Read the Conversation
Conversation highlights:
- South Africa and Africa, as a region of tremendous potential, should not catch up but leapfrog.
- Thom's mission centered on "health is wealth, emphasizing the economic benefits of a healthy population.
- Focusing on addressing high unmet treatment needs in breast cancer, ophthalmology, and neuroscience, striving to improve survival rates, reduce vision loss, and improve neurological health with equitable access to therapies.
- Roche is committed to accelerating healthcare improvements through value-driven, sustainable public-private partnerships and multi-stakeholder collaboration.
- The organisation’s future success relies on three key elements: developing local talent, utilizing high-quality data via AI and automation, and maintaining a strong sense of purpose.
- Roche’s goal is to treat four times more South Africans with innovative therapies by 2028.
EF: What attracted you to this position in South Africa, and what mission did you set for yourself?
TR: Having worked across several geographies, including most recently as Chief of Staff at headquarters supporting Pharma International, which is present in over 150 countries worldwide, I gained a fantastic global perspective on the healthcare landscape. Africa, as a region, is complex and dynamic, with tremendous potential. At a macro level, the projected youth population in 2030 suggests that 42 percent of the world's youth will be in Africa. While structural challenges exist, they present opportunities, particularly with the rise of digital technology. This is Africa's moment to leapfrog in healthcare, not just catch up, but to lead the new frontier, a movement that will be supported by AI and digital tools.
When the South Africa position opportunity arose, I was eager to join. The country is an incredible place with outstanding institutions like Wits and UCT and a deep history of scientific advancement, including performing the world's first heart transplant. Roche has been running clinical trials here for three to four decades, understanding the importance of research originating in Africa, particularly South Africa.
My mission can be summed up simply: health is wealth. Healthcare is often viewed as a cost rather than a vital investment. A recent WifOR study that examined seven African countries over five years helps clarify this. The study found a staggering $10.3 billion economic loss resulted from not effectively treating HER2-positive breast cancer. By focusing on health, we can help turn that economic loss into Africa's next economic transformation, driving wealth and GDP growth.
EF: How can South Africa raise awareness that health should be an investment, not a cost?
TR: It is important to bring a global perspective into South Africa, but equally, and perhaps more so, to bring a South African and broader African perspective back into the global space. This continent has immense talent, and we must ensure this talent and its ideas have a platform to be seen and scaled globally. Ideas emerging from South Africa should grow here and then expand beyond the country.
South Africa holds a unique position as one of the few countries in both the G20 and BRICS, and I am passionate about seeing it take a leading role in healthcare for the continent and the entire world. We view South Africa as the strategic gateway into Africa and want to see its influence grow globally.
EF: Could you share your views on collaboration and the importance of bringing every stakeholder together?
TR: One of my greatest professional achievements was helping establish The Eyes Have It Coalition in the UK. This multi-stakeholder policy group included patient organizations like the Macular Society, professional bodies such as the Royal College of Ophthalmologists, and industry partners like Roche. We came together behind one clear goal: reducing waiting times in ophthalmology and pushing for increased government focus and investment. This led to a welcome decrease in waiting lists and faster movement of new medicines through the system, resulting in better outcomes for patients. This multi-stakeholder model is one I hope to replicate, as I am positive it can only bring positive outcomes.
EF: What does Roche's portfolio look like in South Africa, and what opportunities excite you?
TR: Roche always aligns its portfolio with the areas of highest unmet medical need in a country. In South Africa, we are currently focused on three primary areas: breast cancer, ophthalmology, and neuroscience.
For breast cancer, we support the Africa Breast Cancer Ambition (ABCA), spearheaded by the Africa Breast Cancer Council across the continent. The ambition is to increase the five-year survival rate from 5 in 10 to 8 in 104. We are confident this is achievable, as seen in other parts of the world, but it requires true public-private partnerships. No institution can achieve this alone.
Ophthalmology is the second key area. The consequences of vision loss can be devastating for a person's ability to be an active member of society and for their family, directly affecting economic prosperity. This area has not received enough attention, despite the significant impact, and it is close to my heart because of my personal experience.
