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EF: Can you elaborate on Roche Diagnostic’s role over the last eighteen months, considering the relevance diagnostics has acquired?

SO: We have been on an incredible journey; the pandemic highlighted the importance of diagnostics for the healthcare system. The starting point is prevention and early detection, which has never been so relevant. With the arrival of the pandemic and the healthcare crisis, its relevance became even more apparent. Countries with solid diagnostic, digital and health infrastructure were better prepared to manage the pandemic, South Africa had that necessary infrastructure to control the pandemic better than other countries. Roche played a key role for many suppliers, a significant advantage South Africa had over neighbouring countries that did not have the same situation. Our mission was clear: to support the population during these times. We knew we had to do this through collaboration. There couldn’t be a better time to lead in a healthcare crisis in terms of diagnostics and having the infrastructure in South Africa. We had to act very quickly and all together. A key learning is that we must advance together – no one alone could handle the pandemic – we need everyone: the government, the private sector, suppliers, etc., not competing but each of us bringing our best in aid of the country. From the start, we had to be very quick in bringing in PCR tests. I’m proud to say that we worked very closely with SAHPRA to achieve this. From March 1st to April 14th, we gained regulatory approval for our PCR test, with other suppliers getting support soon after. We couldn’t have done it alone. We needed a lab to validate the tests, SAHPRA, and a solid supply chain. It was not easy to get products in, and what we got was never enough, as resources went to other countries as well. Collaboration was fundamental. We focused on bringing COVID-19 tests into the country. We brought in 5 different types of tests achieving regulatory approval for all five during that period. We have a new PCR test that distinguishes between influenza A, B and COVID, which is very helpful as it quickly mitigates the panic felt when one starts coughing. These are examples of the importance of diagnostics, proper infrastructure, and why South Africa detected the new Delta variant when it came out. In Africa, we have high technology and reasonable capabilities, which we must bring together to find solutions as soon as possible. We have also tried to help in other ways, offering training and doing proper virtual installations, and I am both thrilled and proud to be part of that solution, working with competitors and suppliers together all as part of a necessary solution for the country and the continent. It is essential to highlight how successful this was because Roche made a considerable effort for Africa, and we couldn’t have done it independently. 

On the other hand, we saw a decline in patients’ routine tests, mainly because many people are living with chronic infectious diseases that need to be diagnosed. There is a high incidence of new cases. Patients need to be tracked and monitored to know where the vital load is because they receive medication which needs to be monitored, something the lockdown further complicated. The essential burden for other diseases has been a challenge and a considerable concern for South Africa: cancer, heart diseases or other infectious diseases which are really common. Prevention and early detection are critical and if patients don’t return to see doctors, it will cost lives and money for healthcare systems in the long-term. We are trying to get patients to return to see their doctors, and one way of doing this is accelerating digital health -an area we need to work on. 

EF: What were the lessons learnt from managing remotely through a pandemic? 

SO: We must never forget our purpose is to serve country and continent. We provide critical diagnostic solutions, which show where we are with COVID as well as with other diseases. COVID was a shock to everybody and threw us into a period of transition which was very challenging, it changed our way of working, and we had to remind our people of our purpose -even more critical in tough times. We brought our offices into our homes, invading family spaces and where our children play, and for this reason, empathy was a key element. The pandemic did away with bringing our professional faces to work and leaving our hearts and emotions at home, and we are no worse for the change. I honestly think this is the face of the new leadership, we are all people with our good bad and ugly and with plenty of emotions and we must embrace it all. I start my key meetings with “How are you feeling?” an essential question during the transition and the pandemic as it was a time when it was critical to interact. We did regular catch-ups and what we called Hello Meetings, where we all shared what we were doing and they were rolled out all through the organization, mainly to share feelings which suddenly became important –a gift from the pandemic. A Key learning from the pandemic was the importance of mental health because the work-life balance was completely destroyed, now a person needs to take a longer break for lunch as they need to cook for their children but could still be working at 7 or 8 pm. Summarizing the key learnings were understanding and empathy for our employees, bringing emotions to the table with an emphasis on mental health as we have to care not only of our employees’ performance in terms of KPIs but how they are emotional. Roche South Africa employs about 250 people -200 of them based in South Africa- and we sadly lost two of our people to COVID, both in professional services taking care of the instruments around tests. Many of our members lost loved ones to COVID, many of us needed help with our new life balance and others needed help to deal with loss and grief and we really prioritized these mental issues. I realize I have focused mainly on the emotional side of things but it´s intentional because I think emotions tend to get forgotten over more factual business points.  On a more practical level we focused on structure and our contact points with newsletters and Hello Meetings and now with a hybrid model we are using more technology, we are more flexible, and we are bringing more credibility. There has been a change in the style of leadership, embracing new ways of working, which means trusting our employees and moving away from a hierarchical approach that South Africa has favoured. Roche is very keen on creating networks where everybody has the same voice and the pandemic has accelerated that, which I am grateful for. We worked on breaking down many obstacles for our people to be creative. Creativeness needs mental health to operate as it's hard to be creative if you are not in a good place. 

