How a Purpose-Led Culture Transformed AstraZeneca with Pascal Soriot

What if the greatest turnaround in modern corporate history wasn’t driven by financial engineering or restructuring, but by an unshakeable belief in science and human talent? 

In this powerful episode of the Positive Leadership Podcast, I welcome Pascal Soriot, CEO of AstraZeneca—a visionary leader who transformed a struggling pharmaceutical company into a defining global force in oncology, cardiovascular disease, and respiratory care. 

He is also someone I know personally: I had the privilege of serving on the AstraZeneca board between 2008 and 2016, and I was in the boardroom when we appointed him as CEO. 

What makes Pascal’s leadership so rare is his non-traditional ascent. He didn't start with an elite corporate playbook; his foundational lessons were grounded in learning the value of loyalty and protecting his people. By beginning his professional life as a practicing veterinarian, he developed a profound sense of empathy—traits that continue to drive his unwavering commitment to putting patients first today. 

But Pascal’s story isn’t your typical corporate trajectory. Raised in a humble background where he learned early lessons about loyalty, standing up for his team, and defending his territory, he began his professional life not in business, but as a veterinarian. It was this experience that profoundly shaped his empathy and his "patient-first" approach to leadership. 

In our conversation, we explore: 

🔬 The Turnaround – How Pascal orchestrated AstraZeneca's massive transformation by instilling a clear, shared purpose and focusing relentlessly on patient outcomes. 

🛡️ The Pfizer Takeover – How Pascal defended AstraZeneca against a massive hostile takeover bid from Pfizer by betting everything on the truth of long-term science. 

🌍 COVID-19 & Global Access – The leadership lessons learned during the pandemic and the drive to ensure global, equitable access to the vaccine, particularly for countries in the Global South. 

🤖 AI and the Future of Discovery – How AI is accelerating the race to cure cancer and redefine medicine. 

Pascal’s insight: “People come to work because they believe they can make a difference. First, a shared purpose. Second, clarity about each person’s contribution to that goal.” Whether navigating a corporate crisis, defending core values against short-term pressures, or building a culture of psychological safety and innovation, this conversation is a masterclass in resilient, purpose-driven leadership. 

Key Themes: Corporate turnarounds, healthcare innovation, purpose-driven leadership, AI in medicine, empathy, resilience, scientific truth, navigating crises. 

🎧 Related Episodes You’ll Love: 

• Indra Nooyi: Driving performance with purpose
• Sir Ronald Cohen: Reinventing capitalism for impact
• Gianpiero Petriglieri: Leadership, a matter of love
• Fabio Barbosa: Leading with Purpose: Profit, People, and the Planet
  
  

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JEAN-PHILIPPE COURTOIS: I'll with a short introduction of the minute on you, Pascal, you'll be officially on the podcast. Yep.

JEAN-PHILIPPE COURTOIS: Hello and welcome to Positively Issued Podcast, the podcast that helps you grow as an individual, a leader, and eventually as a global citizen. I'm Jean-Philippe Courtois. Today I have the pleasure of speaking with a leader who sits at the intersection of science, strategy, and global impact. He's the CEO of AstraZeneca. The company has become a defining force in oncology, cardiovascular disease, respiratory care, why are we getting as well the hardest questions of our era, pandemic? pandemic response, global access to medicine, geopolitical fragmentation, and of course now the air revolution in drug discovery. He's also someone I know personally, I must disclose. I served on the AstraZeneca board between 2008 and 2016. In a way, I went together with the chairman, Leif O'Hansoen, and the board. We onboarded him as a CEO in the last month so long. AstraZeneca has been in the headlines. for major oncology progress and for accelerating AI-driven discovery, including a recent AI partnership aimed at finding new immunology targets. Pascal Soyou, a very warm welcome to Positiv Leadership Podcast. It's a pleasure to have you.

PASCAL SORIOT: Thank you, Jean-Philippe, and it's a pleasure to be with you and it's suddenly a pleasure to see you again.

JEAN-PHILIPPE COURTOIS: Super. Pascal, let's start with the very beginning, which I do with all my guests. You've had quite an unconventional journey. think you grew up in a suburb north of Paris. And I'm told, at least you share that story, that you had some times to fight to defend your turf, your territory with your friends. So can you take us back to those early days? What was your upbringing like, your family values, and maybe the gang values as well?

PASCAL SORIOT: I must say I didn't expect that question, it has sometimes this story has sometimes been a little bit inflated by the media. But it is true that I grew up in a difficult suburb. And but I had a very happy youth and my parents really were great parents. had three brothers, they are doctors. So you can see that everybody has done well in the family.

JEAN-PHILIPPE COURTOIS: Okay.

JEAN-PHILIPPE COURTOIS: Hmm.

PASCAL SORIOT: But we didn't have much money actually. In fact, for instance, I always loved horse riding. I love horses. I've always loved the horses since I was four or five, but I could never ride a horse until I could pay for riding lessons on my own. was 18 or 20. But yeah, we were kind of fighting, not so much to defend our turf, as you said, but more to help each other. And I learned suddenly the value of team spirit.

