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EF: What was your given mission when you were appointed as one of a new generation of managers to manage a pandemic? 

ZB: First and foremost it was about keeping our employees safe. Sales and opportunities have to come second. For the better part of the last 18 or so months, our employees have been working from home. We implemented specific protocols for safe work for the critical employees, for the ones that had to report to work such as the clinical trial division and manufacturing, and all non-essential face-to-face engagements were put off for the better part of twelve months. We have since gradually introduced people back into face-to-face engagements but withdrew them again when there were threats of a second and third wave. Secondly, our contribution as an organization was investing in research -we are an innovation company- we looked into vaccines and we are now at the end of a process, doing three clinical trials on a Covid-19 therapy which we think will have an impact not only on the continent but around the globe towards the latter part of this year. Now is the time for innovative companies to innovate as humanity depends on it. The third mandate given to me was not to disappoint the patients, we deliver lifesaving medicines on HIV, oncology, vaccines. It wasn’t the time to have problems with our supply chain. At the beginning of Covid-19, we struggled as we have a huge access business that delivers HPV vaccines across multiple low and middle-income African countries and at the beginning of the pandemic getting vaccines into the countries was incredibly tough and we had to work our way around it. We needed to ensure the delivery of our critical medicines and we did not disappoint patients. We had a lot of insight and input from our global leaders; we could charter planes specifically to bring in medicines or to take them to other countries. Fortunately 12 months down the line I think we have done pretty well, we have ticked the boxes of the pillars of the company's mandate and it won’t stop here. The world changes as the Covid situation changes and so shall we, it is the natural order of things. 

EF: What were the lessons learned managing through a time of transition and a pandemic?

ZB: The biggest lesson I have learned is that digital is a friend; we had got into a rut where everything had to be face to face, always traveling from country to country or moving from province to province for meetings and here we are 18 months later doing 90% of our interactions online and business is still happening and companies are performing. Covid shocked us into a new way of doing things, into engaging health practitioners virtually and even though we are not quite there yet it has been an important jolt and has a wider-ranging impact in terms of environmental friendliness. Another lesson learned was having been made aware of who are the essential workers that keep the company going, not myself or the leadership team but those who keep the organization running from the ground up. The crisis gave us a new appreciation for people who are often unseen within the organization, I come from a community background and was aware of this but now seeing these people never skip a beat, keeping our supply chain and our clinical trials kept going and people getting their medication while I was sitting at home and gave me a new appreciation for what they were doing. The third lesson was that our people care, they all wanted to do more and kept offering themselves up to help and this catalyzed a whole new way of working in our organization. We are building agility and multiple skills in our workforce because we are aware that the future will dictate that, gone are the days when people are specialists in one area. We want to build a workforce that can rotate and add value and we have found that gives our people joy as well. The positive inheritance of Covid is that it has pushed us in this direction. 

EF: Are there any new KPIs that you introduced over the last year? 

ZB: We have standard commercial KPIs which look at sales, expenses, operating income, etc., but we want to utilize innovative experiments in aspects related to digital for the Covid period. We moved away completely from face-to-face engagements and gave our sales reps virtual engagements instead, to see how many virtual engagements they could do. One of our big deliverables is around healthcare practitioner education and we have shifted from the face-to-face environment towards a completely digital one. I was impressed by the response from the healthcare practitioners. On a random Wednesday evening, we would have 500 or 600 doctors dialing into a 6 pm webinar completely of their own choice and these were the kind of metrics we want to measure. Healthcare Practitioner education is an area we do extremely well in and which I suspect is grounded in the content and value it provides but it also showed improvements that need to be made in day-to-day sales and health practitioner engagement and we continue to innovate in this aspect. 

EF: If you had to design a Master in Pandemic Administration program, which two courses would you consider mandatory? 

ZB: I think a course in critical thinking is something that every young person coming out of school needs to do as it allows to dissect problems and gives a person the ability to take a step back and think through problems considering both the positive and negative impact in an ecosystem and track that impact to see if the potential end outcome is aligned with what we are willing to deal with. Secondly, agility, I don’t see us going back to work as we did as we have gone too far developing a new muscle and we are in a far better place than we were 18 months ago. I think critical thinking and agility would be my choices.

We have cross-functioning teams that normally would never have worked together but because of the particular skill set they have they can solve problems that pop up across the business. We recently launched the “Data Squad'' responsible for solving data digital and technology needs within the organization. I was the managing director who decide on implementing an idea and give it to the data squad and they think around how to best bring that solution to life. This is something we never had before and they are people who don’t necessarily report to one manager as they are various people from different pockets of the organization and this is the kind of agility we like to see. HR has been phenomenal during this period and I think we were already ahead of the curve generally going into the pandemic with some of our thinking. The pandemic hitting was an opportunity to experiment on things we already had thought about and agility and cross-functionality were right at the top of our list. We started the process of mapping out critical skills which we believed our employees of the future needed. Gone are the days we see a person solely as a sales representative, but as somebody who can contribute across multiple facets and pockets within the business. We are mapping out those capabilities and bit by bit started up-skilling individuals with those identified capabilities and it has been an fulfilling journey. Through this process we have realized the incredibly talented people we have, to the extent members have gained promotion over this period, there are two very young capable women that have exuded agility and capabilities over the last 18 months and only recently are new members to our leadership team. The same goes for my chief of staff who came into the role quite recently. Coming from running our clinical trials division we moved him into a rotation in our access department where he was working with funders and now as part of his responsibilities are dedicated to his role as chief of staff. It is our way of churning the inner pipeline of talent, we want to send them into the rest of the world and then bring them back to lead in South Africa and the continent. 

