Read the Conversation

EF: What are your expectations for 2023; what is on the agenda for Guerbet? 

ML: There have been many strategic changes in the pharmaceutical environment; specifically, in Guerbet, we have made a strategic change for 2023 for the next ten years, focusing on artificial intelligence and a refocus on the Interventional Imaging business. Guerbet has acquired a 55% stake in Intrasense, an AI company, to bring our artificial intelligence products to the market through the Intrasense platform. Previously we had a partnership with IBM Watson, where we had algorithms and frameworks for the detection of liver lesions, prostate and pancreatic cancers, and bone metastasis, and this new stake in Intrasense will allow us to grow and enhance the value we offer in artificial intelligence and algorithms. There has been a divestment from interventional imaging focusing mainly on developing new specific indications for our oil-soluble contrast agent traditionally used in lymphographies. We will be shifting our focus away from the microcatheter and other businesses acquired in that space to turn our resources to technology and AI. The change will allow us to help assist healthcare professionals to make better and faster diagnoses in their clinical decisions: AI will be used to help detect, characterise and stage lesions on imaging findings, and eventually, AI will help quantify risk.

In South Africa, we have established our interventional imaging portfolio and onboarded a manager to strengthen our relationships in that field. Through AI, we hope to speed up the process of creating value in the South African healthcare framework. 

EF: In a country with a transforming healthcare system where the private sector is much more advanced than the public, how do you balance the two extremes and the adoption of new technologies?

ML: Adopting artificial intelligence solutions in South Africa is slowly growing with the potential to grow further. However, in the private healthcare sector, its value is recognized. Despite the promises offered by artificial intelligence (AI) for healthcare in South Africa, existing policy frameworks are not adequate for innovation in this field. Practical, concrete and solution-driven policy recommendations are needed to encourage the creation and use of AI systems. Artificial Intelligence (AI) is transforming the imaging field. New data analytic methods can augment clinicians’ ability to interpret and act on large and complex data sets. As an innovator in medical imaging, Guerbet has identified AI partners with validated software technology to expand its portfolio of augmented intelligence solutions with the same aim of helping radiologists diagnose better and faster than ever before. 

Continued education in this field is important, we play an important role in linking medical communities with education programmes and webinars between countries for e.g  Asia-Pacific that provide a catalyst for knowledge transfer, sharing of best clinical practices, network cultivation and relationship among the healthcare community.

The disproportion in the value of healthcare care between the public and private sectors is an important gap t to be, to ensure equal healthcare for all South Africans. South Africa is also experiencing a  shortage of healthcare professionals' resources.  A major problem is that the healthcare system faces a significant number of qualified SA doctors leaving the country, meaning that the healthcare system is facing an outflow of professional and technical skills.

EF: South Africa is at a unique moment in healthcare with universal coverage; what opportunities do you see for Guerbet and the healthcare sector considering post-pandemic distilled lessons and all these new technologies? 

ML: A lot is happening in the NHI space, getting the structure in place, positioning pricing, and procurement. The government recently published the NHI bill, so it is important to move into the next step. Establishing public-private partnerships to leverage the skills, expertise and resources of the private sector and the investment infrastructure is a positive sign. At Guerbet, we aim to create lasting relationships to enable people to live better. help and support healthcare professionals to have a more efficient working system and provide better and faster diagnosis and care. We believe that sharing is the key to moving forward and helping others progress; employees, healthcare professionals as well as partners. To grow together as individuals, a company and a community, we share what we know and are open to the knowledge of others in return. In all our relationships, we seek a win-win collaboration. We promote simple and authentic relationships, beyond reporting levels. We develop partnerships with multiple players, on a global scale. We bring together chemistry, physics, computer science, image processing, electronics, biology and medicine.

EF: Post-pandemic many companies are adapting to trends; Guerbet is setting up an AI trend, shaping a new business model and the future of diagnostics. What does it take to be a frontrunner in technology for the healthcare ecosystem? 

