A lot has changed since the devastating 1980s Aids crisis depicted in the Channel 4 TV show It’s a Sin – but the stigma attached to the illness remains, says Deborah Waterhouse. As chief executive of ViiV Healthcare, a GlaxoSmithKline-controlled joint venture that develops HIV drugs, she leads one of the largest commercial developers of Aids treatments in the world.
“I remember in 1987 GSK brought the first medicine out for HIV and at that point the life expectancy for someone living with HIV was 18 months,” she tells the Observer, speaking via video link from her study lined with novels, travel and music books in her home in Richmond, west London.
“Today if you become HIV-positive, your life expectancy is the same as for somebody not living with HIV. While science has created amazing treatments, stigma has not evolved, and this is a battle we’ve got to fight. It’s a highly stigmatised disease. We know that health systems don’t always treat people living with HIV in the way they should.”
Waterhouse has led ViiV, one of GSK’s most successful businesses, for almost five years. It made £4.9bn sales in 2020 but only employs 1,400 people, compared with GSK’s 94,000. This week GSK will unveil its 2021 results, which are expected to show further strong sales for the HIV venture. Its dolutegravir tablets are taken by 18 million people, half of all those living with HIV.
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CV
Age 54
Family Married with two children.
Education Hamstead Hall comprehensive school, Birmingham; English literature and economic history at Liverpool University.
Last holiday Somerset
Best advice she’s been given “Having a global perspective is incredibly valuable, so live and work in as many places around the world as possible.”
Biggest career mistake “Not realising for many years that there is no way to juggle career, being a mum, daughter, friend and a wife perfectly. Banish guilt and ask yourself: did I do the best I could today?”
Word/phrase she overuses “Can someone unpack the dishwasher please?”
How she relaxes “Spending time with family and friends, travelling, reading and walking with my dogs in Richmond Park.”
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According to the World Health Organization, 1.5 million more people were infected with HIV in 2020, and nearly half of them died, despite a commitment to end Aids by 2030.
In December, ViiV got the green light from the US health regulator for Apretude (cabotegravir), which is injected once every two months, as the world’s first prevention treatment for people who are at increased risk of acquiring HIV sexually . The injections replace daily pills, allowing those affected to forget about the disease for a while. However, these drugs need to be kept in the fridge, which can be a challenge in countries like Malawi and South Africa.
The world’s first treatment for HIV and Aids, Zidovudine, was developed in the 1980s by Marty St Clair, a virologist at GSK’s predecessor company Burroughs Wellcome, and her colleagues. When the drug was launched, Waterhouse, the daughter of a butcher who grew up on a council estate in Birmingham, could not have dreamed of being at the forefront of developing HIV drugs one day. She was studying English literature and economic history at Liverpool University. After graduating, she went into the car industry and became a marketing trainee at Jaguar Land Rover in the Midlands.
In 1996, she was headhunted by Glaxo Wellcome (which merged with SmithKline Beecham to become GlaxoSmithKline in 2000). She went on to work in GSK’s research & development arm for four years; moved to Melbourne to become general manager for Australia and New Zealand; went back to the UK to head central and Eastern Europe, looking after 22 countries; then spent three years in Philadelphia, where she ran the US vaccines business and its primary care division. In April 2017, she assumed her current position as head of the HIV business, and joined GSK’s corporate executive team three years later.
“I was always interested in science but it was not the thing that I chose to study,” says Waterhouse. “I worked in R&D for a few years, early pipeline analytics and target medicine profiles and that was the thing that really did it for me: the promise of a medicine and how you could develop it, how you could imagine the impact on human health.”
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We talk against the background of GSK’s battle with the aggressive activist shareholder Elliott Management, a New York hedge fund that emerged on the shareholder register last spring. It has clamoured for change, including demands for GSK’s chief executive, Emma Walmsley, to reapply for her job, as the company prepares for the spinoff and stock market flotation of its consumer health arm this summer.
Waterhouse strongly backs Walmsley (who appointed her to the top job at ViiV) as the right person to lead GSK after the split. “She has built an amazing team and the future for GSK is really bright. She’s a fantastic leader.”
Her own focus is on developing HIV drugs and contributing to GSK’s ambitious £33bn revenue target for 2031. ViiV is working on long-acting treatments that can be self-injected at home, while a potential HIV “cure” is set to be tested on volunteers this year.
The cure ViiV is working on would flush the virus out of every reservoir in the body it is hiding in and kill any remaining virus cells, leaving people in remission so they could go from one to three years without medication.
What is striking about ViiV is that seven of 10 on the executive team are female. Waterhouse hopes more women will rise through the ranks, noting that more girls are choosing Stem subjects, even though those are still male-dominated. “We need to be much more inspiring and encouraging. It’s obvious to people now that Stem subjects and technology/artificial intelligence are areas of the future.”
Chip Lyons, chief executive of the Washington-based non-profit group Elizabeth Glaser Paediatric Aids foundation (EGPAF), has worked closely with Waterhouse on providing effective HIV treatments for children who are born with the virus, especially in sub-Saharan Africa. He describes her as a “problem-solver”.
In his first meetings with her as part of a Vatican-hosted consultation on paediatric HIV in 2017, he was struck by “how carefully she listened”. “Not only was she listening but she was also texting feverishly with her team: ‘Here’s what I’m thinking – can we do this?’”
Lyons says she and her company never wavered from their commitment to tackle HIV in children, which is often neglected. ViiV makes a version of dolutegravir for children, including a dispersible single tablet that tastes like strawberries.
As to when the HIV epidemic will end, Waterhouse says her team “talk about this a lot”. She is predicting a significant reduction in new infections this decade. However, South Africa faces by far the biggest HIV epidemic, and Covid-19 has led to a drop in testing for HIV, diagnoses and treatment in many countries.
“The HIV epidemic probably won’t end until the late 2040s but it’s on the horizon,” says Waterhouse. “As a passionate believer in science I truly believe we will find an ultimate cure but it’s going to take another few decades before we get there.”
