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EF: What was the mission you set for yourself when you were appointed General Manager of Takeda´s Access Market Cluster in March 2021?

UM: I had to have a cohesive approach through our transition and across the whole cluster. The transformation of the Access Market was from a commercial mindset with the patient at the centre of our actions but with access at the core. We addressed the barriers patients face along the continuum of care to gain access to innovative therapies, not so much at the stage where they are genericized or when biosimilars come to the market, but ensuring access happens a lot earlier. The cluster covers South Africa and Sub Saharan Africa, servicing needy and under-serviced communities with no access to therapies. The transition occurred during the pandemic. This forced us to focus on our people and the patients and customers - especially during our restructuring as a mature access market cluster- and was a significant change for the company. Part of the goal was to ensure regular interaction for our people to continue to feel valued and for our mission or vision for the region to be clearly understood and aligned across the different markets I am responsible for.

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

UM: The focus was very much on Covid-19 and the pandemic. Very early on, we realized we would not be part of the front runners developing the vaccine and therefore continued to focus on the overall healthcare sector as even with the pandemic, patients were suffering from many non-communicable diseases. We have key areas of focus, such as oncology and gastroenterology. Maintaining our supply chain was our priority, not forgetting our patients and having business continuity with our customers. An important lesson learnt internally was to stay connected, to pivot to become more digital savvy, have information available, respond rapidly to queries and keep all lines of communication open with our people as well as with our customers. Embracing digital platforms and various ways of communications was key for business continuity but to also make sure that our people, patients and customers continued to feel supported.  

EF: Takeda is famous for its culture so how did that work with your efforts in adapting?

UM: Our local market transformation was done with integrity and fairness. Integrity and fairness aligned with our portfolio and paying particular attention to the skillset needed combined with an open dialogue with our people to ensure we took them on this journey. Trust is a critical element of this interaction. In a transformation, the discussion is fundamental and to move forward. We need our people's trust and regular transparent conversations to advance with fairness. Our actions were part of the Takeda culture centring our decisions on patients, trust, reputation and business in our external focus towards customers and internally. During the pandemic, we did this with added attention having additional contact points to make sure our people understood our transformation, staying true to Takeda´s values even with a transformation and a pandemic occurring.

EF: Did you have a shift in your portfolio performance this year?

UM: Yes, we did, and the same is true for many organizations involved in non-communicable diseases. In the cancer space, the reports indicate fewer patients have been screened. We know fewer patients came for their repeat treatments mainly because patients were fearful and hospitals were not allowing elective surgeries. There was a significant change within the healthcare system and in the prioritization from a patient perspective, with fewer and fewer patients being diagnosed. As a result, we transformed into a highly specialized organization aligned with Takeda global. The decline of patients returning for treatments has had a financial impact, but now they are beginning to return but the delay in therapy will have a negative impact in the long term effects in patients´ health outcomes and the data and follow up over the next five years will show to what extent this is true. Fortunately, we are seeing a return to normal as people are getting vaccinated.

EF: How can we restore importance to non-communicable or chronic diseases in a communicable disease scenario?

UM: In the pharmaceutical industry, it is critical to continue our work to support our different partners; we are working with the Cancer Alliance, Campaign for Cancer, and Rare Diseases in South Africa to ensure those organizations survive Covid as well as the model under which they work for patient education, advocacy and disease awareness. When our organization has received unsolicited requests for grants, we have assured the organizations received financial assistance for them to remain sustainable and survive through the pandemic. Due to the pandemic and subsequent lockdowns, these organizations could no longer do their normal fundraising efforts and for this reason, we have been supporting their requests by being hands-off and ensuring the organization stay sustainable. We have also worked on education with our key customers around healthcare communities: nurses, doctors, and pharmacists maintaining that link because they are treating the non-communicable diseases in the gastrointestinal, oncology or rare disease space. We share best practices that we have seen in other countries following the guidelines that have come out, for example preferring oral therapies as opposed to patients coming in for intravenous treatment. We put out information, share knowledge with doctors keeping that dialogue open and I think it has made a big difference in raising awareness on other diseases besides Covid that need attention in the long run. Covid has made us pivot to digital and we continue to innovate in this space, we are getting used to the new way of doing things but as an industry, we must ensure the focus is kept on other diseases as well.  

EF: Have you identified any new KPIs during this period as a response of managing digitally or measuring contact with physicians? What are you looking at now as opposed to pre-Covid?

