Read the Conversation
Meeting highlights:
- Localization and Export Ambition: Sanofi’s long-standing partnership with Biovac led to successful local production of high-quality vaccines in South Africa. The next step is expanding exports across Africa under the “Africa for Africa” vision, starting with an injectable polio vaccine for UNICEF tenders.
- Access to Innovation: Sanofi aims to improve patient access to its global immunology pipeline by accelerating registration, streamlining reimbursement processes, and working closely with regulators, insurers, and healthcare professionals in South Africa.
- Clinical Trials Commitment: South Africa hosts one of Sanofi’s key clinical study units, which ensures African populations are represented in global trials. The goal is to link trial participation with timely access to approved therapies in-country.
- Strategic Value of South Africa: Despite slower bureaucratic processes compared to other regions, South Africa offers long-term stability and legal reliability, making it a strong base for sustainable pharma investments and regional leadership.
- Future Pipeline and Public Health Impact: Sanofi is excited to launch breakthrough products like RSV prevention therapies, as well as new innovations in immunology. These aim to reshape public health outcomes, especially in paediatrics and chronic diseases.
EF: How do you see this year, and what can we expect from Sanofi vaccines in South Africa in 2025?
JB: From a vaccine perspective, we started our journey a long time ago. It was around 15 years ago with Biovac, and it was focused on localization. Interestingly, localization came up as a topic after COVID, but we were already doing localization in South Africa many years ago. This has not changed. South Africa, through Biovac, has successfully completed a tech transfer for a state-of-the-art vaccine, the same one used in the US and Europe. The vaccine is produced locally in South Africa and is delivered to all the babies in the public sector, which is amazing when you think of it. This is one of the only examples that we have of a successful tech transfer for such a complex state-of-the-art vaccine.
For us, it is now about ensuring that all the investments, capabilities, and expertise we have built over the years with Biovac benefit the country in the long term. We are part of the discussions on preferential procurement and how to promote a differentiation between locally produced vaccines and imported ones.
The conversation shifted when the focus turned to "Africa for Africa," and we pointed out that South Africa has already been successful and is effectively producing vaccines. It is not just a plan or a project on paper. It is already happening, with over 4 million doses produced each year. So, who is better positioned than South Africa to export more on the Africa for Africa ambition than the African CDC? It is now up to us to push for additional investment.
Under the Africa for Africa initiative, we want South Africa to be one of the first, if not the first, countries to export locally produced injectable polio vaccines (IPV) for UNICEF tenders. Sanofi and UNICEF have a strong partnership. We are participating in various tenders for multiple products, and we aim to have the polio vaccine locally produced in Africa to support the UNICEF business.
We are also keeping our eyes open to any other tech transfer that could make sense to us. This is conditional on changes in the procurement rules, because the current system does not fully encourage investment. We did it many years ago with Biovac. There was an agreement and certain safety nets in place so that our investments are secured. Preferential procurement is not yet effective. The President has signed the Preferential Procurement Bill. Now, it needs to be translated into actual policies and actions. We are closely monitoring this situation and working in collaboration with the relevant authorities.
The Pharma side is very important for us in South Africa. To this end, our main objective is to evolve into a company focused on science, with massive investments in R&D and innovation. The challenge for us, as a global immunology company, is to maintain that same level of energy at the local level, beyond vaccines, and create opportunities to launch innovation and create access for patients in South Africa. Now, our focus is on shaping policies and creating an environment that makes South Africa an innovation-friendly country, where we can bring the global pipeline that we share with investors every year. How do we bring this innovation to the patients in South Africa? This is what is at stake today in South Africa.
We have immunology medicine available in South Africa with various indications. That being said, access to this innovative medicine is still a challenge. Monoclonal antibodies are bringing a different future to the industry. I think the question is now, “How do we do that in South Africa? How do we translate this global road map about being an immunology company developing those immunology medicines in the pipeline? How do we bring them to South Africa?” This is what we are looking at in 2025.
To sum up our work in vaccines, we focused on localization, continued investing, and positioned South Africa as a pioneer in the Africa for Africa roadmap. But it is also about shaping the environment to bring global R&D innovation to South Africa, so that patients and the wider population can fully benefit. That is our role and mission, Sanofi as a public health and innovative partner in South Africa.
