A conversation with Joaquin Duato- Vice Chairman of the Executive Committee, Johnson & Johnson

Joaquin Duato is best known for driving the transformation of Johnson & Johnson’s Pharmaceutical sector into a global powerhouse by refocusing strategy and investment around core therapeutic areas with the greatest potential for business growth and impact on human health.

During his 30-plus year career at J&J, Duato led multiple business divisions, geographies and functions. In his current role, he provides strategic direction for the Pharmaceutical and Consumer Health sectors (a $60 billion portfolio) and oversees the Global Supply Chain, Technology and Health & Wellness teams.

When the COVID-19 pandemic began he oversaw the Company’s rapid response to the crisis and drove coordination of global initiatives to safeguard the health of employees, ensure business and supply chain continuity, and accelerate the development of a COVID-19 vaccine. He champions the integration of data science, intelligent automation and new technologies to solve complex biomedical research and business operation challenges with maximum speed and efficiency. This passion stems from his belief that the healthcare industry must undergo a digital revolution to truly change the trajectory of human health.

As a dual citizen of Spain and the United States, his international perspective and global lens gives him a deep appreciation of diverse thoughts and opinions. Duato is committed to nurturing a diverse, equitable and inclusive workplace as J&J continues to develop medicines to transform the lives of patients around the world.

Latino Leaders: How does diversity of thought and opinions help the pharmaceutical industry? Joaquin Duato: Diversity of thought and opinions in the pharmaceutical industry is critical – just as it is in every business. Our Credo is clear. At Johnson & Johnson, we respect the diversity and dignity of every individual and we must use our position to not only speak out, but to take action. Representation and inclusion is part of our DNA.

To meet the needs and desires of our customers and community, we must have a workforce that generally reflects that ethnic and racial diversity. The best ideas and solutions happen when people bring their uniqueness to work with them. Inclusion is an integral part of how we will achieve the goals set forth in our Race for Health Equity.

LL: How do you see the healthcare industry as a whole changing due to the current pandemic? JD: The healthcare industry has undergone massive change. We saw a tectonic shift as slow-moving trends went into overdrive. The role of Telehealth and remote working was more present than ever, and COVID-19 put the spotlight on personal and preventative health. We also saw an urgent need to strengthen our global public health systems because the pandemic also pulled back the curtain on pressing healthcare challenges. COVID-19 exposed the racial and social injustices that communities of color have been facing for a very long time. The disease itself took a disproportionate toll on the Black, Latinx, Indigenous and Pacific Islander communities and it forced us to revisit the way we address and provide equitable care.

Overall, these circumstances have redoubled our efforts - and the efforts of our peers – to tackle these healthcare challenges. I believe that moving forward, we will take the lessons we have learned from the COVID-19 pandemic humanitarian crisis as we look to consider and prioritize the health of all communities, patients, consumers, and their families.

LL: Why is it important to have collaboration among the global public health community in times of crises?

JD: The virus does not recognize borders. It is extremely important for us to collaborate worldwide to help combat this disease. We’re only able to tackle this problem at home if we address it worldwide. As a global company, we were already working around the world, but the pandemic pushed us to leverage our deep scientific expertise and extensive partnerships to take on this challenge. Our 130,000 employees mobilized with urgency to address the critical needs of families and healthcare providers in their country. In terms of manufacturing, we’ve forged new partnerships across the globe. With these additions to our global manufacturing network, we are committed to delivering 100 million single-shot doses of our COVID-19 vaccine to the U.S. government, and delivering 200 million doses to the European Union, Norway and Iceland.

LL: How was Johnson & Johnson able to develop a vaccine in an accelerated timeframe while meeting ethical and scientific standards?

JD: Johnson & Johnson has been committed to combatting this pandemic from the beginning, in fact, we announced in January 2020 that we were leveraging our innovative vaccine technology platform to help fight COVID-19. The vaccine technology platform was designed to help the global health community better prepare for and combat life threatening infectious disease outbreaks and aided in the accelerated development of vaccines. In September 2020, Janssen signed the vaccine maker pledge—to promise the public that decisions around the potential use of our vaccine candidate will be based purely on science and pre-existing guidelines from health authorities around the world. 3 We also partnered closely with the US government throughout the development process to ensure we were meeting important ethical and scientific standards.

LL: What was the basis for J&J to pursue emergency use authorization?

