The Village That Builds the Strategy Is the Village That Executes It

In November 2020, Biogen Canada faced a problem that no single person in the room could solve. They were preparing to launch the first-ever disease-modifying Alzheimer's therapy in Canada — and the system that would need to deliver it wasn't ready. No standardized diagnostic pathway. Insufficient imaging capacity. Deep stigma that suppressed early help-seeking. And a cast of actors — neurologists, patient advocates, health administrators, provincial policy officials — who had never been asked to solve the problem together.

The conventional pharma response would have been advisory boards: invite experts, gather input, synthesize internally, and publish a readiness report. Biogen had already done that. They understood the problem in detail. What they didn't have was a coalition of people with a shared stake in solving it. So instead, we convened 27 people over three days — nine internal Biogen participants and eighteen external stakeholders — and let them build the strategy together. They left with 18 integrated action commitments and, more importantly, with something a report cannot manufacture: they had been in the room. They owned what came out of it.

Farah Jivraj, Biogen's Head of Market Access, put it simply afterward: "It really does take a village."

It does. And the village that will implement a strategy is the village that must build it.

Why delivery fails when builders and implementers are different people

Psychological ownership — the state in which a person's professional identity becomes bound to an outcome — is one of the most thoroughly researched constructs in organizational psychology. It is not the same as agreement, or alignment, or even enthusiasm. A meta-analysis of 351,919 individuals found it to be one of the strongest predictors of task performance and execution commitment. Strategies that people built, they defend. They adapt when circumstances shift. They carry them through friction. Strategies delivered to them, they file.

The mechanism that creates ownership is not participation in the abstract. It is the specific experience of being present for a trade-off decision — understanding why other options were rejected, knowing what assumptions the chosen direction depends on. When those assumptions get challenged in execution, people who were in that room have the resources to adapt. People who received a briefing document do not.

The BTS and Economist Intelligence Unit research on strategy buy-in found that when managers work directly with their teams on strategy — not forwarding communications, but actually engaging — 80% of employees can articulate how their work connects to the strategic direction. When management only passes communications downward, that number falls to 44%. When there is no strategic engagement at all, it falls to 9%.

A strategy that 9% of the workforce can connect to their work is not a strategy in any operational sense. It is a document that leadership endorses and implementation ignores.

The question most planning processes never ask

Before designing any high-stakes strategic process, the most important question is not "who needs to be informed of this decision?" That produces the communication plan. The question is: "who needs to have been involved in making this decision in order to own implementing it?" The two produce radically different participant lists.

In pharmaceutical strategy, it means bringing market access, medical affairs, and key external stakeholders — payers, patient advocacy organizations, clinical practice leaders — into the session before the strategy is finalized, not after. In government, it means including programme managers and frontline delivery leads in the policy design session rather than presenting them with a finished plan. In every context, it means treating implementers' knowledge as diagnostic data about what will actually work in the real system — not as resistance to be managed after the fact.

I have seen the alternative play out too many times. The room is full of the right seniority and the wrong people. The strategy is technically sound. And then it meets the world it was built without.