Health May / June 2020

Culture of change

GSK’s journey for better health, teamwork and communication

Long before Covid-19 turned the business world upside down and presented the health­care industry with one of its greatest challenges, GlaxoSmithKline (GSK) was transform­ing how teams work together.

The UK-headquartered, science-based pharma­­­­ceutical and health­care firm’s global team researches, develops and manufactures innova­­tive pharma­c­eutical medicines, vaccines and consumer health­care products.

Behind everything they do is a special purpose: to help people do more, feel better and live longer. And at the heart of that are values and expectations that help define the firm’s culture—allowing the GSK team to deliver extraordinary things for their patients and consumers.

Key areas of focus in the pharmaceutical busi­ness include respiratory, HIV, infectious diseases, oncology and immuno-inflammation. And during the current coronavirus pandemic, GSK has been playing a role in the pursuit of vaccines and drugs with great urgency and investment.

Japan is an important market for the firm. As issues such as ageing and lower birth rates present societal challenges, there are opportunities for GSK to make a difference in people’s lives to address unmet medical needs, including preventive care and to collaborate with stakeholders—including the government—to share best practices from the global market that can further shape and improve the environment and policy.

Two years ago, Montréal, Canada native Paul Lirette arrived in Tokyo to lead the firm’s Japan operations. Right away he began a journey to strengthen an already solid foundation and enable GSK to provide local physicians and patients with the best possible service and most effective treatments.

To learn more about this journey, as well as GSK’s Covid-19 efforts and business goals, ACUMEN sat down with Lirette at the firm’s head­quarters in Akasaka, Minato Ward.

How did you come to lead GSK’s Japan operations?

Having spent many years in Australia and the UK, I came to love living in different countries and being challenged by different cultures. After five years back home in Canada, I was wondering what I would do next. So, I had a conversation with Emma Walmsley, our CEO, and she asked me what I would like that to be. I said that I’d like to have a more complex business to manage, and to do it in a very different culture. I wanted to be able to do what I had been doing, which was, basically, to enhance a culture and make sure that we have a business that is sustainable.

What I didn’t know is that I was describing Japan. But one Friday evening, I received a phone call and was asked, How about Japan? It was a big compliment for a leader, because the country is the second-biggest market regardless of the company you work for or the industry you’re in. It took me just one minute to say yes.

How does it compare with other places?

The challenges are very, very different. Australia was my first experience as a general manager. In Canada, as head of sales and marketing, I knew the market by heart. I even knew the key opinion leaders, having been born there. And I knew all the employees, so I knew which levers I could use. But when I moved from Canada to Down Under, I had no internal network and no external network. I had expertise based on knowledge, but not based on who I knew. So, without knowing the environment, I had no choice but to rely on leading people. I also learned the hard way to ask questions. So, it required different leadership skills.

Then, moving to the UK and leading our Central and Eastern Europe operations meant the people I worked with were very different again. They weren’t native English speakers, so I learned not to be judgmental based on language skills and I learned to slow down when I speak. I also learned that every market has different life cycles in terms of integrating innovations, culture and how you inspire people. The way you inspire the Polish, for example, is very different than the way you inspire the Czechs. Learning about their history and their role models is very important.

I’m applying all this here in Japan. I’m listening and learning every single day. The people are fascinating. I love my colleagues. I love the business. There are lots of challenges and opportunities, but it’s a very humbling journey. I feel very privileged to be in Japan. I couldn’t ask for more.

How are GSK’s Covid-19 efforts progressing?

Obviously, coronavirus is a top priority world­wide and finding a vaccine is critical to getting life and business back on track worldwide. Since the outbreak began, we have quickly turned our resources towards this challenge with our science and expertise while also protecting the health and well-being of our people. We are taking a compre­hensive approach to three areas:

  • Prevention
  • Treatment
  • Disease management

Prevention is focused on the development of a vaccine. Globally, our primary aim is to develop multiple adjuvant Covid-19 vaccines using our innovative adjuvant technology, and we are colla­borating with several firms and institutions around the world. This is the time for firms not to compete but to collaborate. We are in this together and are competing against the virus.

