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EF: What are the lessons learned from this last very atypical year?
AM: As a leader, I have been amazed by the agility of our team. The ability people have to adapt positively to change while remaining totally committed to a purpose. What differentiates pharma from other industries is the purpose for which we work, we impact and save patient lives. Our people have been very responsible and conscious that we need to ensure continuity of our mission which is serving patients. I was amazed how in less than a week we were able to operate remotely, a company of more than one thousand people including activities such as manufacturing and supply chain. In Colombia, we have our factory and another third-party factory dedicated to us and they have been manufacturing at 90% of their capacity throughout the pandemic, we faced no shortage of products even for the Covid related products that were very much in demand. To supply without disruption was quite an achievement. In times of crisis, the present is a moment of truth and a chance to show whether consistency with one’s values, the company´s priorities and at Sanofi we put people first clearly demonstrated during the pandemic. We did not restructure, we kept all of our people, kept on incentives, gave employees the possibility to work from home, insured their safety, providing digital support and protective equipment, platforms for e-learning, and vaccinated the whole workforce on a voluntary basis against flu last year for them to feel better protected. We have put a lot of dedication into showing our commitment to our people and as recognition, we have been certified “top employer” in 2021 in Colombia and across LATAM. The speed of the digital transformation was such that during the pandemic we gained maybe a year or a year and a half on our transformation, on how we engage with patients, on doing commerce, and the way we relate to healthcare professionals. These changes have created a before and after and are here to stay, but what hasn’t changed is the value of collaboration and in the last month I have seen more collaboration in the healthcare sector than ever before. There has been a collaboration between universities and government, between governments and the private sector, and within the private sector itself. Sanofi is a good example of collaboration on a global level, with a vaccine development project with GSK and manufacturing vaccines of other companies (Pfizer and BioNTech) something that two years would have been unimaginable. With the crisis, we were able to unite and put the interest of the community and the patient first and this type of collaboration will serve us well in the healthcare sector.
EF: How could a more collaborative environment be achieved between the public and private sectors?
AM: On a vaccine level, we are already seeing a high level of collaboration between the public and private sectors. Sanofi has a vaccine program in direct collaboration with BARDA of the United States, they are government entities that have provided funding and have a program to speed up regulatory approval showing high collaboration between sectors. A local example in Colombia is that we are manufacturing a lot of Covid-related products here and we want Colombia to be served first even though we export to various countries in the region. Now, we have a very close collaboration with the government to define the local needs so that as soon as we can guarantee the local needs are fulfilled we can then continue exporting to other countries. We have been working very well so far on a very collaborative basis to ensure the continuity of the supply chain. The awareness of the need for collaboration definitely increased in 2020 and I think there is more trust between the government and the industry, we are seen as a real partner in healthcare for the long term, and on that basis, we will be able to build for a better future. An example of this is the speed of regulatory approval for the Covid-19 vaccines, governments have taken the decision to review much faster than they were doing so before, and secondly, the work many governments have put into strategic decisions for the country and their willingness to strengthen research and manufacturing of healthcare-related products in their country. Sanofi launched an initiative in Europe of creating a stand-alone company called Euro API to be a number one API manufacturer in Europe which will be listed as an independent company for other companies to work with them. It is a very strong commitment from Sanofi to re-establish strategic investments in the European Union for API manufacturing. And this trend can be seen in many countries; last week the president of Colombia made a very strong call to local companies to retake the manufacturing of vaccines within the country. This trend will have an impact in the next 3-5 years to come. As a company, we are pushing for collaboration, and as proof of this, we have collaborated with COVAX, the mechanism for sharing vaccines worldwide. In Latin America, we are talking to the different governments but we are mostly in contact with PAHO (Pan American Health Organization) because we think it is the fairest way to allocate vaccines and address a healthcare issue like Covid in the continent.
EF: Could you elaborate on the footprint you have in the country and its strategic importance to the group?
