Saundra Pelletier, CEO, Evofem Inc. and Woman Care Global

Saundra Pelletier, CEO, Evofem Inc. and Woman Care Global

Thank you so much for coming in,
and thank you for inviting me. It was 20 years ago, when I made
my very first trip to Africa. And when I made that trip,
I was invited by a friend of mine, who had a bucket list. And she wanted to go and take
this long, extended, very civilized safari and go to Kenya
and Tanzania and the Ngorongoro Crater. Take a hot air balloon
ride over the Serengeti. And it was just going to be
this wonderful, magical time. And when we got there, I really
connected with our guide. And his American
name was Richard, and he was from the
Maasai Mara tribe. And I told him about
my passion, that I cared about working
with women and girls. That in the US, that my
focus was all around access to choice and
contraceptive choice. And he said, well, if
you’re interested in taking one day out of your
vacation, I will take you to some of the
places where women go and access contraception here. And I thought it was going to be
this lovely, wonderful, amazing day of these women
coming together in community, hand-in-hand,
and it was just going to be this really
communal experience. And I was going to get to
see this sisterhood that I was sure doesn’t happen in
the United States of America. I really believed that. I was shockingly
naive back then. And instead, what
happened was profound– profound sadness
and anger and shock that these places
where there were children, pregnant, with their
second and their third child. These girls that
were child brides. These women that
were desperate– desperate not to have another
baby that they couldn’t feed and another child
that was dying of HIV. And the blood on the
floors and the blood on the table and the conditions
in which these women were being served was something
that forever changed me. It forever changed me. And I thought I have
to do something. I can’t do nothing. And so I’m really
excited to be here today to talk to you about our work– the work of WomenCare
Global, the work of Evofem Inc. And really to
share with you how and why I think that Darden’s Net
Impact mission, as you heard from Elizabeth, to inspire and
to equip and to educate people on how to use the
power of business to create a more socially and
environmentally sound world is exactly what I
care about as a human. And it’s exactly what
I care about as a CEO. And I’m going to really
divide this talk today into three sections. Into who, what, and why. And so the who, you
heard a little bit. Thank you for that nice
introduction, by the way. I’m going to take you everywhere
with me if you don’t mind. So you heard that I have
a wonderful privilege of being the chief
executive officer of WomenCare Global,
which is a UK charity. And our charity is unique
because we’re a hybrid model. I like to call it the
Robin Hood approach because it sounds good. Because we go in, and we
generate modest profit in places like Turkey,
Mexico City, Puerto Rico. And we use that profit to use
when we, on purpose, operate at more of a loss– in Ghana, in Kenya,
in South Africa. And our platform is
contraceptive choice. We believe that every
woman– no matter who she is, and no matter where she lives– should be able to
choose when and if and how often she has children. And she should do
that with access to safe, quality,
affordable contraception. And with a choice– not force-fed sterilization
but real access to choice. And Evofem Inc, as you
heard, is a biotech company. A for-profit
biotech company that invests a lot of money
and a lot of time into disruptive
innovative technologies that really meet an unmet need. And you’re going to hear about
a product called Amphora, today. That I think is going to be
truly game-changing for women– as it relates to their
contraceptive options. But I’m going to first tell
you a little bit about myself. Because, sometimes, what
we choose chooses us. And I started out growing up in
a place called Caribou, Maine. It is the northernmost
city in the US. It is the furthest
point you can travel to from where I live
now in San Diego, if that tells you anything. And in my town, girls
were told that they really had two choices– who they married and how many
kids they were going to have. And I can remember growing up,
and instead of playing outside, I would sit and play cards with
my mother and her friends– a game called Scat. Don’t play Scat with me. I’m very good at it. You will definitely lose. And we would play cards,
and I would listen to them talk about putting their kids
first and their husbands first and their church first
and their community first and wondering when was it
going to be their time. And they weren’t angry. And they weren’t complaining,
and they weren’t whining. It was just that was
their lot in life. That’s just what
you do as a woman. You can’t really have it all
because you have to– something has to be sacrificed. So I grew up
thinking two things. One, don’t get married young. It wasn’t get good
grades and go to college. It was whatever you do,
don’t get married young. And whatever you do,
make enough money, so you can make
your own choices. So you’re not beholden
to someone else, who makes the money, and you
can’t choose what you want. That’s what I left home with. And my mother had 12
brothers and sisters. She grew up on a potato farm. And she had all the
modern luxuries, like outdoor plumbing. And my mother said
to me, look, I am teaching you no domestic
skills, whatsoever. No cooking, no cleaning– that
will never get you out of here. And you’re only
going to learn things that will get you out of here. And when you leave,
don’t come back. And if you want me to visit
you, you should send me a plane ticket and I will come. And I took that very seriously. And so my way of deciding that
I was going to make my own money and not get married young,
I was really focused, first, on broadcast journalism. A lot of you are too
young to probably know who Connie Chung
is, but that’s who– I really was going to
take Connie Chung’s job. You probably know Diane Sawyer. I’m not sure, but I thought
that being transparent and delivering the news
and being factual about it, that was pretty noble. But, instead, I was recruited
by a pharmaceutical company, G.D. Searle. And they said to me, we
launched the first birth control pill, Enovid, in 1960. And your job is going
to be providing access to education and information
to women about contraception. And they were
amazing salespeople. And they definitely sold me that
this was what I needed to do. And I thought, wow,
this is fantastic. I am going to bring all
these contraceptive products to all these women in all
these rural places in Maine. And that’s what I did. And I did it very well. I spent a lot of years
caring a lot about moving up the corporate ladder. And I relocated seven times. I took nine promotions. Anything was dangled
in front of me, I was pretty fanatical about. Because what I
recognized very early on that, unfortunately, it
didn’t really matter how smart or benevolent or how
much wisdom you had– if you sat in the
highest position, you made all the rules,
which I cared about a lot. And a funny story was
the very first class I went to be trained, I was
really thoughtful about what I was going to wear and how I
was going to present myself. And I showed up
on the first day, wearing the most fantastic
pantsuit, I promise you, you’ve ever seen–
fantastic pantsuit. So I got into this class, and
halfway through the class, I was asked to leave the
room, and to come outside because my boss
wanted to talk to me. And my boss said,
we have to tell you that we know that
you’re from Maine, and you might not realize
this, but women in business don’t wear pants. And you have to immediately
go back to the hotel, and we have a car
waiting for you outside, so that you can change
into something more proper. And on my outside, I apologized,