One of the most recent such collaborations is a global joint project with Sanofi, which we announced in April. They are a French pharma­ceutical firm that has developed a Covid-19 antigen. We’re providing them with our proven pandemic adjuvant technology and hope to have a candidate vaccine that can enter clinical trials in the second half of 2020 and, if successful, be available in the second half of 2021.

The use of an adjuvant can be of particular importance in a pandemic situation because it may reduce the amount of vaccine protein required per dose, allowing more vaccine doses to be produced and, therefore, contributing to the protection of more people, sooner.

In addition to Sanofi, we are also collaborating with firms and institutions across the world, including in North America, Australia and China.

Alongside vaccines, we are also exploring thera­peutic options. In April, we entered into a colla­bo­ration with the US firm Vir Biotechnology, Inc. to identify and accelerate new antiviral anti­bodies that could be used as therapeutic or preventative options for Covid-19 or future corona­virus outbreaks.

Through this collaboration, we’re combining Vir’s technology with our expertise in functional genomics. We are also evaluating their marketed pharmaceutical products, as well as medicines in development, to determine if any could be used beyond their current indications in response to the pandemic. This includes medicines with potential direct antiviral activity and those with possible utility in prevention or treatment of secondary complications of Covid-19.

Beyond vaccines and medicines, we are also making other contributions using our capabilities and expertise—for example, to support national testing centres in England.

In addition, we are supporting global and local community funds, including the donation of $10mn to the United Nations–World Health Organization Covid-19 Solidarity Response Fund, to support distri­bu­tion of essential supplies and personal protective equipment to health workers.

We have also made donations to contribute to healthcare in Japan, namely the Japan Respiratory Foundation, Japan Foundation and others.

As part of disease management in Japan, GSK also started an initiative using a telemedicine system that aims to enhance adherence to treat­ment. This could potentially protect asthma patients from Covid-19.

Finding solutions, such as vaccines and drugs, to Covid-19 is an unprecedented challenge. Supporting the global response to Covid-19 is at the heart of GSK’s purpose—to “do more, feel better, live longer”—and our business and portfolio are highly relevant and much needed.

What stands out about healthcare in Japan?

That’s an interesting question. From a macro point of view, Japan has processes in place that allow them to bring innovations—medicines and vaccines—to market at the same pace as the United States and Europe in some therapeutic fields. That ability to accelerate approval to market in Japan is attractive. The government is making significant progress and we’re very competitive here.

The science in Japan is unbelievable. We have great scientists here—I call it the fertile ground—and that’s why we are focusing a lot on business development opportunities. It’s one of the reasons we’re committed so strongly to doing clinical trials in Japan. It’s not because we have to, but because it’s important to make sure that we’re able to address patient needs and we’re learning a lot from the scientific community here. It’s a good environment to be in, full of challenges and opportunities.

Why is preventive care important?

GSK is dedicated to ensuring that people are protected with appropriate care at appropriate timing, notably with a vaccine that is effective as a preventive measure. We see life-course immunisation against various diseases as so important for all ages, not only for children but also for adults.

For the sustainability of healthcare system in Japan, we must do more to protect more people from vaccine-preventable diseases. I believe this can contr­ibute to the extension of healthy life expectancy in an increasingly ageing society such as Japan.

What workplace challenges do you face here?

There are a few, but one is culture, and that’s part of our journey. When I arrived, I made it a point to really listen to the team. In the first two months, we did what we called the Listen & Learn Tour, during which we interviewed almost 400 employees out of 3,000. We did this 10 people at a time and asked the same five questions. Amazingly, people talked honestly in that atmosphere.

We identified areas that people see as challenges and opportunities, then started to address them one by one. And once we had a good feeling for their views, concerns and ideas—and what changes we would make—we started to explain the reason for the changes. Explaining the why and listening are very important.

We also started to talk more about GSK, our Values and Expectations we have for everything we do. That was the start of the journey two years ago. And during that cultural journey, we identified three areas of focus with regards to culture:

  • Learning to speak up
  • Diversity and inclusion
  • Managers’ capability to foster a better culture based on values and expectations

Since then, we’ve initiated a lot of actions. First, we encourage everybody—at all levels and functions—to talk more about our Values and Expectations, how they relate to our daily life and how we can demonstrate better ones.