AM: Colombia is a very important country for Sanofi in Latin America; we are the number one pharma company in the country thanks to the dedication of more than one thousand employees that work with passion every day to save patients. We have been in the county for just over 30 years and we are involved in long-term investment in the country. We have a facility in Cali which manufactures over 40 million units a year and we have a second factory which is a strategic partnership with a French company called FAREVA in Villa Rica, south of Cali where 70 million units are manufactured per year. Both plants are exporting to Central America and the Caribbean and Ecuador, Peru, and to some extent to Bolivia. We have a strong presence in the country and in the region. In terms of portfolio, we have just over 270 references in the country allowing us to serve from common diseases like flu or diarrhoea to very complex diseases like oncology, rare disorders, and haematology. We are working on a portfolio of quality accessible products with an important local brand in the country for consumer health, vaccines, and speciality care.
EF: During the pandemic, the focus has been on communicable diseases, how can we balance resources for communicable and non-communicable diseases again for the focus to be brought back to chronic diseases?
AM: This a very relevant question because in 2020 patients suffering from chronic diseases have been negatively impacted as their access to the healthcare system has been reduced due to the pandemic and as a company, we are tackling this issue. We are strong in vaccines and know it to be the most efficient tool to tackle disease; we will continue to do this not only with Covid but with other vaccines as well. We are the world leader in flu vaccination and have a very strong franchise in pediatric vaccination not to mention we are a trusted partner of the Colombian government when it comes to pediatric campaigns and vaccination. We play a key role in non-communicable diseases in all cardiometabolic and cardiovascular; we are also leaders in the country providing insulin solutions and we are expanding in immunology for chronic diseases. We are very conscious of the urgent need to offer solutions for patients suffering from chronic diseases to access the healthcare system. In Colombia, we have been working with HMOs to provide telemedicine solutions, providing the HMO with a platform to interact with chronic patients that for various factors don’t want to come it for consultations, we are also delivering medication to patients at home as well as working with the HMOs and other logistic operators so the patients don’t have to come to the health centre to receive their insulin receiving it instead directly at home. We have developed digital apps for patients to access healthcare information related to their disease remotely and several simple patient programs where nurses call the patients to manage their diseases in a holistic way. The beauty of Colombia and its universal healthcare system is that it is relatively well balanced so the Covid vaccines budget will not impact the country´s healthcare budget.
EF: What changes have you seen in the portfolio performance over the last year?
AM: In a time of crisis, the value of a big diversified company is apparent as the impact on the different parts of the portfolio is shown up, consumer healthcare has suffered mainly because while in quarantine people have not been in contact with basic diseases, there have been less common colds or diarrhoea and sales have decreased, vaccines to a certain extent has also suffered because people have been afraid to get themselves and their kids vaccinated in the Covid context. Another area of products that have suffered is specifically related to hospital procedures that have been shut down during the pandemic, transplantation for example because health emergency hospitalization must be separated from Covid patients which can be difficult in the present context. On the other hand, products related to the management of Covid have been doing very well and because healthcare is well structured in Colombia we have been able to give continuity to Covid related ailments. SANOFI has very innovative treatments and life-changing therapies for treatments of acute dermatitis which is very much in demand despite Covid.
EF: What is your personal definition of access?
AM: For all the eligible patients for therapy get rapid and sustainable access to the treatments they need, rapid and sustainable being the keywords of that definition. In Latin America right now, we have two main challenges: i) speed: how fast between the approval of the FDA or EMEA can treatment be accessed and reimbursed in international markets and ii) sustainability: when the patient gets to access it must sustainable access meaning the patient doesn’t have to go through the legal system or be vocal in media to gain access. There must be a law and agreements in place, sustainable systems so the therapy the patient needs to access can be done over time. The access situation is very diverse and depends on each country. Colombia is very advanced, to compare the two countries I know very well, Egypt and Colombia, universal access to healthcare in Colombia is a reality where even a person with no job or an informal job can access the health system. There are two systems one contributive and the other subsidized and both have the possibility to access lifesaving therapies and this in my opinion is one of Colombia’s strengths for the future. It has been a challenge and a fight and it has to be recommitted to again and again as it is a very important investment for the country. Today Colombia is benefiting from the decision taken some years ago, a structural, strategic decision that looks to the future.
EF: What do you think will impact the speed of digitalization on the pharma companies in the future?
AM: The digital transformation has been much faster in consumer companies while the pharma industry has always lagged behind in terms of digital, but in SANOFI we have three pillars by which we will transform completely:
1. Growth, the first pillar which includes engagement with healthcare professionals. I don’t think the relationship between the industry and the ACP will stay fully virtual as there will be some in-person interaction but it will be much more limited than in the past, the digital side of things will increase tremendously and our objective is to offer a better experience to healthcare professionals through digital. Commerce is also part of this pillar as it impacts healthcare as well, we bring vaccinations to people partnering with Rappi and delivering them online in a safe and secure way and the system is here to stay and will grow.
