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EF: What could be done to make investors more comfortable investing in Mexican healthcare? How can investors’ confidence be restored? 

HV:  Mexico has comparatively a young population especially compared to Europe and this gives us a lot of possibilities, if looking to the future, we start at this point in time and can make it with business in the long term from an investor’s perspective. I see Mexico growing faster than other growing markets and giving options to people willing to solve the healthcare crisis which Mexico will face in upcoming years. Today we have a gap in access to healthcare based on our physicians; we have too many paediatricians and gynaecologists and not enough endocrinologists, oncologists, and cardiologists so we need to work on having the right specialists in the right geographies and not only in the big cities and state capitals as it adds to the existing gap of access. We also have a lack of infrastructure, of pharmaceuticals and medical devices and adding the fact that we are a younger population transitioning to be an older one, the existing gap will only widen. This is the moment to reinvest in Mexico, in infrastructure, in bringing in new technologies so we can be part of the game over the next few years.

EF: This seems to be a very global problem. Do you have any ideas of how to specifically deal with this ever-increasing burden on a younger population with a slowing economic growth?

HV: Businesswise, the demand of health services will increase so the only way to work for the demand not to continue to increase, is to move into a model we call 4 P's with predictive, preventive, personalized and participative medicine. With this model, people will know what they tend to develop and can prevent having personalized diets, exercise, and personalized precision medicine. We also expect to have patients that are more participative in their own health situation, work together with other patients with their same disease and most importantly, we want patients to participate with their data and be part of the big data so we can make an analysis. From an offering perspective, we need to invest more and we need new technologies to be part of the game. With the 4 P's and the inclusion of technology, the gap would be reduced and help the population to not develop new diseases or at least, lengthen life expectancy. 

EF: What kind of technology are you looking at?

HV: Generally speaking, we work mainly in ten technologies, and we work on the understanding of genomics. With all that has to do with AI where a lot is happening in imaging and understanding the algorithms which are critical for the physicians. Pathology, ophthalmology, and dermatology are developing very fast as is telemedicine, which is very relevant for a country like Mexico in closing the gap for people who have no geographic access. FUNSALUD is working in this area with the Health Ministry with the understanding that these ten technologies are the answer to closing the gap in Mexico. We are working on Blockchain for tracing prescriptions, 3D printing, and robotics. We have a council within FUNSALUD that is specialized in new technologies and they work with small companies and entrepreneurs, people that have a business plan in a PowerPoint to big companies like Microsoft, Amazon, and J&J among others. The small guys want access to resources whereas the companies are more worried about the regulatory aspects as they don’t want the uncertainty of developing something and have COFEPRIS ban it. For this reason, FUNSALUD is working on writing a new proposal for the new regulatory environment of genomics. We are also working on how Tele-Medicine should be approached as well as Health Electronic records which the Health Minister has asked us to give our position on how it should be handled. 

EF: Are there any existing policies that you would like adapted or changed?

HV: The FDA has 750 people exclusively dedicated to new technologies in the US, while in Mexico, we have zero. We don’t even have a law or any framework for new technologies so they can’t even be registered.

EF: So how do you de-risk the situation and inspire confidence?

HV: First, we will have discussions on regulatory. We have discussion groups for each one of the new technologies, the small businesses and the big companies are all part of the table and have exactly the same voice and vote regardless of the size of the company. As soon as the regulatory framework is decided, it goes to the House of Representatives and the Senate and once it is approved, there will be confidence. The insurance companies, private payers, and the hospitals are all willing to see this happen. We are working on electronic medical records, telemedicine, drones for delivery, and genomics with the government. Our council works closely with IMSS and departments of the government like the Consejo de Salubridad General for example, on campaigns for COVID-19 and we are very happy to be actively working with them.

EF: What campaigns have you been doing for coronavirus?

HV: We have worked on a project together with the Consejo de Salubridad General, FUNSALUD and ANADIN to make sure we have the right training for the physicians, how to prepare patients, how to detect the coronavirus and how to deal with the whole process. 

EF: Do you think the current Mexican health infrastructure is ready to handle the coronavirus?

HV: No one was ready to handle the coronavirus. Everybody has underestimated it and its impact and as it is appearing in other countries, we are learning from it. It has been underestimated from two perspectives, as a healthcare issue and as an economic issue and we are going through a bad moment but we will overcome it as we have in the past overcome other crisis. From a Mexican perspective, there is a lot to be done and we must work together, the government and the private sector.

EF: What advice would you give to other GMs on managing strategy and tactics? 

HV: More than ever we must think long term and that is critical. There are the short term issues like problems with registrations with COFEPRIS which must be solved quickly, things like patients not having medicines, physicians not having medical devices or pharmaceuticals, and from company management, the issue of not delivering results every quarter.  My advice would be to have a more long term approach, a longer perspective.  I am concerned when I see companies trying to review and reassess their investments in Mexico due to difficulties with COFEPRIS, with tender processing and the lack of reliability in the system. Mexico should be considered with a long term view and as a good market to invest in, moving as it is from a younger population to an older one and we mustn’t lose view of that. For the solutions to arrive, the private and public sectors must work together as it is a business opportunity and a public need. 

EF: With the changing demographics there could be changing epidemiology so, what new therapeutic areas do you think will be more of a concern in the next decade?

HV: Cancer is already big and it will get bigger. INCAN has a predictive statistic that says 1 of every 3 women and 1 of 2 men will get cancer by 2030.  That bleak statistic tells us 50% of the men and 30% for women will have cancer by 2030. Mexico also has a big issue with obesity, diabetes, and cardiovascular and that includes from day to day diabetes treatment to dialysis and everything in between. FUNSALUD is working on prevention and we have developed a program together with the Consejo Mexicano de Negocios we call “Compromiso por la Salud” which consists of three areas: a company physician to do pre-detection and programs for the specific patients, personalized nutrition and exercise, and all our companies around the country are joining the program. The third area I foresee as an issue is mental health.  We are developing a national program called "Wellness Mental Health" which is being launched as we speak and we are doing analysis in five different communities to understand how mental health is evolving and based on that, we will launch an e-assessment so that people can access and understand if they suffer from anxiety, depression or any other symptom, and if so, to be directed to a physician. It’s a way of training patients as well as physicians using e-material for mental health detection. I think this will be big as it is growing very fast and will be a burden and therapeutic area to watch. FUNSALUD is also looking at orphan diseases. We have a mandate from the Minister of Health through the Consejo de Salubridad General to do the national registry of orphan patients which we plan to deliver in a few years as we have already done with the national registry of cancer. With the FUNSALUD council, we are writing a book on the status of new technologies in Mexico, how to include them in the existing policy, and on their implementation in aid of closing the gap. When it comes through, it will make cost come down and give access to the Mexican population. 

Statement on Africa

HV: We look into the different regions of the world we see South America developing and continuing to develop but Africa, based off the many lacks of the continent, will grow in a very big way and every one of its sectors: infrastructure, mining, new technologies, communication, etc. The investors just have to concentrate on four or five countries and the growth will be huge.

March 2020