Sanofi’s Fresh Boss Has a Tall to-do List — Fix the Drug Pipeline, Replace Dupixent and Steady the Ship under Trump

With input from Reuters, Bloomberg, and CNBC.

Sanofi’s incoming CEO, Belén Garijo, walks into a classic pharma fixer-upper: a giant company with one runaway hit, a thinning bench of new drugs and investor nerves to calm. She’s also the first woman to land the top job at the firm — a milestone — but the work waiting for her is anything but symbolic.

Let’s be blunt: Sanofi depends on one drug too much. Dupixent, the eczema-and-asthma superstar, still pulls in a massive chunk of revenue. Finding a replacement for that cash cow is the company’s existential mission. If Garijo can’t kick R&D into higher gear and identify a believable successor, shareholders won’t be patient for long.

What Garijo brings to the table is operational grit. She’s a clinician by training who climbed the ranks at big firms and ran Merck KGaA’s sprawling empire, where she tightened structures and pushed through deals. The flip side: her record on launching blockbuster new drugs is mixed, and during her time at Merck KGaA the share price didn’t exactly soar. Investors will want to see clearer proof she can turn scientific promise into approved, profitable medicines.

And then there’s the political weather. Sanofi’s vaccine business — nearly one-fifth of sales at times — hasn’t been cruising. In the US, a choppier policy environment and a skeptical tone from the White House mean swings in uptake and pricing could persist. Navigating vaccine sentiment under Donald Trump’s administration will be part of the job, whether Garijo likes it or not.

So what should she do first?

1. R&D triage, fast. Sanofi needs a clear roadmap to replace Dupixent. That means prioritizing candidates with the best science and the fastest, least risky regulatory pathways, while cutting distractions. Investors will reward focus.

2. Show deals that matter. If in-house fixes lag, smart bolt-on acquisitions or licensing deals — not headline-grabbing vanity buys — could plug gaps faster. Garijo has done M&A before; now she needs to do it with speed and surgical precision.

3. Calm the market. Sanofi’s shares have been punished. Early, tangible wins — a positive data readout, a tidy acquisition, sharper guidance — will help reset expectations and restore credibility.

4. Stabilize vaccines. Whether via targeted public engagement, clearer pricing policies or smarter US partnerships, Sanofi must shore up that unit. Political headwinds are real; so is the demand for reliable vaccines.

There’s upside here. Garijo reportedly gets things done. She knows Sanofi’s culture (she worked there earlier in her career), and she’s got operational chops. If she can pair that with tougher R&D decision-making and some smart business development, she could steer the company into a healthier growth phase.

But don’t mistake optimism for a guarantee. Turning around a giant drugmaker’s pipeline is messy and slow. Sanofi’s reliance on Dupixent isn’t a one- or two-quarter problem — it’s a decade-long strategic puzzle that will be judged in clinical readouts, approvals and revenue curves, not press releases.

Bottom line: belén garijo’s appointment is a clear signal that sanofi wants someone who can execute. Whether execution means fast fixes or steady, patient overhaul is the real question. Investors will be watching — closely, and without much mercy.