2. Innovation: Digital is bringing disruption in R&D, in the way we enrol and how we follow up patients doing clinical trials. In 2020, SANOFI had more than 30 clinical trials on course with none of them being disrupted by the pandemic mainly because all follow-up has been done remotely. But innovation is about the patient’s experience, having the ability to provide digital services to patients in an integral way for them to manage their diseases. Emphasizing efficiency we are building a digitalized factory in which all areas can be monitored by the operator on an iPad. Thanks to the digital monitoring they can really focus on the point of concern at the plant at any given moment which will tremendously increase the productivity of the manufacture.
3. Reinventing the way we work: working from where the employee feels most productive, we will still come into the office but only for what really matters, for teamwork to co-create innovate and collaborate together but not to do individual work in front of a computer, that can be done from where the employee is most comfortable and productive, transformative for the company moving forward.
EF: Looking forward what are your expectations for the performance of Sanofi in 2021 and 2022?
AM: It´s about balancing short-term tactics with the mid to long-term strategy and no easy task. In Sanofi, on top of the external disruption, we are transforming internally and the changes within the company will accelerate in 2021 and 2022, also because we have a very rich pipeline of new therapies that we will bring to patients in various areas such as oncology, strengthening Sanofi as a speciality company. We have always been diversified but we are now dedicating more effort to speciality care especially in haematology, oncology, and haemophilia investing a lot from an R&D point of view. Obviously, the vaccine-related topic will also play a very important role in 2021 with Covid vaccine management. All in all, we are quite optimistic, healthcare has been so high on the agenda in 2020 that there is an awareness of the strategic investment healthcare means for the countries. In Colombia, there is an ongoing structural reform of the healthcare system before the 2022 election which might change the outlook for the healthcare sector in the country and for the years to come, so I think we will see a lot of change in 2021 healthcare is a fundamental topic for the society and the government.
EF: What would you like your 2021 tenure to be remembered for?
AM: During a crisis, it is important to rightly manage between short and mid-term but fundamentally one must bet on people. 2020 showed us more than ever that in a digital world people need to be protected, that we must function in a decentralized way, and decisions are taken fast in relation to the problem or to the patients. In order to make fast and efficient decisions trust is necessary because without trust a person will not risk taking a decision alone. Shared values are also needed because leaving the decisions up to your people means those decisions have to be taken according to the same values as there must be consistency in all decision-making. There must be core values on respect, integrity, teamwork, and courage embedded in the day-to-day your people are acting on. Diversity is also needed to introduce innovation in a situation like the present, diversity of gender, training, and personality for there to be a diversity of opinion. In Sanofi, we focus on this because we are convinced it is the source of innovation for the future. Finally, the work conditions for the people must be the correct ones for them to deliver their best in difficult times with flexible times and incentives. As a leader, my key priorities in 2021 will be focusing on people and making sure that culture and values are well understood and shared within the organization because I think that is the recipe for success. When we talk about digital transformation we talk too often about tech and not enough about the people behind it, the best tech is useless without the right people that believe and promote it. We have a policy in SANOFI whereby any employee can take 6 months to leave to have a baby –man or woman- and Sanofi does this because it is a strong believer in diversity, valuing all employees equally in knowledge and giving them the conditions to show their best capabilities.
EF: Pharma loses a lot of talent to tech, so what does it have to do to make it an attractive sector to work in?
AM: I think there has been a change, tech now is not as attractive as it once was, the digital transformation in the pharmaceutical industry is giving them the opportunity to innovate and create new ways to connect patients and HCPs with new and more modern technologies and secondly in healthcare we bring something which is unique: purpose. In a company like Sanofi people can impact lives; transform and change patient’s lives. I have worked in the sector for 17 years and purpose still motivates me every day and on the hardest day, I remember we are not managing a business, we are working for society. Developing a vaccine in one year has been a historical event and never done before. With the help of universities and governments, we can impact the lives of millions. I would like to transmit to the younger generations that this sector allows for doing something meaningful with their lives. At Sanofi, you can have a voice and make an impact.