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How Bupa’s CEO Iñaki Ereño woke a sleeping giant—and set a 100,000 strong workforce running toward digital health 

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CEO Agenda provides unique insights into how leaders think and lead and what keeps them busy in a world of constant change. We look into the lives, minds and agendas of CEOs at the world’s most iconic companies.

When Iñaki Ereño assumed the role of Group CEO of Bupa in 2021, the global healthcare landscape was being rewritten in real time. At the helm of a company serving over a million customers worldwide, Ereño faces the challenge of transforming a large and established organization into a faster, more agile, and digitally enabled provider of care. 

Founded in 1947 with the purpose of helping people live “longer, healthier, happier lives,” Bupa is more than a health insurer: It builds hospitals and dental centers, offers global private medical insurance, and invests heavily in digital health. 

Ereño’s mission? To wake the sleeping giant. Through what he calls the “elephant strategy,” the 61-year-old CEO has sought to digitize the business, embed customer-centric listening (including 300,000 annual detractor calls), and align a global workforce of around 100,000 people behind a single agenda. “The elephant is now running and the majority of the people know the elephant is running. We keep reminding everyone: don’t let the elephant go back to sleep,” he says. 

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Bupa’s rank on Fortune 500 Europe

A self-described “fanatic of the digital economy,” Ereño believes technology will define the next era of healthcare. Bupa has accelerated its use of AI and virtual platforms such as Blua, launched initially in Spain, to connect doctors and patients digitally and make consultations faster, smarter, and more personal. 

In an interview with Fortune, Ereño discussed his evolution from lawyer to retailer to healthcare CEO, explained how his triathlon training anchors his leadership, and why, for him, productivity isn’t just about profit—it’s about delivering better care, faster.

This interview has been edited for length and clarity.


Down to business 

Fortune: Walk us through your career journey.

Ereño:  My background is in law, and very quickly I realized I didn’t want to be a lawyer. So I did an MBA and moved into corporate life. I view my life in three distinct periods. For one period of my life, I worked as a retailer. In another, I was an entrepreneur, and in the most recent period, I have worked in healthcare. 

I joined Bupa 20 years ago in Spain [in Spain, Bupa is called Sanitas]. I joined Sanitas and was appointed CEO of Sanitas, and in 2012, I was appointed CEO [of a regional division within Bupa]. My evolution has progressed from my initial role as marketing director of Sanitas, then CEO of Sanitas, followed by CEO of a region, and finally Group CEO. It’s been a bit of a journey.

What was your role in the digital shift?

Covid was a huge challenge for all healthcare systems. For Bupa, we realized that our healthcare system was not digitized enough. Health can be digitized. I was in the executive team of Bupa for many years and that was my big fight: We needed to digitize the business more quickly. [Since then] it’s been a bit of a journey. 

After Covid, we started calling ourselves the “sleeping elephant,” and so we built a strategy called the “elephant strategy.” I remember I went to the board with one slide: an elephant asleep on the left, an elephant waking up in the middle, and an elephant running on the right, with a big arrow from 2020 to 2024. We needed to wake up.

The elephant is now running, and the majority of the people know that the elephant is running. We keep reminding everyone: Don’t let the elephant go back to sleep.

What are you most proud of in the last five years?

In every presentation, we highlight the Triangle of Performance. At the top of the triangle is Financial Performance, supported by the two other sides: Customer Performance and Employee Engagement. We need to be good at all. 

Customers are very important. We have 25 businesses in various countries that follow the same pattern. We map businesses by micro movements, and every year we do 300,000 detractor calls asking customers: “Why don’t you like us?” 

Every year, we measure the results in terms of customer experience improvement and we take this very seriously. There is a lot of engineering work and logistics involved in making this happen. 

We also have a team of 100,000 people. You’d assume that all of them have health coverage provided by Bupa—especially since we are Bupa. But that was not the case.

[Despite the fact] that it would cost around 50 million pounds to do this [it was essential that our own employees] have health coverage provided by Bupa. Now in the Bupa world, every employee is supported by Bupa. 

