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EF: What was Roche´s role in South Africa during the pandemic and over the last 18 months?
DG: It has been a dynamic year for most executives. Roche has a pharma and a diagnostic footprint and at the beginning of the pandemic there was a need for diagnostic tests, then our colleagues in diagnostics developed PCR tests, rapid tests, and eventually antigen tests so we worked closely with the South African department of health to scale up testing operations. At the same time, our pre-Covid patients around the country rely on the services and medicines we provide, oncology patients, neurology patients, patients that need their chronic medications, and this added an additional burden on the supply chain with our staff supporting the Covid initiative and keeping the usual business going. Roche has made a huge contribution considering the impact Covid and lockdown had on the communities, we have a 25-year partnership with the department of health on the Phelophepa train which normally does primary healthcare. As part of the Covid response, together with Transnet we transformed the trains into Covid testing centers and disseminated information, personal protective equipment, and safety indications. It was quite a big shift but made for very interesting times.
EF: What were the lessons learnt managing through a time of transition and a pandemic?
DG: Staying agile is a key component of the times as plans are made to be changed. With Covid, we had to learn as we went and it was important to maintain flexibility as we never knew what was coming next. This time last year we were coming to the end of the first wave, there was very little to go on to know how many more waves would come or how to prepare, whether to organize separate teams or lean back into what we were comfortable with. Ultimately what we had done for the first 6 months of the year had actually achieved a lot in spite of not having firm plans of how to deal with Covid. We kept agile putting our people in working squads to respond to requests and to what our customers need while trying to anticipate what would happen next with Covid.
EF: Are there any new KPIs that you introduced over the last year?
DG: We looked a lot harder at our supply chain making sure our tests were getting to the right places at the right time, and secondly that the medicines were getting to the patients that needed them. There were a lot fewer patients coming in for a diagnosis, testing, and getting treatments so we started supporting patients so they could come to healthcare facilities safely.
EF: How did you manage to attract resources to South Africa at a time they were scarce and when other countries were vying for them?
DG: Our global colleagues managed rather well under the understanding that there were critical requirements in certain places and they adopted a very agile approach to give us all the allocations of test kits or critical medicines making sure we were never out of stock. The better lesson learnt from that was the absolute necessity of closer collaboration cross borders so that nobody hoarded test kits for the next wave when they could be badly needed in another African country. It has I think widened the need of a global view across the world and countries individually, although I must give credit to our global colleagues that played a big role in this area.
EF: How can we refocus on the importance of treatments and diagnosis of chronic diseases (the silent pandemic) with the present focus on communicable diseases?
DG: The big issue is that the pharma dynamic has been completely disrupted, during the pandemic it was not possible to see a GP or to be referred or follow up on any health issue arising and pharma has a big role in solving this. We must find new ways of reconnecting patients and doctors so they are comfortable going in for their diagnostic tests, get referred to the right specialist at the right time, and receive their medicines in a way that doesn’t put them at risk. Discovery has telehealth consulting applications which have been generally speaking effective and we are looking where we can play a role on the medicine side of things. In cancer, there is a lot of medication that can be delivered to the patient’s home and on this front, we have started supporting and working with mobile health companies doing rapid diagnostic tests for people who need to know if they are infected to then go to see their oncologist or see the specialist for treatment. As the vaccination rate goes up we can step up the digital health campaign which will play a big role in the future.
EF: Do you think that once the pandemic is over we will go back to old way of doing things or will there be a new normal in terms of health mobility and deliveries?
DG: I don’t think we will ever go back to where we were in 2019, and that is very probably is a good thing. The Covid pandemic has out of necessity shifted forward all the initiatives that maybe would have happened in five years later, forcing us to quickly adapt to what we were originally very uncomfortable with. Working from home for the last 12 months was something that in 2019 I would not have considered possible but in the space of two weeks we did it and it has worked out just fine. The way we work both internally and externally is going to fundamentally change, offices will become places where people go to collaborate for deliberate projects and outcomes as part of a hybrid operating model. Service delivery will also change together with the expectation of our customers and our patients. We won’t be successful unless we start meeting the changes and that will echo through the whole chain of sale and all divisions and areas. Data will be a critical component affecting the direction of the future and the patient ultimately wants a carefree and positive user experience. This is the challenge we need to face and shift, it might be uncomfortable getting there as it is very difficult to know what the endpoint will look like. The patients haven’t come in for diagnosis and treatment like they have in the past -we have seen 10 to 15% less of cancer patients- fewer patients are coming in meaning that patients with early-stage cancers will eventually come in with later-stage cancers which will bring a whole new healthcare crisis in the future. We are probably seeing the light at the end of the tunnel for Covid, but we are just entering that tunnel on how to work post-Covid as that still has to be solved,.
