Read the Conversation
Meeting highlights:
- Expanding Vaccine Access: How MSD is working towards expanding access by launching new vaccination programs in Nigeria, Ghana, and Namibia, with a special focus on oncology and HPV.
- Collaboration: How the company leverages collaboration with partners, funders, and industry groups like IPASA to improve vaccine access across Africa.
- Innovation for Africa: MSD is a strategic, innovative company, using science to develop cutting-edge medicines and vaccines tailored to African health needs.
- Leadership and Talent: Zwelethu's patient-centered approach focuses on keeping patients at the heart of its work.
- Zwelethu's 5-year celebration as Managing Director: Excited by MSD's impact from HPV vaccination campaigns and how he aims to make a similar impact on cervical cancer.
EF: It has been two years since our last conversation. Could you share the key strategic priorities that have guided your work at MSD, and highlight some of the major initiatives that are making a significant impact?
ZB: During the past two years, we remained committed to our strategic priorities, with a particular focus on sustainably expanding access to innovative vaccines and medicines, with a particular focus on cancer prevention and treatment across the continent. We have achieved notable progress in increasing HPV vaccination rates, now reaching approximately 17 million girls annually through 30 programs continent-wide. This represents a significant milestone for our organization.
We have also advanced several critical initiatives. Our HPV immunization program launch in Nigeria was highly successful, and we are preparing to introduce new programs in Ghana and Namibia this year. These efforts reflect our ongoing commitment to cancer prevention through vaccination.
In addition, we have made considerable progress in broadening access to oncology and immuno-oncology medicines. Our participation in the African Medicines Agency project was particularly impactful, resulting in the approval and broad registration of three products, including Pembrolizumab, our immuno-oncology therapy. We are proud of these achievements and are now focused on ensuring these registrations translate into real patient access. We are enthusiastic about the progress we are making and the positive impact on healthcare across the continent.
EF: Could you elaborate on how you are collaborating with different organizations to strengthen the importance of developing public-private partnerships in the region? What are some of the lessons learned from that experience?
ZB: We are engaged in a range of collaborations, particularly in the area of vaccines, where our commitment extends well beyond product provision. We recognize that vaccines only have an impact when they reach individuals, so we take an active role in every product or program launch. This involves partnerships with ministries of health and various NGOs to foster an enabling environment, with a strong focus on education and awareness across the healthcare ecosystem.
Our approach is comprehensive, engaging not only healthcare practitioners but also educators, community leaders, and religious leaders, especially in regions where their influence is crucial. We also prioritize informing the general public, such as parents, about new vaccination programs—their importance, and key considerations—ensuring positive reception and uptake of these interventions.
This work is critical and highly adaptive, as each country presents unique needs. We maintain ongoing engagement with ministries to shape our interventions to local requirements and the specific challenges in those markets.
In oncology, particularly in South Africa, we are deeply involved in industry-wide access initiatives, collaborating with patient organizations, funders, manufacturers, and healthcare providers. These efforts, coordinated through IPASA, aim to expand access to oncology and other essential medicines. While we face legislative challenges, our collective commitment has created a positive cycle of problem-solving in collaboration with a multitude of like-minded stakeholders. Whenever we identify practical solutions, we present them to the ministry, with the hope that they will be implemented.
I am especially enthusiastic about our newly launched Health Equity and Partnerships division. This division is dedicated to driving access initiatives in low- and middle-income countries by identifying and advancing commercially viable partnerships. Unlike traditional philanthropic efforts, we focus on high-impact projects that can be integrated into our commercial operations once proven successful. Currently, we have promising projects underway in India and Kenya, with plans to launch in Nigeria in the near future. It is an exciting time, and I am optimistic about the positive impact these initiatives will have.
EF: The African Union is pushing to produce locally 60 percent of the vaccines needed for the African population by 2040. How do you see the role of MSD in advancing this objective?
ZB: The primary role of MSD is to leverage innovation and science to develop advanced medicines and vaccines that address the healthcare needs of the populations and environments we serve. This will always remain our core focus and responsibility.
The conversation around localization and manufacturing is indeed significant, and it must be approached methodically to ensure sustainability. Unsustainable manufacturing can delay access to treatment and increase costs. The first step is to create a viable market for locally manufactured products, which requires active collaboration at the Africa CDC level or among regional bodies, where pooled procurement processes and protocols exist.
To prioritize localization and facility development, it is essential to develop an economic framework that can support sustainable development. Working together in policy alignment is another critical factor. Harmonizing policies and establishing clear procurement preferences are crucial steps to justify significant investments in manufacturing infrastructure on the continent.
I was encouraged by recent discussions at a G20 event in Johannesburg with key stakeholders, including Dr. Kaseya, the South African Minister of Health. There is a shared understanding that while localization is important, especially for pandemic preparedness, parallel conversations about market viability and policy clarity must continue. Addressing these uncertainties is essential for progress, and I am pleased to see these discussions already underway in relevant forums.
EF: How do you foster a culture of innovation and resilience within your teams?
ZB: Our organizational mission is truly at the core of everything we do; it defines our purpose and is the driving force behind our existence. This mission is a key factor that attracts talented individuals to MSD, as it resonates deeply with those who join us.
Currently, with a robust product pipeline, we are focused on strategic planning for near-term launches and are committed to expanding sustainable access to medicines that have historically been out of reach, particularly from an African perspective. This has required me to challenge my teams to elevate their ideation and to approach our ambitions with renewed structure and creativity. By consistently pushing ourselves to think bigger and ask how we can achieve more, we have found this approach to be a powerful motivator, both for me and for the organization as a whole.
Celebrating our achievements is essential, as it reinforces the belief that progress is possible and inspires the team to strive even harder. For instance, during our recent mid-year brand reviews, we secured a significant win in market access: a mid-sized funder in South Africa agreed to fully reimburse the nanovalent HPV vaccine across multiple cohorts, aligning with best practices seen in developed markets. This outcome is especially rewarding, given the initial skepticism and the persistence required to present a compelling value proposition.
Our success stems from challenging ourselves, maintaining a patient-centric focus, and steadily advancing, even if progress sometimes appears incremental. Each step forward affirms our mission and energizes our collective efforts.
EF: Which product are you most excited about right now that you believe has a great impact in the region?
ZB: I am particularly proud of the significant progress we have achieved in expanding HPV vaccination across the continent. When I assumed my current role in January 2021, our vaccination reach stood at approximately seven million lives. As we approach the end of 2024, that number has grown to eighteen million—a remarkable and transformative increase.
Our efforts extend beyond public healthcare; the advancements we are making in the private sector are equally impressive. We have successfully balanced commercially sustainable market initiatives with a strong commitment to public good, especially through our healthcare consumer education programs.
Our ambition is to replicate this transformative impact in the fight against cervical cancer, which remains one of the most prevalent and deadly cancers in Africa. Countries like Eswatini and Nigeria face particularly acute challenges, but through targeted interventions, we have the opportunity to alter their futures dramatically. For instance, the program we launched in Eswatini last year has the potential to change the fabric of society by ensuring more women are present to raise their families, with far-reaching positive effects.