JEAN-PHILIPPE COURTOIS: Okay.

PASCAL SORIOT: and the real team spirit, not talking about it, but being there for your friends, your mates, as they would say in Australia, when time is difficult. so I learned that very early on. And I also learned another important lesson, which is never start a fight you think you're going to lose. So it's a kind of judgment of what you're going to go for, where you can win, not win.

JEAN-PHILIPPE COURTOIS: Aha.

PASCAL SORIOT: and also be ambitious in what you want to achieve, of course.

JEAN-PHILIPPE COURTOIS: That's a first great nugget to just share with us. I'm sure we'll discuss that later. What about your parents as well? You talk about family with a lot of doctors. So what kind of values, what kind of environment did you grow in actually?

PASCAL SORIOT: Well, actually, my father, my father lost his father. So he basically grew up with his mother just post-war. And for some reason, which I don't exactly know, he wanted to study and then joined the French Navy. But in the end, because he himself didn't have much money, had to work. So when he finished his studies, he studied. He still studied and was able to finish his studies post-war and then joined the French administration. And he worked for the French Treasury. And I can tell you sometimes people think employees of the state don't work hard, but I my father work so hard to the extent he one day experienced a heart attack, but he was working incredibly hard. Maybe different times. I can't judge today, but

JEAN-PHILIPPE COURTOIS: Yes. .

PASCAL SORIOT: Suddenly people working for the state actually in those days were working very hard to the extent that a few times he had people in his team that were missing and he was was unrolling us to do some of the work that his team could not do. And I still remember working for the state myself. was was and yeah, I was I guess 13, 14, 15. So, you know, I think again, our parents taught us the value of hard work.

JEAN-PHILIPPE COURTOIS: Ha. Ha ha ha.

JEAN-PHILIPPE COURTOIS: Hmm.

JEAN-PHILIPPE COURTOIS: Yes.

PASCAL SORIOT: And I think it was general in those days, people who had lived the war. I grew up in the northern part of France, of course, and the war was a real event for those people. And they suffered a lot from the war and they really wanted their kids, their children to live a much better life. So everybody was working very hard to build a better life and a better life for their kids. So that was my mother stayed home because she took care of four boys.

JEAN-PHILIPPE COURTOIS: Okay.

JEAN-PHILIPPE COURTOIS: Hmm.

PASCAL SORIOT: I was a full-time job and I'd argue she did a reasonable job because everybody got a reasonable job. so, but you know, we had a happy youth, but suddenly out in the street, it was not always easy every day for sure.

JEAN-PHILIPPE COURTOIS: Thanks for sharing that, Pascal. And I can hear from you loudly this very strong work ethics, which I can see in you for sure in the years we shared at the board of AstraZeneca and still today, I know. But also interesting to hear you about kind of the sense of public service from your dad as well. Because in many ways with medicine as well, it's a service to patience to people and the world.

PASCAL SORIOT: Yes. Yeah, one thing that one thing that I sometimes tell people, know, I think growing up in an environment that is not rich, where you struggle a little bit is not necessarily bad. It can be a godsend. Now, if you live in a very, poor neighborhood and you cannot study, I mean, going to school is difficult and it's really hard. But if you experience hardship when you're young, I don't know that it's necessarily bad. It certainly was not bad for us because it gives you, you know, the the energy or the yes, you want to you want to work hard, you want to do better. And, and essentially, when you're in an environment like this, the only way out is school. That's why school is so critical in any country, especially, especially law school, because that's really where you actually make a difference and learn the values of that you need to have in

JEAN-PHILIPPE COURTOIS: The Grit.

JEAN-PHILIPPE COURTOIS: Education.

JEAN-PHILIPPE COURTOIS: That's right.

PASCAL SORIOT: So I often think that being too, growing up in a rich family or well off family is not necessarily a good sign. I mean, you can do well there too, of course, but you know, having a little bit of a struggle in life actually can help.

JEAN-PHILIPPE COURTOIS: Yeah.

JEAN-PHILIPPE COURTOIS: I agree with you and many guests actually coming also from challenging environments and you can see there the way it shaped them as leaders. So Pascal, you talk about your passion for horses and eventually I'm sure you've been riding horses. But is it why you became actually, you went into veterinary medicine, which is quite a leap before becoming a sea of pharma giant actually. So what did becoming a vet help you? in shaping the way today, you need scientists, teams, and patients in your first choices.

PASCAL SORIOT: Yeah, I wanted to be I love horses when I was very young and I wanted to be a vet when I was four or five years old. Many kids actually want to be a policeman, policeman, woman or vet or I mean, this this or fireman. Those are very popular jobs when you're very young. then often people kids lose that as they grow up. didn't lose that. I finished high school. I was very young. was 16. And so I went to prep school.

