Every leader's journey is shaped by a handful of defining decisions. Those moments of risk, doubt, and conviction that influence their lives and careers. In this podcast, we get to hear the stories behind those choices. Welcome to Executive Decisions with me, Steve Sedgwick.
I think it's easy to get too fixed kind of in your career as well. And yet I think to be open to possibilities that a decision in one direction could open three other decision doors in another direction.
As the son of two first generation immigrants to United States, Vas's life and career have been guided by a core mission instilled by his parents.
By bringing me back to India. Many times in my youth, particularly my mom, she would always take us back to say you've had these extraordinary opportunities to get to the US to get an education. What could you do for the world? Like what could you do to impact the world with the opportunities that you've been given?
After attending Harvard Medical School, Vas considered becoming a doctor, but instead he went to consultancy McKinsey before settling at Novartis. When he eventually became CEO, the company was embroiled in scandal and faced several investigations.
Talk about getting thrown into the maelstrom. It's easy to coach new CEOs about these things, but when you go through it and it's the first time it's your name and seeing all of that, it's jarring.
These are Vas Narasimhan's Executive Decisions.
I've had the privilege of interviewing you throughout your career as a CEO at Novartis, but I haven't got to know you. And as my preparation for this has gone on, I've just found you unbelievably fascinating already as well. Why don't we start off earlier on though with your parents and the importance of where you come from?
Hey, look, Steve, I always say we stand on the shoulders of giants. And I think about the journey of my grandparents coming from really small villages in southern India, farming villages. My parents making the grand trek from India to the United States, and then growing up as an immigrant kid in Pittsburgh, Pennsylvania, a steel town, but it was a steel town back then. And they put inside of me the values that I think I cared for today. You try to impact the world in a positive way. You do it with humility and kindness. You're always trying to learn about yourself and learn about the world. So, it's been, I'm very grateful for all that they've done.
Your mother was a nuclear engineer. Your father was a senior executive at Hoeganaes Corporation as well.
Well, thank you. We try. Having a mom especially with that kind of pedigree is phenomenal.
My mom is a brilliant, brilliant person and she managed to raise three boys while being a nuclear engineer at Westinghouse while still trying to make ends meet. So I think that was really important for us to see, right growing up. And then my father having come from nowhere to come all the way up to the executive ranks. Even during his career he would make multiple steps where really high-risk steps, leave his job, get another degree, bet on himself again and again, always with this kind of boundless optimism, and I think that carried through into me as well.
Yeah. I read somewhere that you one of your key aims as a young man was just trying to fit in. You know you're coming from an immigrant background as well. Was it hard to fit in?
Well, you know, I think it was, but we had a beautiful community there in Pittsburgh. Actually, my parents helped found a temple there. And I actually grew up, even though I was growing up in the United States, I grew up really grounded in Indian culture, Hinduism. Books I now still quote like the Bhagavad Gita were important in my upbringing. So, I always had a sense of belonging there. But of course, at that time, there wasn't large immigrant communities in these places where I was going to school. So a big focus was yeah just trying to fit in. You know sometimes it was funny, I would only know the words for things and the language I learned first which was Tamil not English, and always trying to catch myself when the kids would then laugh at me. I mean little things like that, but it was still a wonderful childhood.
What drove you as a young man?
You know, I think my parents instilled in me this idea by bringing me back to India many times in my youth, particularly my mom. She would always take us back to say you've had these extraordinary opportunities to get to the US to get an education. What could you do for the world? Like what could you do to impact the world with the opportunities that you've been given? And going back and seeing that of course especially at that time in India you would be seeing that there are millions, hundreds of millions of people without those opportunities, and so I was left with that thought that I've had the privilege to have these opportunities, it's not a given, just a luck of the draw in many ways, and then what can you do with that to make the world better.
Yeah. Did you always want to be a doctor?
I think very early on, if you probably saw in the history even in college, I went to Africa and I went to West Africa and I went to the Gambia, to work with the Red Cross, and probably it was that experience that more than any other really instilled in me this desire to pursue medicine and public health.
Because you also looked at child poverty in India and you were in Kolkata and other places, studying HIV treatments in Botswana. Part of me can see how you could have gone down that route and stayed with people at Medicine San Frontier and working in humanitarian relief, working in the charity sector as well. I can easily have seen you going that way given your resume.
Well, first I want to make a call out there. You know, when you go back to Kolkata, that was actually the first trip my wife and I took and we had only been dating for like 3 months and we ended up working with street children and child laborers in Kolkata together. So, think about a love story. That was like an interesting place to kind of, but we it was a crazy, crazy time then in Kolkata but we managed and it was incredibly rewarding. And then as you said, to be part of the first HIV AIDS treatment effort in Africa and Botswana was extraordinary. But you know through those experiences I also saw that in many of these ways, management, leadership was not very evolved in public health and so I think my first step into the business world was very much motivated by that desire to learn how to lead, learn how to make change happen at scale because I think the history is that usually a great physician is just thrust into a leadership role without any of the experience, and that's what I was observing on the ground. So that's where the initial inclination came from. Now I had no idea I would end up being a CEO. It was always like I'm going to go to business and come back to public health and then one thing led to another.
It's really interesting because more than one of my guests on this podcast said I always knew I was going to be a CEO. I always knew that was the aspiration as well, but for you that wasn't the goal. That wasn't you weren't making an early decision to be a CEO. I think the idea of becoming a CEO only fully occurred to me 6 months before I became CEO of Novartis.
But you had you had a whole series of management roles, we'll come to your evolution of your career from 2005 onwards over at Novartis. But I would have thought that it would have been at the back of your mind.
You know, when the global head of human resources then at Novartis said I was one of the candidates that they were considering for the CEO role, I thought he was actually joking. I mean, I was like, me? I'm like a physician scientist working on drug development. Yeah. So, it never occurred to me honestly.
