Stéphane Bancel: The 5% Bet That Built Moderna

Thank you very much Philip for having me. It's a pleasure.

It's a great question, Jean Philip, and it's true that I think for all of us, at least for me, for sure, those early years growing up and discovering the world and who I was and who I am, were shaped by and I think you touched on all the key of them, maybe a new one I'll share with you. So, of course, my mom is very demanding which I think has stayed with me for a long time. And I think she became even more demanding once my parents divorced because she felt a lot of responsibility to raising my brother and I. The Jesuits have had an amazing impact on me, very profound that I only realized maybe 20, 30 years after and it's for very simple reason as you would appreciate which is I only lived my own life. And so given I went to school since CM, so middle school, to a Jesuit, all the things we'll do in term of education, engagement to the community, helping others and so on just seemed normal to me because I knew nothing else, right? And I think this passion I have for medicine, using our time on this planet to help other people through medicine. Even when I was at bioMérieux, it was still the world of medicine, diagnostic disease. I think so had a very profound impact on me. The other big impact that had on me that I didn't realize until maybe a few years ago is my dad used to love sailing and he was kind of nuts but actually they moved to Marseille from Saint-Étienne because he wanted to sail all the time. So not because of soccer obviously. And it's interesting because we will sail all the time. It'll be raining outside on Christmas day. We'll go sailing. And the piece I realized much later that growing up on the sailboat, it wasn't a big boat. It was a 30 ft, 10 meter boat. Taught me to enjoy adventure. We always go to places we never been before. You know, try to be on the middle because there's no GPS of course when I was a kid on the middle crossing to Corsica and trying during the night to look at the radio and try to do on a map the different axis to figure out where we were roughly. And I think the sea teaches you a few things. I mentioned that to my team last year when as you know we've had quite some challenges with the US administration on science, NIH, vaccine, mRNA and so on and I told my team I said look the thing you learn sailing is a few things about a storm. The first thing you learn is that when there's a storm you need to be very thoughtful and you need to be very calm because overreacting is usually when people do something silly that end up being sometime bad or very bad. And the second piece is a storm will always go away. You don't know if it's going to be a day, you know, three days. But the storm always end up passing. And I think this side of adventure to be comfortable in the unknown has been critical for me as a CEO of Moderna because as you know there was no mRNA company before. Nobody knew if mRNA was going to work when they decided to join Moderna when it was a one scientist company. Most of my friends told me not to do it because I had a great job at bioMérieux and bioMérieux is a great company. And so I think this sailing also taught me the sense of adventure and dealing with the unknown.

Oh for sure. And I think again the passion for doing medicine is really helping people. I mean some of the basic Christian beliefs but I think it's true in most religion which is you know being a good person, helping people around you, welcoming people, you know all those basic I would say Christian teaching again that you see in all the big religion have had a huge impact on me. I could not see myself not doing what I'm doing. It's interesting this week, Jean Philip, at one of my weekly lunch meeting with 20 employees selected randomly just to catch up and get feedback from the team. I got asked a question that I've not been asked I think ever. And the question was like if you are not in life science, what would you be doing? And I paused because it never first crossed my mind I would not be in life science. And then I paused I say I will be working for clean energy. Ah, you know, one of the things that I've done recently is I joined the board of a fusion company. Trying to make energy out of fusion. It's called Zap Energy. It's an amazing team out of MIT. And the idea that you could do like a little sun, you know, plasma into a factory and create clean energy without the toxic waste that we have with nuclear energy will be of course amazing. A glass of water will be all the energy I consume for a year which is kind of crazy to think about it including my travel by airplane and so on. And so I think this teaching from the Jesuit and this Christian teaching of doing good and helping others has of course had a very very profound impact of how I think about the world.

And the other one is I think on the philanthropic side which I never talk about.

Okay so I will wait.

So it's interesting. So first I was very bad at geography and history when I was young because studying about the past I thought I was not interesting and I'm dyslexic and so remembering geography and so was not something easy because I was not very interested. I became interested more as an adult and read a lot of books and so on and geography is because geography as you know well has a huge impact on history. And I got really the travel bug when I started working in Asia and discovering cultures and people. It was really interesting for me as a 23 year old living in Japan full-time. I think I started to understand the French culture, the good and the bad of a French culture when I was out of a French culture by being in Japan. I also learned a lot of great thing about the Japanese culture. Some not so great thing about the Japanese culture and I really got the bug of discovering the world and as you know I lived in many countries in Europe and in the US. I think this is my fourth time living in America. And this time is 18 years. So it's a I've not done the math yet of when I would have lived more in America than actually in France. And so, history is interesting because it teaches you how to think about things and how to think about humans because at the end of the day, business is a group of people working together to do something for other people. And the human interaction, the human psychology, I think, is something really important and very interesting. And I think you can learn a lot from it through history. I love business and so I got into learning about business history. How company were built 50, 100 years ago. As I like as I talk about AI to my team to remind them that there were companies operating before there was electricity. I know it's hard for most people to even think about it but the railroad companies were built across countries when the steam engine was discovered and invented. There was no electricity. So everything was written on paper on notebooks, right? You couldn't pick up a phone and call somebody or send an email. But those massive national enterprise still were run most probably we'll see today very inefficiently but they were run. So I think there's a lot of interesting thing about history that can be used in every day and also as you think about where the world is going because I think as a leader of a company I need to spend a lot of time thinking about where the world is going. The world in general and the world of life science and medicine in particular of course.

