Read the Conversation
Meeting highlight:
- Roche Diagnostics is executing a 10-year “10X” strategy to expand diagnostic access in Africa. The vision is to expand its reach from 50 million to 500 million people. The approach is built on three pillars: strengthening its foundations in Africa, advancing Diagnostics Access through policy & partnerships, and driving innovative business models.
- Africa is currently at a historic inflection point; changing global geopolitics dictates an accelerated shift from donor-funded to domestically funded health systems. Dr. Pamba emphasized that this transition must be seen as an opportunity. There is a golden chance to drive stronger integration of care systems, hence better efficiencies. Further, the need for Public-Private Partnerships has never been clearer.
- It is time for the Abuja declaration of 2001 to be dusted off the shelves and revisited -African governments committed to putting 15% of their National budgets into Health.
- Investing in Health is investing in our Economic competitiveness on the global scene. Africa's biggest asset is its people, 1.5 billion with an average age of 20 years. If we invest in their Education & Health, this demographic dividend will unleash Africa's true economic potential.
- Diagnostics should be recognized as a cost-saving investment. Without diagnostics, diseases are caught late, and treatment becomes imprecise and ultimately more expensive. By investing in testing, healthcare systems can deliver more value even with current budgets.
- Roche has expanded its direct presence from 2 to 6 African countries and grown its team by over 50%. Dr. Pamba highlighted that people are Roche’s greatest asset, with major efforts focused on talent development and strategic training partnerships.
- Dr. Pamba is particularly excited about Roche’s growing point-of-care portfolio (including LumiraDx) and the potential of digital pathology to leapfrog Africa’s specialist shortage. New cooperative lab models are also in development to improve access and scalability.
EF: What does this year look like for Roche Diagnostics Africa, and what can we expect in 2025?
AP: We continue building on our long-term plan, the 10X Strategy. This strategy, which we laid out three years ago, aims to increase the number of diagnostic tests we bring to Africa tenfold over ten years. Back in 2021, we reached 50 million people. We're aiming for 500 million & remain focused on hitting that goal. 2025 is shaping up to be a pivotal year. There has been a noticeable shift in US policy, particularly in donor support for developing countries, and Africa is at the center of this shift. The funding cut from the US has affected the HIV/AIDS space. Roche holds around 50% of the HIV viral load testing market in Africa, so these disruptions have caused some instability. We're working through that as we move forward.
Africa is at a turning point, moving from predominantly donor-supported healthcare to domestically funded systems – a significant and necessary transformation. Our company and the wider industry are partnering with Africa throughout this transition.
EF: How are you and Roche working with other stakeholders to push the moment and highlight the value of investing in diagnostics?
AP: We conduct stakeholder mapping & support critical stakeholders to have the facts they need to make informed decisions with respect to Health in general & Diagnostics in particular. When it comes to health, ministries of health often frame the conversation with emotion front & center, ie, how many people might die or how devastating a disease is. That language usually doesn't resonate with ministries of finance, who speak a different language, focused on ROI! For a long time, finance ministries have viewed health as a cost center. It's not viewed as an investment or something that can generate value. That's completely wrong. The emotional argument is valid & humanizes the challenge, but we must generate the evidence of ROI & lead with the language of finance ministries if we are to unlock budgets for health. Curiously, private companies get it -eg, mining companies in Africa often invest in in-house clinics or even small hospitals for their staff -the cost of a day off work by a skilled worker is undoubtedly clear.
Africa's 1.5 billion people, with an average age of 20, are a significant potential economic asset. Neglecting their health and education risks this advantage while investing in these areas can unlock substantial productivity domestically as well as internationally, in the case of Africans who choose to work in the diaspora.