Sorry Vas, You're one of the smartest people I know, how did you not spot that?
I missed it. But, you know, I'm kind of, another thing my parents gave me was this notion you have to throw yourself fully into whatever you're doing at that moment because who knows what comes next. And don't worry about the result. Throw yourself into the process. Whatever role I was in, I was all in and it never was thinking about and that's the best advice I'd give to young people listening. Don't always think about the next role. I mean, think about how you can maximize the experience of the role you're in.
You are a very smart guy. Although you're the second smartest person in your marriage from what I can see. Your wife's got more Harvard degrees than you.
That's absolutely true. Absolutely true.
But you kind of found it easy to talk to smart people on a smart level but actually hence you mentioned the scientists but on a broader level not everyone's got your IQ Vas, you know, and did you find it hard to relate to the rest of us the mere mortals of us out there.
Well, I think there is that element of communication, but I think there's also an element of getting to what are the underlying things that drive people and really understanding that it's okay that people have different motives and different drives, but you as a leader have to find a way to tap into that and really get people to do extraordinary things. That's what we tell leaders. Leadership at Novartis is getting ordinary people to do extraordinary things. That's what we need to be able to do. Autonomy, mastery, purpose. It kind of covers it, doesn't it?
Autonomy, mastery and purpose. Yeah. So Daniel Pink's work and we've I've talked to Daniel now still ongoing for many years. I still believe he's got it. For most people once you pay them enough, it's not paying them more is not going to motivate them even more. But it's the idea that they're working for something that's bigger than them. That they have the freedom to do that work which we later called unboss and then the opportunity to grow as people. You should really be talking about mission and purpose three times more than anything else. I mean many people have talked about this. Simon Sinek, Adam Grant, many of the leaders that I really think again Adam Grant. Yeah, you know, start with why. Leaders start with why. And you should be talking about the why we're doing the work three times as much as the what and the how because that's what really can motivate people. But the art of it is not just the big P purpose always. I've learned over the years it's not the big P purpose always. You also got to bring it down to the little P purpose. I love the story of people who work in our manufacturing facilities cleaning the facilities. And when you ask them why do they do what they do at Novartis, they say we're saving people's lives. Yeah. Because they've connected the work they do in that facility to the bigger purpose. And so you have to be able to make those connections. It's not enough just to say let's reimagine medicine because somebody in our organization seven eight levels down has to understand what that means for them.
I want to just mention your wife as well because we've already talked about her. She's an incredible woman in her own right. She's the CEO of Idorsia pharma now as well, lives with you in Basel with your kids. She's got four Harvard degrees, which I hasten to add is more than you, isn't it? I think so. It is. But you've mentioned her about three times, so she deserves an honorable mention as one of your key... She's your partner in this, isn't it? This isn't just you, the CEO. This is you together, isn't it?
Absolutely. And my best friend as well, but I think throughout the ups and downs, we've been on this project, whether it's the streets of Kolkata, whether it's the hospitals of Africa. Now, interestingly, both as biopharmaceutical CEOs. I haven't, I'm not sure if it's true, but I think we might be one of the few or the only married couple that's both CEOs of public companies, maybe in the world, which is kind of incredible thing. Um, yeah. So, it's been extraordinary and I would be nowhere without her. Uh, for sure.
One thing that's really clear is having one amazing career is tough on the family and is tough on the relationship. Having two amazing careers, you must make some really tough decisions. And again, this is not a Novartis thing. This is about you and your amazing partner in life. How do you make those decisions about what you prioritize and when you prioritize?
Yeah, I think early on when the boys were young, we have two incredible incredible boys. Early on, actually I took the lead. She was traveling. She was a McKinsey expert. She was traveling around the world working on projects. I was kind of muddling my way through as best I could trying to get the kids to daycare. Then, you know, she took the lead on the kids and my career at Novartis really blossomed. And then, look, when the opportunity to become a CEO came up, we talked with the boys and we said, 'Are we willing to do this as a family?' And my boys said, 'We want to make this happen for our mom.' And so, we figure it out. I mean, and so it's not always easy. I don't have a magic formula to make it happen, but we figure it out.
Quickly, you just mentioned McKinsey. Why did you join McKinsey? After all the amazing life experiences you had after from Botswana to Gambia to Kolkata, you end up at McKinsey.
Yeah, it was interesting. But you know, I am very grateful. I was there. I was there for 18 months, 20 months. But in that time, I learned so much for somebody who'd never been, you know, done an MBA or knew anything. I didn't know what a balance sheet was. I didn't know anything about P&Ls and valuation. And I'd been trained in medicine. And then I learned all of that and I got to apply it in the business world. I think of it as I learned another language. Like you have to as leaders you have to be able to speak different languages, you have to speak medicine, public health, finance and business, and you have to be able to communicate and I learned that.
But that decision speaks volumes to me. You didn't go to one of the big hospitals, you didn't go to big teaching hospital to carry on that side of your career. You went to McKinsey instead because you knew you wanted to make a bigger impact in health and health services. It wasn't going to be medicine, it was going to be scientific?
I wasn't exactly sure, you know. And that's the point, young people shouldn't be sure. I mean, I think people watching should know these were all just experiments. I was in my kind of late 20s. I was like, go, let's give it a shot, right? Maybe McKinsey will lead to something or maybe I'll just go back to medicine. And I had no idea where it would go and I had no idea that McKinsey would lead to Novartis, right? So then when that happened and then suddenly I was sitting in Basel, Switzerland working for a pharmaceutical company. Suddenly my mother was asking me what exactly is the plan right now? So I thought you were going to, you know, be working at a hospital. You're a Harvard Medical School grad. I'm with your Mom, this is where I was going with your history.
