The 2025 edition of the symposium, held in May, was filled with highlights. Among them was the thought-provoking exchange between Mikael Dolsten, former Chief Scientific Officer at Pfizer and visiting professor at Lund University, and Jan M. Lundberg, professor at Karolinska Institutet and former global head of R&D at Eli Lilly and AstraZeneca.
Science, culture and courage behind innovation
Dolsten, who spearheaded Pfizer’s R&D efforts during the COVID-19 pandemic, highlighted curiosity and openness to technology as decisive factors in the record-breaking development of mRNA vaccines. It was mRNA technology that enabled the first approved vaccines against COVID-19, developed by Pfizer/BioNTech and Moderna. But innovation, he stressed, is not just about technology – it is also about culture, courage, and long-term partnerships.
“We had the advantage of starting a collaboration with BioNTech long before the pandemic, originally around influenza. A key factor is being open to new technologies and daring to explore the unknown. An exciting development today is the power of machine learning tools, which allow us to better understand what particle composition is optimal – and for whom,” Dolsten explained.
He underlined that it often takes decades to build the kind of capacity and technical maturity required to deliver tangible results in certain research areas.
When two become one – but not three
Long-term leadership and well-functioning organizations create the foundation for innovation. Drawing on his experience from several major pharmaceutical companies, Lundberg emphasized that large-scale restructuring can sometimes drive progress – as seen in the merger of Astra and Zeneca.
“Synergy is often described as 1+1=3. In reality, a merger is more like 1+1=1.5, since large organizations tend to shrink after a merger. The key is to preserve – and ideally strengthen – research even when under financial pressure,” Lundberg observed.
Later, as head of R&D at Eli Lilly from 2010, Lundberg faced different challenges: few new products, a weak pipeline, and low success rates in late-stage clinical trials. By doubling down on research and innovation, Lilly was able to reverse the trend, launching several blockbuster drugs in type 2 diabetes, obesity and immunology – products that each went on to exceed USD 1 billion in annual sales.
“At that time, Phase 3 trials succeeded only 25 percent of the time – a very low figure given the cost of such studies,” Lundberg recalled.
By identifying and supporting talented scientists, Lilly was able to raise its Phase 3 success rate above 70 percent.
“Some researchers never give up. They believe in their molecule, don’t always listen to management – and often they are the ones who succeed in the end. They need support,” Lundberg added.
Pharmacology in new forms
Both Dolsten and Lundberg returned repeatedly to the importance of pharmacology as the foundation for precision medicine and long-term therapeutic impact.
“The beauty of pharmacology is that you can follow patients over time and truly see the effect of medicines on health and life expectancy,” said Lundberg.
Dolsten pointed to today’s antibody-based therapies as an example – engineered to last for months and to deliver functions far beyond what nature provides. But he also argued that pharmacology as a discipline must evolve to remain relevant and attractive to the next generation:
“Perhaps pharmacology needs a new name to attract young talent. The field is still central, but it must be reshaped at the intersection of biology, chemistry, mathematics and AI,” Dolsten suggested.
Lundberg added:
“Pharmacology is also about risk versus benefit – something we always need to weigh carefully. Animal studies do not always predict what happens in humans.”
Decisions under uncertainty
Both Dolsten and Lundberg have faced decision points where billions of dollars and years of research were at stake. When should a project be stopped? When should it be pushed forward despite the risks?
Dolsten drew on the expertise of Nobel laureate Daniel Kahneman, professor at Princeton University, to better understand decision-making and cognitive bias.
“When I started, we needed to take about 20 projects into human testing to achieve one approved drug. By the time I stepped down, that number had dropped to five. It is crucial to see through the optimism that naturally arises when you love your project – optimism that can make you bury your head in the sand,” Dolsten said.
Lundberg emphasized the importance of not letting wishful thinking drive late-stage development decisions:
“We introduced a rule: no Phase 3 program without robust Phase 2 data in the right patient group. It cannot be based on wishful thinking.”
AI, regulation and future horizons
Looking ahead, both saw the coming decades as transformative.
“We are facing an acceleration unlike anything we have seen before. Many diseases will be redefined into smaller, more specific subgroups, and treatments will be tailored accordingly,” Dolsten predicted.
Collaboration across boundaries
Both scientists stressed the importance of collaboration across academia, industry and society.
“The world is complicated, and these are turbulent times. But I always look for the opportunities that arise, even in difficult circumstances. Science must focus on doing the right thing for the right reason at the right time. We cannot solve everything – but we can show what is possible,” Dolsten said.
Lundberg added that the growing skepticism toward science makes it all the more important to demonstrate its relevance:
“Everyone, including politicians, gets sick. Perhaps it is at that moment that views on medical research change – and become more positive.”
The conversation was moderated by Adam Smith, who has interviewed all Nobel Laureates since 2006 and is the founder and Editor-in-Chief of, among others, Nature Reviews Drug Discovery.