EF: If you had to design a Master in Pandemic Administration program, which two courses would you consider mandatory?
DG: Communication and Psychology; communication because remote communication has been critical for working on the same page, chasing the right focus areas and objectives as well as connecting with customers and clients. Phycology because working alone can take a toll and people must be kept motivated to get the best from them and they must be approached individually. We must bear in mind that some people live alone and going to the office was their time to connect with other people and with Covid their worlds became a lot smaller. As leaders we must look after our employee's mental health. I have a very good team, my head of communications played a very strong role in tackling these areas effectively and all I could do was encourage the leadership team to stay close to the people. We had a meeting every two weeks and checked in with the teams more frequently and if we saw somebody looking down and out we would reach out to them individually.
EF: How was the portfolio performance in pharmaceuticals over the past year?
DG: Between 2019 and now we have gone through a very dramatic -and positive- portfolio shift, we have moved away from our established product portfolio where we heavily relied on three big oncology drugs. It has now been refreshed and we have added new molecules, over 2020 despite the lockdowns we managed to launch four or five products. We have entered new disease areas such as neurology, hemophilia A and we expect to enter ophthalmology, so overall it has been positive. Revenues have gone down in some areas but they have gone up in others, we have a big flu portfolio even though there hasn’t been flu anywhere in the world, fortunately –albeit unfortunately for us- but we have made up for that with other brands and the business is ticking along nicely. I am optimistic about the new focus on healthcare going forward, Covid has put the spotlight on health and vaccines, for example, Pfizer has become a household name since the pandemic and a lot more people understand the importance of being healthy and taking healthcare seriously -a big step forward for pharmaceutical companies. We must hold on to this achievement and use the awareness to get more patients diagnosed and on treatment. Our portfolio is very strong in oncology, breast cancer; therapy, and lung cancer. South Africa has always been a bit behind on the regulatory side but there has been a recent dramatic improvement and we have the opportunity to bring the new molecules into the country for patients especially in the private sector. The pandemic has also highlighted a few weaker areas in the public sector which the government will concentrate on reinforcing the infrastructure where needed.
EF: Do you think the role of pharma and innovation will be better understood by the world in general after Covid?
DG: Yes and no; on the one hand the world has seen pharma´s positive role in solving complex problems, it is an incredible feat that pharma companies have come up with vaccines and diagnostic tests in the space of one year but on the other hand there has been a lot of debate on the intellectual property issue. We invest heavily in innovation and finding complex solutions and we have to ensure that we are able to continue investing by protecting intellectual property and so allow future generations to find new solutions in different disease areas, maybe the cure to cancer or eradicate the common flu, which might be achieved as a result of what we have learnt from Covid-19. But regardless there will be a lot more public interest in health and an increased responsibility for players in the pharma industry. Universal healthcare coverage does not exist in all the countries of the world –it actually exists in very few places- therefore the equitable access to cancer medication is vastly different in South Africa to what it is in Europe and this has been highlighted in the access to vaccines. Pharma will need to solve this issue by focusing on equitable healthcare distribution going forward and not just during a pandemic.
EF: As a pharma sector leader what do you envision to be the skill set needed for the new generation coming up and how can they be attracted to working in the sector?
DG: Roche is one of the biggest investors in developing innovative medicines and we have to do that because it is our future and how we thrive. There is a huge amount of money going into research and development so for me the skills we need must be complementary to remain innovative and at the top of the market. We need people with a curious mindset and biased toward action, willing to look at things differently, not only to think up solutions but to act on them. We need people with collaborative personalities because Covid has broken down a lot of the silos, before Covid we didn’t talk as we do today to the distribution industry or the hospital groups and we need people who are open to this dialogue and to the idea of co-creating solutions with non-traditional partners. People with cross industry experience, cross functional knowledge and experience will be able to contribute always maintaining the innovative aura and attract people who are fascinated by making a difference through innovation. We have to find people who can figure out and develop ways of bringing digital aspects to the table and at the same speed we are commercializing. We have an application called Floodlight for multiple sclerosis used in clinical development performing in rural settings which combines medicine and technology for the advancement of what we can deliver to patients.
EF: When you look back to this period in your professional career, what would you like your 2020 and 2021 tenure to be remembered for?
DG: It would be great to be remembered for navigating a fairly complex time bringing medicines that shifted the status quo for South African patients. Having made available a new set of medicines to a broadest of South African patients in spite of the difficulties of Covid, the economic environment and political uncertainty with our focus always on making sure we help patients in South Africa. In ten years’ time I hope to look back and say that at the beginning of 2017 we didn’t have a lot of new medicines and ten years later all patients in South Africa have access to new medicines. I hope we can keep on making a positive impact and now that vaccination has started to flow Covid will be over soon.