Repositioning health and diagnostics is a significant opportunity driver for Africa's economic future. Allocating the right portion (15%) of the National budget to the health of the population will yield substantial returns. Currently, foreign exchange remittance from Africans in the diaspora exceeds donor financing to the continent, educated and healthy Africans working abroad and sending remittances home. Imagine the potential economic impact of a healthier, skilled population within Africa. Therefore, health is not solely a social issue but a crucial economic driver.
Diagnostics are the backbone of a robust health system. Many African health systems face inefficiency by over-prioritizing treatment funding over diagnostics due to a lack of understanding of the value of Diagnostics. Diagnostics drive early disease detection & precision in disease isolation, thereby triggering early treatment & precise deployment of remedies. Without Diagnostics, Caregivers often resort to broad, expensive "shotgun therapy," treating multiple conditions simultaneously based on symptoms. With a diagnosis, such as malaria in a child with a fever, treatment becomes targeted, effective, and less costly. This smarter approach highlights the economic value of investing in diagnostics.
Investing in diagnostics strengthens the core of African health systems, potentially increasing the effectiveness of health budgets by 20-30% without additional spending. As African nations transition towards domestically funded healthcare, two key elements are essential. First, African Union members must recommit to the 2001 Abuja Declaration, allocating a minimum of 15% of their annual budgets to health. Second, it is crucial to achieve the optimal allocation of these funds between disease diagnosis and prevention versus treatment. Correctly balancing these areas will significantly enhance the benefits derived from our health systems compared to the present.
EF: Could you elaborate on your African portfolio and its evolution?
AP: When we set up our strategy, we did not have the full portfolio we needed, but we had reasonably good clarity on where we needed to go and what we needed to do to get to our north star, 10X. In the last three years, we have focused on three key pillars in our strategy. One is to build a strong foundation in Africa, which involves establishing a robust infrastructure and network for diagnostics. The second pillar is to drive access via policy & partnerships, which includes advocating for policies that promote access to diagnostics and healthcare. The third pillar is innovative business models, where we explore new ways to make diagnostics more broadly accessible in a sustainable way.
We focused heavily on pillar one. When we started, we had a legal presence in just two African countries: South Africa and Egypt. In our strategy, we identified six countries or markets that would enable us to reach all 54 countries on the continent. We have added Kenya, Morocco, Nigeria, and Côte d'Ivoire in the last three years. We have filled and made investments in people. We identified the skills and capabilities required to scale 10X across general management, finance, supply chain, marketing, and other areas. We have expanded our team by over 50 percent in this time period.
We've also invested a lot in the policy space. The passing of the resolution on diagnostics by the World Health Assembly two years ago was a team effort by many stakeholder groups. We played our part. We contacted Ministers of Health across Africa and positioned diagnostics as a crucial backbone for Africa, emphasizing that this resolution would be necessary for investments to follow. Many of them went and voted for it. When the resolution was passed, we were excited because it meant that many African countries that never had a diagnostic strategy or a diagnostic essential list are now drafting them. That's where the story starts. Now, ministries of health are prioritising the diagnosis of some infectious and non-communicable diseases at the very minimum. Therefore, we now have a policy framework that becomes an enabler for our 10X vision.
We've also moved on to our third pillar, innovative business models. We have a model that we are about to pilot and scale rapidly, but I will leave that out as a surprise to come! In short, we have made good strides in building a strong Diagnostics company in Africa over the last three years, while maintaining double-digit growth, which I'm excited about. The opportunity is still there, and now that we have a new organization and vehicle compared to what we had before, I expect that we can move even faster in the latter years.
EF: From a Roche perspective and your perspective, how are you identifying and unlocking the talent potential, and how can Africa take it to the next level?
AP: When people think about Roche, they often picture the blue hexagon, the machines, and the medicines. But that's not Roche. Roche is us, the employees. We have circa 500 people working across Africa in diagnostics. They are Roche, and that's how I see it. I am very intentional about how we match people to roles. It's worth taking the time to find the right person because it saves a lot of trouble down the line. I'm also very focused on creating a culture that supports delivering on our 10X ambition. That starts with leadership and the tone set at the top, filtering through the entire organization.
