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Novartis CEO Dr Vasella will organize a restructuring designed to get rid of bueaucracy in Novartis operations. He has see more than six layers between senior management and the lower ranks in many situations inside Novartis. The goal is speedier decisionmaking. He will also look at the large expense of third party companies that oversee clinical trials.

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A 41 year old doctor, Vasant Narasimhan, is the new CEO of Novartis in Feb. 2018. Under Narasimhan R&D is expected to get prominence. His predecesor Mr. Jimenez's focus was on developing new prescription drugs. Dr. Narasimhan sees a shift to new technology, improving data science and digital capabilities to discover new medicines. This shift raises the possibility of a spinoff of the Alcon eyecare business and the Sandoz generics business.   Narasimhan joined Novartis in 2005 from consultancy Mckinsey & Co. and becoming head of R&D. He is expected to push a series of tech based initiatives including artificial intelligence to be used for new biomarkers showing effectiveness of treatment, new sensor technologies developed with Microsoft. This shift is a result of the earlier effort under previous CEO's to make up for the loss of patent protection on profitable drugs by diversifying into consumer healthcare. During the period under Jimenez Novartis share price performance was mediocre, rising 41% over 8 years. Its business is stagnant with a 1% increase in 2017 for revenues, the first increase in 3 years.   ...

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Yuka Hayashi describes the remarkable comeback of prime minister Shinzo Abe in Japan, his "Japan is Back," strategy and its personal overtones. He describes a visit- by Japanese known for taking that second or third chance and making it work through difficulties- to the prime ministers residence for discussion on the theme of "the second chance." The premier tells the visitors that Walt Disney would never have been heard of if he had not tried the sixth time after five failures, and not succeeded in Japan, which has a risk and failure averse business environment. Encouraging risk taking to setup new ventures and open up new frontiers and markets is part of the growth strategy for Japan. His personal struggle with ulcerative colitis during the period of his first term as prime minister, and the new drug discoveries that made it possible for him to recover, give Abe a fresh burst of energy this time. His story and Japan's story now coincide. Abe says the mission of the new LDP is to make sure that talent now flows from mature industries to the industries of the future....

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Changes Novartis CEO Daniel Vasella is making in the pharmaceutical business. He has hired Joe Jimenez, who is running Novartis's consumer health care business to be the new pharmaceutical division chief. Jimenez previously worked at packaged goods companies including H.J. Heinz Company. Jimenez is cutting 25% of the jobs at pharmaceutical division's headquarters in Basel to reduce bureaucracy and costs. In March he promoted Trevor Mundel and Andrin Oswald, 2 young executives, to head the drug developmet group which puts drugs through human testing and submits them for regulatory approval. This group had become too bureaucratic and slow to move and take initiative. To improve its functioning Jimenez is organizing it into small teams with each team assigned an experimental drug in Novartis's pipeline. Each team of 8 people including physicians, experts in regulatory affairs and marketing and toxicologists work together to spot potential safety issues early and discuss them with regulators to determine whether to put the drug through expensive clinical trials. Each team takes the responsibility to take its drug to the market. The pharmaceutical unit is also being organized to be more nimble. It solicits health systems early on whether its willing to pay for drugs. And Jimenez has startd 4 pilot projects in tough markets to improve relationships with payers, including the Pacific Northwest where Novartis has offered to train an HMO's nurses in aspects of heart disease. Vasella supports the generics division of Sandoz because the growth is in generics, with generics commanding 60% of the prescription volume in Germany and USA, and sales for generics up 25% this year in the generics division. And Novartis paid $39 billion for Alcon, a eye care company. Its also working aggressively in the vaccines business, which like generics enjoys double digit growth. ...