ML: It is exciting to know that we can globally invest in new future solutions. AI is a major trend and

Guerbet is determined to be at the forefront of its application. It showcases our continued contribution to building the future of medical imaging, just as we have done since our foundation some 95 years ago

The implementation will be about having the right people in the right places to communicate the value of the products effectively. It is a new space for us as a company in South Africa, however on a global level, there has been a lot of investment in teams for artificial intelligence and digital solutions. We will have the necessary skilled people in the right places to ensure we are efficient and effective in creating sustainable growth for the company and South Africa in the future. 

EF: Many multinationals currently focus on “design products,” which involve skilled technology, reshaping the healthcare map. When implementing your products, who are the stakeholders you interact with?   

ML: Driven by its commitment to advance radiology today and tomorrow, Guerbet Diagnostic Imaging has designed a portfolio of interconnected contrast imaging solutions to enhance decision-making at each point of the patient journey from diagnosis to treatment and follow-up, to focus on what matters most, efficiently improving patient outcomes. The injector modalities and software forming part of the interconnected solution offering are registered with SAHPRA and these applications are game-changing for Africa, reshaping decision-making at each point.

This is why we collaborate with start-ups, major companies, centres of excellence, academic organizations, hospitals and leading actors within our sector. We want to be a spearhead in developing new concepts in the world of healthcare. Every day we strive to advance knowledge in the field of medical imaging, together with physicians, scientists and technology partners, all over the world.

For the AI solutions or tools to be usable and function as intended, they must be integrated into existing radiology systems. Standards-based application programming interfaces (APIs) between systems are required to enable seamless, in-context communication of data and tasks. For this one of the stakeholders with be the IT network specialist in the practice or hospital.

In South Africa and to my knowledge, we do not have individual registration of these applications, so as we move into this space, there would have to be more regulations created around artificial intelligence

EF: If you had to create a startup company tomorrow in the South African healthcare sector, what would it be and why? The hypothetical question is to understand where the opportunities lie. 

ML: I would go for a startup in the digital space using AI to support and facilitate diagnosis, decision making and therapeutic follow-up for healthcare professionals. Innovative technologies to diagnose and detect cancers, and lesion early on, is the way to go. There are some public-private partnerships, and they are working on a digital strategy for the government. Still, patient information and geographical locations are not captured in a digital system for NHI, many patients are undocumented and knowing what healthcare services should be provided in provinces is not clear. Many patients from provinces over South Africa come to Gauteng for treatment because their provinces do not provide certain services and this place a huge burden on the healthcare system. Nor is there a proper record for healthcare professionals on patients providing information of previous diagnoses and treatments received. There are big opportunities in the digitation space for NHI to have more efficient systems.

EF: The project management iron triangle used in a transformation has three variables: price, quality, and speed. Picking speed and quality, you sacrifice price, making it expensive, but choosing quality and price would take a long time. If you had to choose two variables to navigate Guerbet´s transformation, which would they be, and why? 

ML: Quality is key as we work with patients´ lives. Quality of the products and services we deliver and ensuring patient safety while considering the environmental impact are crucial. In today's environment, price is important for positioning the company. We all want things to go fast, but if we choose speed it is expensive, which might create some sustainability or affordability issues. All healthcare companies have seen the impact of inflation over the last years, and the massive rise in manufacturing costs, the costs in raw materials, plastics, and transportation, all this is causing huge pressure on product manipulating cost and price. My answer, therefore, is a quality product at an acceptable price over an efficiently managed value chain to create sustainability. We must take the time to plan our strategy properly to have a successful implementation. Speed can cause mistakes. Taking a step back to understand how to advance with all the variables is a positive way to be prepared for what to do next. 

EF: Could you elaborate on the importance of the imaging and diagnostic segment and how you attract investment and resources to South Africa? How do you manage to get South Africa on the corporate map?

