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Exclusive Life Science Feature Zerhouni, who joined Sanofi in 2011, said he viewed the position, his first in industry, as an opportunity to transform biopharmaceutical research and development from the inside. "Clearly we need to reinvent. We have to change the culture of the industry, which needs new ways of doing things," he said. Zerhouni has long been aware of the role biopharmaceutical companies play in combating disease and improving human health. His views about why pharmaceutical R&D; has become sluggish and how it can be reinvigorated were shaped by his experiences at NIH and Johns Hopkins University School of Medicine. At the latter, he not only was a professor and chair of radiology and radiological science and executive vice-dean, he also founded and co-founded five start-ups. But more than anything, at both places, Zerhouni was a TIPS FOR SUCCEEDING AS A "CHANGE AGENT" Although "change agent" has become an overused term, it aptly describes the career of Elias Zerhouni, M.D. Before joining Sanofi as president of global R&D;, Zerhouni was a professor and chair of radiology and radiological sciences and executive vice-dean at Johns Hopkins School of Medicine and director of NIH. "I've had the opportunity to be put in the middle of circumstances in which things were not going well, and the organization's leaders recognized that they had to find a new direction," he said. To reinvent Sanofi's R&D; culture, Zerhouni took advantage of his perspective as an outsider, a native of Algeria, and a newcomer to the executive suite of a major pharmaceutical company. He came to the U.S. from Algeria in 1975 for his residency in diagnostic radiology at Johns Hopkins. "Being an outsider has been a huge benefit for me at Johns Hopkins, NIH, as well as Sanofi," he said. An outsider is more willing to question an organization's way of doing things. "Also being an immigrant has helped me to understand different points of view that exist in any complex organization, because today, all great institutions are multidisciplinary and multicultural by nature," he said. "Part of my ability to succeed in the U.S. may be that I can bring a viewpoint that many people feel is sometimes surprisingly different and constructive in showing there is a different way." Believe In Your Vision Zerhouni learned how to make things happen even when many of his colleagues thought it was impossible to do so or did not agree with his vision. For example, NIH leaders did not uniformly embrace his vision for the agency, outlined in the NIH Roadmap for Medical Research, published in 2003. Their attitude was, "Who is he to tell us what to do? What does he know?" recalled Zerhouni, whose first government job was the NIH director position. The road map called for greater collaboration among the 27 institutes and centers of NIH, a substantial investment in translational research, and the awarding of research grants to support the high-risk innovative studies that, if successful, typically have the most significant impact on medicine. Because he believed these and other initiatives would strengthen not just NIH but the entire R&D; ecosystem, Zerhouni turned to the U.S. Congress to enact legislation. The result was the NIH Reform Act of 2006. "I wanted to make sure the change we implemented at NIH would be institutionalized," he said. "When I set out to change the law governing NIH, due to the very partisan Congress, very few thought it would happen, and yet it did, despite great opposition, thanks to a lot of strategic preparation with the relevant senators and congressmen over the preceding three years." You Will Become Unpopular A successful change agent must not be afraid of becoming unpopular. Because change is uncomfortable for some people, you will likely become unpopular. "Twenty percent [of the people you are working with] will be rabidly against you." Zerhouni said. However, if the change makes sense to them, most people will not oppose it even if it is unpopular. "Twenty percent will agree with you and will say, 'He's right, we need to move on to do things differently if we're going to adapt.' Sixty percent will be in the middle. Their attitude will be, 'I want to see more. Let's see how things go.' They may not like the change, but will respect it." You Can't Do It By Ordering People Around In his past and current leadership positions, Zerhouni could have mandated that his vision be implemented. "But that would not have changed anything," he explained. "You must understand that you can't bring people to the same passion and vision that you have because of your position of authority. You can't do it by ordering people around." Change agents should not compromise their vision to win the support of staff, he noted. "You must believe in your vision totally and have a deep understanding of what you want to accomplish and what makes you, as the leader, excited about it in a genuine way." Rather than order staff members to change, Zerhouni persuades them. "You first have to persuade others of the need for change, and then organize a fair, open process for all to participate in earnest and have the resilience and courage to implement what was agreed upon." Zerhouni also said that change agents should be transparent. "You can't motivate others by not being genuine," he said. "You want colleagues and staff to realize that you're not initiating change for your own self-interest." 32 LifeScienceLeader.com August 2013