Yes, I think the world has as you know many more tensions than we used to have 5, 10 years ago. The world is much more polarized. I think personally that technology has played a big role in that polarization that some politician have exploited. On some parts there is more collaboration and I see some pockets of more collaboration than two or five years ago and then some parts of the world where there's much less collaboration than we used to have 20 years ago which seems a bit crazy because one will think almost linearly about where the world is going and actually and again you go back to history you see that through history where you have those phases of huge step forward and then step backward and a huge step forward. Humans have not evolved on this planet in a linear fashion and I think we just at another moment where this is happening.

So it's interesting. So you're correct as in sales and marketing. I thought it was really interesting to learn how do you serve a customer because at the end of the day in any business and I love businesses and I don't see myself doing anything but working in companies. You are here to serve customer whether it's a product or service and being at the interface I think teaches you a lot. And so I wanted early in my career to have that experience. I was very lucky that the team at bioMérieux allowed me to do that because it's not the linear path and I've learned a lot which by the way made me realize that I didn't know much about business that I went to business school.

So, it's interesting. As I told you, a lot of my friends and family members told me not to do it, except actually my wife told me to do it. And my wife is interesting. She's not a scientist at all. She's a photographer, creative person by background and now she's running a philanthropy full-time. But she got very excited about how I was describing medicine that we could do especially for kids with genetic disease using mRNA. And as I was describing all the challenges and this is where the 5% came as a very low odds of this working. She actually told me you have to do it. And I look at her puzzled say what do you mean I have to do it? She said you are so relentless and bold and stubborn. She added that if it's going to be that hard or that improbable of working, you will find a path. You will get around you the right people, the right team. You will set a culture of relentlessness. You are so obsessed about again going back to Jesuit with peace to doing good for the world, good for people, you will find a path and so you have to do it which became an interesting moment in our marriage was like I think this is crazy. Everybody around me tell me I should not do it, all my coaches, except my wife who by the way is not a business person and doesn't understand science. I'm like okay but I think she had the key sense of a mission of a company at heart from day one. And then the reason why I decided to do it is it became very clear if you look at the history of the biotech industry. The biotech industry Jean Philip as you know was started by Genentech and Amgen in the 70s and if you look today most of the drugs that are the most impact in cancer or think about the GLPs or anything you want they all are biologics products. They come from a biotech technology, biotech industry that those two companies started 50 years ago. And so I use the biotech industry as a mental model to say look if we can make mRNA work and you take a 30, 40, 50 year arc and you think about what medicine you could do, you cannot even think about the medicine that you could do. We had a town hall last week with our team after our Q1 earning call and I closed by telling them I still believe that we have not invented yet our best drug despite we having amazing drugs including what we did during the pandemic for COVID. I don't think we've invented yet our best drugs. And so as I thought about this arc of innovation and medicine and the impact it could have on people around the planet, I'm like, you have to do it because even the upside is so big for the world that if the downside is we're going to lose some investors money and I'm going to have to find a new job because we were bankrupt and help my team find a new job. That's a very manageable downside. And the asymmetry was so gigantic between the upside and the very manageable downside that it ended up being a very easy decision.

Almost. Right. Yes. And it became even more after which is interesting because it was more intuitive initially. And as I learned more about the technology and I saw what the team was inventing and how we were going through the S-curve and the technology was improving very quickly and so on it became yeah it became almost a calling. Yeah.

Sure. So to do very simple biology, we have around 22,000 genes in our DNA so instructions for 22,000 proteins. And a third of those proteins are called secreted protein, think about insulin where they made inside the cell like your pancreas from your DNA instruction and once they made inside the pancreas they are secreted, they are delivered outside of the cells of the pancreas and they go into your bloodstream do their business. Well, two-thirds of the protein in every cell are to make your cell function. Think about yourself like a town with a lot of different jobs. You have a police and you have fire people and educators. That's what a cell does. It has a lot of jobs. And to keep the cell living two-thirds of a protein in that cells never leave the cell. And so if you make a protein in bacteria like the biotech industry does or cell for let's say cancer or insulin for diabetes when you inject it it stays inside the blood it goes turn around. It doesn't go inside human cells and so the entire world of protein staying inside cells is just unaddressable, undoable using recombinant biotech technology. And so because in the case of mRNA the protein is made inside the cells. Once we bring the mRNA we make in the factory inside your cell like we did for COVID, we are right there and so we can make any protein inside the cells that we want which is the fun part of the science.

