Integrity is the most overused word in corporate communication and the least useful as stated. Every company claims it. Almost no company defines it in a way that would let an outsider check. In drug development, though, the word acquires teeth, because the consequence of getting it wrong is not a reputational problem. It is a person taking a compound that does not work.

The Specific Version of the Problem

Biotechnology has an unusual relationship with uncertainty. A company can be entirely honest and still be wrong, because the underlying science is genuinely unresolved. Preclinical data suggests a mechanism. Early trials look encouraging. A larger study fails to confirm what the smaller one appeared to show. This sequence has played out hundreds of times, and it is not by itself evidence of misconduct.

What makes the field difficult is that the same sequence can also result from selective reporting, and from the outside the two look similar. That ambiguity is the actual governance challenge. It is why integrity in this industry has to be operationalized as a set of procedures rather than as a disposition, and why leaders who talk about values without describing mechanisms should be treated skeptically.

Mechanisms That Actually Constrain

The procedures that matter are known and mostly unexciting. Pre-registration of endpoints before a trial begins, which removes the option of choosing the flattering measure afterward. Independent data monitoring committees with the authority to stop a study. Publication of negative results, which costs a company something and is therefore meaningful.

Leen Kawas has argued for treating scientific rigor as an operating discipline rather than a compliance obligation. The distinction has practical content. A compliance culture asks what is permitted. An operating culture asks what would have to be true for this result to be reliable, and then goes looking for the answer before an outside party does.

The Impact Question

Impact in life sciences is easier to define than in most industries and harder to achieve. A drug either changes an outcome for patients or it does not. There is a measurement, it is public, and it arrives years after the decisions that determined it.

That long lag creates a specific leadership problem. Every incentive available to a chief executive operates on a shorter cycle than the outcome being pursued. Financing rounds close quarterly. Boards meet monthly. Public markets react daily. A therapeutic program answers in a decade. Leading well under that mismatch requires deliberately building internal measures that track the long thing, because the environment will supply only measures that track the short one.

What Taking a Company Public Teaches

Leen Kawas led a neuroscience company through an initial public offering in 2020, raising a substantial sum at a moment when few women founders had done so. The gender statistic is worth stating and worth not over-reading. It describes an unusual outcome, and the interesting question is what the process itself demanded.

Going public converts a private disagreement about data into a public one. Every assumption becomes a disclosure. Every optimistic reading acquires a legal weight it did not previously have. Founders often describe this as burdensome, and it is. It is also a forcing function. A company that has to write down precisely what it believes, and to be held to it, tends to discover which of its beliefs were load-bearing.

Integrity After Something Goes Wrong

Any serious discussion of this topic has to address what happens when a company faces questions it did not anticipate. The reflex is defensive, and the defensive reflex is usually wrong. Organizations that handle scrutiny badly tend to do so by treating the inquiry as an attack on their character rather than a request for information.

The alternative is procedural and unsatisfying in the moment. Commission an independent review. Give it access. Publish what it finds. This approach is slower, more expensive, and considerably less comfortable than a firm denial. It is also the only version that leaves a durable record, and in an industry where careers span decades and reputations are transmitted by word of mouth, the durable record is what eventually matters.

The Investor Seat

Moving from operating to investing changes the leverage on both questions. An operator sets the standard in one company. An investor sets it, partially, in every company she funds, a list that her Crunchbase founder and investor record captures only in outline. Much of the board work Leen Kawas has taken on since sits at the same intersection, where governance questions get settled before a program is far enough along to make them expensive.

This is a quieter form of influence than a public statement, and it is more effective. A fund that consistently asks about trial design assumptions, and that declines deals where the answers are evasive, changes the behavior of the founders it turns down as much as the ones it backs. Word travels.

A Working Definition

Leen Kawas holds an operating role alongside the investing one, and the chief executive seat at EIT Pharma keeps the same questions live from the opposite direction. Integrity, made concrete, is a willingness to build systems that could embarrass you. Anyone can commit to honesty in a setting where no independent check exists. The meaningful version is agreeing in advance to a measurement you cannot adjust afterward, and then publishing the result whichever way it falls.