UM: For us, it is essential to look at quality versus quantity when considering interactions with physicians. Part of the interaction is how long we can hold the physicians' attention by means of digital or telephone versus face to face and the number of appointments that get cancelled versus the number of appointments that physicians keep that tells us of the value of interaction and the knowledge of our team. We continue to track our business and the financial KPIs will always be there but with our transformation, the portfolio and putting access first we have observed based on programs we have put in place and working through patient support and programs a number of patients are getting into innovative therapies much earlier as well as patients staying on treatments longer. As our focus shifted, we are also looking at people's experiences because we want to know if they understand where we are going and what we believe in, and I am happy to say people want to join us in our journey. There is eagerness as new positions open up in the organization or people wishing to join up, and this is due to company culture and about wanting to be part of the transformation of the South African market and the future of universal healthcare. We don’t look at access for today but in terms of where the country wants to move towards because we want to be part of that partnership for our local organization and as a country. We cannot do the work on our own; we need partners to create a better future and be part of the move toward universal healthcare for South Africa. There is a 2050 vision for Africa to embrace universal healthcare. The success of all our medicines is doubtful because it will mean meeting the highest unmet needs and correcting inequalities within healthcare systems. For us, it is critical to monitor interaction, the ability to transform and embrace digital and innovation and take care of our people internally and patients.

EF: How do you attract the younger generation to work in Takeda over other tech companies that tend to be more alluring to them? How do we make healthcare ´sexier´ to attract the best and the brightest?

UM: Takeda´s culture encourages and allows people to learn, pilot and share and is a critical part of what we do. The long term goal is to become an ethical, responsible and compliant manager or leader in healthcare innovation in the digital space. The goal is also to embrace data, to use it for artificial intelligence, to predict and to plan for the future. When we bring new talent into the organization on a local level, we have the opportunity to give them a voice in strategic planning, decision making and listening with new ideas creating an environment not only for what we call best people´s experience but as a learning environment for pilot projects which we assess. Our approach and mindset to access are reflected in the partners we choose, for example, young innovators without much experience that can access the whole healthcare sector range and can transform it from the first awareness stage to the aftercare stage, as we can support them and provide the tools in the continuum of the disease. Two such students joined us here in South Africa after they finished their PHDs and are being mentored in this learning environment and is something we see as essential to help accelerate their careers. It is well worth Takeda´s time to do this. I think Covid has given us a gift, being able to provide more flexibility in the workplace in terms of working from home instead of from working from the office, establishing a new level of trust between employer and employee. Covid has given us a great opportunity, flexibility as a company policy for young people who want it.  

EF: What is your definition of access?

UM: When I think about access, I think about not only access to medicine but access to information regardless of the person´s culture or background. Access to the care the patient needs is about the disease and a network of support in the aftercare, which is just as important. Access means access to information, access to be treated fairly and equitably -receiving the best standard of care in the country or a global average of care- and finally access to the necessary support along the disease continuum. Treatment is just one point in the patients’ journey and if we address only that, we most probably have excellent outcomes but if we address the before and after through fair and equitable healthcare I think it will make quite a difference with even more outstanding outcomes.  

EF: What are your expectations for Africa to be gained through Takeda´s different partnerships, for example, your alliance with Pfizer to develop a norovirus vaccine?

UM: We have partnerships beyond freeing up capacity for the production of the Covid vaccine with Moderna, and with J&J. We partner with several organizations in Africa looking to raise awareness on non-communicable diseases such as the International Cancer Alliance. Our efforts around NCD are a global issue, hypertension is underdiagnosed, often not adequately managed and happens across the country and continent. There are challenges people in the different markets face from lack of information, from what they eat to cultural changes, so we have to concentrate on the NCD alliance which is a partnership made up of many consortia to reach all countries in the continent. One of the biggest Blueprints for Innovative Healthcare Access is in Meru County in Kenya; we have already expanded the International Cancer Alliance into Tanzania and Ghana focusing not only on the disease but on the education of healthcare professionals and earlier diagnosis. We have a partnership with an organization called Axios working with patient assistance programs for early access and we aim to improve the level of education and disease awareness and provide solutions for the patients who need innovative or new forms of therapy. We do a lot of work with the rare diseases group as there are a lot of gaps in understanding and a lack of data when it comes to patient outcomes -no data is collected. Our intent is to support the collection of data because country-specific evidence is so much more powerful when driving for change in policy especially for diseases that have not been prioritized by governments. It is important to quantify the burden of disease, the potential burden of care and the difference achieved by early diagnosis and treatment and the impact it has on society and on government spending. My idea of access is about the extended continuum of the patient's journey, every drug must come with information and the necessary support to the patient to understand what a treatment involves. Evidence of the burden of diseases specific to a country will become more and more important in the shaping of policies and looking to improve outcomes and universal healthcare coverage.

EF: When you look back to this period in your professional career, what would you like your tenure to be remembered for?  

UM: For me, it is about the people and living through this period with integrity, having always been fair and not having lost sight of our people internally or our patients and their health journey. I want patients to have received their medicines when they needed them, when resources were focused on fighting the pandemic. To know we had an internal focus and never lost sight of our external obligations: the patients and securing the supply chain.

September 2021
South Africa