Sure. So it's interesting to go back in time. So I was made aware of the virus as you said during the Christmas break by reading the newspaper. I reached out to Tony Fauci's team at the National Institute of Health in the US, the NIH. And they were monitoring the situation. They clearly were aware already before the news, the reporter of the Wall Street Journal was aware and they were monitoring. And when the sequence, the genetic instruction of a virus was put online in early January, we started to prepare a product to put a clinical trial because I thought like everybody at the time it was going to be like SARS or MERS or a local outbreak and then it will go away. But I wanted to prove to ourselves, to myself and to Tony Fauci that we could go in a clinic in 60 days which was what I told him before in 2019 that he didn't believe me could be done because when SARS happened it took the NIH, Tony had told me 20 months to go to the clinic. And when I told him we could do it in two months of course he didn't believe the guy with French funny accent. Plus I'm not even a biologist, not even a PhD. So, think about it. What credibility do I have to make such claims? And so my goal at the time in mid January was let's get a vaccine made with a sequence that was just published by the Chinese online. And Tony Fauci will run the clinical trial. We will have proven we can in case something really bad happened one day do that in 60 days. And then I'm in Davos and I'm monitoring the cases on my laptop. I build an Excel spreadsheet by country. And the R, you know that everybody has learned now which is the pace of contamination of people, people transmission seems really really high and as I spent time in Davos with a few people including Jeremy Farrar who is now the chief scientific officer of WHO. He was running the Wellcome Trust before. It becomes very clear that the R is very very different from SARS or MERS. And then the piece as we discussed with Jeremy because we will meet a couple times a day between meeting at Davos just to catch up. So, a few things then happened on the Wednesday of Davos. I don't if you remember the Chinese government decide to close Wuhan. And I'm like, geez, what do the Chinese know that we don't know? Because you don't close a city like this. And it's not a small city. I know most people in France or others had not heard of Wuhan before. But Wuhan is a very big industrial city. And then one of the thing I had done at Davos when I started to get more and more worried is I had look at all the flights leaving Wuhan, direct flights. And I had to realize that every capital in Asia direct flight from Wuhan, every capital in Europe and every big cities on the west coast of the US. And as I look at the R and the incubation time which you know was estimated at the time seven to 10 days and the travel and number of flights I went back in time even to when I read the article between Christmas and New Year and just calculate how many people could have been contaminated with no symptoms and I've left one. And the number was so gigantic that it became very clear that this was going to be like 1918 which again connecting the dots why studying history is helpful because I knew how bad 1918 had been when we had the Spanish flu which by the way didn't come from Spain, poor Spanish, came out of Russia. And so that's the week where I pivoted, started Wednesday or Thursday night. I forgot now of that week to realize this is going to be like 1918 and I need to change my plan because my old plan is wrong. It's obsolete.

Yes. So I would say there's some piece that are linked to the technology. It has nothing to do with my organization. It's just mRNA and a piece of what we had built. So a few things. So mRNA because it's an information molecule. I can make another vaccine on the computer in two minutes as long as I have a sequence. I literally copy and paste it to a cassette that we built before and we had done which most people didn't know nine vaccine in clinical trial before January 2020. So we have done a lot of different constructs never coronavirus but we've done flu, Zika, a few other viruses. And then the other piece we had done for cancer which is why this platform is so interesting because you can connect the dots in ways that are science fiction like for traditional pharma. For our cancer treatment which I hope we can talk about in a moment. Yes. We had had to develop a manufacturing machine to do individualized product for one human at a time. So we shrunk everything and we also shrunk the cycle time, the time it takes to make product. And so we basically use a cancer machine to make the entire lot because in vaccine the dose are much lower per human than in cancer. So you could make for the 60 or 70 people of a phase one study, you could make the entire batch. And that process I knew could take 30 days. So it took us around 30 days from mid January we got the sequence to make the product. And then it was the 30 days for the FDA to review the file to authorize Tony Fauci's team to start dosing human with a green light from the FDA.

Yeah and that was a long storm it was a couple month storm where I tried everywhere I could to raise money. I talked to every big foundation in the world didn't get a penny. The biggest one I call them three, four, five times. I even told them I will put a factory just for low-income countries. But please help me. Got not a penny. Nothing. I asked big pharma company, all the big vaccine players. They decided not to work with us. And what actually ended up saving us which is an interesting calendar from the capitalism system. It's actually it's a public market who saved me. So what happened in May 2020 we knew the clinical data were coming over phase one. And because we couldn't find money anywhere. Big pharma not helping, foundations not helping us either. The government was starting in the US to help us because in the meantime Congress had passed some budget for clinical trial. So the US was helping us as has been well documented. We got more than a billion dollar from the US government to pay for the clinical studies to be able to accelerate them without taking any safety risk for the population and the people in the study. But what was not part because your players were all big companies was manufacturing and buying machines, buying raw material and so on. And so when we got the phase one data in early May 2020, we went to the capital market to make a raise. And one of the amazing thing that happened is Morgan Stanley was one of our bank and James Gorman the CEO is retired now. Morgan Stanley called me on the Sunday and said you cannot waste time on a road show. Your vaccine is working. The team told me you're going to do a fundraising and a road show next week. You cannot. It's a waste of your time. The bank will buy everything. What? And he's like, you know, James, it's more than 1.3, 1.4 billion dollar. He's like, I know. He's like, we'll buy everything. We'll put it on our balance sheet and then we will resell it to investors. We might make a gain, we'll make a loss. It's not the point. The point is you cannot waste a week on a road show. It would be criminal now that you have the first vaccine that seems to be working in the clinic given we are living a pandemic. And Morgan Stanley and I've said that story many times and James is a great man. Morgan Stanley basically took the entire when the market closed on Monday at 4:01. We signed the transaction. They got everything all the stock. We got over cash and then we were able to use that capital to buy machine, to buy raw material, to hire people to could scale manufacturing because I think the media has done an amazing job during 2020 to cover all the different vaccine by all the companies. But what the media has never really done is a story about the incredible industrial challenge which was to go from no manufacturing capacity to a billion doses in 12 months. That was incredible and the team did it. It's really even more remarkable than getting a vaccine out of the door in a year.

Correct.

Yeah. Which is also fascinating to build on your point because again, as I said, big foundations around the world said no. Which you will think a foundation there's a pandemic, people dying, they're going to be helpful, said no. And big pharmaceutical companies that were the biggest players in vaccine in the space said no as well. And it's a public market and a bank who helped us.