JEAN-PHILIPPE COURTOIS: I'll your men as well.

PASCAL SORIOT: university, if you want for international listeners. So I went to university, I was 16. And I actually was absolutely convinced I knew what I wanted to do. I wanted to be a vet. And in reality, I didn't know. I thought I knew but I didn't really know. So I became a vet and started working in a horse practice. I did this three years and then my father died. And so I had to finish my studies, apologies. My father died and then I worked for three years. I had to work because my brothers were still young and my mother didn't work at the time. She found a job later on, but at the time didn't work. So I had to work and help the family. And as soon as my mother found a job, I went back to business school and went back to HEC in France and did an MBA. and joined the industry. the reason I did this is, you know, became more and more interested in the business world, even though I had no clue about the business world. Nobody to guide me. I was sort of guiding myself. And so, you know, I essentially still love horses, I still love animals, but I'm still a nature lover, I have to say, but I didn't want to spend my life at the same time. in same place. So I decided to do something else. And curiosity is really something that has, I guess, driven me my entire life. So I was curious and went and did this. I think this education helped me. It helped me in two ways. First of all, science. I mean, you learn biology, so I learned biology. And then secondly, I think vets are people who have to be self-sufficient. You you really... you're really on your own and you don't have a lot of support. So you have to be self-sufficient, you have to be flexible, you have to move quickly. So maybe that's also something that the job taught me at the time.

PASCAL SORIOT: Yeah. mean, a couple of things before I answer directly your question. mean, a couple of things I've learned over time is the importance of curiosity and the importance of pushing yourself outside of your comfort zone. actually finished business school and I joined Rossellu Clough in Paris originally as a financial controller, which was a first step outside of my comfort zone. I always was good in maths and physics and I was I love maths and physics, so finance is not that far away. It's all about numbers, of course. So I was a first step and then very quickly I was sent to New Zealand to be a rep. And that was clearly a stretch for me because my English was suddenly difficult, know, while it was beginning, let's say. Because in those days, you know, I learned German and good. good students in those days in France, they were learning German as a first language, not English. So my English was a bit broken, I have to admit. So that was difficult with my wife and the kids who had never left France. going down under so far in New Zealand in those days was not the New Zealand of today. You know, we didn't have, we didn't have nappies, for instance, you know, we didn't have nappies, we had like tissue nappies that you had to clean as an example. So for my wife and I, it was a bit of a surprise. So it was a challenge. then I moved to Australia, was sent to Australia. Then I went to Japan. Then I went to New Jersey for Aventis at the time I became head of US Commercial and then Sanofi head of US Commercial. And then I joined Genentech in California. Yes. And I think really the defining moments for me are probably number one going down to New Zealand because it was a bit of a stretch. I still remember in those days lying in my bed at night looking at the ceiling and thinking, what am I doing here? Yes.

PASCAL SORIOT: There was stuff and you know, in those days, they were still doing morning tea and afternoon tea in the office like, like in the UK and then they'd speak English, of course, with their New Zealand accent that go home at night with a terrible headache, trying to understand what they were saying. So that was like a really, you know, what you might call a teaching moment. so that and then I often think, you know, operating in a small organization teaches you a lot because I had to do everything. And so you become a jack of all trades and you learn a lot. So I learned a lot. Yes, you become an entrepreneur. mean, I was running a small business. knew exactly how much money I had to make every month to break even because I was not making money. Not personally, but the company was not making money. So I was counting my dollars every month. So you become an entrepreneur, know how to run, you know how a biotech entrepreneur or any startup entrepreneur thinks and operates. So I learned all of this. The other big defining moment, I mean, three defining, another one was to go to the US because the US was like a huge learning experience and being thrown out in the US organization, managing an organization with maybe 10,000 sales representatives at the time. had 12,000, 13,000 people in commercial. And the only place we could have a national sales meeting was Vegas. was not enough place, nowhere else you had a large room. But probably the most important one was Genentech because I really learned, I learned a nice working there. I mean, I worked with people who are like so smart. and you kind of see what top talented people actually can do. But also the most important is I learned the purpose, the value of shared purpose. mean, everybody at Genentech, the shared purpose at Genentech was so deep and so strong. And I'm sure it's still the case. Whether it was science and patients, was really, people understood fully why they were

PASCAL SORIOT: doing what they were doing. You work in the industry and you can think, okay, I'm selling pills or I'm selling whatever, I'm selling medicines. And so you look at your market share, your sales, and of course you think of patients, but the connection was so strong and the belief was so strong. People actually would give up some of their budgets sometimes in admin functions or anywhere else. to be able to reinvest in R &D because everybody was so convinced of the mission that everybody was working on. So I think this shared purpose and the importance of making sure everybody actually is on the same mission is critical. I think it's Kennedy or someone who said, Jeff K, mean, who said a long time ago, meeting someone who was on the cleaning team at NASA and said, what are you doing? And the person answered, I'm, yeah, as a janitor. And the person answered, I'm sending rockets on the moon. And of course, you can see it as an anecdote, but actually, it really captures completely the spirit that people had in adjunct tech. I assume they still have it, I don't know, but. It was very, very strong at the time.