What encourages staff to speak up?

There are a lot of things. One is the way that we gather our Japan Executive Team to meet once a week at what we call Comm Cell. We catch up with each other to check the progress of the things, and we do it in the open areas so anyone can stop by and see what is going on. That kind of transparency is something that we encourage of everybody at all levels so that we can escalate issues smoothly and openly discuss them. That is something that is making the environment better for people to speak up, and it also encourages improvement of our managers’ capabilities. We’ve been encouraging managers to have more dialogue with their staff.

I think that one of the key principles is that people follow not only the why of something but also your behaviour as a leader. A few examples come to mind. One is transparency in feedback.

Globally at GSK we’ve started the process of 180-degree feedback, which we call One80, to receive feedback from those who report to you. That’s as opposed to 360-degree, which includes everyone at all levels.

After the first round, I was speaking with employees and realized that managers had not shared their One80 results with their staff. As I reflected on this, I asked, Why? Then I lifted the mirror and asked if I had I shared mine? So, I made a statement: I put my One80 results on Workplace, on our internal social network. Everyone, all 3,000 employees, got access to my One80 results. I was leading by example, showing a case to all leaders that it is important that you talk about your One80 results, get feedback on it and commit yourself to action. It’s very important that you lead by example.

Another thing we’ve learned is that the popular belief that Japanese people don’t speak up is a myth. I’m telling you, if you set up the right trusted environ­ment, they do. And they talk a lot. More and more of our Japanese colleagues are raising issues and doing so faster than ever.

We’re trying to create an environment in which we help each other. One of the things I’m keen on is that, as a manager, I protect the back of my colleagues and vice versa. We’ve come up with rules of engagement for the executive team. We agree that it’s important to voice our opinion, and, once we make a decision, we are all committed to it. That’s fundamental. Leading by example is very, very, very important in Japan.

How do Japan and UK workplaces differ?

One big thing that I learned in the UK—one of the people’s strengths in business and as a culture—is that when they face an issue, Brits will look at it and sit on it. Unless it’s really important, there’s no sense of urgency to address it. They leave it there and think about it. And because the environment keeps changing, after a week or a month, their perspective is different. That’s one big thing I’m trying to bring from the UK to Japan.

What is the problem we’re trying to fix? Can we look at it from different angles? We have a tendency in Japan to be unclear about the problem and, there­fore, the solution isn’t right. Slow down, iden­tify the problem and be clear about it. As the English would say, sometimes problems fix them­selves. That’s a richness about the Brits. They have this ability to sit on a problem, look at it and reflect on it from different angles, then act on it. We’re trying to embrace that here as part of our GSK culture.

Virtual and face-to-face “Coffee with Paul” sessions

How have your Listen & Learn Tour, Comm Cell and other engagement efforts helped?

One thing is that we hold casual, small Coffee with Paul sessions with employees every two weeks—we’re doing them almost every week right now during the Covid-19 situation—and we capture all the questions and comments from employees. We review these every two or three months and see what actions we should take next. One of the things we identified was the need for more dialogue and feedback between managers and staff.

Also, we hold town hall meetings called Let’s Talk every month or two at which we share the company direction. At Let’s Talk, we also encourage each employee to share their recent successes and lessons learned. At the beginning, people hesitated to speak up. Recently, however, more and more want to speak at such occasions.

In connection to the business, these sessions have helped us serve patients better by creating more cooperation among the different functions. For example, it has helped us to be better at provi­d­ing our healthcare and drug information to doctors when we launch new products. The open-conversation culture between the functions accelerates things and creates a better atmosphere in the office.

It also helped us perform better when working with healthcare professionals last year when we launched our new product for chronic obstructive pulmonary disease, which turned out to be one of the most successful launches of the product world­wide. So, the culture we are creating is nicely connected to the positive results for the Japan business. If you bring people with you, engage them, explain the why and provide clarity about what success look like, the possibilities are unlimited. It’s been just great. It’s a fun place to work.

Has the office climate changed to reflect this?