Yeah, it's a great point. It was most probably the most difficult decision I made in 2020. It was very painful. We debated it for around a week and then like we cannot keep debating. We need to decide and is exactly what you described which is as we're getting the data on the trial not the clinical data but the representation of a study which is something every company gets. We had mostly white people to be simple. And because we wanted this vaccine to be a vaccine for the world not a vaccine for white people. There's a lot of things about the human body and human health we don't understand collectively around different genetic background, different representation and it was really important for us that this would be a vaccine for the world not a vaccine for white people and so we decided to slow down and the way we slow down is we told some site we had recruited mostly white people you cannot get any more people into the study and we added new site in communities where there were people of color. It was agonizing it was even organizing at the end because as you say people were dying. And then you know we ended up having a product approved one week before Pfizer and they really twisted it in our back saying they were the first product approved and so on and we're ahead in that race but it was the right thing to do again in the end of the day you have to live with yourself and your decisions. Very happy I made I hope I will make the same decision again if it was presented to me because at the end of the day it was me and the team debating it and with a board because it became at some stage a board discussion with my recommendation to slow down because we wanted this to be a vaccine for the world, not for white people.

Sure. So I'm going to try to be very simple and any doctor scientist listen to me might have a few goosebump and I apologize in advance. So basically we all have cancer cells in our body all the time of our life. And if we are healthy, which is why sleeping and sport and eating well and so are so important, your immune system, which basically lives in your blood and goes around your body, will see that first cancer cell and will eat it. Again, massive simplification of what's happening. If a cancer can grow because for example you spend a period of your time you go through a divorce, you have a big trauma in your life where you don't sleep for a month or two you see sometime five, 10 years after people having cancer but it started at that moment. So if your cancer grows your immune system becomes blind to it because it becomes used to it. It's part of the environment and it doesn't fight your cancer anymore. So what we developed is a technology at Moderna where we basically take a sequence of your tumor meaning we take a biopsy of your tumor. And we read all the letters of the DNA of your tumor the 3 gigabytes of letter. We do the same on a draw of blood to get the DNA of a healthy cell of your body. So we can know what is Jean Philip DNA and we compare via informatics all the mutation where all the letters has changed in your cancer cell compared to your healthy cell and then through our software we pick the 34 mutation that we think based on biological rules and medicine rules are the most relevant. And we make one mRNA with all those 34 mutation in one molecule in the factory in 30 days. And when we inject it in your arm in your hospital, what we've shown is after around four doses, because remember your immune system missed the mutation in your cancer. After around four doses, we start to see your immune system recognizing your cancer. It's waking up to your cancer and it starts eating it. And so the data, as you said, are quite incredible that we've showed in the five-year survival study of a phase two. The phase three is coming soon. We are now in lung cancer, in pancreas, in bladder cancer, kidney and many many cancer type in clinical studies. And the uniqueness is because mRNA again is an information medicine. It allowed us during COVID to flip very quickly to make a design of a vaccine on a computer. That same technology allows us if you and I get diagnosed having skin cancer the same day by the same doctor in any hospital of the world. We'll make a molecule for Jean Philip. We'll make a different molecule for Stefan that in each case is adapted 100% like a hand to a glove of the right size to your tumor and to my tumor.

That's the way. And our biggest vision is to go actually much earlier in cancer. We just announced last week we are starting a lung study, but we've already done lung study that's ongoing for people with stage three and stage four disease. So advanced disease. We're going to start our first stage one testing because in lung cancer you can find cancer early. If you do an X-ray of a former smoker, you can find a cancer early and we think that would be even more powerful because there's less disease. And there so you have a stronger immune system. And so the thing we're trying to do in Moderna is to go as early as we can in disease and also to prevent disease. We have also another product that's going to start a clinical study in the UK at Oxford any week now that is for people that have Lynch syndrome. You have one in front of people that don't know but they have mutation in their DNA that increase tremendously that chance of having colon cancer. And so in that case when you develop yet another product where we're going to give you instruction so that the cancer will not develop. So it's a prevention of cancer. So there's a lot of things that we're able to do with this technology because as I said it's an information technology in your body and our life is information and so we can as the world learns more about disease and mechanism of disease we can then very quickly make new tools to fight disease.

Yeah. So we are trying to scale out the process by shrinking everything. So if you were to go and visit our Marlborough factory in Massachusetts in the US, what you will see is a lot of engineers trying to shrink everything smaller and smaller and smaller because if I can make more per square foot on the floor or square meter. And I can do more 24/7. This is how I improve my output. The team has already reduced compared to what we used for phase two study to what we're now ready to go commercial because we're hoping to get the data this year and to launch a product next year in 27. We've already reduced by 10x the size on the floor and the team has a road map for another 10x. So of course that will be 100x. And we're trying to also shrink the manufacturing time because if I can do something in one day versus five days, of course I can do five times more, right? This is a basic math. And so we just obsess about the output and think what are all the variables we have. That's why being an engineer comes handy. What are all the variables we have in term of improving the output and we're working on all of them in parallel at the same time.

100% and just one example of I was discussing with the engineers maybe six months ago and I was obsessed about square inch on the floor and so on and one engineer came with a great idea that nobody had thought about before and he's like by the way we can move all the compute of a machine out of a room because you know we operate of course in clean rooms for the safety of the patient because you don't want bacteria in the product of course. But they say all the compute is still in some of the robots. I'm like what I didn't realize so they moved all the compute out and so all the compute. So there's a lot again human ingenuity when you are very clear about what problem are we solving for is just amazing. Has no limits.

Yeah, that's a great question. So I think in our world there's two big application of AI. There's AI for science making new medicine and AI for accelerating business processes like work reinvention around AI so we can serve a customer faster. Those are two very different use. On the innovation side of the house. We at Moderna have had a few innovation that have come from AI that have been put in place in term of the molecules we are developing. This is just the beginning of a huge tsunami coming for the industry and for Moderna. But most consumers will only see the benefit in years from now. Because you need to invent a new molecule and then you need to test them in the clinic. Of course, where there's already impact on the consumer positively with AI in our case is shrinking business process time because then if you can develop drug faster and it can be available to patient faster and cheaper and that's what we're trying to do with work reinvention and that has already example in Moderna in manufacturing where the team have used AI, are using AI every day in quality to

Improve quality, like we build an agent. But when there's a mistake happening on the manufacturing floor, by law and it's like good business practice, but by law in my industry we need to document what happened as a deviation and you need to document a corrective action.

