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EF: You have been General Manager of Roche Peru for four years; how did Covid-19 affect or change your mission or priorities? 

JS: Our mission has never changed. Our purpose is to increase access to transformative healthcare innovation to improve the Peruvian healthcare system; this includes access to cutting-edge medicines and diagnostics technology.  At Roche, as allies of the healthcare system, we are committed to give access to treatments and care to all Peruvians for a healthy life.

As a result of the COVID-19 pandemic, Peruvian authorities are more aware of the primary care network's deficiencies, which is essential to filter and ensure the appropriate treatment to all patients. Additionally, it optimizes healthcare costs and enables robust prevention strategies. The Peruvian authorities are trying to close these gaps with support from international organizations but, there is still much to do. For example, there is a massive need to invest funds allocated to health to improve infrastructure and close gaps in doctors, specialists, nurses, and health personnel in service areas. Hence, the importance of promoting collaboration between the public and private sectors to develop comprehensive and sustainable solutions.

EF: What is your personal definition of access?

JS: At Roche, we aim to achieve better outcomes for more patients faster, which is my definition of access. We have access when the patient has the best possible outcome in the appropriate timeline and any place in the country, independently of location or economic status. It is not about winning a tender but about ensuring the drugs, diagnostics, and other necessary services that are used by the patients at the right time -when that patient needs it. 

In Latin America, when the patients have access to medicines, they may not have the expected outcome because there are deficiencies in the supporting health ecosystem preventing them from benefiting from the whole setup. Accordingly, the ultimate purpose of the healthcare intervention, which is getting healthier, is lost or diluted.  So, we say that we achieve access when the patient has the expected delivery and impact on their health.

EF: How does Roche adapt its portfolio to the Peruvian system? 

JS: The innovation we are bringing is transformative. Suppose there is a medical need in the country. In that case, we will make our best effort to deliver the necessary drugs, diagnostics, and services to create patient- appropriate conditions. We have found that the epidemiology of Latin America has similarities to the epidemiology of the US or Europe. Roche portfolio is robust in cancer, which is the number one cause of death in Peru, neurosciences, as Multiple Sclerosis, immunological diseases, as arthritis, and rare diseases, as hemophilia. As per example, our medicines continue transforming lives; patients taking our Hemophilia drug,  Hemlibra, can make a "close to normal" life, which in the past was just a dream for these patients.

We are so committed to the local healthcare system that in the last five years, over 1,000 Peruvian patients with complex diseases from the whole country have benefited through our clinical research, with an investment of more than 20 million dollars. For many of them, it was the only opportunity to access innovative treatment for their disease.

EF: How do you balance tactic and strategic decision-making between communicable and non-communicable diseases -for example, Covid-19 & cancer- in Peru to address the health transition and allocate resources to both areas with the present urgent need to address Covid-19? 

JS: Covid -a communicable disease- has stressed the healthcare system and made it collapse. When an external stressor is big enough to break the healthcare system for so long, other health crises will follow some months later. In a study we made with ALAFARPE on the impact of Covid on non-communicable diseases, we have clear evidence that the effect has been dramatic, showing that death rates have tripled between May and August. Additionally, the study indicates that the capacity to treat non-communicable diseases, like cancer, decreased by 70%, and creating a cumulative disease burden. The impact on the country's death rate based on all the services refocused towards Covid is enormous, and it is clear that the next crisis will be in non-communicable diseases.

EF: Governments are now shaping their fiscal budgets for next year. How can we keep momentum on the importance of Healthcare when building those budgets? 

JS: I believe there are capable people in the government that realize Healthcare as a strategic priority. Peru was transiting a similar event as twenty or thirty years ago when there was a macroeconomic crisis, and the result was an excellent transformative process of depoliticizing macroeconomics. Since then and for the last twenty years, Peru has been one of the most prosperous countries from a macroeconomic perspective. My call to action to the government would be that Healthcare is as crucial as macroeconomics and should have a high priority. Without Healthcare we have no country because a healthcare crisis affects every single segment of the country: tourism, consumption, retail, and mining, which are Peru's primary sources of income. 

One idea would be that the government take a similar strategy to macroeconomics and de-politized Healthcare. Then the leaders of the main institutions could drive a long-term healthcare strategy and make Healthcare independent from the government in power; something good could be created by technocrats -not politicians- for the country's future.

EF: As a result of the pandemic, what changes do you see happening in Healthcare in Latin America? 

JS: What is happening today in the world is giving us clues as to how to increase access in Latin America, and two very important things have happened as a result of the Covid crisis:

1. Leverage and technology, telemedicine, and telehealth: if we can develop telehealth in the healthcare systems, we will probably close many of the gaps. For example, In Peru today, we do not have enough doctors in some areas, so via telehealth, we could have a virtual presence of doctors from all over the country, or even the world, in a specific place. As promoters of digital transformation in health centers, at Roche, we have supported strategies and facilitated the implementation of tools to achieve comprehensive health solutions.

2. Collaboration: during the pandemic, we have seen many successful collaboration examples between the public and private sectors. Guayaquil in Ecuador and Arequipa in Peru are perfect examples of how the partnership between the public and private sectors helped a critical situation immediately improve. For instance, in Roche, we contributed to the "Arequipa Unida" campaign, developed by the Cámara de Comercio e Industria de Arequipa, with the donation of more than 740 food baskets, to be distributed among the neediest population. The power of collaboration between the different segments can change the future of Healthcare for the better.

October 2020