The 20th-century view of shareholder primacy is flawed. By focusing first on creating wins for all stakeholders—customers, employees, suppliers, and society—companies build a sustainable, beloved enterprise that paradoxically delivers superior returns to shareholders in the long run.

A biotech's primary focus should be on creating tangible value for patients. Jack Elands argues that by successfully addressing patient needs and improving their quality of life, value for investors and other stakeholders will be generated as a natural and sustainable byproduct.

When offered a chance for his daughter Grace to receive a one-off experimental drug, CEO Matt Wilsey refused, operating on an "all of us or none of us" principle. This demonstrates a community-first ethical framework in patient-led drug development, prioritizing collective benefit over individual gain.

Successful biotech leadership requires a clear decision-making hierarchy. Dr. Bahija Jallal advocates for a framework where patient welfare is paramount, followed by scientific rigor. Financial success is treated as a byproduct of excelling in the first two areas, not the primary goal.

The current model of capitalism prioritizes profit above all. A more sustainable and just version would reorder the priorities: first, advance a greater cause; second, protect the people and places you operate in; and third, generate profit as the means to continue the first two indefinitely.

"Stakeholder capitalism" often fails because it frames progress as a zero-sum compromise and an appendage to a broken system. A better model is "mission primacy," which redesigns the organization's core purpose to be the creation of specific value, from which all other benefits flow.

A company's purpose statement serves as a 'GPS' in rough waters. Johnson & Johnson's patient-first credo guided its decision to pull all Tylenol during a poisoning scare. This decisive, purpose-led action ultimately strengthened trust, demonstrating how a clear 'why' enables effective crisis management.

One of the easiest yet most powerful actions to build an incorruptible company is to legally embed its mission into the corporate charter. This simple step restores the historical norm that companies exist for a specific purpose, providing a legal bulwark against purely profit-driven pressures.

To fulfill their 'social contract' and combat poor public perception, companies must move beyond just selling treatments. By taking a broader public health stance, advocating for policy change, and filling leadership gaps in prevention, they can build the long-term trust that a product-centric approach cannot.