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Alnylam CEO Yvonne Greenstreet: What Leadership Has Taught Me
January 21, 2026
Yvonne Greenstreet, MD, MBA, OBE
CEO, Alnylam Pharmaceuticals
Last week at the J.P. Morgan Healthcare Conference, we unveiled our “Alnylam 2030” strategy, highlighting our enormous ambition for the company. As I step into my fifth year as CEO, I’ve thought a lot about what it’s taken us to get here and what it will take moving forward.
I’ve also reflected on what this journey has meant for me personally. My time as Alnylam’s CEO has been an extraordinary chapter in my career, one that has sharpened and reaffirmed lessons about leadership that I’ve gathered over many years. At this important moment for the company and for me, I want to share a few of these lessons.
Be Bold and Chase Unreasonable Goals
Bold ambition has defined Alnylam from the beginning. That is what drew me to a company that was still a risky venture when I joined, with a few hundred employees and no approved drugs.
Every five years, we have challenged ourselves with goals so audacious that even we were unsure we could achieve them. Last week, we announced that we had met or exceeded each of our “P5 x 25” goals, with remarkable impact: approximately 500,000 patients are now receiving one of six approved Alnylam medicines; we delivered a five-year compound annual revenue growth rate of 50 percent; more than doubled the size of our clinical pipeline; and achieved profitability for the first time.
Pursuing these “unreasonable” goals on behalf of patients has made us more courageous, creative, and accountable, and has established Alnylam among the top biotechnology companies in the world. I am focused now on sustaining this culture of audacity while scaling the company for the future. We must continue making bold bets while building the commercial, operational, and financial strength required for our next chapter.
Listen for Illumination Not Confirmation
Listening is critically important for any leader, especially in an industry driven by innovation where you are charting completely new territory. Listening leads to learning. The role of listening in my own leadership style was forged at my childhood dinner table. I grew up in a large, diverse family in Ghana, where many languages, religions, and perspectives filled our home. Dinner conversations were lively and often included interesting visitors from the university community where my parents worked.
These conversations helped me appreciate the value of listening. We all know that it can be hard to be a great listener in our professional lives. The image of the leader we have in our heads is often the image of someone talking—giving direction, announcing decisions—not the image of someone listening. It takes courage to sit quietly and consider what others are saying when we feel an expectation to be speaking. But listening deepens our understanding of an issue and opens us to possibilities beyond our own experience and imagination.
Live and Die as a Team
Drug development is a team sport. We can go fast alone, but we can go farther together. One of my earliest priorities as CEO was to build a strong leadership team. We had to ensure our team had a clear purpose, establish trust, create space for everyone to be heard, commit to a strategy.
Since then, we have managed many tough decisions together, none more consequential than our decision to amend the statistical analysis plan for the HELIOS-B study of vutrisiran—the clinical trial that would determine Alnylam’s future—just months before its conclusion. It was the biggest bet of my career. Many doubted us, but we believed this change would increase the likelihood of success. We followed the science, sweated the details, and stood by the rigor of our approach—and by each other. This decision helped deliver the landmark results that changed the trajectory of Alnylam forever.
Foster Resilience
We fail far more than we succeed in the business of developing medicines, thwarted by a gauntlet of challenges that includes the complexity of human biology, clinical trial setbacks, regulatory agency rejections, financial market volatility, policy uncertainty, and more. Navigating this gauntlet depends on fostering a shared sense of resilience, a deep belief that if the current program falls short, the next breakthrough may be just around the corner.
Steer Toward a North Star
Defining a purpose is critical to fuel any journey that involves a challenge. A North Star brings people together and creates a feeling of being part of something bigger. That purpose for us in the biopharma industry is the patient, and connecting our colleagues with this purpose creates the energy, determination, and hope needed to overcome the huge obstacles inherent in the high-risk adventure of drug development.
Conclusion: Looking Forward
I feel a deep sense of urgency to ensure that Alnylam—this incredible biotech company that we are building—can deliver on the promise it holds to transform human health and help millions of people. As we step into this next chapter, I will trust in the lessons that leadership has taught me and in the audacity, talent, and passion of the amazing colleagues I share this journey with.
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