I was getting frustrated that our corrective actions were not really improving. So I told the team, let's build an agent that will refuse a corrective action submission if it's not good enough because the agent finds holes in the corrective action that it could still happen again. So we built an agent to do that and our quality has improved.

So that's another example. We use it in marketing, we use it in finance, we use it in HR. So I think you're going to see mid to short-term, but already today, impact on the speed at which medicine can be developed through business process reinvention. The science will take longer but the science will be very profound.

We're going to be able to invent medicine that my best scientists cannot think about because the human body has 20,000 genes as we spoke about, has 40,000 metabolites, think glucose and other things in your body, and you have trillions of cells in your body and those things are talking to each other sometime in nonlinear way. So there's no human who can have the functioning of a human body in their brain like a good engineer can have a functioning of an engine of a car in their brain.

So I'm the de facto chief AI officer because I really think given the impact the technology has already had, if it will never improve again, and given we know the compute is doubling every six months, I think any company that's serious in AI, the CEO has to be the chief AI officer in terms of understanding the technology and driving the change in the business.

Then of course I have teams helping me do that. I'm not alone. So of course we have a tech team who's spending a lot of time understanding what the technology can do. As you said we have partnership with OpenAI but we're also working for example with Anthropic on coding a lot. With vibe coding we actually this morning I was on a call with the leadership of DeepMind at Google on the science side of things.

We're also developing our own machine learning system for doing some biology where LLM is not the right tool for doing machine learning. And then for the work reinvention we actually started with my head of HR a work reinvention team where we basically prioritizing what are the few, we have three right now, big enterprise-wide projects that we want to redo from scratch, business process reinvent AI first.

We have the same thing happening in each of the big functions of the company. Like for example my CFO has four or five projects within finance to totally reinvent how you do things in finance and something across each function. And then we are trying to really help managers at the department level to think about what they can do in the department.

And then at the individual level we are doing a lot of work in terms of training. Every employee of Moderna has access to GPT Enterprise from OpenAI. We are doing training on how to use tasks, how to use projects, how to write prompts. So all those things we have done. We deployed GPT at Moderna in the spring of 2023 just after OpenAI came in November '22 with a Moderna version in the Amazon cloud with only Moderna data coming in and the data not going back, educating the rest of the world with our confidential information. So we have been at it early.

And we're trying to stay on the frontier of what can be done with AI by having deep partnership with those frontier companies like OpenAI. And so I was with leadership of OpenAI on the phone last Friday and again with somebody here at Moderna on Tuesday this week. So this is a permanent reinvention and a permanent learning from all of us starting with me. I even have tasks set up to keep me updated several times a week on what use cases at the moment but also outside the company.

Yeah. So within the pharma biotech companies I think it goes back to the two chapters I spoke about which is going to be huge innovation in new medicine that were just unthinkable before. And the acceleration of the time it takes to develop a drug because of all the business process work reinvention. I would not be shocked in three or five years time it takes half the time, so five years versus 10 years to develop a medicine. So when you multiply this across the industry that's an amazing impact for patients of course that are waiting for the medicine but the biggest impact will be on medicine as we learn more and more about how the human body works.

So I think outside the companies themselves there's a few things that I think going to be really important. First is I believe we are a few years away, maybe five years away, to be able to map the human body in silicon, I mean cell by cell, mechanism by mechanism like you will map an engine of an airplane or an airplane with the engine as one of its parts, with all the wires and all the mechanical parts. We're going to be able to do the same thing. And again it's a very complex problem, 20,000 genes, 40,000 metabolites, trillions of cells, but it's not an infinite problem, right? And it's not black magic. It has rules. A lot of time things happen in biology, in medicine, in disease, we don't understand. But it's because we don't understand. It's not because it's black magic.

So I think we're going to get to a world where there'll be no more black magic, where we will really understand mechanistically what has happened to somebody. And this will enable us and others in the field to invent new medicine. Because if you know how the engine works, you can go fix it because you understand how it works, right?

The other piece I think would be fascinating is the improvement in understanding of how disease progresses. We spoke about cancer earlier. Cancer, you don't have a tumor, you know, 5 cm large happening overnight. It starts with one cell and then two cells and then four cells. And then the diagnostic tools whether it's through blood work or through imaging enabled by AI enabling to see much earlier disease because we all know the earlier you can treat a disease the higher the chance of treating it and especially if you have exactly the right tool versus guessing or taking like chemotherapy, big tool like big hammer going after and destroying a lot of things around the problem like happens with chemotherapy.

Chemotherapy will be a thing of the past and in 20 years people will say why did we ever use chemotherapy, this was barbaric.

The other piece I think is going to be a huge impact is on health inequalities. One of the pieces that drives me crazy is just here in Boston where I live, between the richest zip code and the poorest zip code there's 10 years of life expectancy difference.

10 years in the same city just two different small zip codes a couple of blocks away. It's crazy. And one of these things is the inequality in understanding disease early. Inequality is of course access to healthy food. That's just crap food in the back in the box. There's a lot of pieces but diagnostics is really important. Understanding disease early is really important. So I think another place where the world is going to change tremendously is we're going to move from sick care to really healthcare. Today if you think about what we call healthcare is not healthcare, it's really sick care, which is I have a cancer, I have a heart attack, I have something, do something for me. I think the world is going to change and the companies of the future are going to be companies that are going to help people stay healthy.