The third focus is neuroscience, where we have seen great advances but still have a long way to go. In South Africa, the healthcare system is fragmented, meaning many people do not receive the same level of care due to financial constraints. We are determined to ensure neuroscience is understood in the local context and to support equitable access across our entire portfolio. We are very excited about the future of neuroscience and have built a portfolio to serve both current and future needs.
EF: Do you see opportunities in South Africa to replicate the UK's multi-stakeholder model to leverage different players' expertise?
TR: During my first six months, I deliberately immersed myself in the country, meeting with policymakers, key clinicians, and government officials to understand their perspectives. One area we must fully embrace and amplify is public-private partnerships. Real, positive change requires partnerships that share a clear direction and trust in unified outcomes. It cannot be Roche's voice or the pharma industry's voice alone. We have seen the impact of this multi-stakeholder approach in the UK, and elements of it are already present in South Africa. Our team will continue this journey and seek out more aligned partners.
EF: What does access mean to you?
TR: Access, to me, is when the medicine actually reaches the patient. Everything that precedes it, regulatory approval or reimbursement, is just a part of the access process, but not the end goal. The way we achieve patient access is set to change quickly.
We are already seeing new models of care, such as telemedicine, which has been around for a long time but offers significant benefits. The future is real-time: a patient could have wearable tech indicating a potential condition, receive a remote validation from a specialist, and have their treatment set up in real time, perhaps even with the medicine delivered and used on the same day.
EF: How should South Africa leverage digital tools, and how receptive is the population to technology?
TR: The youthful population in South Africa and Africa is a major catalyst for progress, and this is why the region will leapfrog. Unlike Europe's aging population, this younger generation has a natural affinity for technology, having grown up with it. As they enter the workforce, they will push for better solutions and challenge the status quo, demanding that we use the data we have effectively.
Good data matters, as the quality of any AI model depends on it. We are seeing African populations beginning to clean up their large datasets and leveraging them to leapfrog. Examples like Medsol Breast AI, which is working on early breast cancer diagnosis and has the potential to reduce imaging costs by up to 65 percent, show how technology can be used to equitably increase diagnostic rates. EMGuidance is another great example, making top-quality educational and clinical guidelines available at scale in real time to help the healthcare community make quick, quality decisions. The combination of a youthful, tech-savvy population and its ability to capture data puts South Africa in a strong position to lead.
EF: What kind of resources does Roche South Africa need to accompany the legacy you are building?
TR: I identify three essential ingredients for Roche's future in South Africa.
First is people. South Africa has fantastic talent and great institutions. No amount of technology can replace strong individuals. We are doubling down on graduate recruitment to bring top minds from South Africa's best universities into Roche.
Second is data. The quality of the data we capture is crucial for success and for the country to leapfrog. We put data at the forefront of the entire value chain, from clinical trials to access and regulatory work. All our decision-making is driven by solid data analytics and automation through AI programs. We have made a dedicated investment in this through our "Everyday AI" program, training the entire organization, which we continue to do.
The third ingredient is purpose. Our clear purpose, co-developed with the organization, is to treat four times more South Africans with our innovative therapies by 2028. This is an ambitious but achievable goal, and everyone in the organization is clearly aligned to contribute to it.
EF: Do you have a final message you would like to add?
TR: Change is the only constant, especially in healthcare, and the only way to make real progress is by working together. We must break down silos and embrace public-private partnerships as the future of how we operate; government, industry, and academia all working together is crucial. Digitalization and AI will be the catalyst for this change.
Secondly, this country has vast potential. Compared to a country with a similar population size, like the UK, South Africa is not yet achieving the same health outcomes, which means there is tremendous room to grow. We don't just want to catch up; we want to leapfrog. This is an area with tremendous potential to make a real difference for patients.
Finally, it comes down to purpose. Making a real difference for South Africans. When you help one patient, you affect their entire family and improve their economic productivity. For example, HER2 breast cancer uniquely affects younger, working-age women in Africa6, who are often the heart of their households. The impact on people's lives is enormous. If you can make a big difference anywhere, it is here in Africa. South Africa should lead the way to achieve what I call the triple win: a win for patients, a win for society, and a win for Roche.