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This NYT report on Mohamed Bin Zayed of the United Arab Emirates, who comes from Abu Dhabi one of the 7 emirates in the Gulf Coastal region, is rare and unusual. It provides stories the prince loves to tell that make a point about how he sees the world. Here he tells them to Robert F. Worth, in the only interview Mohamed bin Zayad has ever given to a journalist from US or Europe. It took a year just to get the interview. The title about a Dark Vision is inappropriate as Mohamed Zayad simply reflects what is a British way of looking at things- valuing the Constitution, keeping religion private even its deeply held beliefs and cultural traditions such as Bedouin's practice, and a general tolerance that characterizes British society and similar societies throughout the history of Europe and Asia that were sitting on shipping lanes and practiced trade for a livelihood. It is also important because the other Mohamed, Mohamed Bin Salman of Saudi Arabia is seen as someone influenced by the ideas of Mohamed Bin Zayad of Abu Dhabi. President Biden plans a trip to the region in coming months to continue on building a narrative of development for the region. This provide an insight into the coastal regions that include Gujarat across the Gulf in India, that for centuries traded with the Gulf kingdoms. They have a trading mentality and with it comes a tolerance that is also seen in trading nations such as England. This is what brought Britain to India (and China) says Mohandas Gandhi. Gandhi went so far as to say that if there was trade on the moon you would find a British shopkeeper was first to setup shop there. Zayed has as a minister in his cabinet, a woman who is minister of Tolerance, Sheikha Lubna al Quasimi.  Zayed is unique for three reasons. He has embedded in his views the spirit of tolerance. As Worth puts it in NYT, Zayed has grasped what is true to the spirit of the Gulf region. The country's location on an ancient shipping lane has bred a type of Islam in the Gulf region, that is open to the world and tolerant.  His father Zayed Nahyan's  tendencies to openness and frank demeanor combine with this tolerance to provide a different kind of leadership. His father had the pluralist instincts that combined traditional Bedouin attitudes with a rare liberal mindedness. He died at age 86 in 2004. Zayed bin Nahyan MBZ's father was selected for these very reasons by the British in 1966 to rule the small Gulf kingdom of Abu Dhabi. In 1966, says this NYT report, the country was mostly illiterate, half of all children died during childbirth and one third of the women during childbirth, there was a complete lack of western medicine. Zayed Nahyan's brother was averse to development making the British select Zayed Nahyan at the request of Abu Dhabhi families. These early years shaped Mohamed Bin Zayed's views of how to see the world. Zayed the son loves to tell stories, and this one in the NYT shows how Mohamed bin Zayed the son and Mohamed bin Nahyan the father share a sense of what it means to be human and support all people's aspirations for a better life. This is the narrative in India and the region of 1.8 billion people that extends from India to Indonesia and Vietnam. This was seen at the G7 when leaders of India and Indonesia were invited to meet with the G7 in Munich, Germany and taken as utterly serious participants in the discussions to shape the Free World. To see the difference- UAE has signed agreements to increase trade with India to $100 billion over 5 years and was thanked by prime minister Modi for treatment of 8 million Indian workers in the Gulf region during the pandemic. Saudis are now stabilizing the Turkish and Egyptian economies with aid and providing some of the funding assistance for Siemens to modernize the entire Egyptian rail system with the latest technology over the next 5 years. Projects of this size that have never been undertaken since 1945. Sometime in the 1980's when Zayed was a young military officer having completed training at the Royal British Military Academy at Sandhurst, England, and educated in Scotland, he went to the grasslands of Tanzania. During his visit to Tanzania he went to several villages to see the Masai tribes. When he returned he sat with his father crosslegged on the floor in traditional Bedouin and Asian style and told him about his travels. His father asked Zayed about all the details- the wildlife, the Masai people and their customs, the extent of poverty in the country. After hearing it all his father asked Zayed what he had done for the people he had encountered. In response Zayed shrugged and answered, the people he met were not Muslims. Zayed still recalls his father's reaction, sudden, forceful and indelible from memory. Zayad says his father took a sudden hold of his arm and spoke to him in a harsh tone and stern demeanor- " We are all God's children."     ...

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Japan's governing LDP party wins over two thirds of the seats in parliament in a snap election called one year before the end of the term in office. Prime minister Abe's popularity by summer 2017 dropped to about 30%, and yet with a divided opposition he managed to win the election with a large majority. The opposition led by the Democratic Party and Tokyo Governor Mrs Koike fragmented with the formation of new parties, Yuriko Koike's Party of Hope, and the Consitutional Democratic Party. Mrs. Koike failed to keep the opposition united with some missteps including asking for a loyalty pledge from candidates. This election win makes it possible for Abe to get a third term as leader of the LDP and eventually becoming the prime minister with the longest term in office. Abe had a poor start during his first effort as prime minister when he resigned in less than a year. This is a comeback for Shinzo Abe from that difficult period. Yet the constitutional changes to support Japan's Self Defense Forces with the growing threat from North Korea are not getting the same level of support. Opinion remains divided on that issue.  One aspect of this election is that very few women candidates are running for parliament. In contrast to the election in Britain with more women running for office and getting elected, in Japan's 2017 snap election less than 10% of candidates elected are women. ...

