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It’s just over two years since the first Pfizer Covid jabs reached Britons’ arms, with the goal of quickly preventing deaths and halting further strain on the NHS. Now, the US pharmaceutical giant hopes once again to play a part in protecting the health service, at a time when staff are striking, waiting lists in England stand at more than 7 million, and the organisation is at breaking point.

Pfizer’s president in the UK, Susan Rienow, is lobbying to switch the focus towards early-stage illness to prevent people being hospitalised. “We have a once-in-a-generation opportunity coming out of the pandemic to try to break the cycle of ill health that holds back the economy, the NHS and the health of the population. The key to that is prevention,” she says. “We don’t have enough hospital beds for all the patients who need them.”

Rienow hopes Pfizer can help move the system from one “prioritised on end-stage disease and significant ill health to a place where we’re actually preventing people from getting sick”.

To this end, she is attempting to tackle “the silent pandemic”: antimicrobial resistance . For years, scientists have bemoaned public apathy about bacteria and fungi that develop an ability to defeat drugs designed to kill them. The World Health Organization estimated that 1.27 million people died due to this resistance in 2019, and this figure is expected to hit 10 million by 2050. “If you’re in a situation where you don’t have working antibiotics, you almost go back to sort of a medieval dark ages,” says Rienow.

The American executive, a Pfizer lifer with two decades at the company under her belt, has made the resistance threat a priority since taking charge last February.

We meet at the firm’s UK headquarters in Surrey, a complex designed to look like a hand from the air. The “palm” is a spacious grassed area where rabbits appear and the occasional deer has been known to leap the fence. Mist covers the tranquil scene – it’s hard to believe this company was at the centre of the global Covid fightback and all its associated controversies. There’s no sign of white lab coats (the firm’s scientists are in Kent) and the offices are sparsely populated, with endless rows of empty desks a reminder of the pandemic’s remote-working legacy.

Pre-Covid, Pfizer’s public profile in the UK largely extended to its landmark erectile dysfunction pill, Viagra, and a failed £69bn tilt at buying AstraZeneca in 2014. Fast forward six years, and both companies were racing to develop a Covid vaccine – Pfizer teaming with BioNTech and choosing not to take US government support, but to make a profit. Astra, meanwhile, partnered with Oxford University and pledged to simply cover its costs during the crisis.

To date, Pfizer has shipped 4.4bn vaccine doses to 181 countries. The firm invested $2bn (£1.6bn) in research and development before regulatory approval, so without a guaranteed return. But it has since raked in $75bn in vaccine sales (and $18.9bn from its Covid pill Paxlovid), triggering accusations of profiteering. Its stock has risen more than 60% since March 2020, to value it at $248bn.

Is Rienow comfortable that Pfizer didn’t profiteer from a horrific global crisis? “Very comfortable. The scale of [our] intervention has never been seen before. It was $2bn when you don’t know if you have any revenues at all.” She says executives had a “moral clarity around the importance of what we were trying to do”.

The firm remains in the crosshairs: last month its chief executive, Albert Bourla, was interrogated as he walked through snow in Davos over Pfizer’s vaccine venture.

Then, recently, users making false claims that Covid-19 vaccines caused spasms went viral on social media with the tagline “thanks Pfizer”. Are the anti-vaxxers frustrating? “It is important that if people have questions about the vaccine that they aren’t dismissed. They should speak to their doctor or look for credible sources … and not just take what they see on social media at face value,” Rienow says. “We’ve tried very hard during the pandemic to be as transparent as possible.”

Rienow, whose father was a heart surgeon, was born one of seven siblings in North Carolina and moved around the US before starting her career consulting in Boston for companies including Pfizer. Before long, she moved in-house at its New York HQ and then to Belgium, Japan, Australia, South Korea and the UK, where she landed in 2015.

She first led Pfizer’s critical care division, and then took on its vaccines business just before the pandemic. She is guarded at times, declining to answer questions on whether the NHS should offer an annual Covid booster programme, on perceptions of big pharma, or on how much she is paid. (Her boss, Bourla, received $24m in 2021, a 15% bump). A senior pharma industry executive describes her as “thoughtful, pragmatic and authoritative”.

Her plan to get to grips with antimicrobial resistance includes a new funding method agreed with government which sees Pfizer paid an annual subscription for antibiotics rather than by volume used in the health service. This will encourage research and development of new drugs and reduce the incentive to overuse some existing ones. “It de-links volume from revenue and thinks about the value of the antibiotics in terms of what it does for society and reducing resistance,” she says.

During his leadership campaign last summer, Rishi Sunak set out a vision of the UK as a life sciences superpower. More recently, Kate Bingham, the former chair of the UK Vaccine Taskforce, and GlaxoSmithKline chief Emma Walmsley have raised concerns about Britain’s ability to remain a force in research and big pharma.

Rienow shares their concerns, noting that the UK is falling down industry league tables for manufacturing and research investment, while clinical trials are taking longer than expected. She advocates a return to pandemic tactics, when regulatory hurdles for new treatments were cleared faster through parallel approval processes. But overall, she is hopeful. “The idea of positioning the UK globally as a life sciences superpower is something that we’re quite excited about”.


Age 43
Family Married with a teenage son.
Education BA in History, Boston University; MBA, Stern School of Business, New York University.
Pay Undisclosed.
Last holiday A long weekend in Sardinia.
Best advice she’s been given “Seek progress not perfection; manage your energy not your time.”
Phrase she overuses “This has changed the longer I’ve been in the UK – it’s now ‘Super!’ but it was ‘Awesome!’ before I moved here.”
Biggest career mistake “Not a mistake exactly but I’m always looking to find solutions where there seemingly aren’t any, which means that I don’t always succeed – but usually even in failure there are things to learn that make you better next time.”
How she relaxes Gardening and walking the dog.

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