EF: Could you expand on how you are working with different stakeholders within South Africa and what needs to happen to bring more access to innovation?
JB: Collaborations are essential for our organization; discussions take place with multiple stakeholders, with the objective of forming partnerships and participating in the evolution while comprehending new policies which are aimed at improving the industry's operations.
While not all, a selected number of clinical trials benefit from the work being done by the clinical study unit here. This helps to include the African population within the data, and that is important because it is a commitment to Africa and to the country where we run those clinical trials. This all helps to make innovative drugs accessible to the patient. In the short term, including patients in clinical trials offers them a potential solution to treat their disease. It gives patients an opportunity to access treatment through participation in the trial.
The second aspect is that once a clinical trial ends, it gives us the opportunity to build a strong case for the product in countries where the trials were conducted. Having local data, which is usually requested by local authorities, supports the approval and access process. We do have local data that we generate within those trials, so we can easily and quickly get those drugs into the country. Without participation in clinical trials, a country may be seen as less of a priority, making the process more complex. We leverage a lot of our clinical study units for that.
The only challenge we face is that, although we are happy and proud to conduct clinical trials in Africa, we want to ensure that the drugs we bring to South Africa are effectively accessible and administered to patients. That is the commitment we are trying to adhere to, so that we avoid enrolling patients in clinical trials and then failing to bring the products to market, especially given past experiences where some of our launches were unsuccessful. We want to make sure that our clinical study unit's ambition is matched by our launch and access ambition in the country, for the benefit of the South African population.
EF: How do you attract resources to the country?
JB: It is quite interesting because in most of the countries I have worked in, like those in the Middle East and North Africa, there is a very different approach compared to working in a strongly regulated and mature constitutional democracy like South Africa. Often, decisions are made by a single person who has the flexibility to bypass certain processes and push for their desired outcome. They have a vision and implement it quickly.
South Africa does not work like that. If the president makes a decision, it does not mean he decides on his own. You need to go through the government, the parliament, and adhere to a very strong constitution. In terms of timelines and approach, the planning process is quite different. That said, the benefit in South Africa, compared to some other African countries, is the strong contract enforcement index, which is very high in the country.
This means that decisions take time, similar to what you might experience in Europe or the US. You go through a hectic and often lengthy process, convincing many people and advocating for hours on end. However, once a decision is made, the contracts and commitments, including reciprocity with the country, are very strong. The good thing is that it has become very sustainable. Whatever is put in place, there are laws and systems to support it, ensuring that your business is sustained in the long term.
You have a clear vision and certainty in South Africa, whereas in some other countries, I have had past experiences where decisions were made, but there was less predictability and stability in how they would unfold. And if there is a change in government or any shift, whatever agreements you have made might not matter anymore. A strong, lasting commitment does not always back it.
In South Africa, the process can be complex, but this is because the country is a mature democratic state that requires respect for its procedures. From a business and investment perspective, especially in pharmaceutical localization, which is a mid-to-long-term, long-cycle endeavour, this approach is crucial. You need this kind of visibility, and you need this decision process to be the one that you have in South Africa.
South Africa is a good example, and I hope that we can get what we need from the South African authority in terms of preferential procurement, because once that is in place, this means that we will be very comfortable investing in South Africa and continuing to support the country. It is a win-win, helping South Africa as a leader and pioneer in the Africa for Africa roadmap.
EF: What aspects of your portfolio are you most excited about, and which areas of investment or upcoming treatments do you believe will have a significant impact on the region?
JB: It is very clear that our next key milestone is translating our global immunology ambition into a reality in South Africa. We need to deliver on this, particularly with our Dupilumab objectives and ambition, because that is really where we want to be. It will be the door opener for all the other immunology products that will follow in South Africa, but we must first deliver with that one.
I am very excited about the global vision of being an immunology company and the way we, as a management team, translate it into a reality in South Africa. It is a challenge, and it is not easy in the emerging world. These are expensive products and they require a lot of shaping and advocacy, and new funding and financing model instruments. This does not come quickly and easily, but I think it is beautiful work to do because, in the end, you allow those patients on the African continent access to those drugs and therapies. This is a source of motivation for me every day.