PASCAL SORIOT: Yes, you know, I think since we talk about positive leadership and before answering directly your question, other thing I learned along the way, which I brought, I integrated in the way I operate is, and I'm not perfect, so I'm not sure that I practice that all the time, but it is to always assume good intent and always assume everybody is actually doing their best. And that's really key, right? If you want to build positive environment and a team that works together towards a common purpose. But, you know, I'm not a believer of a CEO that comes in and fires half of the people and say, well, you guys, what you guys are doing is really bad and we're going to change it completely. I'm not a believer in this. AstraZeneca was really going through a tough patch, as you know, because you were on the board. that happens to companies. And my approach was always because I was influenced, I guess, by the image that I had of Asha when I was in Australia, had a very positive image of the company. And I had met a number of people along the way over the years. My approach was even though the company is going through a tough patch, I'm sure there is quite a number of very good people in this company. So The first thing we did was to try and focus our strategy on a few limited priorities. That is, I guess, simple if you want the difficulties to do it, because it actually meant that we had to bet. And I'm sure you remember that being on board again, but we had to bet on what we were trying to do and we had to fund it. We had to put money in it because we were running out of money. profit was crashing very quickly. I when I joined the company was selling $30 billion and we were on a rapid decline. And the forecast was we would drop all the way down to 17, 18 billion. And we did drop as we lost several big products to patent expiries. And I think we were able to stabilize the company down at 19 or 20 billion before we start going again. in through this journey, we had to sell all products.

PASCAL SORIOT: to reinvest that money into R &D. so, you know, saying you're going to focus and then you have to resource your priorities, textbook business school, is it to say difficult to do because the way to do it for us was to sell all products, take the profit, put it into R &D, but there was no guarantee of success in the R &D investments. So we lost the profit coming from all products. And if R &D had not delivered, we were finished. And suddenly I was finished also, and the thing was finished. So, you know, we actually decided to set a strategy that was focused on oncology, cardiovascular disease at the time and respiratory disease and left it at this. And over time, we built an additional leg disease through the acquisition of Alexion. But essentially, we've kept focused on this and following the science, betting on good science. And I'm not saying we were successful all the time. We also had a few setbacks. But the important piece was over time to continue building the team. Not sort of fire everybody or half of the team, but really take the team as it was and good people. And over time, really continue to increase the talent on the table and across the company. I often think about it as a sports team, a football team or a team, whatever kind of sports team you think of. You continuously have to strengthen your team if you want to go from regional championship to national to international.

PASCAL SORIOT: Yes, mean, AstraZeneca was, I think, still leaving the sort of mantra of the pharmaceutical industry of the 2000, 2010 period and a little bit after, which was everybody was saying, know, pharmaceuticals is like consumers, consumer goods. It's all about marketing. And of course, you know, even if you have a good drug, you have to make sure Physicians understand the value of your medicines and know about it. Otherwise, they can't use it. But it was excessively for the whole industry. I have to say, I was very focused on marketing. And that didn't help the image of the industry for sure. But also, think the industry lost its focus a little bit. And when I was at Roche Genentech, because I was a Genentech originally, and then we merged with Roche and I became head of pharma for Genentech. In the late 2009, 10, 11, before I left, because Roche and Genentech were focused on science and pipeline, I was talking about it and investors were not very convinced. were saying, well, the age of time of products and pipeline are behind. you're really, the industry, I heard this many times, the industry is spending too much in R &D. And when I joined AstraZeneca, I was told this almost at every call because, not every call, but many calls because people think you put money in R &D, but your R &D is not very good, so you're not going to produce anything. So what we did from the beginning was transition from this sort of marketing era to science and patients. We integrated this in our values. We integrated this in our messaging. And really, was about the focus on science. We put patients first. We're entrepreneurial, which means we take risks. In our industry, you got to take risks. If you don't take risks, basically you're just going to be plodding along, I mean, maybe even decline. If you take risks and if you fail, then of course you're in trouble. But if you succeed, you can actually do very well as a company.

