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EF: Could you elaborate on IPASA's economic spillover and your agenda priorities today?

BP: The role of the innovative pharma industry was crucial this past year. We had to start working very quickly on a vaccine for Covid-19, and this became the priority for most of our member companies in 2020. By the end of the year, 3 or 4 member companies had already managed to bring a vaccine to the market in South Africa and offer their vaccine to various governments locally. As soon as the crisis and subsequent lockdown started, we formed Business for South Africa (B4SA), a coalition of business partners that began by procuring personal protective equipment and therapies for people in need to support the government's effort. Because hospitals and clinics were giving priority to Covid-19, very few people were taking their chronic medication and our member companies worked around on getting these medications to their patients, patients with high blood pressure, diabetes, HIV and TB, etc. This was done to avoid having a later even more serious crisis on our hands. We managed this delicate balance successfully while protecting our employees and keeping them safe from infection. This year, aside from the Covid crisis, South Africa and India have called for a waiver of the Covid vaccine at the World Trade Organization. The next biggest issue for our industry in South Africa is that of intellectual property protection and we have had interaction with stakeholders and are working closely as part of the alliance in the private sector. We cannot support a waiver of the intellectual property vaccines; if we do it, will kill innovation and research & development and nobody will want to work on new future innovations.

EF: 2020 was the year of diagnostics, and this year is all about getting the vaccines delivered, which tends to detract the focus from chronic diseases. How has South Africa coped in this area? 

BP: It is an interesting fact that some non-governmental organizations are not supporting the waiver and they have managed to mobilize academia, the private sector, and the NGO sector. The companies in South Africa won’t be capable of any level of vaccine production by Biovac partly state-owned- and Aspen PharmaCare -the biggest generic producer in South Africa and the southern hemisphere- and are working closely with owners of intellectual property. I recently attended a BRICs webinar with the participation of the South African ambassador to the WTO, many legal funds conducted by our government as well as Biovac and Aspen. While most government speakers continue to advocate for the waiver of the vaccines the executive of Aspen PharmaCare said they preferred to work closely with the owners of intellectual property because they believe they will voluntarily transfer the necessary licenses and the technology and help with the equipment needed to become more independent and do these things on their own. The chief executive of Biovac virtually said the same thing, preferring to negotiate with the owners of intellectual property as they believe that only through licensing and the voluntary transfer of technology BioVac would be able to succeed. Their opinion is valuable, as they are supposed to be the beneficiaries of compulsory licensing, but they believe that we should engage in proper negotiations, which in itself is very telling. I believe that discussing the waiver of intellectual property is not necessary, as intellectual property is not enough to develop a product. Companies would still need to contact the patent creator to perform a technology transfer and the know-how, and then to submit the molecule to the regulatory authority for what they have copied to be accepted as having the same properties as the original molecule. 

Another important step is that we have started working with the WHO and member companies to improve the facilities and conditions for vaccine production on the African continent. This is happening in collaboration with legislative authorities of various African countries, and distribution agencies on the continent. We are aware that we need to improve the supply chain process within African countries. We have seen several countries that have not been able to use the AstraZeneca vaccine because of logistics. There are also problems with the sourcing of key components for vaccine production, as countries are establishing constraints on the raw materials for the vaccines, for example, the United States decided not to allow raw materials to leave the country until they had sufficient production for their own country, a barrier that must be dealt with here. 

EF: Did any of your member companies drive initiatives in the country to ensure the focus remains on chronic diseases? 

BP: An initiative done by our member companies was creating a hybrid system whereby they spoke virtually with doctors and pharmacists to know in what areas to drop off medicines. Hospitals were practically all allocated to Covid with very little consideration for patients with chronic medication so some of our members successfully approached the regulatory authority SAHPRA to be able to supply medicines to patients for a 3 to 6 months period as a way of ensuring medication getting to patients. In certain remote areas, it was not possible to supply chronic medication but by and large supplies were available to most people.

EF: Do you have any advice to offer the newly appointed Minister of Health in South Africa? 