and said, oh, my goodness, I’m so sorry. And on my inside, I thought,
what sexist, idiotic, draconian morons made
a rule like that? I am going to get promoted. I’m going to change the
rules and fire whoever created those rules. That’s what I really thought. I really did. I used to think like that. I still do a little
bit, to be honest. I can’t lie to you. But instead of saying, this
place isn’t for me, I thought, I’m going to change this place. This place has to be changed. They need an upgrade. And I clearly am
the one to do it, so I was very successful
in my career there. And I worked so much
that I met my first goal of not getting married young. I was a terrible
girlfriend, terrible. My own doorman said to me, after
I lived there for three years, asked me who I was
there visiting one day. And so I just
spent a lot of time being focused on my career. But what I cared
about in my career was that we were
doing qualitative and quantitative
research on women– from puberty to menopause. Women are the health
care decision makers. Women decide for themselves
and their husbands and their children
and their parents. And if you can
understand what are the levers inside the
mind of a woman, when it relates to health
care, you might have a brand loyalist for life. And she might use
all of your products in all the different areas. So I really wanted to answer
Sigmund Freud’s question, what do women want? I joked in Dr. Freeman’s
class this morning, if any men needed any
questions answered about women, they could certainly
pay me for my time, and I would let them know. None of them seemed
to think they needed any help, by the
way, just for the record. So but I really was
convinced that I was going to retire there. And I was really
valued, until I wasn’t. One day, I was up
for a promotion, and I was brought
in, and I was told that I was not going to be
considered for this promotion because I had not checked
off the list, checked off the boxes, on a checklist. I didn’t have the
right education. I didn’t live in the right
countries in my expat career. And they went through
a whole list of things of what I wasn’t and
what I didn’t do. And no one spent any
time talking to me about what I did do, which
was huge contributions. And I quit. I quit. Everybody thought I had a
complete mental breakdown. They were like, what? Like you were on
this trajectory. You quit? And I said, I quit. And it was very
dramatic, and that’s a story for another time. But I quit. And when I was saying, I quit,
I really thought to myself, I’m really a fraud. I’m not really doing all these
things for women and girls that I think I’m doing. And it’s not enough. And I really kind
of always knew it. It’s the secret that
you always know inside. The elephant in the room
that you choose not to ever see because
it’s too painful. And when I quit, it
was like this moment, and it was like the moment
when I was in Africa, where it was like time stopped. And I decided to write a book. And I wrote a book called,
Saddle Up Your Own White Horse. And it was about, really,
you decide what you deserve. And don’t wait for someone
else to create it for you. Create it for yourself,
but it was really to encourage women to step
into leadership roles. And there’s a lot
of data, by the way, that talks about
women in leadership. That women do deliver
higher shareholder return. That women do recruit
and retain better talent. That women do take
more calculated risk. Women don’t necessarily seem
to believe it, unfortunately, sometimes. And I’m sure it’s not
the women in this room. But there’s a lot
of women, in a lot of rooms, that they don’t
think that leadership is for them because they have
to sacrifice too much in order to have it. And so I met a lot
of wonderful people. And I had a really
interesting career and time with speaking and talking
and the book tour. And then I was approached by
an organization that wanted me to start WomenCare Global. And I said, look,
I’ve left that world. And I don’t really want
to focus on a nonprofit. And between us, I
thought of the mentality of people in nonprofits
confuse motion with action. They don’t really
get results done. And I’m too hardcore for that. I don’t want to sit around,
hold hands, and kumbaya. I’m not interested. I’m just all about results. I can not go to a nonprofit. And so the
conversations continued. And then they started talking to
me about all their global work. And about the footprint that
already existed in Africa, and maybe I should do
an environmental scan, and maybe I should see
what the needs were. And it was a moment in time. It was the moment. Aristotle has this
quote that says, “When your skills and the
needs of the world cross, therein lies your vocation.” And I had been
unbelievably trained in private sector pharma, I
cared about women and girls. And this was finally my
moment to do something better, to do something different. And so WomenCare Global
was launched in 2009. And in the process
of launching it, I had a lot of these demands
that I wanted to have met. All these things that
I thought, they’re never going to really agree to. And that’s always
a funny experience, when you ask for all of these
things, and someone says, OK. And then you think, wow,
what am I going to do now? And I really thought
this was meant to be. And so WomenCare Global
originally started as a 501(c)(3). And a wholly owned subsidiary
of an organization called Ipas. And if this tells you
anything about my desire to take the right
opportunities, at the time, I had a son that was
a year and a half old. I was in San Diego. And they said, in order
for the seed money to come to launch
this organization, you have to live
in North Carolina. I said, what? I don’t think I
necessarily heard, where– North Carolina? Like, I live in San Diego. Have you been here? This is paradise. And I said, OK. And I left San Diego with my
one-and-a-half-year-old son, and I moved to North Carolina. And I called my
mother and said, you are going to have to leave
and come to North Carolina because I have to
travel the world and do this environmental scan. And I can’t trust
anybody else but you. And so she did. And I showed up there with my
one-and-a-half-year-old son. Never really been there,
except for a visit. And when I really did the
global environmental scan, it was shocking to see
that the number one problem was something we call– I call it the unsexiness
of the supply chain. In the morning, in the middle,
and at the end of the day, it is about the supply chain. It’s about getting these
products to the last mile– and I’m going to talk a lot
more about that in a minute. But it was a real
interesting opportunity to say, how are we
going to do this better, and how are we going
to do it different? And there’s a lot of people
that do amazing work, and there’s a lot of
wonderful nonprofits. So to justify to yourself
that another one is needed was a really tough sell,
by the way, to myself. To say, how are we
going to do something that really leaves an impact and
doesn’t just make us feel good? That actually
delivers real results? So that was sort
of the beginning. But once we recognized that if
we got products and we could generate profit, we knew
that generating profit can negatively impact
the 501(c)(3) status. So we looked into a lot of
different elegant models. And we decided to transition,
and I pitched the board to become a UK charity. And as a UK charity, you
can have trading arms. So today, our design is
WomenCare Global is a charity. We have a trading arm in the UK. We have a trading arm in the US. They’re called CICs– Community Interest Corporations. We generate profit in
both of those entities. And as long as the profit is
used to subsidize the mission, we don’t have to pay tax. So if you’re a donor
to our organization, you don’t want us to pay taxes. I mean, you want us
to create access, so that’s how WomenCare
