Read the Conversation
Conversation highlights:
- Market Dynamics: Africa splits into two trajectories, North Africa/South Africa with expanding coverage, and Sub-Saharan markets, where faster regulatory approval is the main unlock for access.
- Portfolio Strategy: Prioritize oncology in cancer-burdened countries and scale NCD solutions amid a steep rise to 37% of mortality.
- Partner Model: A compliance-first partnership, robust infrastructure, and alignment on patient-centric disease focus.
- Technology Leverage: AI emerges as the catalytic layer for real-world evidence, epidemiology, and genome initiatives, reducing dependence on costly trials.
- Talent Profile: High-ambiguity environments demand agile, scenario-driven leadership and accelerated adaptability, supported by a digitally fluent youth base.
- Regulatory Outlook: Harmonized approvals could double growth via single-dossier submissions; fragmentation persists with 45 registrations and multi-year reviews, making long-term access partnerships essential.
EF: As we approach the end of 2025, what word would you choose to describe the year? What are you most proud of achieving, and what was its central theme?
MN: For us, 2025 is a year we are very proud of. Transformative best captures 2025 for Amgen in the Middle East and Africa. Our foremost accomplishment has been advancing our mission to serve more patients by delivering innovative therapies that address their most challenging diseases.
EF: As a longtime leader in the sector, what key trends do you observe across Africa?
MN: Africa exhibits diverse trends shaped by its geography and demographics. In North Africa and South Africa, healthcare coverage is expanding, though at varying speeds, evident in markets like Morocco, Egypt, and South Africa itself. In sub-Saharan Africa, the emphasis is on broadening patient access by accelerating medicine registration processes, which remain largely country-specific despite efforts to streamline them.
EF: Given your oversight of markets spanning high- and low-GDP per capita, how do you adapt strategies to succeed across your markets in Africa and the Middle East, while sustaining innovation amid resource constraints?
MN: Our core focus remains on ensuring innovative medicines reach patients through adaptable models tailored to each healthcare system. In lower-resource settings, we often collaborate with distributors to leverage their local infrastructure, avoiding the need for extensive direct investments. This partner-based approach suits Amgen's specialized portfolio of therapies for severe diseases, enabling economic viability until markets mature enough for a direct presence. Ultimately, these strategies balance patient access with sustainable business operations.
EF: What criteria guide Amgen's selection of partners in these markets?
MN: Number one is compliance. Compliance forms the cornerstone of our partnerships, encompassing ethical, promotional, quality, and supply chain standards across the entire value chain. Equally vital is a shared commitment to patient-centric outcomes, where actions prioritize long-term benefits over short-term gains. Finally, we seek alignment in market operations, particularly in disease areas, customer reach, and infrastructure, ensuring partners can effectively serve the same hospitals and specialists we target.
The three most common criteria are compliance, a shared mission, and the ability to serve the same disease areas through common interests.
EF: Looking at your portfolio, where do you see the biggest opportunities in Africa?
MN: I always divide Africa because it is a huge continent, and it is very difficult to talk about it as a whole. When you look across Amgen’s portfolio, we serve different patients with different diseases, many of which are very serious, starting with cardiovascular diseases. We also focus on cancer across different categories, inflammation, and, more recently, rare diseases. It is a wide range of diseases, but we make sure to align closely with healthcare system priorities.
In some African countries, there is a strong focus on oncology and cancer. These countries want to ensure that patients with cancer receive treatment, and in those markets, we prioritize our oncology portfolio and ensure our innovations are available. We work to register our medicines as early as possible so that healthcare systems can benefit from our innovation as soon as possible. In other countries, particularly in sub-Saharan Africa, the situation is different. Historically, Africa has faced major challenges related to infectious and communicable diseases, such as malaria, which has been very prevalent and difficult to address.
Today, however, non-communicable diseases are growing significantly. One of the latest studies I have seen shows that they account for 37% of deaths in Africa, which is a shocking figure, up from around 20% in 2000. These include cardiovascular diseases, diabetes, and other non-communicable conditions such as inflammatory diseases. Addressing these diseases generally requires the right infrastructure.
EF: As Amgen’s ambassador for Africa, what is the importance of Africa to Amgen, and how do you attract resources to the region?
MN: Africa represents a vital long-term opportunity for Amgen, emphasizing accelerated access to medicines through multifaceted partnerships. We collaborate with distributors for commercial reach, engage the WHO's Essential Medicines List for broader availability, and partner with NGOs to enhance healthcare capabilities, such as training nurses and physicians or building clinical trial infrastructure. As a company just over 40 years old, yet operating in 100 countries, our approach prioritizes enduring market development over short-term transactions, fostering capabilities in oncology and other key areas to improve patient outcomes sustainably.
EF: Looking ahead, what resources and talent will Amgen require to build its presence in Africa over the long term?
EF: I will use the analogy of telecommunications in Africa. 30 years ago, it was nearly impossible to scale Africa to the same landline infrastructure and efficiency as European countries. Mobile phones and wireless technology significantly enhanced mobility and telecommunications capabilities across Africa. If the continent had continued to rely on landline infrastructure, it would likely not have reached this level of connectivity. AI brings to the table in healthcare is similar to what wireless technology brought after landlines in Africa. There is an unprecedented opportunity to enhance the patient journey through AI.
First, AI allows us to collect and analyze data much faster, enabling better healthcare decisions from both efficiency and patient benefit perspectives. There is a unique opportunity today because AI is more accessible and, in some cases, lower cost. Africa may be missing opportunities in clinical trials, but it should not miss real-world evidence and epidemiology. These are less expensive, easier to implement, and do not require the same infrastructure as clinical trials, yet they have comparable scientific importance.
On talent, we need people who can work with ambiguity and manage competing priorities in a highly dynamic and evolving environment. This is driven by geopolitical factors, rapid technological acceleration, and other external forces.
We need talent with an agile mindset, an anticipatory way of thinking, and strong scenario-planning capabilities. In Africa, we need this twice as much. The level of ambiguity is higher, and the need for adoption of technology is greater than in more established economies. When we talk about the talent fabric, it is essentially the same profile, but at double the intensity. What makes me optimistic is that this talent exists. Africa has a very young population, and their openness to technology is significantly higher than in regions with older demographics. That represents a major opportunity for Africa’s healthcare systems.
EF: We like to understand the future through the voices of leaders shaping it. If you had to describe what the next five years for Amgen in Africa will look like, what would you say?
MN: Regulatory harmonization could revolutionize pharmaceutical access across Africa by enabling single-dossier approvals valid continent-wide, dramatically speeding innovation delivery. If realized, this would double our business through enhanced patient reach alone. Absent such changes, we anticipate single-digit market growth, with Amgen outperforming at single-digit-plus rates due to our first- or best-in-class therapies. Either path underscores our commitment to long-term partnerships and infrastructure development for sustained impact.
