Rhulani Nhlaniki - Cluster Lead, Sub-Saharan Africa & Country Manager, South Africa, Pfizer | President, IPASA (Innovative Pharmaceutical Association South Africa)

Conversation highlights:

Pfizer: 

• Patient Access & Partnerships Remain Core: Pfizer remains focused on expanding access to innovative medicines and vaccines, especially in under-resourced communities, by strengthening collaborations with governments and stakeholders. 
• Sub-Saharan Africa is Strategically Critical: with over a billion potential patients, Sub-Saharan Africa is central to Pfizer's global mission. The region plays a major role in both vaccine distribution (e.g., Gavi) and clinical research. 
• AI and Innovation as Tools for Equity: Pfizer sees AI and digital technologies as essential to improving healthcare access in remote areas, enabling faster diagnosis and treatment delivery across underserved populations. 

IPASA: 

• Top Industry Priorities: Access, Policy, Sustainability: IPASA's three key goals are ensuring access to innovative medicines, actively engaging in policy-making, and building a long-term, sustainable pharmaceutical industry in South Africa. 
• Advancing Alternative Reimbursement Models: IPASA is actively exploring alternative reimbursement models to improve access to high-cost and innovative treatments. Industry-wide support exists, and engagement with government is expected to intensify in the coming months.

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EF: How do you assess 2025 so far, and what are your expectations for next year? 

RN: 2025 has been a unique year, with a lot of changes happening around the world, especially in politics. For us, though, our priorities have not shifted. We are still focused on helping patients get the medicine and innovative treatments they need. Even though the ways we get funding have changed significantly, especially at the start of 2025, ensuring patients can access new treatments remains our main goal. This year has really highlighted the importance of building strong partnerships with governments and other groups. Working together now is more important than ever. 

If I had to sum up 2025, it has been all about the power of working collaboratively, which has supported our efforts to increase access to care, particularly in regions experiencing challenges such as Sub-Saharan Africa.  

EF: From your perspective as IPASA president, what are the organization's current key priorities? 

RN: Our top priority remains ensuring people can access new and innovative medicines and vaccines. That is our biggest goal. The second, which actually aligns with Pfizer's focus, is building strong relationships with governments so we can participate in important policy discussions. We want to be at the table when decisions are made and help shape those policies. These two priorities align with our third goal: contributing to a sustainable pharmaceutical industry in South Africa.  

EF: How serious is antimicrobial resistance, and how is Pfizer addressing it? 

RN: Attention to antimicrobial resistance (AMR) remains a critical priority. Adhering to appropriate stewardship practices is imperative. Data presented earlier this year underscore the gravity of the issue and highlight its ongoing relevance. Rigorous antimicrobial stewardship ensures that patients receive the most appropriate anti-infective treatments—whether antibiotics, antifungals, or antivirals—for the necessary duration and only when indicated by independent, evidence-based guidelines. Pfizer maintains a dedicated, comprehensive approach to stewardship, ensuring that anti-infectives are administered in strict accordance with established guidelines.  

EF: How can the importance of vaccines be maintained on the global agenda, and what steps is Pfizer taking to promote vaccines? 

RN: Vaccines have always stayed at the top of government priorities. At Pfizer, when we talk about breakthroughs that change patients' lives, we mean both medicines and vaccines. That focus has not changed for us. As the WHO said a few years ago, vaccines are still the most effective public health tool in the world, especially for communities with limited resources. For us, vaccines remain central to our mission—we want to keep bringing innovative solutions and making a real impact. We will keep advocating for vaccines and for stronger healthcare systems, since both go hand in hand. Vaccines not only help prevent disease but also support antimicrobial stewardship by reducing the need for antibiotics. And to make them effective, we need reliable systems to deliver them, which is why strengthening healthcare delivery is just as important. 

EF: How do you view South Africa's potential for innovation and the government's support for it? 

RN: In some of our recent discussions with the South African government, like the health dialogue we had with the Minister of Health in August, we focused on how to bring more innovative medicines into the country. There is a clear understanding of how important that is. Most of the companies in IPASA are the ones introducing new innovations here, and the Minister recognizes how vital that contribution is. Based on what the government has shared with us, they see innovation as essential not only for improving healthcare but also for driving economic growth. Innovation can contribute to faster progress in improving the health system. 