When we moved to this office, the concept was to build a flexible and inspiring space where people can perform better. For example, we removed personal offices for all the executives, so there are no personal offices for anybody. There are no walls between staff and executives. None of the desks are fixed either, so anybody can sit anywhere, and there are so many areas where we can talk or openly discuss things. That is helping us to interact better.

And we’re trying to go beyond this. It’s one thing to have a nice office with no walls separating people and so forth. But more important is what you do in that office. The feedback we’re getting is that the executive team is more visible than ever, and they go and talk with people. How was your weekend? Thank you for the great presentation you did the other day.

Because of the transparency, we have clear metrics in terms of how we measure our innovation, performance and trust. And it’s available out there—anyone can look at it. Transparency is important. At Comm Cell, we get together in the middle of the 17th floor and, as an executive team, we love to have fun. People can hear us laughing. We also love to have a conversation with healthy tension. They hear that, too. It’s this atmosphere of support­ing each other that is critical.

How is GSK helping the “new normal” here?

GSK has been at the leading edge of teleworking, and we have a beautiful space for conducting webinars. We have been using the technology for many years.

So, in this severe situation with the coronavirus, we’re leveraging the capabilities that we already had in place while also prioritising the safety of our employees and their family members. But we can absolutely do more. We, as individuals and as a company, need to think about the safety of society beyond ourselves. With the new ways of working, including work-from-home and the utilisation of digital technology, we can also contribute to the new normal.

This virus is, of course, difficult, but we’re all here to support physicians and patients as much as possible. This is our commitment. So, the way we’re dealing with the situation for the time being is to align ourselves with the government, physicians and clinics. Our presence is important.

And we do the same here. As we discussed earlier, we’ve significantly increased our visibility as leaders. In my case, I do live Let’s Talk mini sessions every week. People use an online tool called Pigeonhole to ask questions, and I answer them on the spot together with some of the execu­tive team members. We also meet with the issue management team three times a week, and we share the actions and decisions to all employees.

Our strategy is simple. We overcommunicate with employees, and we’re getting good feedback about it. During this crisis, people understand it’s important to work from home, so we’re trying to keep them feeling connected and to provide more and more information—and sometimes laughter—to keep them connected and help them understand the company’s direction.

How is GSK supporting the community?

Currency of trust is so important to us. We take this very seriously and we’re really proud of what we’re doing in terms of aligning ourselves with societal expectations. Our commitment to the community is a very big part of GSK. We have a system called Orange Day that allows our employees to take one day off to spend on volunteer activities.

Last year, 60% of employees took Orange Day. Sometimes it’s used to go out and support the parents of child patients, and sometimes it is used to help the camp for disabled children. It’s not only to contribute to society. Through these activities, people can realize that, as responsible citizens, they can contribute and learn from things that they don’t usually do.

What does 2020 and beyond hold for GSK?

From a culture point of view, I’m really proud of the journey that we have started, and I think the coronavirus situation will accelerate that journey. When you have to deal with a crisis like we’re in, it creates amazing teamwork. My colleagues are supporting each other like I’ve never seen before, and there’s a sense of caring among our people—whether at the head office or in the field. More than ever, there is a sign of respect in our Values and Expectations, and people are rising above those expectations. I’m super energized and I know that this Covid-19 crisis—as difficult as it is—will change the way we work as a team.

From a business point of view, we’re committed to growth in this market, despite the fact that the market is declining. It’s important to grow in the right way, which means supporting employees, support­ing more clinical trials in Japan and invest­ing more. It’s important to grow and to make a profit so that we’re able to reinvest in R&D and in our people.

While our current business focus in Japan is on respiratory and vaccines, GSK’s next focus is oncology with several global assets in our pipeline, and we would like to bring our progress to Japanese patients as soon as possible.

I’m proud that GSK, globally, has the techno­­logy to support global health by assisting the development of vaccines and medicines, which will protect and help people do more, feel better and live longer. It gives great hope for us and, I think, the whole population. That’s something that makes me proud of working for GSK.

From the patient’s point of view, and for the business, we’re pleased to be launching several new products this year, and next year will be the same. We’re back in immunology and oncology as a business. We want to make a difference. We’re approaching all this by bringing leading-edge science to the challenge. That’s our mentality.