Trained in public health with early exposure as a US Peace Corps volunteer in Africa, Erin Gainer came to her present role by serendipity via a common acquaintance with the founder of HRA Pharma. Ten years later, her decision has been vindicated. "My job combines scientific leadership on women's health and reproductive rights with the practical satisfaction of commercializing new medicines to improve the quality of life," she says.

Headquartered in Paris, HRA is a pioneer in emergency contraception and other products for gynecological use. It also specializes in orphan drugs for endocrine disorders, including the treatment Lysodren for cancer of the adrenal glands. HRA's sales footprint now covers 60 countries. The key management challenge for Gainer is adjusting to growth that has seen company staffing more than double in the past 18 months. "As a small biopharma company, deploying our human capital effectively is critical," she says. "Regulatory and compliance burdens are increasing and pricing pressures require more specialized expertise. If we don't manage these issues right, they can quickly become barriers to market entry."

And looking forward? Gainer believes that transparency has to be front and center in the leadership skill set for future CEOs, if only for the fact that sales will depend increasingly on good contacts with governments and public buyers who are heavily influenced by reputational issues. Ethics and integrity are closely related—"Absent these, in this industry you have no business."

I am the "management by walking around type." I enjoy chance meetings and interacting with all levels of the organization; if your team understands why something is important, they are enabled to get it done.

The challenges of the pharmaceutical industry have focused me. Good science and medicine alone are not going to improve healthcare. We need good and transparent business practices, a focus on low cost value to patients, and complete diligence to safety. I find all these aspects are present every day at J&J. On a daily basis, I feel enabled to do the right things for patients and the company without conflict.

I look at globalization, cultural diversity, and strategic decentralization as opportunities. Globalization has opened new skills and new markets. Cultural diversity brings new perspectives, histories, and thinking that is potentially non-traditional. Strategic decentralization allows each piece to focus on excellence internally without overextension and distraction. The leadership challenge is about helping your organization optimize the utility of the matrix.

Unlike the previous generation, I never had any expectation of long-term security with any given employer. It is pure employment at will and performance-based advancement. I think this approach is a necessity of the challenging economic environment in which business is now conducted. I also feel the new leadership model is decentralized and virtual. I seldom sit in my office, but everyone knows where I am and what I am doing.