PASCAL SORIOT: But risk taking is associated with innovation and breakthrough science. So we focused on science. We focused on the connectivity to patients and patient benefits and then taking risks. Because one of the things that had happened at AstraZeneca is the company bought in 2008 or so, they bought MedImmune, a biologics company in the US, US-UK. And they were criticized at the time for overpaying. I think it was actually a good decision, quite frankly, whether they overpaid or not. mean, you know, who knows? But at least they had the asset. But they were criticized for this. Then phase three projects failed, which were going to be big projects. And I'm sure you remember that period too. And the management told the team, we will not fail in phase three anymore. But actually, if you tell the team that what happens is you never fail in phase three, because nothing moves into phase three. When I arrived, there were a couple of products that were in phase two and the team wanted to do more work in phase two and more questions because they were so nervous moving it into phase three. We moved it into phase three and it worked. Of course, it could have failed, but it worked because I thought at the time this product has a good chance of success. So the risk taking and then moving to science and moving to, know, we are here for patients. Time matters. We have to take risks to come up with products that make a difference for patients and time matters because patients are waiting. mean, especially in cancer, if you think about it, if you come up with a product that gives patients only two years of extra life, people will say, okay, well, you know, you pay a lot of money for two years of extra life. First of all, I will argue if you're the patient, it actually means a lot. You can see your son or daughter graduate from school. can do all sorts of things. But the other thing is science in our industry is moving at full speed. So having an extra two years may give you a chance to get to the next drug that will either cure you or give you an extra five years of life. And time matters because if your product arrives too late, then some people are going to miss out.

PASCAL SORIOT: Yeah, it's a great question. in fact, we at the time, I must say also Pfizer. was very much focused on the financial aspects. And the father of today is very different from the father of the time. Father of today is a lot more focused again on innovation. But at the time when they approached us, it was really about financials and tax savings, et cetera, which of course, I mean, none of those things excites anybody who is committed to making a difference to patients through science, right? But we had already sort of spent a year and a half, roughly a year and half, right, on our strategy, our pipeline, on our science. And there were a few early shoots. Is that the right expression? Early shoots of early signs that we are making progress in the right direction. had a product in particular. We had a called Limparza for ovarian cancer, breast cancer that we had relaunched because the management before had decided to stop it. And we restarted it and it became Limpasa, which is a multi-billion dollar product today and is helping a lot of patients. But at the time, we were in the early phase and moving nicely. And we had a product called Tagrisso in particular for lung cancer. And I was convinced that a merger would merger can work well, by the way, but I was convinced this one would actually totally distract us and disrupt the process of development of Tagrisso because in those days we didn't have much. So we were a hundred percent focused on the few products we had in the pipeline. you know, everybody in the company was sort of in charge of Tagrisso if you want, because it was such a critical product. And I thought we're going to be distracted. I

PASCAL SORIOT: I didn't think it would create value. And I thought we can do well or better on our own. And our chairman and the board were of the same conviction. You say it could have failed, we could have all been wrong, right? But it worked because in the end, when I joined the sharp price was 29 or 30 pounds when Pfizer approached us, were approaching 38 or 40 pounds. and made an offer and increased it and I think they finished around £55 at the time. And today we are around £140. So hopefully I have shown that it was a decision. But it was a stressful experience for everybody. I spent, and I'm sure it was the same for you on the ball, but you remember how many ball meetings we had. mean, it was incredible.

PASCAL SORIOT: I tell people, yes, I tell people, you know, in the end, you've got to listen to everybody who has an opinion to give you and advice to give you. You listen. think listening, being open-minded, listening is key. And that's what I do all the time. I listen to many, many different people. Ultimately, if you're in charge, you're going to make up a choice and a decision and you got to go for it and stick to it and rally people behind you because You cannot be waffling. I if you waffle, you're finished. So, and at the end of the day, you have to say, OK, you know, it works or it doesn't work, but I'm going to give it my best shot. And that's what we did with the Pfizer in the Pfizer case.

PASCAL SORIOT: Yeah, can I? It's a great question, actually. Jean-Philippe, can I go back to the Pfizer story and say one last thing, maybe quickly? Because I think it's also, again, it talks about, you know, pushing yourself out of your comfort zone. When Pfizer approached us originally, the British government was in favor of the proposal because they had sort of been told and believed that the headquarters were going to be in the UK. So they saw that as a good deal. But rapidly, and that was also helpful because of our focus on science, rapidly the scientific community rallied behind us actually. we ended up, you know, created of course a political discussion, debate. And we ended up having Pfizer and us to... testify in front of Parliament. We had a Parliament inquiry. You remember that? Yeah. And, you know, I was shaking when I was going there because I was thinking the little guy from the northern part of France who grew up in a low-cost housing suburb going to Parliament in London. But in the end, we could have said, no, we don't want a participant. But I thought we have to go because we have to tell our story to everybody. And it worked again. But I went there with two scientists, a woman and a man who accompanied me, and I'm sure I still remember that story being in Parliament, and we of course were questioned. But I think it's another example of you got to push yourself and then, you know, take your chances really. Going back to your question now about COVID, you know, throughout all of this, I think All of this Pfizer story and then the turnaround, the journey we went through. First of all, I think we had a very strong board, very cohesive board. And that's important, right? Because when you make a difficult or challenging decision, you take a risk, let's say you have to have cohesion in the board. Number one, number two, we had a team, a management team, leadership team that was also very cohesive.