Global is designed today. One of the things that
we quickly realized is that we needed
to heavily invest in regulatory and
quality assurance. That if women wanted
access, we needed to get these products
registered and approved quickly. And, unfortunately, one
size does not fit all. So what works in South Africa
does not work in Mexico, does not work in India. It’s very, very different. Some of these countries
make you do studies. They say, well, we don’t
think Mexican women are like Indian women,
and you’re going to have to do a study
here– even though it could be FDA approved. And, sometimes, hurdles
are put in front of you because they’re– the opposition doesn’t want
you to be there anyway. They don’t want you
to bring contraception into these markets. And so getting
very sophisticated about regulatory,
and also quality– vetting the suppliers,
vetting the packaging in some of the
markets where we work, heat degradation is an issue. So really understanding
all of these intricacies about the whole product. Because what matters
most is sustainability. We see women that will walk two
days to stand in line to get a pack of sugar pills. We see women that will risk
their life to not have a baby. We do. It’s true. And we see women that
they want a smaller family size and a quality of
life for their children. They really do. They don’t want six
and seven children. They just don’t have access. There are 225 million women
that don’t have access to contraception. There are 80 million
unplanned pregnancies. And 79% of all these
unintended pregnancies, it’s because of a
lack of contraception. Not because they didn’t want it. Because they couldn’t get it. Unlike for us, we could
have a plethora of choices. But it’s just not the same. And so at the end
of the day, I always say, when I’m talking
to other groups, that if you care about nutrition
or clean water or energy or deforestation or whatever
it is that you care about, I promise you, that
if women have access to sustainable contraception,
what you care about will be better impacted. It will be. There will be less
people on the planet not because we force women
to not have children. Because women choose to
have smaller families. So the other thing
that we recognize– and how this gets
to Evofem Inc– is that we needed an
innovation, though. Because at WomenCare Global,
we only had so much money. So we would figure out, what are
the products that are needed? Maybe it was an IUD. Maybe it was emergency
contraception. Maybe it was an implant. And we had very savvy
people to negotiate with these manufacturers
to get the right price, so that we could take
it into these markets. But we wanted an innovation–
something game-changing. But you know when you have
a beer budget and champagne taste, that doesn’t
always go your way. So we have gone to a lot of
places and met a lot of people. And we ended up
meeting, by fate, the founder of an organization
called Evofem Inc. And when I started talking
to the founder, he said, I have to be candid. You are exactly what
we’re looking for. And we would like you to
leave WomenCare Global, and come and run Evofem Inc. And I said, you
don’t understand. WomenCare Global is not my job. I don’t actually work there. WomenCare Global is a part of
me that I could never abandon. And I asked, by the way, some
very smart, savvy people, who had a lot of compensations,
to take big cuts in pay to come and help me
build WomenCare Global. They might eliminate me,
should I do such a thing. But at the end of the
day, this wasn’t a place that I was going to leave. And I said, but, maybe we
should talk strategically. Tell me what it is
you really want. Let me tell you what
it is I really want. And let’s just see if
those two things align. And at the end of the day,
what actually happened is that we both cared a lot. Not just about the halo
effect of global access. We really cared about taking
a disruptive technology that has no hormones, and bringing
that option to every woman. And Evofem Inc and
WomenCare Global entered into a true
public-private partnership. And we entered into,
first, a service agreement that was very legalized
and very strict. And I said this in
this morning’s class that it’s really
easy to walk away when you do this kind of work. It’s really hard. It really wears you down. And you want a lot of
reasons not to walk away. And so we created a
legally binding agreement, where it would be
difficult for both of us. And he and I both realized our
character positives and flaws, which was we were both
a little hardheaded. And I think you have to
be a little hardheaded to do this work deliberately
for as long as it takes. So we entered into
a service agreement where WomenCare
Global will represent all the developing markets–
everywhere outside of the US and Europe. Evofem will focus on
the US and Europe. And we will do global
launches of brands that, instead of going to the
US first and generating profit and figuring out that it’s
a good thing to do good, we decided that,
instead, we are going to do this all simultaneously
together, and really do this. But what’s different and
unique about it is that there are two separate boards. There’s an Evofem Inc board that
are capitalistically focused and shareholder focused. There’s a WomenCare Global
board that are philanthropically and programmatically focused. Separate boards, but both
understand that together we’re a lot more powerful,
and together we can impact sustainable change. And some of the statistics– I’m going to read them to you
because I know my team is here. And they’re going
to know that if I say them and they’re
wrong, they’re going to point it out to me later. Not because they’re
perfectionists, or anything like that. They’re all sitting
right there, just in case you want to
know who I’m talking to. So these, I think,
are powerful– 150 to 1. So this comes from
Copenhagen Consensus, and it represents the value
of investing in contraception. And so there are a
group of economists, and they assess the
best way to spend money for global development. They evaluated 200 proposals,
assigned each one with a color, based on how good the value is. Access to reproductive care
earned the highest designation of green for phenomenal
value for the money. University of Michigan
found that one-third of wage gains made
by women since 1960 is a result of having access
to oral contraception. Bloomberg Businessweek
listed contraception as the most transformational
development in the business sector in the last 85 years. And Guttmacher Institute–
the ability to delay and space childbearing
is crucial to women’s societal and
economic advancement. 66 studies over three
decades examined evidence on the impact of
contraceptive use and found that a woman’s
ability to get and properly use contraception impacts her
education, her workforce participation, the economics
of her entire environment, her family stability, and the
well-being of her children. So we know this. If any of you have
seen the Girl Effect– what is the economic benefit
of investing in a girl, getting her an education? It’s profound. I mean, we know
from microcredit, when women were given the
money, they invested it back in their communities. We know that when men
were given the money, they used it on drugs,
prostitution, and weapons. We know that. There’s a lot of data. And so, at the
end of the day, we care a lot about saying that
I feel like sometimes we’ve had this same conversation
for a long time. Some people say to me, we’re
still talking about this? Hasn’t this been solved? Are you seriously
still doing this? Like, aren’t you bored of it? If I’ve had a few cocktails,
I get extremely verbose. If I haven’t, sometimes, I
say nothing because you think, why talk to deaf ears? But it really does
surprise me and anger me and shock me that there still
is such a huge unmet need. And at the end of
the day, it really is about sustainable supply. It’s not that women