ML: South Africa is a fairly small affiliate compared to other multinationals in our space; we feel somewhat removed and far away from our peers and affiliates in Europe and globally. But with the transformation, there has been change over the last years, ensuring we have the right people with the right skills and the right work culture to ensure we work efficiently and create value. From a team perspective, we strive to put South Africa on the corporate map to achieve a valuable impact. South Africa is also at the forefront of many pilot projects and tests because we have a highly efficient team. Guerbet has launched a new gadolinium contrast agent. The first dose was administered in the US recently, so it is not yet available in South Africa and will be registered in Europe in the next couple of months. We can leverage the Europe registration to register the product in South Africa in the future. The product is used to detect and visualize lesions with abnormal vascularity in the central nervous system  We have an outstanding team, market knowledge, and relationships, and we have identified the opportunities. 

EF: Is there anything in your pipeline you are especially excited about? 

ML: I am excited about the new MRI opportunities. With the new MRI product in the pipeline -coming to South Africa- and the first contrast agent launched into the market since the 80s.  We are very environmentally focused in our CSI projects, investing in a Zero Iodine waste program from API to distribution and execution of the decarbonisation roadmap. 

Guerbet invests 10 % of its annual turnover in R&D, to improve our existing products and create new ones to meet unmet medical needs. We want to contribute to diagnosis but also to patient care. 

The  MRI product has been designed with two sites for water molecule exchange to increase relaxivity and contrast, allowing it to use at half the conventional dose. We still have an outstanding image quality with half the gadolinium dosage, which would also have a smaller environmental impact on Gadolinium excretion. Healthcare professionals will be interested in using lower doses and still having great image quality, this benefits the patients and the environment. There are other digital applications to assist in lowering the dosage of iodine while still providing a high-quality image, this has an additional benefit for renal-impaired patients. 

EF: How do you attract the new generation of South Africans that will be building a more sustainable healthcare system to the sector and company? 

ML: Over the last couple of years, I have learned that recruitment and finding the right people is about creating the right opportunities. Company culture, work environment, and opportunities are vital for employees and the organization. We aim to create a sustainable company culture where people feel they are accountable, valued and empowered to make decisions on projects. They have the autonomy to make decisions fast as new opportunities are always coming up. We spend a large slice of our lives at work, many hours per day, more time than we spend with our families in a work week. The work environment should be conducive to creating a happy/content and comfortable space for teams to collaborate in. Every function/department in an organization impacts another function/department, so we should all understand how we impact one another and how we can collaborate to create sustainable success. Leadership should be clear and transparent on vision and strategy and how to achieve it to enhance team collaboration. Finally, the benefit proposition to the candidates is also key and this is something Guerbet does excellent in. 

EF: Are you all back at the office, or do you work in a hybrid model?

ML: Technically, we are fully back in the office, but if an employee wants to work a day or two in a week from home, they can. It depends on the employee. I do not dictate where they must work from, but they should be in the office to collaborate on certain projects to move faster. I am here most days and enjoy being back at the office and spending time with the team members.

EF: Is there any final message you would like to share? 

ML: Transformation is a challenging environment to navigate and consists of many variables. For the sustainability of our South African entity, and the continuous growth of our imaging product and injection solutions, we place human cooperation at the heart of all our relationships and actions with patients, healthcare professionals, employees, public authorities, partners, shareholders, society and the world. We establish our relationships based on respect and integrity to ensure truly value-driven cooperation.  

Our second key priority is to be the hub for neighbouring countries and supply our products and share our knowledge. We are currently collaborating in all neighbouring countries, including Mauritius. Considering the importance of diagnostics, it is no small task, and AI is a critical tool for achieving an early diagnosis. The sooner we can diagnose, the better we can treat and reduce the burden on the healthcare system. We are passionate about our healthcare mission. We put the benefit of patients first. We have been striving towards the highest level of safety, quality and efficiency in the medical imaging market since the creation of our very first product in 1901 by Dr. Marcel Guerbet. We are determined to assume our responsibility and enhance the quality of life of patients at our level around the world.

May 2023
South Africa