We try to find out why we are not good, and work on it. 

Which long-term trend are you most bullish or positive about for society and the economy at the moment?

The digital economy. We [Bupa] started a bit late but we’re catching up very quickly. We’re now fully digitized in all countries. Blua [is an example], which Bupa launched years ago. I like the digital economy and am a fanatic because it will help health.

When you look at Europe versus the U.S., how do you think people like yourself in a leadership role can address the productivity challenge?

Bupa and the whole healthcare industry are currently more focused on growth. We [believe we] are productive, but it’s not at the top of our mind. We think about how we can be more productive so that our customers will be happier and better served, rather than thinking about, “how can we make more money?”

We’ll be implementing an AI generative project where, instead of taking seven minutes for a doctor to see you [and understand who you are and what your issues are], it will take 30 seconds. So in 30 seconds, a doctor will be able to see you and a consultation that usually happens in maybe 15 minutes will now take only 30 seconds. This is the productivity we care about and is the productivity that has a positive impact on our customers.

Being productive

When do you get up in the morning and what sets up your routine for the day?

I don’t sleep that much and usually wake up around 6 a.m. and I start reading the newspaper. I read three Spanish newspapers, the FT and the Economic Times. I have my first coffee, take a shower, go to the office, and normally am in meetings by 8 a.m.

Sports have always been a big part of my life. I’m into triathlons and usually go to the gym with my youngest son, who lives with me in London. We go to the gym together, go to the supermarket, buy dinner (we usually go to an Amazon Fresh store or Whole Foods), have dinner, and then go to bed. I live a fairly basic life and it works for me. 

What kind of coffee do you have in the morning?

I have a black coffee in the morning, a double espresso. When I share [my coffee intake] with doctors, they say maybe too much, Iñaki! But I can share this with you. 

So I start with a double espresso, and then I have another one in the office with a little bit of milk, like a cortado. Then, after lunch, I have another cortado. I know it’s a lot of coffee. 

Do you check back in later in the evening? Are you working over the weekend?

I might sound a bit naive, but I like the job I do and I like my company. I don’t feel like I need to be disconnected. When I am away on holiday, I take my mobile phone with me and I’m checking emails. I’m paid well, I have an [important] job and we’re a big company, so I need to stay connected. 

Do you have any apps that you use, or any methods that you use to be as productive as possible?

I use [most digital tools], to be honest, but I’m not mega techy. 

I used to take notes with a notebook and pencil, but not anymore, because one day I realized that it was taking me more time. I asked myself, “How many times have you come back to your notes?” and it was zero. So I stopped. I prefer to be present and in listening mode.

Getting personal

Who is on your personal board and who inspires or motivates you?

I work with a coach whom I met a few years ago. He is 75, very wise, and a member of my personal board. I have a Chief Executive Committee; there are always people that you tend to call more when you have a problem or need good advice. I also have people on my team that I can call. I have great conversations with my son. We all need people who really care. 

Do you have a favorite company that you admire and why?

I love Amazon. Whole Foods is also fantastic. 

What is your favorite cuisine to cook and to eat?

I eat too much, but thank God I enjoy exercising. I like all types of food, including a big steak, good paella, and seafood. I also like sweet food and desserts. My coach taught me to be kind to myself and I have learnt over the years to be kind to myself. If I want to eat ice cream, I will enjoy my ice cream. 

CEO Agenda provides unique insights into how leaders think and lead, and what keeps them busy in a world of constant change. We look into the lives, minds and agendas of CEOs at the world’s most iconic companies. Dive into our other CEO Agenda profiles.



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Elon Musk’s X fined $140 million by EU for breaching digital regulations

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European Union regulators on Friday fined X, Elon Musk’s social media platform, 120 million euros ($140 million) for breaches of the bloc’s digital regulations, in a move that risks rekindling tensions with Washington over free speech.

The European Commission issued its decision following an investigation it opened two years ago into X under the 27-nation bloc’s Digital Services Act, also known as the DSA.