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Japan's prime minister, Shinzo Abe, is taking carefully planned steps during his second effort as prime minister. Abe is determined to avoid the mistakes of his first effort. This time Abe has focussed on the economy and getting Japan moving again. Nationalist policies are moderated and not allowed to affect trade and economic relations with China. Abe is focussing on winning the upper house elections and creating the stability that eluded other prime ministers.

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German born Joerg Reinhardt, the new chairman of Novartis, is overseeing the plan to revitalize and strengthen its R&D operations. Reinhardt who has a doctorate in pharmaceutical sciences, spent 30 years working for Novartis and its predecessor company Sandoz, before leaving for Bayer in 2010 and returning to Novartis. He is leading the effort by setting up a board subcommittee setup to oversee the research and development effort. The new subcommittee's task is to review the R&D strategy and organization. The subcommittee will advise the board on scientific trends and activities critical to R&D success. Novartis has increased R&D budget to 5.6% in 2013, which will remain at that level in 2014. The pharmaceutical industry by contrast decreased spending by 2.2% in 2013 compared to the high point in 2011, according to PriceWaterhouseCoopers. Research activities will be concentrated in 4 cities- Shanghai, Basel, Boston and La Jolla, California, to take advantage of infrastructure already in place in these places. A review of Novartis's portfolio of business begun in 2013 will be completed in 2014. Reinhardt says acquisitions of upto $5 billion could be made to build scale for promising smaller units. The review also includes Novartis's one third stake in Roche built up since 2001, and conversations Reinhardt is having with Roche's new chairman Christopher Franz....

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Germany has shown that low tech contact tracing efforts work- no apps needed, a phone, a desktop computer with a centralized database, and most important the human relations skills of the person doing the calls. The  sensitivity to the situation facing each person being called, being able to talk to the person in the language they speak in a multilingual environment such as California, is shown here. A 40 person team operates in San Francisco consisting of public health officials, clinicians, medical students and librarians. They call the contacts of people with coronavirus, arrange tests, and as needed send packages of food and medicines to hotel rooms or homes. Every call is expected to last 15 minutes but all sorts of questions are handled.  English and Spanish are used. Here one of the persons doing the contact tracing says she does not use apps, just an open source software used in the fight against Ebola. Definitely low tech, no waiting, get going is the message to every city in the world. She says apps software such as what Google and Apple are putting out can tell you whether the person went to some place, but cannot tell you more about that person, cannot tell you about problems the person is having being tested, and how they are having difficulty providing for families. One of the big lessons from Germany and efforts such as this one in San Francisco, and in other places such as Paris, Singapore, Taiwan, is that there is a complex nature to contact tracing that cannot be solved by tech. In fact the best thing to do is to get started immediately, with a phone and a database on a computer, as long as you have a person who has the motivation and skills, empathy with people, a lot can be done. Waiting for apps is a dangerous waste of time is shown by the low tech German experience, and the experience in other places. Most important is starting immediately. The example shown here of working with migrant workers in contact tracing shows in the most vulnerable places it is these human relations skills that count, that no tech app can do. It requires detective skills to find out and get people to share their history of movements and contacts for 14 days . In Singapore crowded dormitories house 300,000 of 1.4 million migrant workers. Singapore using an app also but its use is secondary. Apps don't work in many situations but fail in the most critical situations such as these dormitories and other eccentric or atypical situations such as faced by South Korea with religious groups and gay communities, elderly people in Europe, that generate the worst dangers of spread and need to be cluster isolated quickly. Human contact tracing has a history of being an effective method and was used in China and South Korea during the 2003 SARS epidemic. More countries need to adopt the method used in Asia and in Germany, particularly Britain, the U.S., France and India. It is OK that Britain's NHS and India's national government with Aarogya Setu app have put out their own apps which balance privacy concerns with the need to act immediately and cover the entire country, but the hard slog of human contact tracing teams in each district is indispensable. This is why the former Health minister in Britain calls it Britain's national mission to do this. Speed is key- putting together teams across the country in every district from skilled volunteers or government workers, and pulling together the phone and a centralized database on a computer as basic equipment. The fact that this is easily doable and people with human skills needed can always be recruited as they have been in Germany- from public officials in local government who are less busy in lockdowns, medical students, clinicians, volunteers, people from different professions- makes it inexcusable not to learn from others experience and get going. Just Do It. You want to reopen business, professions, offices and public services- Just Do It, it makes this possible. You want to prevent spread of the virus- Just Do It, it makes this possible. You want to limit damage to the economy and get the recovery going- Just Do It, it makes this possible. People of all shades of opinion can agree on this- its the only thing that works, even when there is a lack of enough proper accurate testing. ...