haven’t had some access. It’s that they need
continued access. So one of the other
interesting things that has sort of happened, as
we developed WomenCare Global, is that we knew that
the hybrid model was going to be sexy and different. We knew that generating profit
and using it to subsidize would make investors be
interested because we could show transparency. But we also knew we needed
metrics and results. And so– which is
really hard, by the way, in the nonprofit world. I mean, it’s really hard
because you have to figure out what is going to be enough. So we developed a program
called MAX, M-A-X– Maximizing Provider Performance. And what that program
really is– it’s behavior modification. So there’s an
organization called WILLOW that is about women
behavior modification. It’s a peer-to-peer model. Women convincing and
influencing other women. We wanted to be
that to providers. So what we’ve done is our
sales force goes in with iPads. They go into clinics. And these could be
pop-up clinics– every kind of clinic–
hospitals and clinics. They collect data. They look at what kind
of supplies do they have? They look at the
logbooks, and they look at what are
these providers doing? What kind of services
are they providing? And then, what kind of
supplies that they have? And what are the reasons
that women aren’t being offered contraceptive choice? Sometimes, it’s
a training issue. The providers don’t know
how to insert an IUD. Sometimes, it’s a
financial issue. But sometimes it’s
a values issue. They aren’t sure. Should they really be
putting in contraception, after an abortion, for example? So we’re collecting
real data, but we decided for us to
evaluate it ourselves, didn’t really seem
objective enough. So we partnered with
UCSD to say, help us. Help us develop this criteria,
and evaluate us as a metric. To say, are we really
delivering results? Is behavior modification
really happening? Are we drinking
our own Kool-Aid? Does this really matter? Can we justify this as a
model that we can scale, and we can duplicate, and we
can take into every country? Because so far, we’re doing
this in Kenya and South Africa. And in Kenya and South
Africa, we see real change. One of the shocking things– I don’t know, a
little shocking– was most of these providers,
they don’t even interact with anyone else
because they’re so far remote. I mean, they don’t
go to conferences. They don’t do CME credits. They don’t even know
what’s happening. So even our sales reps
are providing them with, this is really the
standard of care, that people really are using
long-acting reversible methods. It’s been interesting to
see the amount of education and interaction our team
has with the providers. And the relationships
that are being built, but most importantly,
we’re also doing interventions. Sometimes, the intervention
is contacting an organization like Ipas that
trains providers, so that they can get up to speed,
and know how to use products. We are very serious that we are
not all things to all people. We have conscious incompetence. We know what we’re not good at. And I always talk to the team. We are not going to chase money. We’re not going to
develop a value that we don’t have to go after a grant. We’re not doing it. We know who we are. We know what we’re good at. That’s what we’re going to do. Until we’ve solved
the piece that we play in the supply chain,
we’re not going to stray. We’re not going
to mission drift. So we bring in other partners
to do the interventions that are needed, which is important. And I think we’re needed. So MAX is one way that
WomenCare Global is defined. Another interesting question
that was posed to me today when I was in Dr.
Freeman’s class was, well, what did Evofem
Inc get out of partnering with WomenCare Global? We can see what you got– WomenCare Global got out of it. What did Evofem
Inc get out of it? And so, they’re very brazen
questions, by the way. I just want you to know. Just kidding. I actually prefer that. But what was
interesting is I said, one thing that I
thought was very savvy about the team at
Evofem Inc is that they knew that there is a lot
of subsidized funding to do interesting
and specific work. So USAID had a
grant called ECO– Expanding Contraceptive Options. And it was about
women-controlled methods, and figuring out what was going
to be the patient acceptability of these methods. And they gave us a
$20 million grant to do work in Malawi,
Zambia, and India to introduce five
women-controlled methods into those markets. So they were not
going to give money like that to a private company. That money was not going
to go to Evofem Inc. But that money came
to WomenCare Global. And in our
collaboration, we were able to include Amphora
in that partnership. So in my opinion, some
people said to me, we can’t believe that
you’re a turncoat. You’re partnering with
a private company. And I smile and say, I
can’t believe you’re not. I mean there really is– when you think about
public and private and aid and civil
organizations– at the end of the day,
there is a sensibility about figuring out why and
how these marriages work. And I’m not saying
it’s all the time. But partnerships can
make a big difference if you can figure out
the value proposition. So the tough thing is I went
to this meeting at the UN about public-private
partnerships. And what was very
obvious was that there’s a language barrier. That the private sector
says, of course, nonprofits want to partner with us. They just want our money, of
course, that’s obvious to us. And nonprofits say
look we’re good people. We’ve got big souls. We’re going to have
a mansion in heaven. They’re going to hell. Why don’t they want
to partner with us? And you know that
might be a little bit extreme, but maybe not. And so I really
say to these people that are in these
nonprofit organizations that you have to really
look at what you can– why this partnership
will make a difference. Maybe, there’s
something that you know about a market, something
that you can add value, that’s better than a halo effect. Because shareholders, by the
way, really like global good. They do. It’s becoming a lot more
sexy and streamlined. So there’s something
that I want to bring up. There’s something
that I just recently read called the
convergence continuum. And it talks about that there
is a fourth sector that’s being created in global development. So it says that there’s
a redefinition of how public, private,
and civil society are coming together to reshape
business in emerging markets. And a fourth sector is
going to be created. It’s going to be–
this is what it’s going to be called–
a new collaborative ecosystem, or marketplace,
blending the best aspects of the three
existing sectors, and coexisting alongside them,
but qualitatively different. Because it will focus on
the financial, social, and environmental impact
that aims to deliver positive and social
outcomes that are measurable,
profitable, and scalable. So if you’re reading
that, and you are at a nonprofit
organization that doesn’t have a profitable way
to measure what you’re doing, and do it at scale, you should
think partnership, partnership, partnership,
partnership, partnership. And I really feel like there’s
this big movement towards it. And when I first came into
the nonprofit world, I– do any of you watch the
Jason Bourne movies? So in the first
movie, there’s a scene where they say, well, you
know what you could do? You could book yourself
a conference room and go upstairs, and you
could talk them to death. And so in the
beginning, I thought, there’s just this
all this talking. There’s just a lot of talking. And the private
sector thinks there’s a lot of talking– by
smart people, good people– but are just a lot of talking. And I have seen different. There’s a lot of non-profits
that are doing sustainable work– really important work. But sometimes, they’re not
communicating it in a way, and using the right language,