I would not be surprised if some pharma companies will end up disappearing because if you think about it if you're in a world where you need much less medicine because you have very early prevention, very early diagnostic of disease and intervention to reverse the disease. It has already been shown in some diseases that some diseases you can revert them back to a healthy state.

You know some companies are developing new organs out of cells from your own body. People have already done, you know, 3D printed bladder. People are working on 3D printed hearts started from just a few cells from your skin or from a blood draw from just your blood and they're making heart cells. They're making bladder cells. So you can think about a world where we're going to be able to change parts in our bodies as they are too damaged, as they are too hurt, an accident or via disease or via aging. So all those things happening outside the industry is what gets me a lot of excitement that we're really going to move into a world of preventative medicine where we find disease very early, a bit like in Star Trek, you find disease very early and then you can treat them so you don't become sick.

So I think a few things come to mind. One is of course a deep understanding of biology because you're going to want to, because human is about biology, to be able to understand it so that you can apply it to do good to serve your customer or the patient if you're directly interacting with patients. I think then the ability to connect the dots and to leverage technology we just spoke about, AI, to leverage technology whether it's for discovery or the delivery of care. You know as we talk about AI in imaging, about AI down the road I believe if I'm still alive that my doctor will have my body in silicon as a model. And as I do blood work, as I go for medical checkup and use other devices that model will be adapted and will allow my doctor to help me do things because also everybody's going to be sequenced, you're going to be able to find a lot of disease early.

Which is of course again the best prevention. I think the use of vaccines is going to be much more amplified because as you know vaccines can prevent cancer. Think about HPV, that amazing vaccine developed by my colleagues at Merck or MSD outside the US, that every, I believe every young boy or every young girl should have when they are teenagers before they start kissing too much because that's how the virus spreads through body fluids. Dying of HPV cancer, head and neck, ovarian cancer down the road is just criminal because that can be prevented.

I think it has to go to communication as a big parameter which is to explain to people, to share the data. If I could go back in time, one thing I will do differently and try to do a better job is to explain in 2020 that we and our colleagues in our companies never cut any corner for safety of the development of the vaccines. And you can imagine how people can believe that we cut corners because how could you do one year if it takes 10 years usually.

We did that because we were able to do a lot of things in parallel because there was unlimited amount of money for clinical studies which is why the US government as we talked about gave us and others billions of dollars because we told them if you want to help stop this pandemic we need vaccines. If you want vaccines quicker, we need a lot of money so that we can take a lot of business risk. Doing things in parallel. So you don't do them one after the other, which is what people do usually to manage business risk, financing risk where they do things one after the other once they know things are working. Because if not they will be irresponsible financially in normal times. But in war times when you fight a virus and people start dying and economies are stopped the government basically just threw money at a company to say everything you can do in parallel do in parallel which is what we did.

The other thing that they did at the government level is that they stopped reviewing all the other non-COVID vaccines. Why? So that all the people at FDA could focus on Moderna and Pfizer and the other vaccines. So we could go very fast. In normal peace time you know it will take a month to get just a meeting with FDA. We had the name and mobile number of all the people on the Moderna team. And so we didn't do a good enough job, we collectively but us Moderna too, explain what was being done that could enable this without cutting corners. Then of course the vaccination mandate which is not the vaccine but the obligation to be vaccinated created in the US a lot of political backlash.

And so there's a lot of things like this. Look, like always in life and again going back to history, pendulums going back and forth. By the way, when Pasteur started doing vaccines there was massive public backlash. And so I think things are going to go back and forth. At the end of the day you can say gravity does not exist but jump out of the window and you will see gravity catch up with you very quickly. And so it's the same thing with biology just a bit slower which is you can say measles is not an issue, stop vaccinating kids by spreading misinformation and your measles cases are going up as we are seeing.

And so I think those real outbreaks that unfortunately are going to hurt a lot of humans that should not be hurt because the product exists are going to remind people and get the pendulum to go back. So again, being a long-term thinker, being an optimist, having studied history, I know the world is going to go back to a good place. It is not right now in a good place. And it's of course sad because innocent people are getting hurt by that misinformation.

I think communicating, I think explaining, mistakes as well because mistakes happen whether it's done by industry labs, government labs, public health leaders, business leaders, mistakes happen. So acknowledging publicly the mistake I think is a great way to build trust. And I think sharing some of the benefits that people are going to get. I mean we just spoke about the improvement in diagnostics, the improvement in disease. I think over time care will become cheaper. In a lot of places some people because of their income cannot or their lack of insurance cannot get access to the best care they can. I think as we move to a prevention world, as a true healthcare not sick care, this is going to be less and less of a problem. So I think those are type of things we need to do more of, communication and explaining including mistakes.

Yeah. So I think to really solve it for good you need technology like AI to move to true healthcare not sick care. Because it's a bit like your car, it's an interesting analogy which is as you know if you never change the oil of your car, never do car maintenance, your car is not going to last as long. Same thing with our bodies as we live every day. As I'm going to eat today my lunch my body gets older because the very process of eating is actually having a lot of consequence chemically inside my body which makes my body older today than I was yesterday and the day before. And so as we understand all those mechanisms and put those in place and really enable through technology and mass dissemination of the information of a technology to deal with things early then the cost will be much lower. It's like, you know, if you do the preventive maintenance of your car, it doesn't cost you a lot every year. But if you wait for your car to be destroyed and you have to change a big part of your engine, then the cost is very, very expensive.

