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EF: What lessons did you learn during the pandemic, and how did it shape the company in Brazil?
CS: When the pandemic began, I was in Europe, and they were going on lockdown. Once I made it back to Brazil, I warned people about Covid-19 and how it would come to the country. The company ensured its employees' safety by taking the pandemic seriously before it came to Brazil. We needed to plan and prepare for it.
We were digitally unprepared for the pandemic. Platforms like Zoom, Teams and other teleconferencing platforms became the new normal. The primary concern was safety, which led to many contingency plans. As a company, we were navigating through uncertain times, there was no knowledge of when the vaccine would come, even though we knew it was the solution. The company’s behaviour changed when the vaccine became a possibility. Suddenly, we had a purpose because we could help save lives. There was solidarity among employees and employers and keeping employees safe was the top priority. Expanding our microenvironment was also crucial to our survival.
Interactions among colleagues, friends, and family have changed because of the pandemic. People now think twice before they get close because they have to think about the safety risk when in contact with another person. Being cautious has become second nature for most people, so we should be considerate when someone continues to be cautious even after Covid is gone.
Patients with diseases like HCV and HIV could not visit physicians, which changed business for the sector. We had to adjust.
EF: What are your portfolio priorities as Gilead in Brazil?
CS: Our primary focus is on HCV and HBV, which is part of WHO and Brazilian MOH elimination programs. We have treated over 150 000 patients since the program came into effect in 2015. The complexity lies in helping the public and private sectors find more patients because many of them are unaware of their condition. This means that the industry needs to get innovative solutions to draw more people to get tested for diseases.
The government has brought Hepatitis C treatment to the primary level, with basic attention within SUS. The treatment has been simplified and can be completed within 12 weeks of administration. Diagnosis is just as crucial as the treatment itself. It is not a one-person job, it is the job of the nurses, physicians, individuals, and communities.
We partnered with an NGO in one of the low-income communities in São Paulo to do a pilot testing program. We involved the community hospital to raise disease awareness and mobilize the community to seek out the local health service for testing, diagnosis, and treatment.
In another project we are running, we use AI (artificial intelligence) to identify potential patients which are seeking healthcare and might be HCV positive. The criteria for such a search include age and medical history. If the history of a person that had a blood transfusion before screening for HCV was available, he or she would have had to be tested. Everyone is aware of the importance of diagnosis. Patients are everywhere, but they are not aware of their status.
EF: What is the economic burden of diagnosing, and how can it be bridged?
CS: We are in a paradigm where the industry is judged based on the cost of treatment. No one looks at the preventative measures and what we could do for other patients. The industry has to engage, evolve and improve the way it gives back to the community before it can trust us. 80% of patients do not know that they have a disease. That is why we need to be in solidarity with the patients and the communities to enable them to have access to the necessary cure and treatments.
EF: Which partnerships would you like to highlight with complementary skill sets to deliver to communities in need?
CS: Our public affairs team is increasing the engagement between our communities. We also engage with PAGS (Patient Advocacy Groups). The challenge with advocacy is finding ways to get their voices heard. When it comes to getting involved in any partnership, listening is a vital part. When the communities come to us with their needs, we have to know how to solve them. We collaborate with like-minded partners to help communities because no company can do everything by itself. We try to make a difference in other people’s lives.
EF: What does Gilead bring that would be attractive to a potential partner?
CS: Companies that do HIV, HBV, and HCV testing need access to patients. The government has a lot of test kits available. We use digital initiatives to link the patients to the testing centres. That is why collaborating is beneficial for both sides. Therefore, we should combine efforts and create access together.
EF: What is your definition of access?
CS: It is the opportunity created for patients to access the best healthcare independently from their social condition. It should be a combined effort from the healthcare community including the public and private payers.
EF: What advice would you give to the public and private systems that will ensure access?
CS: Our government needs to provide for all, while the private system that has more resources per capita can provide the newer and more innovative solutions faster. We should all work together with the aim to provide the best care for both segments. All players should be willing to discuss alternatives for financing healthcare.
EF: What future trends do you see?
CS: One thing is evident for the healthcare industry: digitalization. It is the future of the industry. We need to advance beyond where we are now, which was clarified by the pandemic. Though the industry will become digital, it will not be 100% as this is the industry of saving lives. People will still suffer physically, and physicians will still need to treat patients physically. The human element can never be taken out of healthcare.
We will have to become more digitally savvy. The primary care portfolio will change dramatically. How we engage and interact with physicians has changed, and it will keep on changing because of what happened during the pandemic. Healthcare professionals have to be able to adapt to digitalization and change too.
EF: What would you like your tenure to be remembered for in ten years?
CS: When I came to Gilead, everyone I met and worked with had a great sense of purpose. We had the technology, which could bring the cure to many HCV patients. We managed to treat and cure over 150 000 HCV patients in the last 5-6 years.
The pandemic also had a huge impact on all of us, professionally and personally. I want to remember this period as the time we fulfilled our mission. As professionals, as a team, we did the impossible possible by saving lives with our products.
As individuals, we all suffered emotionally from the absence and companionship. We made the effort to stay close or connected to as many people as possible and never lose the sense of being part of the family, team, and community.
I want my tenure to be remembered because I put people first in every decision I made.