that the private sector can hear it. So it’s not that
it’s not happening. It’s that it’s not
being communicated because the language barrier– really, I mean that. It’s more intense than
I think people realize. Because I see some
of these nonprofits that are doing amazing
things and they’re invisible. I mean, WomenCare
Global was invisible, until we partnered
with Evofem Inc. So I do think it’s
really important– when we think about
public-private partnerships– that there has to be maybe a
different way to skin the cat, so to speak, to really
talk about these things. So the other thing that
I want to make sure that I talk about–
when I talk you about this disruptive
technology called Amphora. When we said we wanted an
innovation, a long time ago, when I was in pharma, I was
very, very, very invested in the art of
emotional intelligence. They really called it
the art of persuasion. It could be perceived as
the art of manipulation– depends on how you look
at it– potato, potato. But it was really about why talk
if no one’s going to listen? And it was really about how
do you adapt your style, so that the listener can hear you? And maybe it’s the
tone of your voice. And maybe it’s the
words that you use. And maybe it’s the environment. And maybe it’s what you wear. And quite seriously
and quite literally, it has continued to shock me
that the adapting my style– and it might seem
obvious to some of you that have a high
emotional intelligence factor. But it isn’t always done. And it takes a lot of work,
and it’s very successful. And my point in
saying that to you is that there’s
a big opportunity around communicating your
message about what matters. So this product Amphora,
why it’s so disruptive, because women, sometimes they
use contraception for decades. If you take birth control,
you take it every day. You take it every week. You take it every month– for years and years and years
and years and years and years and years. And sometimes women, that
makes them really nervous. Because what if they want
to have babies someday? Is that impacting them
in a negative way? Do they know? A lot of women
can’t take hormones. Smokers, women who
are breastfeeding don’t want to take hormones. So a 3400 patient clinical
trial was completed. Huge investment
in contraception. And not a lot of investment
has been made in contraception. And what’s wonderful
and fantastic about this product is that we
really believe that any woman– this isn’t just
for American women and this isn’t just for
women in emerging markets. But if you are in a
market and you can’t read and you can’t write, and you
have a negative side effect, you are not– and you think it was against
your religious belief system to take a contraceptive
product anyway– you certainly aren’t going
to continue to take it. And you’re going to
encourage everybody that you know and care about
not to use contraception either. So we’re really, really
excited about this. And this is going to be
our real first opportunity to show that this
public-private partnership– this global launch– it’s not
just going to be in the US. We’re going to launch
this everywhere, all at the same time– is a really exciting outcome. So it’s a way to
measure and show that everybody’s going to
get access to an innovation all at once, at the same time,
which is a really, really exciting proposition for us. So in the spirit of
understanding and knowing public-private partnerships, I
have really spent a lot of time reading and looking
into and trying to figure out and understand how
to ensure that these things are successful. And so I do this inordinate
amount of reading, sort of, everything. My staff is a little over it. They’re like, please,
don’t give us another book. Seriously, come
on, another book. They’re like, when do
you read these books? You’ve a seven-year-old child? Like, do you sleep? And I do sleep– not that much, but I do. But what was interesting is that
I went to this event at the UN, and I met a woman from
Earnest and Young. And she said, we’re
working on this project. And I want to say
it exactly right. It’s called Entrepreneurial
Winning Women. And what they do is
these women have already launched their company. They’ve already launched it. It’s not a startup. They’ve launched it,
but they’re at a place now where they need advisers. And they need a
little more capital, but they have their plan. They have the platform. They have the business plan. They’ve already kind of
gotten off the ground, and that’s when they
come in and they invest. And with their insertion,
what they’ve seen is revenue growth
of 20% because they brought in these really
smart savvy advisers. Sometimes, they need
financial advice. Sometimes, they need
clinical advice. But the one thing is that
they issued this report that there were three force
multipliers for growth that really made an impact. One was a strong
community or peer group. Now I’m sure some
of you think, wow, that’s obvious– a strong
community or peer group. But even though it’s
said a million times, in the book that I wrote,
I talked about everybody needs a cavalry. You need a cavalry. You need emotional supporters. You do. You need people who
are going to tell you the truth– no matter what. They’re going to say,
that was a bad idea. You shouldn’t have done that. You also need
strategic alliances. People who can mentor you. People who you respect. People who’ve done
something well, and they’ve
demonstrated something that you wish you had. There’s nothing
more complimentary when someone says, I’d
really like to mimic that. I promise you,
we’re all very busy, but pay it forward
makes a big difference. Everybody can find a little
bit of time to mentor somebody. But strategic alliances are not
just someone that mentors you. Strategic alliances are
people who you may want to partner with in the future. The one thing that I
always encourage people is that you never know where
an introduction will take you. You don’t. There are people–
there was an assistant that I spent an hour
talking to because I was waiting for a meeting
that I really needed to go to. Otherwise, I might have
left and not waited an hour. But I waited an hour,
and two years later I found out that she
was the assistant of a CEO that had a product
that we really wanted. And I called her, and I said
you have to get me a meeting. And she’s like, oh, my goodness. I can’t get any– oh, my, duh, duh. I was like, yeah, you have to. And she’s like, you know. And I said, you know,
you told me where your son and your daughter are. I’m going to send
a– like a joke. And she said, all
right, I’ll do it. I’ll get you meeting. And honestly, and we added
that product to our portfolio. And I say that to you
because that’s just being opportunistic. But strategic alliances
are very important. Emotional supporters
are very important, and taskmasters
are very important. And a lot of people
ask me, how are you balancing being the
chief executive officer of both companies? And the answer is that I have
an extraordinary team of people. I do. I mean everybody takes
hiring seriously. I take it so seriously. I care a lot about
people’s personal life. I do. It matters to me. I want to know what
they care about. I want to know about
their significant other and their spouse
and their children and their pets and
their activities. I want to know– and I always say to people,
if money, time, or talent were no object– you could be anything at all. You could wake up tomorrow. You could be an astronaut or
a rock star or whatever it is. What would you be? You cannot believe the answers
that I get to that question. Some people are
very conservative, and they say that they want
the job that they’re in. And I say, OK, I’m going to
ding you for that answer. But no, sometimes it’s true. But sometimes, you get
really provocative answers, which can be a little scary. But it’s very–
it really matters that people feel significant. That they know that
