Ethically constrained optimization of dynamic capabilities: towards sustainable global health

Purpose - This study aims to explain how sustainable global health presents an emerging new form of competition and socio-political and functional pressure for which strategic organizational renewal is a prerequisite for the organic resilience and co-evolution of pharmaceutical firms with their environment. Design/methodology/approach - Through a meta-theoretical analysis in which theories themselves become the unit of creative synthesis, a wider framework is developed to allow a comprehensive and nuanced reinterpretation of the neo-institutional theory and the resource-based view. In focus is the practical utility and relevance of such theories within emerging economies where pharmaceutical firms respond to market and institutional changes. Findings - The imperative for organizational change is very much dependent on the combination of ethically constrained managerial choices as well as entropic institutional pressures that allow firms to successfully adapt to their dynamic environment. This is achieved through legitimization and sustained competitive advantage, the results of innovation and contextually relevant differentiated value propositions. Social implications - Contrary to popular perceptions, recent developments demonstrate that the simultaneous pursuit of efficiency and ethical preferences is possible, irrespective of the institutional matrix within which change occurs. Managers should, therefore, tap into the niche opportunities offered by favorable entropic pressures. Originality/value - The novelty in this paper is the framework it provides for analyzing the massive role played by the micro-political power of managers and how the goals they pursue become fundamental to what the organization becomes as it coevolves with the turbulent era of emergent health needs.