PASCAL SORIOT: And number three, think we had, certainly I had and many people on my team had developed a sort of emotional connection to the UK. And so we wanted to help. So before going into COVID vaccine, actually built with the University of Cambridge, a testing center in Cambridge. Because you remember, initially, there was not enough testing. Everybody needed to be tested. There was not any enough testing center. So was like this huge effort for the UK, a little bit like during the Second World War, when they had this flotilla of boats going to France to take all the army and bring them back to the UK, right? So you had small centers, big centers doing testing throughout the UK and everybody was working together. was an incredible time. then, of course, in parallel to this, we worked on the vaccine. We did it at the time. And I know people, some people don't believe it, but we simply did it because we wanted to help. And we helped with initially with masks in January of that year. We then looked at our medicines. Is there anything we can repurpose? We developed an antibody for COVID treatment, COVID prevention for people who don't respond to vaccine. And then we started working on the vaccine with Oxford. And quite frankly, I think even though we were criticized at the time a little bit here and therefore not being able to supply everything in Europe in particular, if you look at the emerging markets, it was a resounding success. Yeah, actually we delivered 3 billion doses of vaccine. And it was estimated independently from us that... These vaccines saved six million lives. 90 % of people in India were vaccinated with our vaccine that we developed in partnership with the Serum Institute of India. In many countries, Brazil, et cetera, 60 % of people got our vaccine. In Vietnam, Thailand, all these places, Latin America, South Asia, all these places, they really relied on our vaccine because at the time there was no vaccine except the Chinese vaccines.

PASCAL SORIOT: because the US was keeping what they had for themselves, which you can understand there was not enough for the US population. And Europe was keeping everything for themselves too, because there was not enough for Europe. So they started exporting or sharing, if you want, but later on they shared when they had enough for themselves, which was several months later. But think about a country that has access to no vaccine, every day counts for the population. but also for government because the population tells the government, what are you doing? mean, look at France, the US, they're all vaccinating and we have nothing here. So, you know, it helped the populations and it helped everybody actually. And, you know, I can see even today, five years later, many countries in this so-called emerging markets, many, many countries are still thankful for what we did.

PASCAL SORIOT: Also because we sold the vaccine at cost. So, you know, these countries, of course, they're not as rich as the US or Europe. We made no profit. So the price was much lower and then they could buy.

PASCAL SORIOT: The biggest what, sorry.

PASCAL SORIOT: The value of a great team, because it's quite interesting at the time. my team and the board, actually, but my team in particular could have said, what are you doing? I mean, why are we doing this? I mean, we have so many other things to do. It's going to be a distraction. In fact, some investors, some shareholders told us you're going to be distracted. It's going to be a big distraction while you're doing it. And there's not a single person on my team, not a single person who told me we should not do this. Everybody said, let's do it. And honestly, often I think about it, even have some emotional moments about it because of the fact that everybody said, let's go, let's do it. And again, it was not perfect. We gave it our best shot. We made a big difference in many parts of the world, not everywhere. But it was really, I mean, the learning was... having a team that rallies because it's hard to describe. I mean, the amount of work that had to be done because we had to set up regional supply chains because we knew, I mean, we knew, we suspected and we were proven right from day one that countries would not share and they would capture whatever you manufacture in their country, they would capture it for themselves. And in fact, it happened through Zinja. We had an agreement that 50 % of the supply would stay in India, 50 % would be exported. And in the end, COVID exploded in India and they said, no, sorry, we keep everything. So we sort of had a big problem. But thank God we had regional supply chain in Southeast Asia, in Latin America, in different places, so we could continue to supply.

PASCAL SORIOT: Right. Good. So there is a discovery step, what we call a preclinical step, which is lab in vitro and also in vivo in animals. So that's a preclinical step. Then you have the clinical step. And in the clinical steps, are three. You have phase one, phase two and phase three. Phase one, you establish that the drug is has some signal of efficacy, but importantly, it's safe. And you do this in a controlled environment in volunteers. Phase two is you establish the efficacy and the dose that you need to take into phase three. And of course, you do it in a bigger number of patients because you know the drug is safe enough, but the number is still not large enough to establish efficacy fully. And then phase three is made of very large studies. where you recruit lots of patients and you have the statistical power to prove your hypothesis is true or not true. And then you go to the regulator with this data. So those are the steps and the steps and the discovery step, of course, is important. That's where you look for new targets and invent new molecules or new proteins or antibodies or antibody drug conjugates. The preclinical step is probably more an execution step as opposed to a creative step. But it's an important one, of course, to establish safety. But also it's an important one in terms of speed. You have to move very quickly there because speed is important, of course. And then the clinical steps, each of them are important, of course. And then the cost, and that's the important piece. The cost goes up and up and up and up as you progress. The cost of discovery is not that much. I mean, it's a lot of money, of course, but it's not that much in the great scheme of things. clinical, not so much. Phase one. Small number of patients, controlled environments are more expensive per patient, but small number. But it's when you get to phase three, that's where you start spending a lot of money. We have a month, sorry, I'll stop here, maybe.