you value them. That they matter. The biggest human need is
the need to be significant. That is the largest human need. People leave companies
because of people. They do. They go to companies
because of people. We have recruited people
that people said would never leave an organization. Been there 20 years– would never leave. They did. They work with us now. So it really, really matters to
always be incredibly present, to form these alliances
with people that you can use to your benefit. But their study said, one, a
strong community or peer group. Two, an authentic purpose. So an authentic purpose,
it’s, sometimes, you don’t always get there
as a straight line. Sometimes, you find
your authentic purpose by getting beat
up along the road. And sometimes, you
don’t even realize it. When I started out
in pharmaceuticals, I didn’t really recognize
my authentic purpose was about serving women and girls. And I certainly would
not think that it was about serving emerging
markets and focusing on Africa. And when you think about
moments that changed you, I– it really is about the power. And the power of having the
dignity to have choices. Because women will
make the right choice, every single time. They will. If they have access to the right
choice, they will make it– for themselves and their
families and their communities. And we’ve seen it again
and again and again. And after an authentic
purpose, the third one was an adaptive
leadership style. So that was back to the sort of
why talk if no one’s listening? That really being
willing to change, being willing to be humble,
to admit when you’re wrong. And to really bring in people
that are smarter than you, and let them be smart. Everybody that works for
me is smarter than me. I shouldn’t say that
to this crowd here. They’re going to
definitely– it’s going to get really scary after. But they are. And I think that’s great. I think it’s great. And I believe in
consensus sometimes– not all the time. You have to be willing
to make a decision when a decision has to be made. But adaptive leadership
style, I mean, look. A lot of you will end
up being CEOs, really. And there’s a lot of
different kinds of CEOs. I’ve worked for CEOs
that their Bible was what would Machiavelli do? The ends justifies the meanness. Really, I have. And I’ve worked for CEOs
that emotional intelligence was their Bible. And I can promise you that
those companies, people didn’t go to work for their paycheck. They were emotionally
invested in those jobs. That makes all the
difference in the world. It does. Because people are
willing to give you more and to give you
extra because they believe that they’re
all in it together. The social good is
making their life better, but they’re also making
progress and growing. So I have– I was asked should I– are their words of wisdom? I have some popular
wisdom, I guess. I’m told that it’s unpopular. I don’t know if I was told
not to say this or not. I can’t really remember. But the unpopular
wisdom is that one of the things that a really
smart person said to me was for what really
matters is that if you can put your ego aside
when you are moving up the corporate ladder, or moving
through your professional life, that caring about your title
and caring about your salary and caring about your
position of power can really keep you
down in the beginning. And you shouldn’t be like that
forever, but it really matters. You could take
five lateral moves, and maybe that’s what gets
you to a catapult move that’s five levels above. I meet a lot of young
people, and they all talk to me about how these
jobs that are available to them are beneath them. And I think, oh, my goodness. You poor little diva,
like did someone carry you on their shoulders
here to this meeting? I mean, can I get you a latte? And I say that not to be mean. I say it because, look,
these opportunities and experiences that they– and you know, of
course, they’ll say, oh, the youth today
are so entitled. And I don’t know that
I really buy that. I think that maybe
people haven’t been just giving them real advice. A lot of people that
you meet at the top, they’ve done a lot
of things that they wouldn’t want to relive. I used to pick potatoes. Trust me, I don’t want
to do that again ever, for the rest of my life. But my point is that there’s
a lot of opportunities that builds your character
and builds your resume and builds your experiences. And in the job that I sit,
if I didn’t carry a bag, if I didn’t do some of
the jobs that I had, I wouldn’t be able
to talk as credibly as I can about some of the
things that I ask people to do. And it does really matter. So I guess I would just say
to you and encourage you that, as you go out and get these
internships and you get these first jobs and you’re talking
to these organizations, your willingness to take
whatever’s available to get your foot in the door– because
you know you’re going to prove yourself, and you know
you’re going to be a star, and you know you’re going to
be running the company in five years– you can know that. You can know that silently,
and all your actions will deliver the seat
in the CEO’s chair– 100% of the time– 100% of the time. So it is really important. And my advice about
purpose, my positive advice, that’s not considered
negative, that people like– that the purpose thing is. Did you guys see the
movie, The Secret? Well, The Secret had a
lot of hype in California. And it was all about that your
thoughts create your actions. And it was all about
you control two things– what you feed your mind and
what you feed your body. Garbage in, garbage out. If you feed your mind
positive thoughts, and you focus on
what you do want, if you focus on
what you can have, instead of, I don’t
want to get a bad job. I don’t want to
have a bad salary. I don’t want to have
a deadbeat boyfriend. Whatever it is, if you focus
on being deliberate about what you want, and focus on
what that is with clarity– but sort of the joke
was parents were saying, my kids now think
if they just say they’re going to get into
Darden to themselves every day, they’re going to. And they have D’s. And I’m like, so I
say that laughing, because your actions need
to align with your thoughts. But it– purpose,
sometimes, it’s OK that you don’t figure it out. Sometimes you stumble
upon it, by the way. And I’ve met a lot of
people who stumble upon it. And knowing it today
with clarity, if you do, good for you. But if you don’t, it may
unfold, and you may discover it over a period of a lot
of different experiences that will make it come together. So being impatient
will torture you. And so being a little restful
that you will find a way, as long as you have clarity
around the kinds of things you want to do, will make
a really big difference. So the big final
thing that I was asked to talk about
public-private partnerships, and really talk about the
work that we’re doing. The work that we’re
doing, in the spirit of a public-private partnership,
is now becoming something that we hope will encourage
other organizations to do the same. We want to be a model that
tells people, it’s OK. We want to be a model that
convinces other nonprofits that it really is kinder
and gentler than you think to go out and partner
with private sector. And we really want to tell
private sector, you know what? These public health people– it’s not just that
they’re smart do-gooders. That they actually
are results driven. They really are capable. And in the end,
sustainable change can be delivered
if you really find where those two things cross and
where those two things align. And so we’re spending time– and it’s a bit, also, on deaf
ears, like contraception– but really trying to convince
people that the water is warm. That the margaritas
have salt, and that you know you should really think
about opening your mind up to the possibility
that doing it alone might not be the right answer. So when I think about