On the vaccine side, RSV is a key focus. You have probably heard from other Sanofi spokespeople about the respiratory syncytial virus (RSV) vaccine, which represents a real breakthrough. Interestingly, it is not strictly a vaccine in the traditional sense, since it is a monoclonal antibody. There was a lengthy debate in the US around whether it should be classified as a vaccine or as a pharmaceutical treatment. But ultimately, RSV is being positioned as a vaccine globally.
In South Africa, we have contributed to patient access through participation in Phase 2 and Phase 3 clinical studies. We look forward to introducing this product to South Africa. It is currently under registration, and we are working hard to make it accessible to patients as soon as possible because it truly represents a breakthrough. The question now is to what extent this vaccine can truly transform the country's public health profile, particularly in terms of paediatric care and management. During a recent visit to paediatric wards in one of our hospitals in Johannesburg, it became clear that RSV not only affects infants severely but also prevents them from receiving other necessary treatments while they are infected. This is a major challenge.
RSV is contagious. So, of course, it is not only the babies who are affected; healthcare professionals are also impacted, leading to staff shortages in hospitals as they too fall ill due to RSV. So, for the hospital, which is already struggling in terms of resources and trying to push to get everybody on board and have the maximum capacity of healthcare professionals working and serving the patients, now you have not only patients who cannot help themselves and cannot be treated, but also healthcare professionals who are missing from work. This adds additional pressure to an already exhausted medical team.
So, the whole impact, and we have seen it in the studies, in the real-world evidence studies, is that in countries where the RSV vaccine had already been launched, it makes a significant difference. It is really a game changer for all those units and the medical team that are working with those patients in their first year of life. That is really what we want to bring to South Africa. Work in progress.
EF: Looking back on the first 18 months in South Africa, what moments stand out the most to you?
JB: When I reflect on what we have accomplished, one of the most striking moments for me was when I arrived and we launched the first public immunization program booster for pertussis, diphtheria, and tetanus (Tdap). That was a significant launch. You do not launch vaccines every year, after all. When it comes to launching a vaccine, you want it to be successful, but it is not always easy. However, we launched this vaccine in the public program in 2024. The first month we included it in the vaccination program, and the authorities supported it. Then we worked to support the program’s implementation from January 2024 onwards.
For me, the launch of our Tdap vaccine, which resulted in more than two million babies and toddlers being vaccinated in South Africa in 2024, was a significant success. With a cohort of 1.2 to 1.3 million babies every year, it was probably one of the best launches we have had globally. It was a truly successful moment that we shared with the team, and historically, it is not every year that you launch a vaccine in the public program to provide additional protection for babies and toddlers in South Africa. This was a standout moment.
Another memorable moment was the B20 opening. It is rare to have the opportunity to manage a company in a country hosting the G20, especially in the emerging world. This is the first time the G20 has returned to Africa. Being part of this journey was special, and at Sanofi, having been in the country for over 40 years, it felt like common sense to support South Africa in this challenging but incredible opportunity to represent the continent and the emerging world at the G20. For us at Sanofi, we knew we had to be part of this history, and it is our duty to the country as a local affiliate.
We always say this affiliate is dedicated to aligning with and supporting the country’s vision. When South Africa decided to implement the BBBEE (Broad-Based Black Economic Empowerment) framework to encourage companies to sponsor black businesses and empower black communities, Sanofi fully committed to this vision. We are probably the only multinational company certified as a Level 1 BBBEE contributor, which we see as both a duty and a source of great pride.
Additionally, being part of the G20 process organized by the country felt like an essential journey. We knew we had to support South Africa, so we also sponsored the B20. Our contribution goes beyond just financial support; we are also part of the local advisory council, which allows us to contribute to shaping policies. As a multinational company, we ensure that we include insights from all the countries where we have an interest in healthcare policy. Everything we do is aimed at advancing healthcare policy, particularly in areas like respiratory localization, where we can make a meaningful impact. It is an important role for us to be there by the side of the local authorities.
