In December 2000, when Dr. Tadataka Yamada became the new chairman of research and development at Glaxo SmithKline, he was horrified to learn that his company was a complainant in a lawsuit over access to drug therapies for HIV/AIDS patients. GSK was one of 39 pharmaceutical companies charging Nelson Mandela and the government of South Africa with violating price protections and intellectual property rights in their efforts to access lower priced antiretroviral drugs. Close to 25 percent of black South Africans were living with HIV/AIDS and at the time, antiretroviral therapies cost approximately $1000 per month—more than a third of the average South African’s annual salary, putting treatment out of reach for most patients.

Yamada held discussions with his research staff and quickly learned that he was not alone in his opposition to the lawsuit. The team wanted to be a part of the solution to global health issues, not party to a lawsuit preventing such drugs from reaching those in dire need, but they felt they lacked the power to change the company’s direction. Yamada felt differently. In one-on-one meetings with individual board members of GSK, he stressed the company’s moral responsibility to alleviate human suffering and tied it to the long-term success of the company. He stated that GSK can’t make medicines that save lives and then not allow people access to them. He noted the public relations disaster associated with the lawsuit, and set forth a vision, co-created by his team, for how GSK could also become a leader in the fight against TB and malaria, diseases that also were disproportionately impacting third-world populations. The external pressure did not abate, with protests against many drug companies around the world.

In April, 2001, all 39 companies dropped the lawsuit against Nelson Mandela; GSK and others reduced the prices of antiretroviral drugs by 90% or more. Furthermore, under Yamada’s direction, one of GSK’s major laboratories in Tres Cantos, Spain, was converted into a profit-exempt laboratory that focused only on diseases in the developing world, including malaria and tuberculosis. Using his influence, Dr. Yamada also spurred GSK into allocating resources for affordable access to medications and development of future therapies. Subsequently top executives at GSK became leaders in global health issues. Andrew Witty assumed the CEO position at GlaxoSmithKline in 2008 and became one of the leading spokespersons for global health in the pharmaceutical industry. Chris Viehbacher, corporate executive team member at GSK, subsequently became the CEO of Sanofi, and a champion of global health. Both have since partnered with the Gates Foundation on global health initiatives.

Most people would love to be a part of such an amazing turn of events, yet this kind of transformation doesn’t happen very often. While many helped with these efforts, what made it possible for Dr. Yamada to step forward with a steady voice and a sound vision? In several interviews with Dr. Yamada we identified four key mindsets that helped him catalyze this transformation.

[Here’s the first key mindset.]

The power of one.

A single person with a clarity of conscience and a willingness to speak up can make a difference. Contributing to the greater good is a deep and fundamental human need. When a leader, even a mid-level or lower level leader, skillfully brings a voice and a vision, others will follow and surprising things can happen—even culture change on a large scale. While Yamada did not set out to change a culture, his actions were catalytic and galvanized the organization. As news of the new “not for profit” focus of Tres Cantos spread, many of GSK’s top scientists volunteered to work there. Yamada’s voice spoke for many others, offering a clear path and a vision for a more positive future for all.

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Nicholas W. Eyrich is a graduate student at the University of Michigan Medical School.

Robert E. Quinn is a professor emeritus at the University of Michigan’s Ross School of Business and a cofounder of the school’s Center for Positive Organizations.

David P. Fessell is an executive coach, Professor of Radiology, and prior Director of the Leadership Curriculum at the University of Michigan Medical School.