Dear Readers,

Ask anyone in pharma what the industry does, and the answer comes easily: develop treatments, save lives, and push science forward. But underneath that respectable mission lies a challenging dichotomy. In its pursuit of better health outcomes, the industry has inadvertently been generating pressures that undermine global health in other, less visible ways.

Sustainability and health equity efforts may have come under political scrutiny this year, especially in the US, but across the life sciences, organisations have been grappling with an uncomfortable truth: the value of what you deliver is increasingly measured against the impact of how you deliver it.

What's striking isn't just the scale of change, but its direction. Sustainability is no longer a siloed initiative, and health equity is shifting from rhetoric to tangible intervention – whether that means rethinking drug delivery for overlooked patient groups or questioning how policy decisions ripple through access and affordability. These aren't separate concerns. They're deeply interconnected.

And so, for our final issue of 2025, we set out to explore what happens when the industry takes both seriously – from wind-powered trimarans built for pharmaceutical cargo to local supply chain innovation at Sandoz, long-overdue improvements in vaginal drug delivery, the implications of direct-to-consumer trends, and the far-reaching consequences of the US's Most Favoured Nation policy.

Together, these stories reveal an industry grappling with its responsibility to innovate in ways that serve both people and planet more equitably.

Until next year,

Eloise McLennan
Deep Dive editor