Read the Conversation
EF: What word would you use to describe 2024 for Roche in Latin America?
RH: I am absolutely sure that 2024 will be a successful year for Roche, largely due to the innovations we have lined up. I look forward to the challenges ahead with optimism and anticipate a positive outcome. If I had to sum up my outlook in one word, it would be "opportunity." I view LATAM as a region of opportunities for growth and advancement.
EF: You recently received your Master’s degree in Global Public Health. What value does this degree add to your professional profile, and how will you apply the skills you acquired in LATAM?
RH: I acquired this qualification during the pandemic at a time when it seemed like many people were also making big changes in their lives. This degree is an interesting one, because although I am an economist by training, I originally wanted to be a physician, and over time I found myself questioning whether our industry truly understands public health. Do we speak the same language as government ministers on this critical subject? This triggered my interest in the subject and pushed me to study more on the subject.
Because I wanted a program with a stronger focus on social science that was fully available online, I chose to study at Queen Mary University, and I thoroughly enjoyed my experience there. Being the only industry representative in my cohort was challenging but also enlightening, as it exposed me to diverse perspectives from health professionals. It shed light on different perceptions of the industry, which I found fascinating. Looking ahead, as we confront significant challenges in healthcare systems, it is essential to recognize that we are all part of the solution, which means we have to be able to communicate effectively, including with the health ministers. My dissertation about the healthcare budgeting process in Peru was recently published in the Global Health Science and Practice Journal, and it caught the attention of regional media who wanted to learn more about the dissertation due to its social and economic implications for the quality of healthcare in this country.
EF: How is Roche leveraging its existing assets in the LATAM region? How does each country in LATAM contribute to the entire Roche map?
RH: I believe we need to start by looking at the broader picture before delving into specifics. The reason why Roche's future looks promising, particularly in Latin America, is because of the significant impact we can make with our solutions. According to statistics from institutions like CAF (Development Bank of Latin America), the population aged 65 and above is expected to double in the next 30 years. Moreover, there is a noticeable shift towards non-communicable diseases such as cancer, diabetes, cardiovascular diseases, and certain neurological disorders across all countries, including Latin America. These are precisely the areas where our research is focused.
In Latin America, we are experiencing similar trends to the rest of the world, including a shortage of healthcare professionals. Therefore, our goal is to develop user-friendly solutions and enhance the efficiency of healthcare systems. On a macro level, the challenge is that in many countries, healthcare is still perceived as an expense rather than an investment. This mindset needs to shift to realize the potential of healthcare as a strategic investment for the future well-being of societies. This shift will remove the greatest limiting factor for the success of innovations in Latin America. Economic reports consistently demonstrate that increased investment in healthcare leads to improved productivity and higher GDP per capita. Therefore, there needs to be a dialogue with finance ministries to shift this mindset and recognize healthcare as a strategic economic discussion.
Looking ahead, addressing the financing of health systems will require a focus on prioritization and a better allocation of resources towards prevention, early detection, and effective treatments. This approach is essential for ensuring the long-term viability and effectiveness of healthcare systems in LATAM. Latin America invests, on average, only about 3.7% in public health. WHO recommends that this figure has to be a minimum of 6%.
The challenge is clear when we examine health investment statistics in Latin America. Only a few countries like Argentina, Uruguay, and Colombia invest above 6% of their GDP in public health, while the majority are below this threshold, with some countries like Peru around 4% and others even lower, such as Mexico and Venezuela. To address this gap, it is important to ensure that finance ministers understand the unsustainability of current healthcare investment levels.
The COVID-19 pandemic has underscored the consequences of inadequate healthcare systems, where countries with weaker systems suffered the most. Similarly, the looming wave of non-communicable diseases demands a prepared and robust healthcare infrastructure to avoid premature deaths and maintain productivity. This macroeconomic perspective highlights the urgent need for strategic investment in healthcare to mitigate the impact on GDP per capita and ensure sustainable healthcare systems capable of addressing future health challenges effectively.
Apart from the lack of health professionals, we need to determine how we will facilitate the whole digital health and telehealth conversation. This is important because we will not have healthcare professionals for all of the regions of Latin America. Professionals will be found mainly in the cities and we will have to find solutions to address populations in remote areas.
