Read the Conversation
EF: One year ago, you moved from Slovakia to Mexico. When you arrived, what mission did you set for yourself, and what did you want to achieve in this new role?
JC: I am motivated and driven by the need to make an impact. I believe in continuous learning and having an impact on society through disease prevention, early diagnosis and treatment, and personalized healthcare. Ultimately, we want to leave society better than we found it. I also believe in having an impact on the people I work with and those around me. Regarding having an impact on society and patients, we focus a lot on access. Mexico has challenges when it comes to accessing healthcare for most of its population. Roche Diagnostics currently covers around 35 million patients in Mexico. This year, we are aiming to hit the milestone of 37 million patients. Our target for 2030 is to reach 50 million. These are not just numbers; they are real people that we actually reach out to with our diagnostic tests. Furthermore, the benefit of these diagnoses will also be reflected in their families and their society. There is a multiplier effect there. That was one of the main drivers when I came here and will remain the main focus while I am here.
Secondly, it is not a question of quantity; it is a question of what type of care we can provide to the people and making sure that we make the most of our R&D. Innovation is in Roche's DNA. Roche is the leading company in terms of investment in R&D, however, that does not necessarily translate into benefiting patients; the full cycle of R&D is only achieved when innovation reaches the patients who need it at the time they need it. We need to make sure that we bring this innovation to the Mexican patients. This is another part of my mission as part of Roche Mexico.
Another element that is common in many countries is that there is a lot of focus on treatment. We call it a “Healthcare system,” but it is really a “Disease system.” We direct most of the resources to treat diseases; less than three percent of healthcare expenditure goes to prevention. How can we make sure that people do not get sick in the first place, and secondly, when they do, they are diagnosed as early as they can so that they have the best treatment possible? The focus on prevention is absolutely critical.
Finally, resources are scarce. I am originally from Portugal. I worked in Spain, and multiple other European countries, including higher-income ones such as Denmark, and I have lived in Brazil. I have been exposed to these different markets and come to realize that all of them have scarce resources. Healthcare sustainability is a common challenge, and we need to achieve efficiencies so that we can fund the other elements of our mission.
EF: Mexico is seeing regulatory and political challenges while also seeing great opportunities in the macroeconomic climate. Do you see 2023 as a challenge or an opportunity?
JC: I see 2023 as an opportunity. Despite some of the uncertainties that you alluded to, I see an increased commitment from the public and private sectors to prioritize health. There is some macroeconomic stability and tailwind with nearshoring, which helps fund the system, and there is a huge demand for unmet clinical needs in many different areas. For example, 220,000 Mexicans die each year of preventable heart-related diseases. In oncology, a woman in Mexico dies of cervical cancer every two hours. This is a preventable and treatable disease when it is detected early on. There are unmet clinical needs, and there is a will to meet them. I am optimistic because the desire to meet these needs is growing in the private and public healthcare sectors.
EF: Focusing on prevention allows for better resource allocation. How is Roche Diagnostics working towards this in Mexico?
JC: All the markets I have worked in focus more on treatment than prevention. I see a lot of opportunities in Mexico to increase healthcare gains through improving life expectancy and reducing costs through prevention in many areas. Breast cancer is the leading cause of cancer death in women. As a comparison, in more developed countries, mortality has decreased by around 40 percent in the last 30 years because 60 percent of the cases are detected early on. In Mexico, only 35 percent of the cases are detected early. When breast cancer is detected early, the survival rate in the first five years is almost 100 percent, but if it is seen only in the latter stage, only three women out of 10 survive in the first five years.
EF: Could you elaborate on the X project you are working on in Mexico?
JC: With XProject, Roche has initiated a long-term commitment to women's health. It's an ongoing initiative to drive meaningful change through partnerships and action. The objective is to help close the gaps in women’s health for better health outcomes for everyone. In Mexico X project is a good example of collaboration. Cervical cancer is almost 99 percent preventable and treatable if detected early. We are tackling such diseases through collaboration between the public and private sectors.
We launched a pilot project with IMSS in Juarez, Chihuahua, in collaboration with the association of manufacturing companies where women working in the factories can conduct self-tests or screenings for human papillomavirus (HPV). More than 9 of every 10 cases of cervical cancer are caused by HPV. We firmly believe that the elimination of cervical cancer is within reach; reducing barriers to HPV screening by enabling women to self-collect their own specimens for HPV testing is a critical tool in the fight against cervical cancer.
