In 2024, Novo Nordisk A/S was one of the most profitable firms in the world, thanks largely to just two GLP-1-based drugs, Ozempic and Wegovy. Unusually, this incredibly profitable firm was controlled not by individual private shareholders, but by a non-profit foundation called the Novo Nordisk Foundation. As Novo Nordisk's profits began to soar, so did the once small and quiet Foundation's budget, ambition, and public profile, causing its executives to wrestle with a whole new set of exhilarating but complicated challenges: how should it manage and invest what was rapidly becoming one of the world's largest non-profit endowments? How should it shift its strategy and governance mechanisms as it expanded its operations far beyond tiny Denmark? And what responsibility did the Foundation's staff have as they took profits from one life-saving innovation and aimed to deploy them for other social and humanitarian aims? Novo Nordisk's structure as a for-profit firm controlled by a non-profit entity gave the organization a unique power to use profit for the public good. But just how should that power be deployed?