why you’re here– I mean, the mission in which
you know this organization is grounded on in the
platform– it’s really wonderful and thrilling
to think that when we talked on the phone, I
thought, wow, this is going to be like
preaching to the choir. I’m actually going to
go to an environment where there’s not
a lot opposition, and where people really
believe that a more socially and
environmentally sound world is capable and possible. And that your contributions
will make a difference. The power of one is
really significant. So I’m going to close with
a quote from Dolly Parton. I am. I’m going to do it– a
quote from Dolly Parton. And the quote is really simple. It is, “If you
don’t like the road that you have in front of
you, pave yourself a new one.” So I’m happy to answer
questions about Dolly Parton. I’m happy to answer questions
about WomenCare Global or Evofem Inc, or the
public-private partnership, if you have any. Thank you so much for your time. [APPLAUSE] Thank you, Sandra, so we
will take a few questions for about 10 minutes or so. I just ask if you
do have a question, please make sure you
have a mic because we do have some folks
listening in on the cameras. I want to make sure
they can hear you. So do we have any
meaty questions? Yeah. Thank you for speaking
with us today. I am interested in where you
see the long-term, sort of, goals and relationship
of WomenGlobal now? Are you looking to shift the
type of partnerships you have with some of the communities? Or have them be
able to take over, or where do you see that going? Yeah, so it’s our hope– so
the MAX project, for example. It’s our hope that we
will go into markets and do this behavior
modification model for four years or five years. And then, but we’ll be doing
it with less frequency. So two years we’ll be
incredibly frequent. We’ll be there every
two weeks or every three weeks or every month. After two years, we’ll go
every couple of months. So it is our goal to fully
transitioned out of markets. At the moment we have not
discovered or determined yet what that frame will be. So we’ve been doing the
program for two years. We don’t feel that we could
leave at the two-year mark at this moment. But we are hopeful
that we’re thinking it’s going to be a four-year
transition, where we know that the quality
of care is there, and that providers
are delivering access to choice is our hope. Does that answer your question? Hello, thanks for coming. I just had a quick question. How much religious opposition
have you encountered? And can you give an
example of one time and what you did to
overcome that opposition? Well, so, the opposition–
both religious and abortion opposition– is very intense. And they are
incredibly well-funded, and there are a lot of
really smart savvy people that run these initiatives
for the opposition. And so in Latin America, there’s
a big Catholic opposition that we have found. And what’s interesting
is that in most of those markets, we partner
with organizations that are very savvy around social media. So for example, an
organization called PSI. They have a hairdresser
model, where there’s a lot of
education and information given in a relaxed setting. That we work with market
women to figure out, what are different
access points where we can try to shift mindsets? So I don’t know, Ellen, is there
like a real religious example that we can give that
specifically religiously based that you can think of? Not anything that we, oh, sorry. Not anything that we’ve
worked with directly at WomanCare Global. I think that we tend to work
with partner organizations, particularly, in the
Latin America market that are working on the
advocacy part of it and working on legal reform. And with women’s
groups, again, realizing what we don’t do, but the
power of a partnership. There are certainly
some instances of where we’ve submitted
a product registration with a perfect dossier, all
of the paperwork in place, and it just gets held
up for no real reason. And when we do a
little bit of digging, there might be someone that’s
sitting on the approval committee that we find out that
is would not approve something because of personal– –religious beliefs. –beliefs. That’s not something that
we can necessarily change, but at least we know
what we’re dealing with. The other thing too,
to be totally honest, if there are markets that we
go into where we do a scan, and we say, look,
it’s going to take triple the money and triple
the capacity and time to even make a dent. And even then, we don’t know
if it’s going to be worth it. And we could use
those same resources in a much more
relaxed environment, where women have a different
opportunity to get access– we may choose to. And it’s not that we’re not
willing to do the hard work, but we may get
quicker results first by using those resources
in another market if it’s that intense. So thank you very much coming. So I have a question. Can you comment
on the difference between this partnership
and a partnership between a pharmaceutical
company and a distributor for profit, for example,
Cardinal Health? Yeah, so we actually,
as an organization, have a lot of partnerships
with distributors. So we operate in 100
countries, but we have actual proprietary
relationships with over 60 distributors. So the distributor
relationship is just somebody that they warehouse. So, for example, in the US,
they warehouse your product. They ship it out to the shelves
of CVS, Rite-Aid, Walgreens. And so they are a partner that– it’s basically an arm
extension of how to distribute. So in the emerging
markets, we have partners. So, for example, we
go into a country, we might have four distributor
partners in one country. Because some distributors
say, well, we only work in urban markets. We don’t work in
the rural markets. So we go in and partner– nonexclusive, by the
way, on purpose– so that we can change
distributors if we need to. If they’re not getting
the biggest reach. But the distributor is
really just an extension arm of logistics, if you will. But really the strategy
and the decision making is made at the corporate level. So the partnership with
Evofem is different because Evofem is
about investing in research development– the clinical trials to
create the innovations– than they want to market,
us really, in the US. And then WomenCare
Global is taking it into the other markets. So we use the same distributors. Does that answer your question? So my question is maybe more
of a personal or career-related question. As we think about going into
our next phase of our careers and even the stage after that– it sounds like you made
the change from corporate to mission based at a
maybe at a gut feel, or it was the right time. Do you have any advice for us as
we think about when we should– if we want to get involved,
when the right time is? And when you say get
involved with either– in corporate or nonprofit? I mean, I guess I’m
thinking about like do we– do you recommend people get
some corporate experience, so that they can talk the
private and public sector speak before going into the
public sector, or– I don’t know– thoughts on that? Well, OK, so I sometimes– I hesitate to be candid
as I always want to be, but what the heck. So if you were asking me
directly, and I’m telling you, I guess I would
say to you if you had to choose to go
into a nonprofit first, and then transition to the– I would tell you
to do the reverse. I believe– I really believe– in my experience, my
corporate experience changed the way I looked at
the metrics and the dollars and cents of a nonprofit. It changed the way I
interacted with the donors. It changed the way that
I wanted to figure out how we were using this money. Where was it going exactly? I want it to be transparent. I wanted us all to have this
platform of good business sense. And so that really helped me. And not everybody, maybe,
needed it like I needed it. But I do think that
