The Long Road to the Trenches

I never planned to end up in biotech.

I studied mathematics at Oxford. Pure, abstract, elegant. I loved the precision of it, the way a proof either worked or it didn't. But as graduation approached, I had no idea what mathematicians actually did for a living.

So I did what many uncertain graduates did in the early 90s: I became an accountant.

Ernst & Young trained me well. I qualified as a Chartered Management Accountant and learned the mechanics of business: how money flows, how decisions get made, how companies keep score. But something was missing. Accounting felt like keeping track of the game rather than playing it.

I wanted to work on things that mattered.

In 1996, I found it at Abbott. For the first time, I was working on products that helped patients. The complexity was exhilarating: global supply chains, regulatory hurdles, commercial strategy, and underneath it all, science that could change lives.

I spent six years there, then moved to GSK on the R&D side. Different perspective, same realisation: this industry combined analytical rigour with genuine human impact.

But I also saw the limitations. Big pharma moves slowly. Decisions filter through layers of committees. The gap between a good idea and a patient receiving treatment can stretch into decades. I watched good science stall in those committees. Not because the biology failed, but because the organisation couldn't get out of its own way.

I started wondering what it would be like on the other side, where decisions happened faster and the stakes were more personal.

Before I could answer that question, I took a detour that turned out to be the best preparation I could have asked for.

McKinsey taught me how to structure problems and pressure-test strategies. As a consultant, you see dozens of companies facing similar challenges, and you start recognising patterns. The lesson that stuck: most strategic failures aren't failures of analysis. They're failures of execution, alignment, or governance. I saw brilliant strategies die because the organisation couldn't align around them, or because the governance structure created incentives that undermined the strategy itself.

Goldman Sachs, where I led healthcare equity research, taught me how investors think. When you're advising fund managers on billion-dollar decisions, you learn to cut through narrative and focus on what actually drives value. You also learn something uncomfortable: the story a company tells itself is often different from the story the market hears. That gap destroys more value than bad science ever does. I watched management teams lose credibility not because their science failed, but because they couldn't bridge the gap between what they believed and what investors needed to hear.

By the end of this decade, working with inspiring advisory teams not only at these great firms, but also at CRA and KPMG, I'd seen the life sciences industry from almost every external vantage point.

What I hadn't done was run a company myself. I hadn't felt the weight of decisions that affect people's livelihoods. I hadn't learned the difference between diagnosing problems and living with them.

That changed when I stepped into biotech.

As Corporate Development Director and CFO at Celixir, I led fundraising for cell therapies targeting heart failure and negotiated a licensing deal with Daiichi Sankyo. As CEO of Sutura Therapeutics, I raised an £11M Series A for gene therapies targeting Duchenne Muscular Dystrophy. At UTILITY Therapeutics, I secured FDA QIDP and Fast Track designations and built a regulatory pathway that could save years and tens of millions in development costs.

Between these roles, I advised dozens of other biotech founders facing the same challenges: fundraising, governance, board dynamics, partnership negotiations. The patterns were remarkably consistent across companies.

And I learned harder lessons. Ones that didn't fit the success narrative.

I've seen what happens when governance fails. When boards prioritise control over value creation. When scientific founders get sidelined by operators who don't understand the biology. When short-term thinking dressed as capital efficiency destroys platforms that could have transformed patient care.

I've watched companies I helped build fail after I left. Not because the science was wrong, but because the decisions were wrong. Those failures taught me more than the successes ever did.

Every one of them was a medicine that never reached patients who needed it.

Looking back, there's a thread connecting the accountant who wanted more, the consultant who saw patterns, the analyst who learned what markets actually value, and the CEO who discovered what it feels like when the consequences are real.

The thread is this: I believe biotech should solve the hardest problems, not just the most fundable ones.

At Santero, I'm working on treatment-refractory bacterial infections. AMR is one of the WHO's top ten global health threats. By 2050, antimicrobial resistance could kill 10 million people annually. It's not an easy therapeutic area. Investors often look away. But it's where I want to be.

I chair AMPLY Discovery, using AI to find new therapeutics in triple-negative breast cancer, AML, and cystic fibrosis. I chair PFU Therapeutics, developing next-generation RNA targeting for rare diseases and muscle loss. Through Fountainhead Consulting, I advise founders facing the same challenges I face myself.

None of this was planned. But all of it was preparation.

Three decades. Big pharma and tiny startups. Consulting and operations. Investor side and operator side. I've sat in most of the chairs around the table.

None of that makes me special. What it does is give me pattern recognition. I've seen what works, what fails, and what separates the companies that make it from those that don't.

Here's what I've learned: the biotech industry's biggest failures aren't usually scientific. They're operational. Governance breakdowns. Mistimed fundraises. Misaligned boards. Decisions made by people who prioritise politics over patients.

Those failures are preventable. But only if we talk honestly about them.

That's what I'm writing about here. Not theory. Not commentary. The practical reality of building biotech companies in the UK, including the parts nobody puts in the press release.

If that sounds useful, welcome to Beards on Biotech.

Mark