It’s the first time that the EU has issued a so-called non-compliance decision since rolling out the DSA. The sweeping rulebook requires platforms to take more responsibility for protecting European users and cleaning up harmful or illegal content and products on their sites, under threat of hefty fines.

The Commission, the bloc’s executive arm, said it was punishing X because of three different breaches of the DSA’s transparency requirements. The decision could rile President Donald Trump, whose administration has lashed out at digital regulations, complained that Brussels was targeting U.S. tech companies and vowed to retaliate.

U.S. Secretary of State Marco Rubio posted on his X account that the Commission’s fine was akin to an attack on the American people. Musk later agreed with Rubio’s sentiment.

“The European Commission’s $140 million fine isn’t just an attack on @X, it’s an attack on all American tech platforms and the American people by foreign governments,” Rubio wrote. “The days of censoring Americans online are over.”

Vice President JD Vance, posting on X ahead of the decision, accused the Commission of seeking to fine X “for not engaging in censorship.”

“The EU should be supporting free speech not attacking American companies over garbage,” he wrote.

Officials denied the rules were intended to muzzle Big Tech companies. The Commission is “not targeting anyone, not targeting any company, not targeting any jurisdictions based on their color or their country of origin,” spokesman Thomas Regnier told a regular briefing in Brussels. “Absolutely not. This is based on a process, democratic process.”

X did not respond immediately to an email request for comment.

EU regulators had already outlined their accusations in mid-2024 when they released preliminary findings of their investigation into X.

Regulators said X’s blue checkmarks broke the rules because on “deceptive design practices” and could expose users to scams and manipulation.

Before Musk acquired X, when it was previously known as Twitter, the checkmarks mirrored verification badges common on social media and were largely reserved for celebrities, politicians and other influential accounts, such as Beyonce, Pope Francis, writer Neil Gaiman and rapper Lil Nas X.

After he bought it in 2022, the site started issuing the badges to anyone who wanted to pay $8 per month.

That means X does not meaningfully verify who’s behind the account, “making it difficult for users to judge the authenticity of accounts and content they engage with,” the Commission said in its announcement.

X also fell short of the transparency requirements for its ad database, regulators said.

Platforms in the EU are required to provide a database of all the digital advertisements they have carried, with details such as who paid for them and the intended audience, to help researches detect scams, fake ads and coordinated influence campaigns. But X’s database, the Commission said, is undermined by design features and access barriers such as “excessive delays in processing.”

Regulators also said X also puts up “unnecessary barriers” for researchers trying to access public data, which stymies research into systemic risks that European users face.

“Deceiving users with blue checkmarks, obscuring information on ads and shutting out researchers have no place online in the EU. The DSA protects users,” Henna Virkkunen, the EU’s executive vice-president for tech sovereignty, security and democracy, said in a prepared statement.

The Commission also wrapped up a separate DSA case Friday involving TikTok’s ad database after the video-sharing platform promised to make changes to ensure full transparency.

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AP Writer Lorne Cook in Brussels contributed to this report.



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Nvidia CEO says U.S. data centers take 3 years, but China ‘can build a hospital in a weekend’

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Nvidia CEO Jensen Huang said China has an AI infrastructure advantage over the U.S., namely in construction and energy.

While the U.S. retains an edge on AI chips, he warned China can build large projects at staggering speeds.

“If you want to build a data center here in the United States from breaking ground to standing up a AI supercomputer is probably about three years,” Huang told Center for Strategic and International Studies President John Hamre in late November. “They can build a hospital in a weekend.”

The speed at which China can build infrastructure is just one of his concerns. He also worries about the countries’ comparative energy capacity to support the AI boom.

China has “twice as much energy as we have as a nation, and our economy is larger than theirs. Makes no sense to me,” Huang said.

He added that China’s energy capacity continues to grow “straight up”, while the U.S.’s remains relatively flat.

Still, Huang maintained that Nvidia is “generations ahead” of China on AI chip technology to support the demand for the tech and semiconductor manufacturing process.

