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EF: How important is the South African market for your plan for the entire African region?

PB: South Africa is an important part of the overall plan for Africa.  The pharmaceutical market is particularly developed, almost the biggest on the continent. A lot of Health issues have to be addressed. It is also an advanced country in terms of innovation.

EF: You were appointed as the Regional Director in January 2022. What was the mission that you set for yourself?

PB: My role oversees 35 countries. In Africa, we are focusing on almost 20 countries, including South Africa, West Africa French-speaking Africa, and North Africa. We are in the process of developing the English-speaking part of East Africa and are looking for distribution partners.

Our goal is to animate our own teams and partners across the continent in terms of medical approach and commercial activity. We partner with the scientific community in Africa and contribute to the development of the African Pharmaceutical industry. Our scope is quite large. We are focusing on our ability to register innovative products, particularly in the field of innovative oncology and dermatology. We also particularly take care of the development of compliance, pharmacovigilance and market access. The objective is to register those products and give patients wider access to our treatments.

We also want to address the issue of supply and want for that to manufacture more products on the continent. Currently, we manufacture almost 45 percent of our products in Africa for Africa and plan to multiply 3 of our capacities by 2027.

Finally, I would like to mention the Pierre Fabre Foundation, which has been working on a daily basis to relieve and care for vulnerable patients, organize prevention against fake drugs and train health professionals, support local e-health solution players and fight against diseases such as sickle cell anemia for over 15 years. The Pierre Fabre Foundation has 35 programs ongoing and almost 80% of the budget is dedicated to Africa.

In summary, we are working on the organization of the teams in terms of the medical and commercial approach, developing the drugs that we are registering for patients on the continent, and the third aspect is supply and manufacturing. And support our Pierre Fabre Foundation in its positive action for the African continent.

EF: Pierre Fabre Brazil has a large manufacturing plant. Are you working together, or do you plan to reuse synergies from there?

PB: Pierre Fabre is a French pharmaceutical and dermo-cosmetic group, and almost all the manufacturing is done in southwest France. We are very proud of our southwest region. We have only two factories outside of France. One is in Brazil, which manufactures dermo-cosmetics, and the other is in Tunisia, where we manufacture pharmaceutical drugs. We also partner with local African companies to manufacture our products for Africa.

Africa has seen a sharp increase in demand for our products, so it is more logical to manufacture them locally to shorten the distance, to legitimate the sovereignty and also answer to legislation obliging us to manufacture locally

The key aspect to manufacture in Africa is to shorten the distance, and sovereignty and improve global impact.

EF: Could you elaborate on the importance of South Africa as a hub for Africa, and what are the plans that you have for South Africa and the African region?

PB: South Africa is an important element in our strategy for the African continent. In South Africa, we have two product groups that are strategic for the group. The first one is oncology, and the second one is dermatology. These are the two core activities of our group globally.

In oncology, we have been present for several years with a product in chemotherapy, which is a classical therapy, a "therapeutic area," for breast and lung cancer. We plan to introduce some innovative oncology in targeted therapy for the indication of breast cancer. It’s a complex and long process, particularly in South Africa, where access is key.

We have a range of products offering solutions for either Tier 2 or Tier 3 access programs. This means we offer some affordable drugs in the form of a "therapeutic area." We are introducing innovative oncology-targeted therapies and entering the market with more expensive drugs. We are trying to find the best solution to make the drug as affordable as possible and are working with the authorities to make this product available.

We are also present in dermatology. We provide all dermatology treatments for different skin conditions. I would like to emphasize in South Africa our solutions in dermatology that are targeted at the side effects of the drugs. For example, when you are treated by radiotherapy, there are strong side effects that can affect the patient's quality of life. We are trying to bring impactful solutions to deal with the side effects identified by oncologists or dermatologists. 

EF: How are you collaborating with other stakeholders in the sector? How are you leveraging these collaborations for the betterment of the industry?

PB: Our focus is on oncology, dermatology, and rare diseases. We work with different stakeholders to be recognised as the preferred partner.

Recently we signed a collaboration with a company named Puma. We are working together on an adjuvant and targeted therapy in breast cancer that we want to introduce in South Africa.

Pierre Fabre is also involved in rare diseases for several years now, developing specific therapies for that very limited patient population which requires adapted treatments. Examples include infantile hemangioma, where therapy has been approved since 2014 and, more recently, X-linked hypohidrotic ectodermal dysplasia (XLHED) with a cell therapy under development, in collaboration with the Esperare Foundation. Despite being a treatment for a very rare disease, we are very proud of this therapy, as it is life-changing.

We wish to work with all local stakeholders to introduce our treatments to authorities, and health professionals, including local medical partners and insurance. 

EF: How would you rate the level of education and adoption of education in Africa compared to Europe?

PB: African countries have different maturity levels and different approaches. For example, cancer prevention and treatment is very different from one country to another. We have countries like Morocco and Algeria that are very advanced. They have a very strong program to help with cancer prevention and treatment. South Africa is among those countries, but it faces the difficulty of market access. We have a three-tiered segmentation of the population when it comes to access to treatment. Everyone cannot access the same types of therapies. West and East Africa still have a lot of work to do concerning cancer prevention and treatment. There are some initiatives, particularly in prevention, but the infrastructure is still very limited to cover the treatment, and most of the patients who can afford it prefer to be treated outside of their own countries. Patients have to move to South Africa, Morocco, Algeria and even sometimes Europe to be treated. This is quite unfair as it means that many patients remain untreated in the country itself. This is why we have a large range of classical therapies in oncology, that has a good ratio of efficiency, durability, and cost.

EF: How are you balancing your portfolio and business units, and what is driving your access and growth?

PB: Frankly speaking, to speak about "One Africa" is not yet possible. To compare one country with another is very difficult. However, we can identify regional clusters. There are three big hubs, with three very different approaches. We have North Africa, West or French-speaking Africa, and East Africa, where I will include South Africa.

East Africa's product registration process is uniquely different from what we see in other parts of Africa. 

North Africa has a balanced portfolio in oncology, including innovative oncology, and other therapies like urology and gynecology. Central Africa is focused on medical care, with an emphasis on other therapeutic areas such as urology and gynecology. South Africa is focusing on Oncology and Dermatology at this stage.

In terms of approach, we have rationals and prices that are almost equal from one country to another. Depending on the legislation and the request from the health authorities, we have different approaches for when new products can be reimbursed. 

EF: How do you think we can increase awareness about non-communicable diseases? Is there a value in targeting these diseases?

PB: That's quite a difficult question. If we speak about cancer, there are some campaigns around the risks linked to alcohol or tobacco. The first point of focus is prevention. I wanted to implement a smoking cessation program in North Africa when I was based there. Unfortunately, that kind of communication is very difficult to implement if authorities are not involved in the program. Unlike in South Africa, you can still smoke in restaurants in other countries. 

As another example, we have also entered into this new educational approach through digital. Patients are now aware of the products and treatments they are receiving but also about prevention. Companies have an obligation to be very transparent and share openly information. Patients are now better informed, and we need to bring a more detailed medical approach, particularly in oncology. Digitalization definitely plays a key role and helps us to communicate.

EF: Five years from now, how would you want to be remembered as an industry leader who impacted the lives of people from many countries?

To use a metaphor, everyone, at whatever level they are, is bringing a small stone to a big wall. This wall represents humanity. Even if we bring one small stone, if we improve the life of one person, it is a nice satisfaction and accomplishment, reflecting our Company purpose: “Every time we care for a single person, we make the whole world better”. I will be satisfied to know that I helped at least one person in each of my countries and if it's more, I will be more than happy and proud.

May 2023
South Africa