PASCAL SORIOT: On average, it's probably 10 plus years. And the phase three can go from, depending on the products, right? Because some products, you can establish efficacy very quickly with only a two-year study in phase three, like an antibiotic or a blood pressure product. But some products, have to five years, like oncology, you have to show you same lives, it takes five years. Or if you want to show you have an impact on heart attacks or kidney disease, takes four or five years. So the phase three can be up to five, six years. And the cost is high. We have a monthly, what we call portfolio review committee, which I chair. And we meet twice, not monthly, we meet twice a month. I never approve less than 500 million of spend at each of these meetings. The other day I approved two studies for one product, two studies, $1 billion. And if those two studies fail, it's $1 billion in the garbage can for Americans or rubbish bin for the British. But, you know, we bet big money in our industry and that's what people have to understand. The risk is huge.

PASCAL SORIOT: It is. It is.

PASCAL SORIOT: Absolutely. And it's an important piece. know, often people look at us as companies and they say, well, you guys make a lot of money. But to me, it's like looking at Nicole Kidman or some very successful actor and saying, Nicole Kidman is very rich. Well, she's rich because she's been successful. But you have also a lot of actors who live in an underground apartment in Los Angeles and work at a restaurant every night because they can't make enough money being an actor. And the equivalent in our industry is you've got a few companies that do well. But you also have a lot of companies that decline. Now, in our industry, companies don't exactly go bankrupt because they decline and they get bought. That's the equivalent of bankruptcy. We can close ourselves to this. if you go back, the number of companies that have disappeared from our industry over the last 20 or years is very, large. They were all bought.

PASCAL SORIOT: Yes, and I think maybe I need to start with giving people a sort of historical perspective to better understand why this moment in time is so exciting. When I started in the industry, we were selling pills and some injectable products. And essentially, the treatment of cancer was made of injectable oral, to be honest, chemotherapies. that had limited the efficacy and of course, a lot of side effects as we all know. And I started in a company that was mostly involved in antibiotics and cardiology, hypertension, these kind of things. But then in the late 90s, I started being involved associated with cancer. And I have been to the ASCO, the American Society of Clinical Oncology in the US. That's the biggest cancer congress. The European one is more is. ramping up, but ASCO is still the biggest. I've been going to the ASCO every year for the last 25 or 26 years. And I still remember late 90s, 2000s, the physicians were presenting, people were presenting their results, because the ASCO is about doctors coming and presenting their study results. And it was about, always about a little bit of this chemo with that other chemo combined differently, change the regimen or those, etc. And you gain one month of progression free survival, sometimes a little bit of overall survival, throughout survival. And that was the progress at the time. And then in the late 90s, well, in the early 2000s, the first antibody was introduced as septin for a very severe form of breast cancer, so-called hertopositive breast cancer. But we stayed with a few products like this one and a couple of others until maybe seven, eight, nine years ago. In the last eight, nine years, there's been an explosion of science. Immunoproducts, antibodies, now they are specific antibodies. have antibody drug conjugates. We have cell therapy. We have T cell engagers. We have a whole series of technologies.

PASCAL SORIOT: new of course, small molecules that are a lot more targeted. So that's one piece. And then the other piece is we have tools to much better target patients and know which patients is more likely to respond to a treatment. And then you can combine those technologies. a bit of a long introduction to answer your question. The most exciting part is we are starting to cure some cancers. And I can see today, mostly in hematology, blood cancers. But I can see the day is not that far where we will be able to cure cancers, not all cancers, but some cancers and over time, more and more cancers. And we will do this by combining treatments, combining, for instance, IO, immunocollegy products, with antibody drug conjugates, fragmenting, shrinking the tumor, and then bringing T cell engagers or cell therapy and finishing the tumor and curing people. and delivering either cure or long-term sustainable remission. So it's incredibly exciting. It's complicated because you have to find what is the right product. We now have all the technologies. We also have technologies to better diagnose patients earlier. And so if you diagnose cancer early, of course you have a better chance to cure it.

PASCAL SORIOT: Yes, I have to say, first of all, I'm a big believer in collaboration. I science is important, but there's not a single person in the world who wakes up in the morning and has the solution to all the problems in the world. Solutions come out of collaborative work, collaboration between academia and private sector, also and within a country, but also collaboration between countries. And it's really important that we continue maintaining that collaboration across scientists across the world. China is starting to become a massive contributor to innovation in our industry. So Chinese scientists need to work with American scientists and European scientists and other scientists from everywhere. Having said that, you're right. mean, the world is definitely fragmented, fragmenting, and it's going to affect, I think, supply mostly in our industry. And I think it's also learning of all the consequence of COVID. Everybody saw that in time of crisis, nobody shares. They share when they have enough for themselves. And you cannot blame people because if you're an elected leader or politician, you're elected to take care of your own people first. That's what happens, right? And so it's just a reality. You might say it's sad, it's bad or whatever, but I think it's just reality. it's a fact you can't blame people. So everybody's realized that you have to have your own sovereignty in many sectors and in particular in pharmaceuticals. So we are building, we have been doing this for many years, but we're doing even more manufacturing footprint in the US and China. So those geographies can operate independently from each other.

