Medical Affairs Has Outgrown Its Org Chart

Published: 14 July 2026

Author(s): Dr. Jonathan Dsouza

Why the function's real 2026 job has quietly outrun the structures, budgets, and metrics built to support it

Every conference deck I've sat through in the last couple of years has some version of the same slide: Medical Affairs as the "third pillar," standing level with R&D and Commercial. It's a good slide. In most organisations I've come across, it's also still mostly aspirational.

That gap — between what we say Medical Affairs has become and how we've actually resourced it to work — is, to me, the real story of 2026. Not AI. Not real-world evidence. Not omnichannel engagement. Those are the visible symptoms. The underlying condition is that Medical Affairs' actual job has moved a long way past its org chart, and most companies haven't caught up. I want to walk through why I think that, using what's actually changing on the ground this year.