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EF:  You were appointed Country Manager of Pfizer South Africa almost a year ago; what was the mission given when appointed?

RN: Back in 2016, I joined Pfizer’s innovative health business unit to help grow the business and introduce innovative medicines to the Sub-Saharan Africa market. At the time, Pfizer had two business divisions: one dedicated to innovative medicines and vaccines and one dedicated to essential health. Our corporate strategy shifted toward advancing innovative medicines, and it was through this restructuring that I was appointed Country Manager and Cluster Lead of Sub-Saharan Africa, which, in addition to Southern Africa, includes East and West Africa. Pfizer’s mission has remained consistent: it has always been about giving patients access to innovative medicines and vaccines that will help improve their lives. My mission, and that of my team, is to continue to make sure that whatever scientific breakthroughs Pfizer achieves, these can be accessed by all patients in sub-Saharan Africa. This aligns with Pfizer’s “Purpose Blueprint” that aims to have “breakthroughs that change patients’ lives”.  

EF: How would you define access? 

RN: Access is a broad concept. For me and you, it could mean something as simple as going to the pharmacy and finding the medicine we need, as well as having the funds to pay for it. But for somebody in the rural area, it might mean the ability to get the medicine to the area – something we call the “last mile” challenge. It could also mean ensuring that you can access the medicine you need even if you can’t afford it.  We must therefore be innovative in ensuring patients access to medicines. A good example of this is Pfizer’s partnership with the Ministry of Health in Ghana and US-based company Zipline, to implement a drone distribution program for vaccines and essential medicines in Ghana, a cutting-edge example of how technology is being used to improve supply chain in hard to reach areas. 

In relation to financial access, we have explored innovative partnerships on the continent that support the management of healthcare expenses by inculcating a culture of saving at a household level. 

Other access channels we continue to support include access to quality affordable primary healthcare. In this regard, Pfizer remains a key investor in the Unjani Clinics network, a South African enterprise development initiative that empowers black woman professional nurses to own and operate their own primary healthcare clinics in under-served communities, creating permanent jobs and building sustainable businesses. Pfizer is proud of this initiative and, through the partnership has, to date, funded three clinics with a fourth clinic underway out of a total network of 70 clinics. In addition to this, we have donated over 57 sonar machines to the clinic network which has enabled more women to plan their pregnancies, check their baby’s development and pick up on any health risks early on.

EF: There is a concept from project management called the iron triangle where vertices of the triangle are ‘good, affordable, and fast’, but you can only pick two. It can either be  affordable and fast but quality might be compromised. It can be good and affordable but will take a long time, or it can be good and fast but it will probably be really expensive. Which two variables would you choose for the South African health transformation?  

RN: I choose ‘good and affordable’. Quality is, I think, the most important element. If affordability is in place, quality must be considered first and very seriously. Product quality and patient safety and efficacy are critical components of the trust people place in pharmaceutical medicines; therefore, we need to ensure delivery of high-quality medicines that deliver on the promise to prevent, treat and cure disease. 

EF: How does Pfizer SA’s strategic performance within the region drive the company globally? How do you plan to add to the growth of the company in two (2) years’ time? 

RN: Pfizer has operated across the continent for decades, with direct, joint venture, or contract manufacturing operations in five countries as well as products that reach every African market. Africa is central to Pfizer’s global emerging markets, business, and near-term growth strategy. We manage ourselves as a cluster, with more than 400 direct employees in Sub-Saharan Africa divided into Southern Africa, East Africa and West Africa.  This serves as the  springboard for launching our products as it enables us to know where to target investments in East and West Africa and make sure we do what is necessary. 

EF: Do you see the National Health Insurance (NHI) as a challenge or as an opportunity? 

RN: It is a great opportunity. Currently the market is divided between public and private, with 80% of medical spending incurred by 15% of the population in the private market. The NHI would help garner access through reforming the current healthcare system.  Our perception of the current system is that it is  unsustainable and that “no change is not an acceptable option”. The reason for my optimism is that when a system is overhauled or reformed, it presents a unique opportunity to rebuild something that is better than anything that exists. For Pfizer, we believe that the current debate presents an opportunity to open a meaningful conversation around outcomes-based healthcare and is in the best interest of both patients and the national health system.These types of reforms have been done before in other countries and are working well. We believe that it can work in South Africa. 

EF: Could you tell us about the women initiatives within Pfizer South Africa and how it relates to the triple bottom line?

RN: In keeping with the global phenomenon of diversity and inclusion, Pfizer South Africa continues to drive initiatives aimed at promoting greater personnel diversity and gender representation within the company. We have made great strides in the gender transformation of the organisation, and I am proud to say that 74% of the workforce in our organization is female. Furthermore, 50% of our leadership team are women. We have achieved this through the appointment and promotion of a strong diverse female workforce and for this, Pfizer South Africa is seen as a country of best practice in the broader Pfizer AfME region. I believe that Pfizer South Africa is one of the forward looking companies that recognises and understands the positive implications of these demographic shifts and therefore embrace gender mainstreaming as a business strategy. 

EF: What makes pharma such a unique industry? 

RN: I can only speak about the pharma business which has the patient at the center, the safeguards are important and are there to make sure we protect the patient. It is a highly regulated industry, which not everybody appreciates. What makes pharma unique is that we deal with people at their most vulnerable state, when a person is sick they are at their weakest and that is when they need pharmaceuticals. The responsibilities we have as a business are therefore enormous.  Additionally, medicines are also one of the best investments in health care. They can reduce other health care costs by preventing and curing disease, and by maintaining or improving health. These benefits can result in fewer trips to the doctor or hospital, fewer surgeries, or a delayed need for long-term care, each of which can be more costly than medicine, particularly from a “whole economy” perspective.

Since the new administration has come on board, Dr. Zweli Mkhize has been dealing with partnerships in the industry and the government has been very clear in their intention that business and government should collaborate for the benefit of South Africa rather than operate independently. 

The government also came to the conclusion that South Africa needs to build its manufacturing capability. Pfizer is proud to support the national development plan and government’s vision of vaccine manufacturing through a Technology Transfer partnership established with the Biovac Institute. This partnership will enable the local manufacturing of a 13-valent pneumococcal conjugate vaccine at its facility in Cape Town. The technology transfer process has enabled significant knowledge transfer, job creation and direct investment, strengthening South Africa’s standing as a research and development hub in Africa.  It will also contribute to continued security of supply of the pneumococcal vaccine, thereby continuing to make a significant impact in the reduction of childhood pneumonia in South Africa. Pfizer believes that this partnership embodies the potential of public-private partnerships and collaborations.

EF: When you hit your first-year anniversary, what will you be most proud of? 

RN: I am proud of how we have come together and delivered as an organisation. As a new team working together, we have found spaces where we are contributing and making an impact on people’s lives and I find that truly impressive. We have never shied away from getting involved in discussions that are needed. An example is the National Health Insurance (NHI) bill passed in South Africa a few months ago, which for us is not just a political issue, but a conversation – a debate on a reality that must be faced. 

October 2019
South Africa