nonprofits really value a little bit
of business that they can bring to the table. Because I do think
that, sometimes, they overlook certain things. Not on purpose, just
because they don’t know. They’re not wired that way. So if you’re asking
me, I would say, if you had to pick an order,
getting some private sector before you go to the public
sector is the right way to go. Yeah, you’re welcome. Sorry, did you have a question? No, oh, you didn’t. OK, sorry, sorry. I was nodding my head. Oh, you were, OK. You were just directly in
front of me, I was like, OK. I was just wondering,
what are you most excited about over the next,
let’s say, five years? So I am incredibly
excited about Amphora. I mean, excited in a– and I meant to tell you this
story, but I got off track. When I was in private sector
pharma, we had this think tank. We had all these
different think tanks where we would come to the
table and think about– everybody would
bring their idea. And these assignments would
not take a normal person like a month. And they would convince
us, because we all didn’t know any better, you
should do this in a night, and you’re like, OK. And so we were
supposed to develop the most innovative
technology– the thing with the biggest unmet need. And I said, wouldn’t
it be amazing if women had
something on demand? Something that they could
use just when they wanted to, and that it didn’t
have hormones. And my boss said,
tomorrow, when you come to work on your unicorn,
you can work on that. Really, really. I remember him. I can picture him right now. But so I’m really
excited about Amphora. I’m incredibly
excited about Amphora because I think it’s going
to change the way women feel. I really do. I think it’s going to
change the way they feel about their power over sex. They’re not going to have to
worry what is this doing to me and how is it making me feel? And so that’s exciting to me. The other thing
that’s exciting to me is that this
public-private partnership. We all just moved in
together two months ago. So instead of being,
here we are over here and here we are over here,
which is really safe, we’ve moved everybody in together,
two months ago– the WE organization. And I said, if you want to
work at WomenCare Global, you actually can’t have a job. And if you want to
work at Evofem Inc, you can’t have a job. You have to want to work at WE. And we moved everybody in
together in an open floor plan. And so I’m really excited
to be able to show and prove that we both are
better together. Like to really show results too
that public-private partnership can work with two
separate boards, with all the obstacles,
that it can work. So I’m excited to prove
that and to try to encourage other organizations to do it. And I’m excited to get my
son to stop saying bad words. He’s really focused on
bad words at the moment. Not because he hears
them from me, by the way. I’m not sure where
he hears them. No idea. I think we have, maybe,
time for one last question. Or we can take these two. But go ahead, Ana. Thank you, again,
for being here. How much do you find that
the current, I guess, unfriendly or difficult
political climate in the United States around contraception
impacts either positively or negatively what the
WE is able to do, be it abroad, funding for the work
that you’re doing domestically? Or is it null because
it just doesn’t impact? Well, so we’re all holding our
breath a bit about Obamacare. Because there’s a hope that
the class of contraception will be covered. That regardless of
what your choice is, it’s going to be fully covered,
which would be amazing. So then women will
truly be able to choose. It or won’t matter,
you won’t really be influenced by anyone– your provider, who could
be influenced by a company. So in that environment,
it’s actually going to make our
situation great. It’s going to make it
fantastic– particularly for the launch of Amphora. But, I guess I would say to you
that the impact really is, is I think, some of the donors–
there’s some donor fatigue. There’s subsidization fatigue. They want to see bigger and
broader and more impactful results. And the funding is
incredibly competitive. So there’s a lot of nonprofits
that are, sometimes, we a little bit work
against each other, just to try to get funding. So that environment
of donor fatigue, that are mostly donors
in the US, that I think, has impacted us negatively. But for the most part,
it doesn’t really impact our ability to execute
in some of these markets that are outside the US. We have one more question. Thank you so much for coming. I just had a question
about, you mentioned like the last mile getting these
products actually to the women. How does WomenCare Global
work to get the products from the facilities and
like the stockout rooms to the actual women in
the rural communities? Yeah, so we did recognize
a lot, that products would get into these
warehouses, and they would expire before
they were ever taken out of the warehouses. I mean, really incredibly sad. And so we have become really
deliberate with our sales staff and the distributors,
so to know when these products arrive in market. Like within two days,
that those products are being taken out by a variety
of different distributors, some cases. And delivered to the hospitals,
delivered to the clinics, delivered into the markets. And we, I mean, that’s a really
refined process, by the way, that we made so many
mistakes in the beginning. I mean, honestly. But now we understand that it’s
all about logistics– timing and logistics. And it really is
about understanding– the communication factor. I mean, one thing
that we do, I think, incredibly well is we
have so many layers and levels of communication. Like, I have a call
with the entire company, once a month, in every
department we walk through. I have weekly one-on-ones
with my executive team. I have one-on-ones with a
group of executive team. They have one-on-ones
with their teams. I’m talking about, you
can’t even believe it. But the reason that we do it
is because we are investing too much time and
energy and effort, there can be no kinks
in the supply chain. We have to make sure
it’s perfect execution. And so we overcommunicate about
that to ensure that it happens. And we want to know
when does it get there. And all that’s fed back, so that
we know when it’s happening. But I really mean
this– it’s really– when I say we don’t
create competencies that we don’t have, we
really are about access to contraceptives options from
a regulatory and a quality perspective. Starting there, all the way
through getting the products in the hands of the
people that need it. But it’s a lot of orchestration. And the woman sitting next to
you runs our global regulatory. She looks nice, but she’s
very serious and kind of mean. No, no, not mean. But so it is. It’s just all about
communication, coordination, orchestration
of boring things, by the way. They are. It’s like, you can’t believe it,
the level of granular detail. But it makes a big
difference in the end. Great, well, Sandra, thank you
so much for being here today. I think we all agree this
was incredibly inspiring. And we look forward to seeing
how your work continues to grow and expand. And we appreciate you taking the
time to visit Charlottesville. Thank you. This is for you
Thank you so much. Thank you very much. [APPLAUSE]


  1. Fantastic presentation and representation of the dynamics and power of combining a non-profit, mission centered organization with a commercial corporation, unified by the vision of competent, vision driven leadership.  Saundra provides a multi-faceted glimpse into the future through her transparency and leadership of these exciting companies.

  2. you go woman. control your fertility control it all. keep up the great work, don't ever give up! so many women need your work. i hope we cross paths

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