But he warned against complacency on this front, adding that “anybody who thinks China can’t manufacture is missing a big idea.”

Yet Huang is hopeful about Nvidia’s future, noting President Donald Trump’s push to reshore manufacturing jobs and spur AI investments.

‘Insatiable AI demand’

Early last month, Huang made headlines by predicting China would win the AI race—a message he amended soon thereafter, saying the country was “nanoseconds behind America” in the race in a statement shared to his company’s X account.

Nvidia is just one of the big tech companies pouring billions of dollars into a data center buildout in the U.S., which experts tell Fortune could amount to over $100 billion in the next year alone.

Raul Martynek, the CEO of DataBank, a company that contracts with tech giants to construct data centers, said the average cost of a data center is $10 million to $15 million per megawatt (MW), and a typical data centers on the smaller side requires 40 MW.

“In the U.S., we think there will be 5 to 7 gigawatts brought online in the coming year to support this seemingly insatiable AI demand,” Martynek said.

This shakes out to $50 billion on the low end, and $105 billion on the high end.



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Trump finally meets Claudia Sheinbaum face to face at the FIFA World Cup draw

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Their long-delayed first face-to-face discussion focused on next year’s World Cup — and included side discussions about trade and tariffs — but immigration was not the top issue. That’s despite Trump’s push to crack down on the U.S.-Mexico border being a centerpiece of his administration, and the driving force in the relations between both countries.

Trump has been in office for more than 10 months, and his having taken so long to see Sheinbaum in-person is striking given that meeting with the leader of the country’s southern neighbor is often a top priority for U.S. presidents.

Trump and Sheinbaum had been set to meet in June on the sidelines of the Group of Seven summit in Canada, but that was scrapped after Trump rushed back to Washington early amid rising tensions between Israel and Iran.

Soccer took center stage — but tariffs still loom large

Trump and Sheinbaum sat talking in the president’s box and also appeared onstage with Canadian Prime Minister Mark Carney at the Kennedy Center for Friday’s 2026 World Cup draw. The U.S., Mexico and Canada are co-hosting the tournament, which begins in June.

A senior White House official, who spoke on the condition of anonymity to discuss private meetings, said Trump, Sheinbaum and Carney met privately after participating in the draw.

Sheinbaum had said before leaving Mexico that she’d talk to Trump about tariffs that his administration has imposed on automobiles, steel and aluminum from Mexico, among other things. She said after appearing at the Kennedy Center that the three leaders “talked about the great opportunity that the 2026 FIFA World Cup represents for the three countries and about the good relationship we have.”

“We agreed to continue working together on trade issues with our teams,” Sheinbaum posted on X.

Mexico is the United States’ largest trading partner. The the U.S.-Mexico-Canada Agreement which Trump forged in his first term as a replacement for 1994’s North American Free Trade Agreement also remains in place. But U.S. Trade Representative Jamieson Greer has begun scrutinizing it ahead of a joint review process set for July.

In the meantime, the U.S. and Mexico’s priorities have been reshaped by the steep drop in the number of people crossing into the U.S. illegally along its southern border, as well as the White House’s — so far largely unrealized — threats to impose large trade tariffs on its neighbor.

Before speaking in-person, Trump and Sheinbaum had repeatedly talked by phone, discussing tariffs and Mexican efforts to help combat the trafficking of fentanyl into the U.S. But despite other world leaders, including Russian President Vladimir Putin and Chinese President Xi Jinping, having already met with Trump this term, the meeting with Sheinbaum hadn’t happened until Friday.

The Trump whisperer?

Waiting so long to meet in person hasn’t seemed to hurt Mexico’s president’s standing with Trump.

The two spoke by phone in November 2024, with the then-U.S. president-elect declaring afterward that they’d agreed “to stop Migration through Mexico” — even as Sheinbaum suggested her country had already been doing enough.

Trump soon after taking office threatened to impose a 25% tariff on goods imported from Mexico in an effort to force that country to better combat fentanyl smuggling, only to later agree to a pause.