I think we're going to truly solve the cost problem of healthcare by moving to true prevention healthcare, not sick care which is very expensive.

Yeah so look I don't know of a way to lead but by example. And so I hold a super high bar on myself on living to those values. In our case, I had the mission of the company written on every wall of every conference room in the building. And I point to it all the time. And I tell people in my teams which is they need to be driven by the mission because either today or tomorrow or in five years somebody they love is going to need a Moderna medicine whether it's cancer or I would prefer to prevent a disease like vaccines.

And that every day matters. And because by extension, people in your family, Jean-Philip, I don't know them but I know you love people in your world like I love people in my world. Of course that's what makes us human and it's one of the many things we have in common. I use that mental model for people on the planet which is I don't know most people on the planet obviously but I care about them as I care about my family because they are part of a family of an ecosystem of friends, community and so on. And I think that if all of us at Moderna are always obsessed about that and so I try as a leader to talk about that all the time.

I think as humans we get very distracted. I think it's even worse now with social media. By the way, I am on no social media. Which I think is great for my mental health and great for my focus and to stay present and stay on mission. And I think we all get distracted. And I think what is important in leaders is to every day remind people why they do what they are doing because at the end of the day people reduce their job as a set of tasks and a to-do list and going to meetings and so on.

And if you're not passionate every day about what you do then you lose your energy, you lose your commitment, you lose your relentlessness. And so what I try to do as a leader is to always put back the patient in everything we do, every meeting, literally. And I'm obsessed about quality and speed of how we operate the company because I don't believe yet we operate at the best version of Moderna and patients are suffering or patients in the future will suffer because today I'm not operating as the best version of Moderna that I should and I can. And that's a driving force that I want to talk about to people all the time which is if today we cannot develop in the lab a drug as efficiently as we could. Well, in 10 or 15 years, people are going to get that drug later because it would have taken us two more weeks to do something that we should not have if we had done our best work today.

It is. So it is, but at the same time it's very energizing. So, it's both which is interesting. Which is it's very heavy sometime. But if you do your best work every day with the best team, then it's very energizing because I don't know how to do better than my best work with the best team.

So, it's always raising the bar on making sure I have the best team, making sure I do the best work I can. I communicate, I help people, I give energy and I'm always trying to figure out where are we losing energy in the company because of business processes or lack of technology which is why I'm so excited about AI. For me, AI in the business process reinvention side of the company is it should enable all my employees to be much more engaged, much more energized because their work is more impactful every day because the part of their work that drives no value and drains them is gone and run by a piece of software.

No I completely agree with Pascal that will not change the world. Look, media makes us believe that there's a lot of bad people out there in the world. And I don't think it's true. If you look at the facts and the data, it is actually not true. Most people want to do a good job. Most people want to contribute. And when I say most, I mean 99.9. So almost everybody. And so because of that math you have to assume that people have good intent and when you see outcomes that you don't like you need to figure out why. And you figure out if you obsess about the why until you get to the true root cause of a problem and sometime you have a personal problem, some employee at the company might be going through a very very tough time in their personal life which means that they might have made a mistake they might not be engaged and so on because you don't realize they're taking care of a mother with a terminal cancer or a kid with suicidal thoughts and so on and that of course has a huge impact.

I always tell people look I'm one human being I'm not two and so the Stefan that works in your office every morning is the same Stefan. It's one Stefan. And so which is why I always advise our teams to focus on human harmony not work-life balance. I like to tell people my life and my work is not balanced at all. It's totally out of balance. But my job is to keep those two in harmony so that I could be the best CEO I can. I can be the best husband I can. Am I the best husband in the world? I don't think so. Am I the best CEO in the world? I don't think so. But I'm trying to for those pieces that are really important to me to be the best version that I can be in that ecosystem. And I ask, you need to assume good intent.

Sure. Yeah, I still do it. You have good sources, Jean-Philip. I still do it and it took me a couple years after starting Moderna to start realizing I needed to do it because what was really hard for me is you know since now July 2011 I've walked in my office with Moderna on the door of a building and as a CEO of a company but as you can easily understand when Moderna was me and one scientist in actually Flagship's office or VC back in 2011 before we even had the lab, to being preclinical, 20 people doing research, to being in a clinic, to being public, to IPO, to the pandemic. It's not the same company. It does mRNA, it says Moderna, I'm the CEO, but it's not the same company at all.

But I had to go slowly through that process because I live with myself every day, right? And so what I realized a year or two into being the CEO of Moderna is that I was doing things I should stop doing. There was new things I need to start doing and I was not doing it in a structured way and I told myself it's most probably a mistake because you cannot rely on your intuition on people's feedback to do the right thing. And so I realized that because when I was growing so fast the biggest problem is I had to redo the job description of a CEO much more often and that's kind of what I do. I do it at home because that's the only place I can be three, four, five hours quiet whatever time I need. And I start by thinking about the company a few years down the road to a very clear mental picture of a couple key scenarios and what's going to be the size, number of countries, the number of products. So try to really get in my head and my gut kind of the company.

And then I write the job description of if I was hit by a bus today or if I was telling the board I'm something else today. Okay, what would be the job description that should be handed to the headhunter or to the board or to a new CEO of this is your job. And I do it and then I turn back on my computer and my calendar and again I'm pretty tough on myself. I look at my calendar over the last month and I look how I used my time and I critique myself of did I use my time in the places I should have? Are there things I need to start doing that I didn't do before? Are there things I need to stop doing? Do we need to stop doing them or it needs to be somebody else on my team or in the company doing those tasks because they're important. So that process I still do around every quarter and doing it has been really important for me because the company has changed so much and I need to be the best CEO I can of Moderna today not more than six months ago.

