. So my father was in the Navy his whole career. And I think that has definitely informed a sense of responsibility and a sense of duty and a huge amount of, I think frankly, a pretty strong work ethic and a lot of curiosity about the world as well. I mean I think I wasn't well traveled at all as a young person but I had a chance when I was at university to go and live and work abroad. And just before I went to university, weirdly in the 1980s, I decided to take myself off to China, which is in the 1980s, which was an odd thing to do. It was the first long haul flight I'd ever been on, but that opened

my mind to the world. And, you know, I was, because I was in the way the system worked in the UK, I was in a boarding school from a very young age, because that was funded by the military in those days. And I think that gave me a sense of independence. So I quite early in my career had an international career and wanted to go and do that. And that opened up all sorts of opportunities I never dreamt of having. So I had no business background in my family.

You said, I heard somewhere you said that you need to have a really hard skin, a tough skin to survive as a CEO. Well, I think- Six skin. Yeah, I think there's nothing more obnoxious than CEOs saying they have a hard life because it's like, it's an insane privilege and opportunity.

And especially at this time in the world, which is, you know, volatile and uncertain as we all hear and know, but it is extremely exciting and science and tech are advancing and there's just so much talent out there with them, ambition and creativity. So I think these jobs are a tremendous privilege, but with them come the responsibility to absorb a certain amount of public pressure and not take that personally. But I do think part of our job is also to protect

the organization from that kind of distraction and that comes with the territory. So yeah, you need some resilience. What kind of things get under your skin? if your organization is being distracted by public reporting that is factually incorrect, that is annoying because it's hard to, you know, what do people get to measure public commentary on. So, you know, I think, you know, my job is to keep the organization alongside my leadership team, because by the way, I really don't agree with the kind of CEO as superhero notion. I think our first job is to hire people that's part of culture, who are better than us and who stand with us in the leadership, you know, priorities priorities and agenda.

But our job is to keep the organization focused on what it can control and what it is there to do. And our people are so inspired by the purpose of GSK. I mean, they literally blows my mind when you see the energy with which 15,000 scientists get up to do the near impossible and to try and explore new frontiers of neurodegeneration or literally cure cancer or help people breathe easier every day.

Where do you seek advice personally? I have a very good board and a brilliant chairman. I quite like the European way of the separation of these jobs. Everyone will have their different views on that. Yeah, we fully support that too. And a good board and a brilliant chairman means people who challenge you to be better at the job and are at stake for the company and its stakeholders, be they patients, shareholders or our people. I have technical advisors who are externals, who are experts in their fields. And then I have, I suppose maybe they're not advisors as much as the sort

of support system of your family. My children are adult now, so it's not that they advise me on the strategy of GSK, but they sometimes remind me to keep my feet very firmly on the ground in terms of what matters in life and the point of it all. CB You have an honours system in the UK, You have an honor system in the UK, and you were named a Dame. Yes. Right? You are Dame Emma, right? Yeah. What did that do to you, you think? Well, it was a surprise. That was certainly true. I think it was a very important moment

for my parents, actually actually and my family. And then sometimes, I mean, it's an incredible honor and I never dreamt that my life would take the paths it has. And that's, you know, I'm a great patriot. I'm a globalist. I've lived in mainland Europe, in the US, in China, I travel all the time. But I am very proud of this country. So it meant something, but honestly,

it's not something I think about very much. And I usually forget. I saw some research once that when you get an honor like that, you tend to think more about all the stakeholders you tend to think more about all the stakeholders in society. And actually, people tend to lay off less people. They tend, sometimes economic results of the company you run actually deteriorates and take a hit on this because you just become, I don't know, less, you become perhaps less cynical, more thinking about society overall. Do you think there is something in that?