EF: What upcoming initiatives or projects in your portfolio are you most excited about? 

RN: Our IPASA members keep introducing new products that were not available before. The association's goal is to bring innovative treatments and medicines into the country. For example, Pfizer recently launched a vaccine for RSV in May 2025. This vaccine is important because it helps protect babies from serious illness. What is great is that most of the clinical trials for this vaccine were conducted in South Africa, so we are not only bringing in new medicines but also supporting their research and development. We are working with the government to expand access, ensuring more people can benefit from new medicines and vaccines. I am excited about continuing to bring new treatments to the country. 

EF: How is IPASA approaching alternative reimbursement models in South Africa? 

RN: Since it relates to the industry, I will speak from an IPASA perspective. We are currently exploring alternative reimbursement models, both as IPASA and across the wider industry. The goal is to develop a clear policy or framework that allows everyone to use these kinds of models. This approach can improve access, enabling patients to obtain innovative medicines more easily. Our members and the industry as a whole are supportive of this idea. Over the next few months, we plan to actively work with the government to figure out how to make it happen. Europe and other countries already use these models, and we want to learn from their experience and adapt those systems within South Africa's legal framework so we can successfully implement them. 

EF: How is Pfizer leveraging AI to create meaningful impact, and where do you see its greatest potential in regions like Sub-Saharan Africa? 

RN: If we look back to the time around COVID, it is important to understand the real impact that digital technology and AI have had. Back in 2019, even setting up a virtual call was a challenge. Now it is completely normal, and if someone does not know how to do it, it almost feels surprising. That shows how much progress technology has made.  

AI represents a development in technology aimed at increasing efficiency and usefulness, particularly for communities with limited resources. It has applications in supporting healthcare professionals situated far from major cities. For instance, a doctor located 200 kilometers from a hospital might use AI tools to assist with patient diagnosis and treatment, expanding access to advanced healthcare. Technology of this kind may improve the availability of treatments and health services in resource-limited areas. Studies have indicated that AI can enhance diagnostic accuracy compared to human assessment alone. Understanding how to apply these improvements is important. While there are ongoing discussions about AI, its potential benefits in healthcare are frequently noted. Despite some challenges, AI has the capacity to broaden healthcare access throughout sub-Saharan Africa and improve care delivery.  

EF: What is Sub-Saharan Africa's strategic importance for Pfizer, and how are you driving investment there? 

RN: It is actually quite simple because it ties directly to our purpose, which is about creating breakthroughs that change patients' lives. Sub-Saharan Africa is home to over a billion people, so if you want to make a real global impact, this is the place to do it. For Pfizer, this region is central to our efforts, especially through our "Accord for a Healthier World, which focuses on expanding access by working with governments and other partners to make a difference. 

Pfizer has partnered with the Gavi Alliance for almost 15 years, supplying over one billion vaccine doses by October last year. The alliance delivered its one billionth pneumococcal vaccine to Ethiopia, highlighting Pfizer's impact in the region. Sub-Saharan Africa remains a key focus for Pfizer, with ongoing efforts in vaccines and broader health collaborations.  

Beyond access, the region also plays an important role in research and development. For instance, the RSV vaccine was developed here, and several COVID vaccine studies were also conducted in Africa. These examples highlight the significant contributions Africa makes to global health research and innovation. For us, Sub-Saharan Africa remains essential.  

EF: Do you have a final message that you would like to share? 

RN: Collaboration remains a core priority for Pfizer. Establishing robust partnerships with stakeholders across the healthcare sector is essential, and we are dedicated to maintaining this focus. We strive to actively participate in key discussions both in South Africa and across the Sub-Saharan Africa region. Our engagement with governments and partners is vital to advancing initiatives that improve access to medicines. Our purpose, "breakthroughs that change patients' lives," reflects our commitment to meaningful action, demonstrated through our ongoing efforts and collaborations. We will continue to work across borders to ensure that patients receive the medicines and vaccines they require.