Another important aspect to consider is how approximately 80% of healthcare budgets in Latin America are allocated to infrastructure and salaries. Rifat Atun, a British physician and academic who serves as the Professor of Global Health Systems and Director of the Health System Innovation Lab at Harvard University, often illustrates this concept by comparing hospitals from a century ago to modern hospitals. Despite similarities in physical infrastructure and hospital beds, the real advancements lie in diagnostics, surgical procedures, and pharmaceuticals. However, these transformative elements represent only around 20% of healthcare budgets on average. This disparity underscores the critical role of industries like ours.
Without addressing this imbalance, many innovative solutions may never reach patients who need them. Therefore, policy interventions are crucial to ensure that healthcare funding priorities align to deliver cutting-edge treatments and technologies to improve patient outcomes. By making the use of the resources more efficient we will have better outcomes for patients.
EF: What is the strategic relevance of the LATAM region for ROCHE?
RH: I believe that we have significantly punched above our weight in the past few years, especially considering our contribution in various metrics. If we examine the clinical trial landscape, we can observe a substantial footprint in the Latin American region. Moreover, I am hearing increasingly positive feedback from Latin American talent about how valued they feel.
The reason behind this appreciation is likely due to the diverse and dynamic nature of our world. Having navigated through this environment, individuals gain a unique sense of adaptability and pragmatism. One notable aspect of this pragmatism is the willingness to embrace change without exhaustive discussions on every detail. Things change, you adapt and get on with it. I think this is an asset, and we have to make sure that we position this as an invaluable asset to the rest of the world as well.
EF: Why is $1 invested in Latin America worth more than in other regions?
RH: Looking at our recent performance, it is clear that we have demonstrated stronger growth compared to other parts of the world, and this is a recurring topic in our annual budget discussions. We have proven our ability to generate sustainable growth, and given the economic backdrop I outlined earlier, it is evident that about 50% of patients who should receive treatment are currently not accessing it. This long-standing issue, while unfortunate, presents ample opportunity for growth in Latin America. Despite challenges, there are significant opportunities to enhance patients' lives while also ensuring economic viability for the company. LATAM is a promising landscape with clear potential for improvement, making it a strategic focus area. I think we have solid health and social systems that we can build on to materialize this potential.
EF: How are you tailoring your portfolio in Latin America, and have you had a good reception from the local healthcare system?
RH: What I always believe is that real breakthrough innovations can lead to significant success. For example, breakthroughs in oncology have consistently demonstrated this principle. The same holds for conditions like haemophilia and multiple sclerosis, as well as rare diseases. These innovations can truly make a difference in patients' lives. The greatest challenge arises when innovations are perceived as only incremental improvements; this can hinder their acceptance and adoption within different health systems. However, when a product or treatment genuinely transforms outcomes—like preventing bleeding in haemophilia patients—it becomes easier to engage health ministers in discussions.
Having clear evidence of patient improvement not only benefits individuals but also society as a whole. For example, curing a breast cancer patient through targeted therapies in the HER2 field is a tangible example of the impact that transformative innovations can have.
So, what does that mean? Essentially, it underscores the importance of early detection and effective treatment in improving patient outcomes and societal well-being. When patients are diagnosed and treated early, it can lead to significant cost savings compared to treating them at later disease stages. Curing diseases rather than just prolonging life can reduce the number of dependents and individuals who are unable to work, resulting in increased productivity in many adjacent sectors of society.
For example, severe haemophilia patients often face challenges with schooling because institutions may not be equipped to accommodate their needs, leading to missed education opportunities. This, in turn, affects the parents, especially the mother, who may need to stay at home to care for the child. By providing effective treatments that prevent bleeding episodes, we can alleviate these social and economic burdens. Similarly, in conditions like multiple sclerosis or retinal diseases, timely and appropriate interventions can prevent disability. This improves the quality of life for affected individuals and also reduces the strain on families and caregivers.
These are the productivity gains that are brought about by innovations. This makes discussions easier, and as innovative pharmaceutical companies, we have to make sure that we bring something to the table that has a societal benefit. This is what we call a “triple win.” It has to be good for the patient, the society, and the company.