We partner with Salud Digna in the private sector, which will offer 500,000 HPV tests nationwide this year. None of us is self-sufficient. The problem is too big for one entity or sector, public or private, to tackle. We need to collaborate among the different parties in the public and private sectors.
EF: Please elaborate on the role that diagnostics play in the personalized medicine sphere, and how do you envision the future patient journey when everything comes together?
JC: Regardless of whether we are talking about non-infectious disease, metabolic disease, oncology, or women's Health, the solutions for all these healthcare issues start with and depend on diagnostics. Early diagnostics are of the utmost importance. For example, in breast cancer, beyond the reduction in mortality, if there is early detection, there is also a reduction in economic costs for the health system and social costs for the whole community. Many studies have proven that if an oncological disease is diagnosed in the early stages, the treatment is two to four times cheaper than if it is detected later.
Regarding personalized therapies, there have been advances in the knowledge of molecular biology and sequencing. For example, we have learned of different mutations in different types of cancer. If you can diagnose and identify what mutations you have, you can administer the right treatment. This increases the effectiveness of the treatment and reduces the mortality rate.
Roche is an integrated healthcare company combining its knowledge and assets from diagnosis and pharma perspectives into one integrated solution.
EF: How are you using technology and AI in Mexico, and how do you assess their reception and adoption by the physicians there?
JC: First, we must realize the complexity of the healthcare challenges in Mexico and elsewhere. Diseases are becoming more complex. There is also a scarcity of human and professional resources. The healthcare system cannot continue to work in its current state. This is where technology and artificial intelligence play an important role. This is not unique to Mexico. A study found that, in the US, health information technology interoperability can cut health costs by $30 billion USD.
There are solutions to counter this system's interoperability. For example, recently, Roche launched navify® Algorithm Suite, a single platform hosting a library of digital medical algorithms that generate patient-centric insights and can aid in earlier diagnosis of cancer or other conditions per the intended use. Our information as patients is fragmented across the system, and this is seen when we go from one healthcare provider to another. Roche´s solutions allow for quick access to patient data end-to-end for the healthcare providers that use them.
Roche came first in the Pharma AI Readiness Index among pharma companies, but we know indexes are irrelevant if the technology can't reach the patients. In Mexico, our AI solutions can be used to improve insights from a lab and how lab operations are conducted. This increases efficiency and the quality of results. We already use technology and AI to support healthcare professionals in making more accurate clinical decisions. For example, we have AI algorithms that we use for breast cancer and lung cancer diagnosis. These algorithms help pathologists identify what they are seeing.
We also have algorithms that are based on the longitudinal data of patients. This data helps compare patients in similar situations and suggests what should be done for a particular patient regarding the clinical pathway.
In Mexico, healthcare professionals are keen to adopt technology but also have reservations. Roche Mexico is at the forefront of the adoption of digital solutions worldwide. Mexico is not a follower; it is in the leading pack regarding digital solutions because our partners here trust us to push for digital transformation.
EF: If you had to leave Roche to create your own startup business in the Mexican healthcare system, what would you create?
JC: It will probably be at the intersection between the integration of care and digitalization. Healthcare systems are extremely fragmented. Digitalization can be a huge enabler to increase efficiency in the system and maximize healthcare gains.
EF: If you had to create a road map for the diagnostics industry in Mexico for the next five years, what would your three pillars be?
JC: The first pillar is about the integration of diagnostics solutions with an emphasis on efficiency, lab infrastructure optimization, and bringing new medical solutions. The second pillar is premised on decision-support tools for healthcare professionals. The third pillar would focus on disease prevention and disease management, especially for chronic diseases. These are the three layers on which Roche Mexico is working to make a significant impact.
EF: Do you have a final message for our readers?
JC: My final message is an invitation to collaboration. As I said earlier, no one is self-sufficient. Roche is looking for partners that have the same vision and want to contribute to a common mission to increase access, adoption of innovation, focus on prevention and disease management, and optimization of the healthcare system in a fully ethical manner. Not easy at all, but we are positive that this can be achieved and are looking for partners.