EF: How did you manage to attract resources to South Africa at a time they were scarce?

ZB: “Build your network with individuals at a regional and HQ level” was some very sound advice I was given some time ago. I joined just before the first lockdown and couldn’t go to HQ in the US and walk the corridors and introduce myself personally to people there so I utilized the leverage of previous networks. By the time I took over as managing director, I already had the introductions I needed and whenever I had an opportunity to speak to people I always put forward the South African story speaking about the organization beyond financial metrics which they already knew.  People invest because of hope and want to know what the future looks like for the business and the country and an organization and I spent a lot of time sharing what that future would look like, helped by having a very coherent organization and strategy. We knew where our opportunities lay so I was very specific with what I needed, what was the value attached and the outcome to be achieved. The most important thing is building the network in organizations that span over multiple geographies. 

EF: Could you elaborate on the company’s performance over the last 18 months?

ZB: The past 18 months have been a mixed bag, the biggest area challenged was access across the lower and middle-income African countries mostly due to how Covid impacted those countries. Most of the vaccination programs they had in place had to be postponed and there were constant shifts with regards to deliveries into the countries and to make matters worse many of these countries were in various stages of lockdowns. Locally within South Africa, there were challenges with the pediatric vaccination rate both in private and public sectors and we have been doing a lot of work with the South African government investing in education and up-skilling the value chain to bring healthcare to communities to reverse that. Other pockets of the business did well, our acute hospital care business which specifically focuses on antibiotics and anesthesia products did relatively well and we saw a certain level of stability in our HIV business which is chronic. The other pocket of hope was our oncology business which continues to grow in a very challenging environment; all in all, if you had asked me at the beginning of the pandemic about performance, I would have been happy to take our present results.

EF: How were you able to focus on the importance of treatments and diagnosis of chronic diseases with the present focus on communicable diseases?

ZB: From a chronic perspective our portfolio is HIV medicines and there was a huge focus from the government as well as from private healthcare providers such as the HIV Clinician Society within South Africa to drive awareness and education to ensure patients comply with their healthcare. There also is a high level of decentralization of medicine dispensing, people don’t necessarily need to go to healthcare facilities to obtain their medicines. But there is a lot more we can do, on the vaccine side of things we haven’t quite cracked, strengthening the health system on pediatric vaccination to remain high, we can’t do it on our own but I challenge my team to work on this point. We have a partnership with community-based healthcare organizations, nurse runs healthcare institutions within the communities and their healthcare institutions, and we want to take the partnership a step further upskilling those healthcare facilities and practitioners to deliver healthcare services in the communities and not go to a public hospital as at the moment it's not desirable. We want to put these services back in the community and we are already in conversations with a few partners to dispense using healthcare institutions for what can be delivered into the comfort of people’s homes. 

EF: Is there any specific product you are especially excited about introducing into South Africa?
ZB: We have a very busy clinical trial landscape; our clinical trial division in South Africa manages clinical trials across five countries of the African continent. We have a large contingent of about 100 people in our clinical trial department and I am incredibly excited about our new investigational Covid therapeutic as it is a molecule that could potentially make for a huge improvement in the world moving forward. We have started phase three clinical trials and if all goes well towards the 4th quarter of this year we could get emergency use in certain markets. I am also excited about the HIV prep alternatives we are looking into, we are working in that space to find solutions that could be game-changers from a compliance perspective. We do a lot of clinical trial work in multiple therapeutic areas; if my memory serves me well our South African clinical trial division has the second largest allocation of trials outside the US within our organization. We have to research the African market and if we get it right our products could change the landscape across the continent and our work can be seen in the type of products we are developing. To be honest, HIV is something very close to my heart.

EF: What is your definition of access? 
ZB: When every single patient that needs our medication can get it at the time they need it there is access. Even if that concept can be seen as wishful thinking in this space we have to that view. Our medication is complex, it’s for cancer and is lifesaving medication, diseases where people have less than 6 months prognosis and after diagnosis can have a five-year survival rate. This medication marks the difference between life and death and the world needs it. Access, especially oncology access is very close to my heart. My father passed away from cancer and we were fortunate in that we had those 5 years of survival so I know what it means to have 5 more quality years with a loved one and believe from the bottom of my heart is something we need to do.

EF: When you look back to this period in your professional career, what would you like your 2020 and 2021 tenure to be remembered for, what would you like to have accomplished?

ZB: I would like this period to be remembered not only for myself but for the industry as a whole making a meaningful impact and changing people’s lives, we can see this in some of the workaround Covid in the quickness the industry has reacted and moved toward research, to manufacturing and how regulators have all tried to speedily intervene in the best possible way and the impact of science on people's lives. I would also like to take the industry closer to the people, pharmaceuticals have always kept their distance from the people and this in my opinion is a misconception because it causes misinformation, for example, the recent phobia to taking vaccines. We must make a greater effort to engage with the end customers, share information and education and not leave it up to Dr. Google. Technology and social media give us a phenomenal platform and we recently did an HPV education and awareness campaign on various social media platforms partnering with doctors. Because we have a very high social media visibility we wanted to know what sort of impact we could have and one doctor alone on a video engagement session had 16 thousand participants, people joining, listening, and getting educated on HPV and ways to prevent cancer. This is the kind of influence that people like myself of a different generation must-have on this industry.  People need to learn about healthcare and we must influence the world accordingly. I am running a conference for the organization and earlier on today we gathered all our employees to talk about the future of healthcare so they could ideate about the challenges and opportunities and what the future would look like and a point someone made was that we needed to get out of the shadows, we do very important work as an industry and we shouldn’t be shy about telling people about what we are doing.

August 2021
South Africa