BP: The new Minister of Health needs to understand the importance of public health, and that now more than ever is crucial to allocate resources where the health outcomes are the highest. The business sector intervened in support of the government free of charge to get PPE to the people in need and to keep the country’s population safe and productive so the economy wouldn’t be impacted. It was very painful to find out –based on what we now know- that people close to the minister, probably even the minister himself, were responsible for signing off on those damaging contracts for the country, overpaying for services that could be routinely provided by people in the government. In many other countries, the president would have fired the minister immediately, or indeed the minister should have resigned immediately whether he is or not involved as this sends a message and discourages those who want to get to ministers to take advantage of the circumstances. The politician in charge of any ministry is exposed to scrutiny and does not need to be an expert on the subject as long as he knows how to provide the necessary support to get things done as the technocrats are the ones that do the actual work. 

EF: How do you see the future of digitalization in the pharma agenda for your member companies in South Africa? 

BP: Our member companies have been working very hard to digitize their processes, and we have learned from Covid-19 and subsequent lockdowns that there is no choice but to start relying on digital ways of communication and I think this situation will only gain momentum. Even if in January 2022 we have reached herd immunity, the experience of the last two years most companies had will be leveraged for the future. Home office will develop and be the office of the future; companies will reduce costs, there will be less pollution with fewer cars on the road. As the saying goes, a good crisis can be used to find some positives. Digitalization is a positive of this crisis and in the future and we will have to adapt to a future of digitalization. 

EF: Is there a specific topic you would like to elaborate on?

BP: The government tends to talk a lot about localization and the Broad-Based Black Economic Empowerment stipulates that companies operating in South Africa have to show local ownership of those people defined as previously disadvantaged and this goes for companies in all spheres and is not a simple rule for multinational companies. Over the last 5 or 6 years, IPASA has adopted a strategy of not focusing only on issues surrounding registration and regulatory affairs and getting our products on the market but we want a place at the policy-making table. To influence the way things are done we must know all the stakeholders and what they want. Even if we are not in agreement with them, all their wishes must try to accommodate them to some extent. Our government's choice of universal healthcare coverage is the National Health Insurance. There are aspects of the implementation the private sector does not completely agree with. We need to ensure there will be measures installed that will be used to safeguard the huge fund that will be the National Health Insurance. We can agree with the government on the introduction of universal healthcare coverage, to give access to health to everybody at a low cost. We think certain things must be done differently, which is why IPASA and the entire industry have decided to participate in the decisions in policymaking. We want to become part of the landscape of this country, finding ways of doing technological transfer and working with small startup companies that come up with innovation but need funding and technology transfer. We want to ensure South Africa develops its technology through innovative companies. It is a long-term plan but I believe it will be for the company and country. I am South African first and foremost, but am employed by multinationals; I am loyal to my country, and my employers and I can serve both without conflict. Significantly, more and more multinationals employ South Africans to be their CEOs, people who want South Africa to grow, develop and work in their employers’ interests. 

EF: Wasn´t last year enough evidence of the role pharma plays impacting the economy, has the government understood the importance of the pharma sector for the productivity of the economy? 

BP: It was, but I have also worked in the government and was part of the leadership in the mid-90s when we started introducing legislative changes to the Medicines Control Act, Pharmacy Act, etc., and the relationship between pharma and government was not yet developed. Today, there are still people in the government that do not see the pharmaceutical industry as being able to assist. There are also still obstacles to be surmounted in South Africa. It is not an easy country to do business, as supply cannot be guaranteed, and legislation makes it difficult for a company to set up business in the country. We have to work on improving the way of doing business in South Africa; the regulatory framework is also very tough on foreign companies doing business here. When we fail to get through to the government directly, we resort to the academia, scientists, and South African business people who are close to the government and can serve as intermediaries. We have to do our part as ambassadors of multinationals to ensure our government can accommodate those who want to do business in South Africa.

EF: This is a unique time in the healthcare sector globally, when you look back to this period in your professional career what would you like to be remembered for?

BP: When I joined IPASA I thought I was joining “the other side”. Now, I understand what the industry wants to achieve in South Africa which is a good thing, and I also understand the government’s way of thinking. If I can bridge the gap, even by a little, I would be proud to be remembered for that. I want to ensure the multinational sector believes and takes steps to be part of the South African landscape. I know it is not an easy task but I do believe it’s achievable.

July 2021
South Africa