The White House subsequently backed off tariff threats against most Mexican goods. Then, in October, Sheinbaum announced that the U.S. had given her country another extension to avoid sweeping 25% tariffs on goods it imports to the U.S. — even as many items covered by the USMCA trade deal remain exempt.

Mexico, though, hasn’t avoided all U.S. tariffs. Sheinbaum’s country continues to try to negotiate its way out of import levies Trump has imposed worth 25% on the automotive sector and 50% on steel and aluminum.

Sheinbaum’s success at mitigating many tariffs, and other successes in the bilateral relationship, has led some to wonder if she has a special gift for getting what she wants from him.

She’s largely pulled it off by affording Trump the respect the U.S. president demands from leaders around the world — but especially a neighboring country — and by deploying occasional humor and pushing back, always respectfully, when necessary.

Sheinbaum also defused another potential point of contention, Trump’s renaming of the Gulf of Mexico to the “Gulf of America,” by proposing dryly that North America should be renamed “América Mexicana,” or “Mexican America.” That’s because a founding document dating from 1814 that preceded Mexico’s constitution referred to it that way.

Still, Mexican officials continue to work furiously to lessen the trade blow from tariffs going into 2026 — levies that could wreck its already low-growth economy, particularly in its all-important automotive sector. Sheinbaum’s government has also sought to defend its citizens living in the U.S. as the Trump administration expands its mass deportation operations.

Sheinbaum’s government also lobbied unsuccessfully against a 1% U.S. tax on remittances, or money transfers that millions of Mexicans send home every year from the United States. It was approved as part of Trump’s tax cut and spending package and takes effect Jan. 1.

Trump’s push for mass deportations

Trump has directed federal officials to prioritize major deportation pushes in Democratic-run cities — an extraordinary move that lays bare the politics of the issues. He’s also deployed the National Guard in an effort to curb crime, which has led to a spike in immigration-related arrests, in places like Los Angeles, Chicago and Washington, as well as Memphis, Tennessee, and Portland, Oregon.

The Trump administration says its priority is targeting “the worst of the worst” criminals, but most of the people detained in operations around the country have not had violent criminal histories.

Such operations often meant targeting Mexican citizens who have lived and worked in the United States for years and may face deportation to a homeland they no longer know well. It also has meant serious threats of declining remittance income, which has fallen for seven consecutive months.

The lower number of illegal U.S.-Mexico border crossings has knocked immigration off its perch as the top agenda item for the U.S.-Mexico bilateral relations for the first time in recent memory.

Mexican officials now say conversations around immigration have shifted toward cajoling countries into taking back their citizens and reintegrating them to keep them from leaving again — a major Trump administration priority around the world.

Cooperation on security

Sheinbaum has blunted some of the Trump administration’s tough talk on fentanyl and drug smuggling cartels by giving her security chief Omar García Harfuch more authority.

Mexico has also extradited dozens of drug cartel figures to the U.S., including Rafael Caro Quintero, long sought in the 1985 killing of a DEA agent. That show of goodwill, and a much more visible effort against the cartels’ fentanyl production, has gotten the Trump administration’s attention.

That’s a significant improvement. Only a few years ago, the DEA struggled to get visas for its people in Mexico, and then-President Andrés Manuel López Obrador accused the U.S. government of fabricating evidence against a former Mexican defense secretary, though he never presented evidence to back up the allegation.

Not everything has gone so smoothly, though. Trump criticized Sheinbaum for rejecting his proposal to send U.S. troops to Mexico to help thwart the illegal drug trade.

Last month, Sheinbaum said there was no way the U.S. military would be able to make strikes in Mexico, after Trump said he was open to the idea. And she has denounced U.S. strikes on boats allegedly carrying drugs in the Caribbean and eastern Pacific.

“The president of Mexico is a lovely woman, but she is so afraid of the cartels that she can’t even think straight,” Trump said earlier this year.

Sheinbaum declined to take the bait — and avoided turning up the political pressure — by sidestepping Trump’s criticism.

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Associated Press writer Chris Sherman contributed from Mexico City.



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