PASCAL SORIOT: Yes, good question. mean, you know, again, going back to when I started in the industry, we were selling pills and in the late 90s, early 2000s, antibodies and lots of technologies. But at the time, Europe was probably the main contributor to innovation in our industry. And the US was also a contributor, but I would argue Europe was probably the main contributor. And China, of course, was not participating in innovation at the time. And today, The main contributor of innovation is the US and China is the other one growing very quickly and Europe has fallen behind in a big time. And so the question is why? And I think the answer is many politicians and governments see our industry as a cost. And there are three dimensions to our industry, I think. One, of course, is helping patients live longer and better life, but that has a cost. But that is the industry, of course, you know, our products have to be paid. I mean, they create a cost. The second dimension is the value creation, the jobs that we create, the R &D that we invest in. And the important job we create are good jobs that create themselves additional jobs. So we put it in the UK. One job at AZ creates six jobs outside, suppliers, you know, the community at large. And the third dimension is health sovereignty. If you lose your sovereignty over the supply of medicines, then basically you have a problem one day. And I think what will happen is, unfortunately, is that Europe has a large manufacturing base, but for the older technologies, the new technologies, new plants will tend to be built in the US. because of the Trump administration is incentivize everybody to do so. And so if you fast forward 15 years, it is quite possible Europe will source its generics from India and China, which is the case today, and its innovative products from the US and China will have lost its health sovereignty. It will have lost the value creation of our industry. And why is that is simply because they focus on cost.

PASCAL SORIOT: and try to minimize the cost of our products as opposed to having a broader picture in mind. OK, what does the industry cost me? What does it bring me? Of course, it better health for my people, but also reduce hospital costs, reduce heart attacks, which are costly, kidney disease, reduce all the costs associated with those. But they only look at cost. the cost of the drugs in the bucket, not the rest.

PASCAL SORIOT: I think AI is transforming completely our industry and our company in ways that are more traditional, regular, like, you know, administrative process, also manufacturing and robotics and AI. And also the commercial aspects, how we commercialize our products. But if I look at the R &D process, which is what you're talking about, I mean, I'm not sure, to be honest, how they calculate 19%, because there's not enough data yet to do this. But while we can say for sure it will improve probability of success. Now, some people say it will reduce number of jobs. I think it will increase the number of medicines that are discovered and made available. And if you're successful doing this, don't have to reduce your headcount. You just maybe have to recruit different people. And so it is changing the way we do discovery. It's helping us find new targets, new mechanisms of action. And then it's also helping us in a clinical process. Now, people oversimplify. They say AI, AI. But it's more complicated than this. You have to have the data. You have to have the data. And very often, the problem is a single company doesn't have enough data to apply AI constructively on the clinical front. Well, one of the things we've done is we have done a partnership with a company called Tempus that is based in Chicago in the US. And we've done a joint venture called PASS that is basically looking at how do you apply AI to a whole large database of data. So Tempus has access to anonymous data. from maybe 80 % of cancer patients around the US. And then they have the clinical data, they have the pathology data, and they have all sorts of other data, metabolomics and transcriptomics data. And then you bring all of this together and you apply AI. And we've developed algorithms that we've just finished, multimodal model, AI model, that we believe will help us predict

PASCAL SORIOT: the probability of success of a trial. Also identify which patients have a better chance to respond. And so better design our clinical trials and improve the success rate of our clinical trials. I'm absolutely convinced it will be the case. But having AI tool is not sufficient. You have to have the data. Then you have to have the technology to do diagnostic tests. look at the pathology samples you've got, et cetera, et cetera, and bring all of this together.

PASCAL SORIOT: I yeah, think positive leadership, the way I understand it is really to, to create a positive picture to create a, to create a vision or goal and supported by a plan, of course, that people can get excited about. People can look forward to and that's number one. Number two is making sure everybody understands what their contribution to this common goal is. And number three, to create an environment where because of the values, the culture you create, et cetera, people enjoy working. They enjoy working. Of course, they have to be paid the right amount, but that's, you know, they were staked. But people come to work because they think they're going to make a difference about something. You know, it could be anything in our industry. It's making drugs. But they have to understand what is the goal? What is the shared purpose? What is the plan to get to this goal, that goal? What is their contribution? And also they have what they need to work toward that goal. have, they work in a company with the right culture, the right values, and they are, you know, able to grow and become better, a better person. I mean, my career has been about moving around the world, meeting with a whole range of people when in fact, until I was 19. I had not left France. And I grew up with people who in a part of France where people looked like me. They all looked like me. They were all looking like me. I mean, this was like a long time ago, of course. And then I started experiencing working with people who were different from me, not only looking different, but also thinking differently. And I learned to appreciate the diversity and the value of diversity and the value of bringing people together for a common goal.

PASCAL SORIOT: Thank you.