EF: Have you identified any new KPIs during this period as a response of managing digitally and for keeping employees engaged or measure mental health? 

SO: We did a few engagement surveys and at the end of the day we realised we had to add more workshops where people could talk about how they were doing, and we created different forums for that interaction. We had weekly meetings with all the managers and with smaller groups, which I am still doing. Every Friday, I have a 45-minute meeting with five employees of the organisation, where I ask how they are managing with the new working ways, how their work-life balance is and what is keeping them awake at night; or if anything is keeping them from serving patients in the way we want them to be served; and what can be improved beyond that. For our employees, it is good to have direct contact with the GM, and for me, it is very enriching as I can learn what is going on within the organisation. In these small forums likely as not, the employees bring solutions for each other. We will not go back to how we used to work before so we must find ways to have those conversations. To this end we created the “Hello Meetings”, did surveys, have the KPIs and the workshops which were very important. Finally with the home office system -not seeing managers on a face-to-face basis- we detected our employees were unsure if they were doing a good job or if they were considered for a promotion, so we started working on better recognizing our employees. We hired more than 50 people during the pandemic and our contact was mainly virtual and remote, a challenge albeit doable with constant listening and adapting – listening being the most critical element in such a challenging environment. 

EF: How did you manage to attract resources from headquarters at such a challenging period?

SO: I am honoured and privileged, in that Roche South Africa is a crucial priority for the company. This does not happen in every organisation, but in ours, it does, and when I explained the enormous challenge we faced, they listened, and we got a reasonable allocation of PCR – admittedly not as much as we wanted but I don’t think any country managed that. Our commitment to Africa is very strong and can be seen in the resources we are bringing to South Africa and the continent. Our excellent infrastructure helped us get a reasonable allocation of tests but in any case, our advantage was in our firm commitment to Africa. Roche is significant in South Africa, we have close to 300 employees in our manufacturing facility Kapa Roche in Cape Town, overall, in South Africa we are more than 500 employees and are growing.

EF: I understand you are celebrating 75 years of commitment to South Africa.

SO: Not only are we celebrating 75 years in South Africa, but Roche Global celebrates 125 years of existence. What stands out is the investment Roche has done and does in R&D being the pharma organisation that has most invested in R&D, and I am also proud of being the highest investor in diagnostics – we invest more than all our competitors together – proving our strong commitment in that sector. We have over 15 solutions across the globe just for COVID. But we don’t stop there, we have specific elements for example a new instrument tailored for the needs of Africa, we will have a plasma separation card developed by global and requested by us to test a person’s viral load, with a drop of blood of the fingertip which is correctly transported to a lab to detect the viral load of that patient –an excellent system for rural areas where access is much more complex and with this system it is much easier to be tested. We have developed iThemba Life which is a mobile application platform for patients living with HIV to get their viral load results on their phones in a confidential manner and we ran a pilot with the MPB and a team here in South Africa with 500 patients. We then received their feedback and implemented the needs accordingly, this included training materials amongst other requirements, all in aid of developing an excellent tool for HIV. We are now looking at HPV as well, and we need help to raise awareness. Cervical cancer is by far the most common HPV-related disease and it can be completely cured if detected early. We have HPV DNA testing which is very efficacious, and we want more detection so that it can be treated earlier and cured. All emphasis is on the importance of diagnostics, thinking of NHI, our version of universal healthcare which is where diagnostics will play a key role working on early prevention and detection.

EF: When you look back to this period in your professional career, what would you like your tenure to be remembered for, considering you had to lead through a pandemic? 

SO: I would like to be remembered as somebody who cared for people, not only for the people at Roche but for our customers, as somebody who together with my team and provided a positive impact. For me, what really matters is that we cared and worked to have an impact together. 

We need a new way of leadership and in South Africa. We particularly need more diversity in GMs and in general, and hopefully, one day we will be talking about more diversity and inclusion, and I personally am working towards Africa led by Africans.

October 2021
South Africa