Well, the thing I would absolutely argue against is the notion that there is a contradiction between the delivery of performance and strong financial results and being socially responsible. In my industry and in my company, they are literally completely aligned. Because if we grow, we are changing the lives of more patients. If we innovate, that's recognized by the market in terms of the value of our pipeline. So I... And by the way, if you actually look,

not sound offensive, but at our track record of performance since that happened, it has been completely transformed. That is literally probably the pivot point. But I'm afraid that it would be, again, I don't want to, I would express my gratitude, but it is, it's not something I think about. And I honestly, I have never felt more full of energy and appetite for impact. But I do think it's important to remember it's not only about pounds and dollars, it's about the lives that you change,

which is why you asked me earlier, what are the biggest medicines? And I answered in terms of revenue. Actually, I think it would be fair to say that last year, one of the biggest medicines that we gave were donations, I think 440 million donations of doses of a drug that's for a neglected tropical disease in Africa, which we've called lymphatic filariasis, a horrible disease. And the scale of lives, you know,

protected from that is really meaningful. So I think we do have to think in a multi-stakeholder world, but nothing will happen unless we are financially successful, because we need to fund the next wave of innovation. A bit more on the personal frontier at the end. What is energy? Well for me, it's something that is fueled and allows you to keep getting back up, whatever the challenges are, but also inspire others as a leader

to do more than they ever dreamt possible, both individually, but also a scale in terms of- And where do you get your energy from? Purpose, opportunity, curiosity, other human beings, the love of my family, and the deep belief that you get one life and you shouldn't waste a single second of it. What are you trying to learn these days? Everything about what's possible. I mean, I'm just, I am so fascinated by how technology is going to change society again. I mean, as it always has done, by the way, I think

we think we're in a uniquely privileged moment, but probably people have done throughout history. I've been lucky enough to have a lot of exposure to the world and issues that matter to society more broadly and the role of business in society and all of those things I'm extremely curious about. But I get annoyed when I walk into libraries about all the books I haven't read. So what about you? What do you read now? Oh, I've got that. I've got far too many books going on. I've just finished a novel called Demon Copperhead. I don't know if you've read it. But it's absolutely extraordinary and so clever in terms of the David Copperfield alignment. I listen to things when I'm exercising badly

in the gym occasionally. I'm originally a literature student, so I like poetry. I don't get enough time to read, to be honest. It's one of the things. If I could have a, I was gonna say a bad habit, but it's not a bad habit. It'd be a very good habit.

Well, poetry you have in common with Sartre and Adela. He's actually the only one we've had on the Polkart series who reads poetry or who talks about reading poetry. Well, you know. So it's the two of you, so it fits well. I didn't know that. I'll have to ask him about it. You have to.

I definitely can't talk to him about cricket, so I should ask him about that. When do you wake up in the morning? Early, I'm an early morning person. I mean, by the way, because I travel so much, I don't know whether it's morning or night, and I'm an early morning person. I mean by the way because I travel so much I don't know whether it's morning or night. I'm good at sleeping but normally my alarm is set for five. What is your advice to young people? Well first of all I will answer that question if you answer it and I would

say three things. First of all don't listen to the advice of old people too much. Totally. Second of all, you know, we invented a sort of family motto when the kids were little, which for us was, and this is probably us just trying to shorthand what parents thought you should do, which was be kind, be brave and be truthful. And I still stand by that. I'd probably add, be curious, because I think, I worry about the pressure that's on young people today who all seem to be worrying about strategizing their careers. I don't know how much strategizing your career you did. I said, none, like literally none.

I think my entire work experience was weight-trusting when I left university, and then I just worked really hard at things I thought were really interesting and opportunities arose. I mean, luck was a huge part of it, but I think they put too much pressure on themselves and should genuinely be just crazy curious to learn as much as they can in this exciting world at the moment. And then the last thing I would say is I think the title of your podcast, which I'm now going to be very enthusiastic about listening to all the past episodes of is brilliant. Because what matters in life is the company you keep. So whether it's personally or professionally,

hang out with extraordinary people who teach you a lot and make you laugh, help you get up again when you fall over and stretch you to do more than you ever thought you could do. Well, Dame Emma, I want to do that you are for sure an amazing person and a big thanks for coming here. Well, thank you. That's been such a pleasure. But what about you? You've got to tell me the last answer yourself. What do you say to young people? That'd be alright, separate broadcasts.