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India has learned lessons from past health epidemics- the plague Gujarat 1994, avian flu H5N1 in 2005-2006 Maharashtra, Madhya Pradesh, swine flu H1N1 Pune, and more recently MERS. The Indian Express looks at past epidemics, how they were tackled and what India learned from them. Major improvements in sanitation and hygiene since then and advances in medicine, public health.  Experience was gained. The municipal commissioner of Thane near Mumbai was district collector of Jalgaon during the avian flu epidemic. He used quarantine to restrict transmission of infected material. He shifted bus stands, closed weekly markets, and had health workers check symptoms in a 3 kilometre radius area. His message for today- have a contingency plan, track, test and treat people, stay focused, not panic, and know exactly what has to be done. Moving migrant crisis today was also seen in Surat, 1994, with the plague epidemic when migrant workers left the city. The government had to use paramilitary units in 1994 to quarantine the entire area. During these earlier epidemics the Indian Council of Medical Research and other medical organizations played a significant role. One of the lessons learned from the H1N1 epidemic that originated in Mexico was the need for effective surveillance and real time reporting so that the pathogen can be recognized in real time and tests done at labs to determine what it is, followed by effective response through isolation of region and patients. Dr. Pradeep Awate, Maharashtra's surveillance officer, says robust surveillance systems are important to understand the magnitude of the problem and strategically place resources. The strategies put in place for the Nipah virus in Kerala state by its Health Department in 2019 are the same ones now being used for cornonavirus - contact tracing and management of persons under quarantine. ...

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India US relations are critical, and the human element with 4.4 million Indians living in the US is a critical part of this, Jaishankar and Blinken, foreign ministers of India and the US, told a gathering of students in Cambridge, Massachusetts today. This has completely transformed the relations between the 2 countries. "Students, researchers, academics and professionals who have contributed to America's progress even as they remain a bridge between our two societies," Jaishankar told the students. Yet this is not enough as a close understanding between the young Americans young Indians has to be built. "Your appreciation of a civilizational state and a democratic and fellow polity that is overcoming enormous odds is essential. After all we are natural partners when our people have a strong sense of connect," Jaishankar told the students. How many young people in America understand the enormous odds in a democratic country to vaccinate over 1 billion people or meet the basic needs for food and essential medicines for every person in the country of 1 billion. Yet this has been achieved in 2020 to 2022. America has a strong inward sense and insular attitude, and for this reason India needs to take the initiative to reach out to America. India's new education policy puts great emphasis on collaboration with America and European Union in education which has huge potential to build close understanding. To do this Jaishankar and Blinken together launched the Working Group for Education and Skill Development for the US and India. ...

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Dr Kevin Lee, a British neuroscientist, heads EpiNova, a 60 person unit within Glaxo's R&D department. Lee founded two biotech startups before joining Glaxo. The smaller units called Discovery Performance Units are Glaxo's way of creating biotech startup like units which it is hoped will produce better results. The 36 DPU's in Glaxo R&D are given 3 year budgets and flexibility to make their own decisions for drug research. The large bureaucracy, scientists not working across fields and an older mindset are seen as obstacles in the search for new drugs. EpiNova with its own logo operates in a a Glaxo facility, an hour north of London. Decisions are made faster, says EpiNova chemist Dr. Wilson, and the atmosphere is that of a startup willing to try new approaches quickly.

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Research on the human genes by Novartis researcher Dr. Rappouli has helped develop a vaccine for Meningitis B. In a unique collaboration with Craig Venter, the scientist who decoded the human genome, Dr Rappouli, an Italian scientist working for Novartis unit, Chiron Corp., describes his research effort and results to Jeanne Whalen of the WSJ in 2007.

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Krugman describes the break with orthodox economic policy of the Shinzo Abe government in Japan, and says this is working.