EF: Considering the transformative nature of health care and how different the industry can look from one decade to the next, how is Roche preparing for the future?
RH: We have significantly strengthened our ability to partner with health systems and develop optimal solutions collaboratively. In our R&D efforts, we have leveraged cutting-edge technology to accelerate and enhance our processes, focusing on disease areas that carry the greatest societal burden. Our primary goal is to target areas where we can make the most significant positive impact on society, such as cardiovascular health, neurological disorders, and obesity-related complications. For example, addressing muscle loss in obesity while managing neurological disorders like Parkinson's requires innovative approaches that address underlying issues rather than just symptoms.
This commitment to tackling fundamental health challenges represents a significant area of investment and opportunity. Additionally, our unique integration of diagnostics and pharmaceuticals enables us to optimize healthcare delivery through technology. By combining comprehensive laboratory tests with near-patient diagnostics, we ensure that each aspect of patient care is managed efficiently. This integrated approach, complemented by digital tools, enhances our ability to deliver superior solutions tailored to individual needs. In summary, our overarching strategy involves deepening partnerships with health systems, intensifying R&D efforts in key disease areas, and leveraging diagnostic-pharmaceutical integration to optimize healthcare delivery through innovative technology solutions.
EF: When we last spoke, you were in the beginning stages of creating the Movement Health Foundation, which has now matured and become a full-fledged foundation. What needs to happen in the coming years to reach your goal of reducing premature mortality by one-third?
RH: When we first conceived the idea, it was just that—an idea. Today, it has evolved into a foundation with the collaboration of Roche and other major companies. From the very beginning, we realized that to address healthcare system challenges effectively, we needed to think beyond the traditional boundaries of the pharmaceutical industry. That is why we partnered with Siemens Healthineers, Microsoft, Dr. Rifat Atun from Harvard University, and the Copenhagen Institute for Future Studies. Together, this forms the foundation of our collaborative efforts.
When approaching global health systems or ministries of health, the collective expertise of different industries lends us unique credibility. This credibility is crucial in driving meaningful change. After one year as a foundation, we are already seeing progress with our projects in Latin America. We have also started activities in Africa and Europe. The foundation has grown from Latin America and has gone beyond its origin, which is very gratifying to see.
Another good example of our approach is to identify pilot projects that demonstrate significant health impacts. For instance, we conduct pilots in hospitals or specific regions and then focus on making these solutions scalable. A good example is our recent project in Colombia, where the government subsequently invested $1.5 million in a solution developed through collaboration in the Atlantic region of the country. The success of this initiative led the government to expand it to other regions like Maya. Similarly, in Peru, a solution developed in the Cusco region is now being adapted for Lambayeque and Arequipa. This approach highlights our goal of expanding successful interventions to benefit broader populations. While some projects may take longer to develop, our vision for the long term is to leverage digital innovations to enhance the efficiency of health systems.
To achieve our goals over the next six years within our operational framework, we will focus on scaling solutions that can be easily adapted across countries. Rifat Atun often emphasizes that 80% of health issues are transnational, requiring minimal adjustments as the underlying challenges are similar across countries. This perspective underscores our strategy to implement effective solutions that can be seamlessly replicated and tailored to different contexts.
I believe the key to our project's success lies in aligning with countries' clear commitments and needs. Instead of imposing solutions, we adopt a bottom-up approach where local health specialists define priorities. Our role, alongside companies like Microsoft, Siemens, and Roche, is to provide expertise and technology tailored to address identified challenges effectively. The goal is to solve actual, prioritized problems rather than introducing solutions that may not align with local priorities. This is a collaborative approach that ensures our initiatives are driven by genuine needs and opportunities.
EF: Is there any final message you would like to give to our global readership?
RH: I always emphasize the importance of staying curious, non-stop learning, and being adaptable to new developments. Countless opportunities are waiting to be explored, and I am committed to continuing this journey of growth and exploration in the coming years. While focusing on the common goal of elevating the standard of healthcare in Latin America, we must always remember that we are figures working collaboratively to ensure that health is not considered an expense, but rather an investment with guaranteed returns for society.