I'm genuinely happy and excited to work for a company committed to developing diverse talent from all parts of the world to support our global operation. I am privileged to bring talent from across the African continent into the organization and to see them gain opportunities beyond Africa. Many of our team members have grown into roles in Europe, Asia, Latin America, and other regions. Some of them will return and continue to help us grow. This is what global talent management at Roche looks like: giving young people from Africa a chance to see what's ahead and, with those experiences, come back and help us move even faster.
We invest not only in the people at Roche but also in talent outside the organization. You may have heard me mention our training facilities for laboratory technicians, one in Johannesburg, South Africa, and another that used to be in Senegal but is now being moved to Côte d'Ivoire. We've trained over 8,000 lab professionals across the continent who support various laboratories in Africa.
We're also a strategic partner of the African Society for Laboratory Medicine (ASLM), which brings together lab leaders across Africa. One of the main reasons we partner with ASLM is to help them amplify the voice of the lab. They understand what Africa needs regarding diagnostics, but they're often not included in decision-making discussions. Too often, physicians like me who might be appointed to run hospitals make those decisions. As doctors, we focus on treatment and ensuring the pharmacy is stocked; only then do we consider the lab.
However, you cannot treat what you don’t know. Therefore, lab leaders within hospitals or facilities play a critical role in driving the value of the right diagnostic tools.
Back to your question, at the core of everything we do is a belief that any organization that recognizes its people as its biggest asset and actively invests in them is far more likely to succeed because those people make success possible.
EF: From a diagnostics perspective, what are you most excited about now?
AP: We're building a near-patient care portfolio in a way we've never done before. Historically, we've focused on centralized, high-throughput testing with large machines that can run thousands of tests daily, and we've implemented that well across Africa. However, the reality is that nearly 80% of patients in Africa begin and end their healthcare journey in primary healthcare settings. In those settings, point-of-care testing platforms are needed for the near-patient care portfolio.
Two recent developments in this area have me particularly excited. First, we've brought our diagnostics and diabetes businesses together under one roof. We're now one team. The diabetes portfolio is mainly point-of-care, so they have strong experience in this area. Bringing that experience into our broader diagnostics team is a big advantage.
Second, Roche has acquired a near-patient care platform called LumiraDX. It was developed with support from the Gates Foundation and is designed for the kinds of environments we see across Africa. It's compact, doesn't require electricity or water, and runs on battery power. The platform is flexible; you can run different tests for infectious and non-infectious diseases right where patients receive primary care. We've only just begun introducing it in Africa, and I'm looking forward to seeing how it can be developed and expanded.
Another area that excites me is pathology, especially digital pathology. Africa faces a huge challenge with only one pathologist for every million people. We’ll never train enough pathologists to meet that need. The breakthrough will come from adopting digital pathology algorithms that can work faster and more accurately than any human pathologist. These tools are already being developed.
I'm seeing our pathology platforms grow quickly in Africa, and we're thinking about how to build a digital component now so that African data can feed these algorithms. These technologies are ahead of regulations because machines can’t officially sign off on results, so they can’t be fully deployed just yet.
EF: Do you have a final message for our readers?
AP: Right now, healthcare financing in Africa is my major focus. South Africa is leading the G20 summit and co-sponsoring the global fund's fundraising this year. That puts pressure on South Africa and sparks an important conversation about shifting healthcare funding from donors to domestic sources. It is a significant challenge for Africa that warrants genuine attention. As mentioned earlier, it's not about emotions; it's about the economics of investing in human capital. It is about investing in Africa's economic future.
Africa could miss out on a rare opportunity: a young population that has the potential to change these economies for the better if we don't step up now. We have a window to make this happen. And with the US cutting aid to Africa, it presents an opportunity we need to seize, rethink, and move forward with domestic financing of Health in Africa.
