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EF: As the now official country president of Novartis, what are the priorities of your agenda?
SH: I have three priorities. Firstly, developing people across our business units in South Africa. Novartis has a strong culture surrounding employee development because if our people are skilled, we will be able to serve our patients better. Secondly increasing access for patients. Our announcement of One Novartis under Novartis Global Health was to consolidate our efforts in building sustainable healthcare systems in the continent. Thirdly, leading within the NOVARTIS values, culture and behavior. I want to uphold courageousness and integrity-driven business principles. Reputation in the pharma industry is important, and I want to ensure that we are the role models of integrity.
I have been in the pharmaceutical industry for thirty years, my passion has always been around the patient and increasing access to treatment. I have worked in challenging disease areas and considering South Africa’s tiered healthcare system with different benefits, it’s even more critical to ensure access to treatment for patients.
I’ve always been passionate about how we can work across the various socio-economic groups and provide an equitable solution for access for all patients. This is why as Novartis we find it important to be a part of the conversation as far as the NHI initiative is concerned. Our role as industry is to be a partner to any government in the markets that we operate in as collaboration strengthens healthcare systems. It is the right way to go about shaping the policy landscape given the complexity of this particular initiative.
EF: What would be the ideal implementation of NHI you would like to see?
SH: The biggest issue would be around what I call equitable healthcare. It should not be about removing the top end for people who can afford it, yet, at the same time, we don’t want to disadvantage people at the lower end who haven’t been able to afford healthcare. The two ends must be brought together while still allowing people to have a choice. In a democratic society, choice must not be removed absolutely.
EF: Could you provide some facts and figures about Novartis’ South African footprint and performance?
SH: Novartis South Africa has a footprint across innovative medicines which consists of our Pharma Division and our Oncology Division and we also have Sandoz which is our biosimilars Business Unit. The combination of all three makes us the second biggest multinational in South Africa. Across the entire group (including manufacturing and business services), we employ about 770 people. Last year we signed a deal with KIARA Health, a 100% black owned company, who will now take over all manufacturing and our manufacturing footprint will continue through a third party.
EF: How does your local footprint translate to the Novartis global picture and mindset? What is South Africa’s strategic importance to the Novartis group?
SH: We believe South Africa has the ability to become an innovation hub. We signed an MOU in 2017 with the Department of Science and Technology (DST) and the Medical Research Council (MRC) highlighting our commitment to the country. We also actively participate in phase 3 and phase 4 clinical trials in South Africa, so we have a very strong Global Drug Development presence in the country. At the moment, we have 20 clinical trials ongoing in the country, so our clinical trial footprint is significant.
At the moment, the clinical trials are South African based. However, we have recognized that the African population is incredibly important in terms of clinical research. We are in the process of trying to establish clinical trials in other parts of the continent, particularly in diseases that impact the African demographic more, e.g. sickle cell disease. We would like to get more involved in breast cancer clinical trials as it is one of our strengths and one of the bigger disease burdens in oncology. We do a lot for cancer awareness.
EF: What is your personal definition of access? What initiatives are you doing to find alternative reimbursement models? How does SEP play into those new models?
SH: Access is something everybody needs to take responsibility for. Every single stakeholder in the healthcare environment has a role to play whether it is government ensuring that infrastructure supports access or it is pharmaceutical companies creating access with brand products or whether it is healthcare professionals assisting access through lower fees or community work. They are all part of the supply chain. .
For the last three years, I have had the great opportunity working in Sub Saharan Africa, specifically in East Africa. In some markets the conversations were around the discounts WE could offer and what WE could do to reduce the cost of a product. We managed to shift the conversation at the distributor level: if it was a life-threatening disease and we had a lifesaving drug, they would consider removing a couple of percentage points in their distributor fee. Next, we had the same dialogue with pharmacies and hospitals. We know we cannot regulate it. At the end of the day, it is down to the willingness to do good for patients. If everybody plays their part, then we improve access.
EF: Could you elaborate on the innovations Novartis is looking at? How do these innovations contribute to increasing access?
SH: In South Africa, we have SEP which legislates Single Exit Price intervention. We are now participating in an industry conversation around alternative reimbursement models (ARMs). We are trying to engage with multiple stakeholders with regards to high end innovative products that are more inaccessible when restricted to SEP. Our hope is that ARM discussions will result in something concrete. We are still in the early days of conversations, and so we are still hashing out what the proposal to the government will be.
Our MOU with the DST and the MRC, we have a number of capacity building projects we have been involved in. We have a healthcare professional university providing a number of initiatives like training in good clinical trial practice.
From a global perspective, we have been involved in the Next Generation Scientists Program where we give young scientists from various universities in South Africa and other African countries the opportunity to do research work at the Novartis Institutes for BioMedical Research and bring their knowledge and experience back to their countries.
In Sub-Saharan Africa, the mandate is about improving access: the KPI is not the bottom line; the KPI is the number of patients that can access treatment. It is a massive shift as it is not about how much money we can make but about how many more patients we can reach. Novartis has been a key and pivotal player in that transformation.
EF: The pharma sector manages their triple bottom line (People, Profit, Planet) very well. What advice would you give to other sectors of the economy on the key to managing a triple bottom line?
SH: I believe that if people are happy, passionate, and purpose driven , profit will naturally flow. My Ps are People, Passion, and Purpose. If I can get these things right, the profit will follow. People who follow the money are incredibly disgruntled and unhappy because there is so much variability. There is no consistency. If every day you have passion, purpose and patience, it will cause a shift and it speaks to what I have said about my mandate as country president. It is about people: making people passionate about coming to work, making sure they have a purpose, and that the purpose is patient driven.
EF: You mentioned Courage as one of the values. Why do you choose courage specifically as a value?
SH: We are working in a rapidly changing environment where we can choose to sit back and watch things happen or we can be courageous and speak up to be part of the process. A lot of people choose to sit back and wait to see what is happening, but in my opinion, we need to be players. To be a player, one must be courageous and speak up as there are surely things that are not aligned. Novartis, as the second biggest multinational company in South Africa, needs to be able to have a voice and it must be spoken with courage.
