In some regions, raising public awareness for highly stigmatized diseases like HIV can still be a radical act. Janet Dorling, Senior Vice President of Intercontinental Region and Global Patient Solutions at Gilead Sciences, knows this well.

As the executive responsible for Gilead's business covering more than 150 countries, many of which are low- and middle-income, she directly hears the challenges that patients and advocates of these diseases face every day. Within her first 90 days on the job, Dorling visited nine of these countries, meeting with local Gilead teams and stakeholders.

"I have a personal habit: if I go to a local market, I never leave without talking to healthcare providers or community members," she said.

For example, at one market, Dorling sat down with a group of people she calls "professional advocates," who have dedicated their lives to HIV advocacy, despite the dangers of doing this work in that country.

"As we discussed how to collaborate and provide help, I deeply felt that they risk their lives every day to help the people in their communities that they want to help," Dorling said. "They have to worry that someone might burst in and search their small office."

Although she had understood such dangers "on an intellectual level" before, hearing it directly from them was a completely different feeling. Dorling said this experience changed her perspective, giving her more empathy, understanding, and compassion, and prompting her to think about ways she and her team could offer support.

"This is a huge job, and there is a lot to do. It all revolves around building purposeful partnerships."

"That was a very meaningful moment in my first 90 days, and I carry it with me every day as I think about how to do my job," she said.

Gilead has been a leader in infectious diseases for over 30 years, with significant investment particularly in HIV and antiviral drugs. Its HIV drugs include the first single-tablet regimen for treating the disease, as well as the first daily oral pre-exposure prophylaxis for preventing transmission of the virus.

In recent years, Gilead has also expanded into oncology. Through the 2020 acquisition of Immunomedics, the company added the first-in-class breast cancer treatment Trodelvy to its portfolio, and earlier this year received another key approval—the FDA expanded Trodelvy's indication. Its pipeline includes breast cancer, cell therapy, and solid tumor candidates.

Dorling, a molecular biologist by training, has been at Gilead for nearly four years, serving as Senior Vice President of Global Commercial Strategy and Operations before assuming her current role in July. Prior to Gilead, she held commercial and marketing positions at companies including Genentech, Roche, and CymaBay.

Dorling's new role has dual responsibilities. Leading the Intercontinental region is a more traditional commercial role, covering upper-middle and high-income markets in parts of Asia, the Middle East, and Latin America. Global Patient Solutions focuses on sustainable access, working to reinvest in local communities and expand patient access in most low- and middle-income markets. Together, she says, the two organizations cover more than 30 million people living with HIV, more than 30 million with hepatitis C, and more than 200 million with hepatitis B.

"This is a huge job, and there is a lot to do," she said. "It all revolves around building purposeful partnerships."

PharmaVoice spoke with Dorling about her first 90 days and her plans for the future.

This interview has been edited for length and style.

PharmaVoice: You have said you want to lead a new era of health equity. What does that mean to you, and how are you advancing it?

Janet Dorling:What I love most about this role, and what excites me a lot, is that we get to work with different organizations that are on the front lines. Progress toward global health equity is not something we can achieve alone. We are not only focused on drugs or medicines—which is clearly our strength—but I think through these partnerships, we can address underlying health inequities, whether they are barriers to care, cultural issues, or issues with how healthcare is managed.

For example, our team in Taiwan has been advocating for improved hepatitis B virus (HBV) care since 2019, and recently succeeded in expanding reimbursement criteria for chronic hepatitis B treatment, enabling high-risk patients to access drugs earlier and receive treatment at earlier stages of disease progression. This is the result of our collaboration with patient advocates, researchers, and key government stakeholders. As a result, we have gone from a limited scope of treatable HBV patients to now having expanded that scope. This will truly help us move toward our goal of eliminating HBV in that country. This was not done by Gilead alone—absolutely not. The key is how we work with many different functions and stakeholders to achieve this change.

You have been in the role for a few months now. What is next on your agenda?

One thing that excites me a lot is the long-acting treatment transformation that has already begun in the HIV field. Across the industry, many new approaches are emerging, including oral and injectable forms. But if you think about what patients need next... it is these different modes of administration. Thinking from a partnership perspective about how to advance long-acting HIV drugs is something we are considering.

We are focusing on this globally, but with a spotlight on regions like sub-Saharan Africa, where we have the opportunity to impact patients. Sometimes it is very difficult for patients to reach the places where they pick up their medication, and also difficult to carry the medication with them. Therefore, having a drug that patients can take, perhaps without having to carry it or hide it at home, could be very meaningful. Our task is to think about how to evolve existing partnerships—that is already underway. But more importantly, what different partnerships do we need to build in order to move into the next phase of HIV care?

After talking with people around the world, what are your takeaways?

At a clinic in another country in Latin America, the people there made me deeply realize that we need to take a more long-term approach to collaboration. We need to think years ahead, for example, studying the impact of HIV on an aging population. This is a good problem to address because in the past, many people living with HIV did not survive this long. What do we need to research and explore now so that we have the right answers within the time frame needed? That was another important takeaway from that discussion, and we are now following up on those conversations.

Gilead has been accused of delaying new drug launches for profit. How do you respond?

I have not been asked that specific question. My goal, and Gilead's, is to bring solutions to market with a patient focus. We always try to do our best for patients and act as quickly as possible. I am glad I have not been asked that question, because I am focused on all the positive things we can do. I have seen firsthand the strong focus, work ethic, and commitment to global communities and ongoing health crises.

Gilead is making progress in oncology. Can you talk about your role there?

Oncology is our newest area, and we are just getting started. My organization already has our first oncology product, Trodelvy, in limited markets. My work is more about building the infrastructure and capabilities needed for the long term... We are in a building phase. This is consistent with Gilead's overall approach. We are a new player in oncology. I know from previous organizations that there has been a lot of great work in building infrastructure for oncology and global health. I am also learning and borrowing best practices from some excellent leaders. What can we learn, and what can we do better? For me, right now I am hiring people who understand oncology; we are starting to build the initial team and establish understanding, hoping that in the future it will become a larger part of my organization.

Does the enormous global scale of your work feel stressful, or does it energize you?

Honestly, the only thing that stresses me out is that every minute and every dollar we spend must maximize patient access. I feel a deep responsibility to ensure we are very thoughtful. But most of the time, I feel incredibly excited because there is so much we can do, and I am just getting started.