JD: The Emergency Use Authorization (EUA) that we received in February 2021 was based on an independent assessment by the Food & Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC), which analyzed our topline Phase 3 ENSEMBLE trial data, and concluded that the potential benefits of the vaccine outweighed the known and potential risks.

LL: How did J&J consider diversity in clinical trials for your COVID-19 Vaccine?

JD: With our ENSEMBLE COVID-19 vaccine clinical trial, we employed intentional focus and purposeful tracking in the clinical trial design and experience, which allowed us to achieve our enrollment targets within populations disproportionately affected by the COVID-19 pandemic.

Our approach included:

1. Implementing tools and strategies to raise patient awareness and understanding of clinical trials to successfully enroll high percentages of underserved populations

2. Partnering with minority health and community advocacy groups, such as the National Black Church Initiative (NBCI)

3. Educating physicians and investigators and working with diverse clinical trial personnel

4. Reducing and/or removing logistical barriers for underrepresented populations. In the U.S., this included significant representation of Black, Hispanic/Latinx, American Indian and Alaskan Native participants in the ENSEMBLE clinical trial.

LL: Now that the vaccine is available, how can we drive access and uptake in the Latinx community?

JD: At this crucial moment, our society needs as many adults as possible to get vaccinated, and as quickly as possible. According to a recent Kaiser Family Foundation study, 75% of Hispanic adults trust their healthcare provider to give them reliable information about the available vaccines. 5 To put better health in reach for everyone and drive vaccine uptake, we need to meet people where they are.

At Johnson & Johnson, we’re mobilizing to support organizations that meet underrepresented communities where they are and engage at the grassroots level by involving respected elected representatives, trusted local and national faith leaders, community advocates, and other national and local organizations. As part of this, we’re also partnering with leading organizations on vaccine education, including the National Hispanic Medical Association’s #Vaccinate4All effort.

LL: What do we know about vaccine hesitancy in the Latinx community?

JD: Vaccine hesitancy refers to personal reluctance or refusal of vaccines even when they are readily available. It is influenced by factors such as confidence, convenience and complacency. Poor or inadequate communication and information can negatively influence vaccination uptake and contribute to vaccine hesitancy.

That’s why it’s so important for us to engage in these types of conversations to help answer questions and dispel myths about vaccines. Recent surveys show Black and Hispanic adults are more likely to take a “wait and see” approach to getting a COVID-19 vaccine, but are also as likely as white adults to say they definitely will not take one. 8 Enthusiasm for getting the COVID-19 vaccine continues to grow among people across racial and ethnic backgrounds, with the largest increase among Black adults. About 64% of Hispanic adults now say they’ve either gotten at least one dose of the vaccine or will get it as soon as they can.

Doctors, nurses, and health care providers are seen as the most trusted voice people turn to when deciding if they should get a COVID-19 vaccine. This is closely followed by the CDC, family/friends and then by state and local health departments/officials.

LL: What is Johnson & Johnson doing to combat COVID-19 beyond vaccine development?

JD: Throughout our more than 130-year history, Johnson & Johnson has had a legacy of coming to the aid of communities during times of crisis – from natural disasters to health outbreaks. We believe we have a responsibility to step in and invest in solutions for global public health crises, and we are proud to be contributing to the global COVID-19 response.

Beginning early last year, we initiated a multipronged response to the COVID-19 pandemic, which includes developing a vaccine, and providing support to those most in need.

Supporting frontline health workers: In 2020, the Johnson & Johnson Family of Companies and the Johnson & Johnson Foundation committed $50 million to support frontline health workers. We are also taking action to support health equity in communities of color, working with partners to educate the most at-risk about vaccines and working with our partners to advance racial and ethnic health equity in COVID-19 treatment and care through a series of targeted COVID-19 focused programs.

LL: Tell me about something J&J is doing to address vaccination hesitancy among the LatinX community that you’re particularly proud of?

JD: We are a proud supporter of the National Hispanic Medical Association (NHMA) Vaccinate 4 All program that will train and support a cadre of physician leaders around the country to speak with local, regional and national media.

The NHMA’s effort will help reach more Hispanic audiences with the facts and context they need to make informed decisions about getting vaccinated. Through this collaboration with member physicians, we hope to help reduce vaccine hesitancy, build vaccine confidence, and address structural and cultural barriers to COVID-19 vaccine access in Hispanic communities.

Interview by Mariana G. Briones Lideres Mexicanos guest editor for Latino Leaders