Yeah, you need to ask them that.

Sure. So let me start by the end of your question. What we've done differently since the beginning is we've always hired the best regardless of where they come from. And in the early days of Moderna, somebody coined the term the United Nations of Moderna because we literally had maybe 30, 40 people in the company. Most of them were from around the world. The people literally from Africa, from the Middle East, from China, from Japan, from Europe obviously many countries including Iceland. And I know because one day at one of our happy hours on a Friday, I got on Amazon a big map of the world, put it on the wall and the people having beers and stuff and everybody had a pin and the pin was not what your nationality is because this can change in your lifetime and sometime many times the pin was where were you physically born. And we started with a pin in Asia and people slowly went and told their stories and you have pins everywhere.

And so that has shaped me a lot. I remember when I was at Eli Lilly after my MBA. I ended up being able to hire a lot of super smart foreigners. Why? Because they had an accent and especially people from China and people in the Midwest sometime had no patience to see the talent through the difficulty of communicating and they would not promote the best talent and I would go and steal people within the company. The best ones. I had a couple Chinese people working with me that were just unbelievable scientists. Unbelievable scientists who would be doing so much work and be so relentless and because they got the sort of job where other managers were not seeing the talent they'd be super thankful.

So being an immigrant has shaped me in many many ways. And also has allowed me to be more curious as I told you earlier, you know, I always had to understand the French culture by being out of it in Japan. I think being an immigrant also was very instrumental in my journey at Moderna because it's about going to new places you don't know. We went into an mRNA space of making medicine that nobody in the world knew. We had stuff that Nobel Prize winners told me will not work, my team might work. There was stuff Nobel Prize winners told us will work, still 15 years after don't work. I don't know if it's us cannot make it work or it will never work or we don't have the right technology in today's time of humanity. So being an immigrant has been really a wonderful gift that I had the pleasure to have.

Sure just to clarify Jean we have not signed the Giving Pledge but we've said publicly and you're correct that we're going to give everything away. I just want for the record to thanks for clarification. Yes, sure. So, yeah, we said we're going to give everything away but a tiny bit for education of kids and stuff like that because nobody needs that much money and you have so many problems in the world and people suffering that we just could not comprehend with Brenda that we keep all that money versus putting it to use because I have no interest to be the richest guy in the cemetery to do good things for the world. And so we're trying to do two big chapters. One is really around youth.

Because you know we both got lucky with Brenda to get educated and as you know a lot of kids don't have a chance to get an education. And so we're doing a lot around helping people from low-income communities to get access to education including universities. So we have a number of scholarships across the world. We are also doing a lot of things around mental health because we think it's a serious problem in the youth, also to older people but especially in the youth as you know. So we're doing a lot of work in mental health. So youth is a big topic and the other big topic is people later in life that are dealing with a lot of harm.

And so one of philanthropic efforts we are super proud about is we're helping Homeboy Industries. It's a nonprofit organization in LA started by a Jesuit father, Greg Boyle, who reinserts in society around 10,000 people a year that were former gang members. So most of them coming out of jail. He reinserts them, gives them a job. He's created a bakery, he's created a lot of businesses to give them jobs to reinsert them in society because as you can imagine when you leave jail, prison, sorry, a lot of time your family doesn't want to see you, you have no money, you have no job, you have nothing and you have of course prison history on your record so it's not easy.

We're helping a group here in Boston, an amazing doctor with a doctor of the homeless literally, he goes in the street with his team and they know all the homeless and the disease they have and they give them medicine, their medicine, their backpack, they follow them and so on. So, we're trying to help people in those two big chapters, youth and people that are hurting a lot. And we're trying to do it by enabling other entrepreneurs. So, the foundation is my wife plus one person because we hate staff and overhead and so on. Bureaucracy. Yeah. And so what we're trying to do is to find people that are doing extraordinary social work like Greg Boyle in LA and providing to them long runway of visibility of funding. So it's paid for many years usually three to five years free when we don't know them well and then five years so they can hire and build programs like we do in companies.

And the other piece we also do is we provide support to organizations to help them seed new social entrepreneurs. So I'm a big believer in social entrepreneurs because like entrepreneurs in the business world they are passionate about their mission. They sweat every detail of a system and they make the system better all the time. And so that's what we're trying to do with Brenda because we think it's much better for the world that all capital goes toward those organizations than it stays on my bank account.

Oh wow. That's a big one. Yeah. And you need to kind of framing time wise because in 20 or 50 years is different.

Yeah. I would say if we are like 10 years from now, I would love to have developed, you know, five, 10 more vaccines so that for the biggest impact that people can get a vaccine and don't get a disease that will impact their quality of life. I would love that cancer, that we have had a role, because as you know Australia has a huge role as well but I would like to be a company that has had a big role in turning cancer into a disease that is not a death sentence anymore.

As you know because it has happened in your life, has happened in my life, when you have people diagnosed with cancer the world kind of falls apart and changes drastically. Thankfully thanks to the work you guys have done as many companies the survival rate is way different than it was 10 years ago. But I hope that we're going to be a big contributor to making sure that we can find cancer earlier and we can have the right treatment to help people go back to their normal life and to have cancer becoming like when you tell somebody they have diabetes. It's not great news but it's not the end of life news. And I hope that all of us working on this and Moderna in particular will have a big impact in that space.

I think the most important piece is surround yourself with amazing people that share the same mission because you're going to have to go through a lot of tough times, same mission, and the most amazing people you can because there's going to be a lot of hard work and to do great things, you need to be surrounded by great people.

Thank you.