In some places, championing awareness for heavily stigmatized diseases like HIV can still be a radical act. Janet Dorling, senior vice president of the intercontinental region and global patient solutions for Gilead Sciences, is well aware of this reality.
As the executive who leads Gilead’s business units responsible for more than 150 countries, including many middle- and low-income countries, she’s heard firsthand the kinds of challenges those living with and advocating for these diseases face every day. In her first 90 days on the job, Dorling traveled to nine of those countries, meeting with local Gilead teams and local stakeholders.
“I personally have a practice [that] if I go to a local market, I don’t ever want to leave before I’ve talked to a healthcare provider or a community member,” she said.
In one market, for instance, Dorling sat down with a group of what she called “professional activists” who’ve dedicated their lives to HIV advocacy, despite the dangers of that work in their country.
“As we were talking about what we can do to partner and help, it was impressed upon me that their lives were in danger every day trying to do what they needed to do for the people that they wanted to help in their community,” Dorling said. “They have to be worried about someone coming and raiding their small office.”
Although she already knew about such dangers “on an intellectual level,” hearing someone say it from across the table was different. Dorling said the experience changed her perspective; gave her more empathy, understanding and compassion; and made her think about ways she and her team can provide support.
"It is a big job and there’s so much to do. It’s all around creating partnerships with purpose."
SVP, intercontinental region, global patient solutions, Gilead Sciences
“That was a really meaningful moment in those first 90 days, and I carry that with me as I think about doing my job every day,” she said.
Gilead’s been a leader in the infectious disease space for more than 30 years with heavy investments in HIV and antivirals in particular. Its HIV drugs include the first single tablet regimen for treating the disease and the first once-daily oral medication for pre-exposure prophylaxis to prevent the virus’s transmission.
In the last few years, Gilead has also worked to expand its reach in oncology. It added the first-in-class breast cancer treatment, Trodelvy, to its portfolio with the 2020 acquisition of Immunomedics and received an additional key approval earlier this year when the FDA expanded Trodelvy’s use. Its pipeline includes candidates for breast cancer, cell therapy and solid tumors.
A molecular biologist by training, Dorling has been with Gilead for nearly four years, and was SVP of global commercial strategy and operations before stepping into her new role in July. Prior to working at Gilead, she held commercial and marketing roles at companies like Genentech, Roche and CymaBay.
Dorling’s new position is two-pronged. Leading the intercontinental region is a more traditional commercial role, working with upper- and middle-income markets in parts of Asia, the Middle East and Latin America. Global patient solutions are all about sustainable access, focused on reinvesting in local communities and expanding patient access in mostly low- and middle-income markets. Combined, these two organizations cover more than 30 million patients living with HIV, more than 30 million living with hepatitis C and more than 200 million living with hepatitis B, she said.
“It is a big job and there's so much to do,” she said. “It’s all around creating partnerships with purpose.”
PharmaVoice spoke with Dorling about her first 90 days in the role and her plans moving forward.
This interview has been edited for brevity and style.
PHARMAVOICE: You have said you want to spearhead a new era of health equity. What does that mean to you and how are you doing that?
JANET DORLING: One of the things I like most about this role, and that I'm really excited about, is that we get to partner with different organizations working on the front lines. Achieving progress toward global health equity is not something we can do alone. We are doing this by not just being focused on medicines or pharmaceuticals, which is clearly where we have a lot of strengths, but I think we have in these partnership the ability to address the underlying health inequities, whether it’s barriers to care, cultural issues [or] issues in how healthcare is administered.
For example, our team in Taiwan, which has been advocating for better HBV [hepatitis B virus] care since 2019, were able to expand the criteria of reimbursement for chronic hepatitis B treatment to enable broader access to patients at high risk and provide medication earlier in the disease progression. This is where we’re working with patient advocates, researchers [and] key stakeholders in the government. In doing so, we went from having a somewhat limited set of patients that we could treat for HBV, and now we have broadened that. This is going to really help us make progress toward our goal of elimination of HBV in that country. It’s not Gilead doing this alone. There’s no way. It’s really about how we partner across a lot of different functions with a lot of different stakeholders to make that change.
You’re a few months into your new role. What’s next on the agenda?
One of the things I'm really excited about is a transition that's already starting in the HIV space, which is looking at long-acting treatments. If you look across the industry, there are a lot of new approaches coming. There are orals [and] injectables, but if you're thinking about what patients need next … it’s in some of these different modalities for administration. Looking at partnerships through that lens of how we might approach long-acting [medicines] in HIV is something we're thinking about.
We're looking at that all over the world, but a big focus is in places like sub-Saharan Africa, where we have an opportunity for making an impact on patients. Sometimes it’s very hard for people to get to a place to pick up their medication, and it's hard for them to carry medication with them. So having something that people could take, or might not have to carry on their person or have hidden in their house could be really meaningful. Our piece is [figuring out] how we need to evolve our current partnerships, and that’s something that's in progress. But more importantly, are there different ones that we need to make so that we can enter the next evolution of HIV care for patients?
As you’ve talked to people around the world, what’s something that you’ve come away with in terms of action items?
I was in a clinic in another country in Latin America, and what they impressed upon me there was that we needed to have a longer-term approach to partnering. We needed to be thinking several years in advance, [such as] looking at the impact of HIV on the aging population. This is a fantastic problem to solve because a lot of times in the past, we didn't have people living so long with HIV. What are the things that we need to study and do research on now so that we have the right answers in the time frame that we need them? It's another big learning I had in having that discussion, and now we're following up on those conversations.
Gilead has been accused of delaying new medications for profit. How are you navigating that?
I haven't been asked that specific question. My goal and Gilead’s goal is bringing solutions to market in a patient-centric way. We're always looking to do the best we can for patients, and we do it as quickly as possible. I’m glad I haven't gotten that question because I feel so focused on all the positive things we can do. I've just seen a relentless focus, work ethic and commitment to this global community and continuing health crisis.
Gilead’s been making strides in oncology. Can you talk about your role there?
Oncology is our newest area, and we are just kind of breaking into it. I already have our first oncology product, Trodelvy, in a limited number of markets in my organization. Much more of what I'm doing is building infrastructure and the capabilities that we need longer term … we’re in a build phase. That is consistent with the broader approach at Gilead. We’re a new player in oncology. I know from working at previous organizations that there's a lot of great work in building infrastructure for oncology and for global health. I'm also looking to learn and see what some of the best practices are there as we follow in some very fantastic leaders’ footsteps in oncology. What can we learn, and what can we do better? For me right now, I'm hiring people who understand oncology; we're starting to build those initial teams and build understanding with the hope that it will be a bigger part of my organization in the future.
Does the huge, global scale of your job overwhelm you? Or does it energize you?
If I'm honest, the only thing that overwhelms me is that every minute we spend and every dollar we spend, we need to maximize for patient access. I feel an immense responsibility to make sure that we're very thoughtful. But mostly, I find it incredibly exciting because there's so much we can do, and I'm just getting started.