Ties that bind
This broader vision of Europe as a homogenous region is matched by a new strategy for the industry at the global level. The
same CEOs that appointed Bergström are attempting to revitalize the IFPMA, based in Geneva. Relations with the biggest player
of all—Washington-based Pharmaceutical Research and Manufacturers of America (PhRMA)—whose annual budget far exceeds EFPIA's
much more modest resources—have also evolved.
The long history of a "delicate," turf conscious relationship between the two organizations in Europe was one of the factors
that drove the restructuring at EFPIA. The story has it that PhRMA was pressured to close its office in Brussels (and its
parallel lobbying activities in EU circles) in exchange for seats for US-based company CEOs on the new board of the reconfigured
EFPIA. Bergström, who was involved in those discussions in his capacity as head of Sweden's LIF, offers a more nuanced version.
PhRMA "no longer has an office in Brussels, but links are still close," he says, emphasizing that increased communication
with Washington has led to better consensus. The mechanism for consultation has also been more specifically defined. "There
is an understanding that while the chair of EFPIA's executive committee is from a European-based company, the vice-chair will
by tradition be a PhRMA appointee," he says.
Bergström suggests that the shift was dictated by the need for a greater degree of strategic consensus as the stakes became
higher in the European policy debate. "Today, we have to challenge countries like France and Germany at the highest political
level and talk to the International Monetary Fund or the EU Commission on Portugal or on Greece. For that, it is imperative
we go forward with a single consistent message." The consequence, whatever the reasoning behind it, is that of the 26 companies
on the EFPIA board at present, 17 are European and nine are US-owned.
A US putsch?
Despite the improved structure, there remains some smoldering resentment in parts of the European industry over what many
saw as a putsch by US firms—in which the recent reorganization amounted to a reverse takeover, creating a sort of European
PhRMA. And smaller firms, and smaller associations, can be heard to mutter about marginalization of their role in the new
Parallel US policy activity in Europe has not ceased entirely. Some local groups of US companies continue to operate in parts
of Europe, such as the United Kingdom. "These groups are very helpful, particularly in central and eastern Europe, where national
associations are still in a building phase," says Bergström. "The US flag is a good one to wave in some countries, so it's
often good to get help from US diplomatic missions." Meanwhile, most of the effort that PhRMA used to put into lobbying in
Brussels has been switched to emerging markets, he says, with a focus on assessing how the industry can make sure it has a
sustained presence in the right debates in China and Russia.
The new man is also having to bed in the new configurations of the expanded EFPIA. In addition to the constitutional changes,
membership has grown in parallel to the recent enlargements of the EU into the former Soviet bloc. Even further, in fact,
since the Russian and Ukrainian pharma associations have also been admitted to EFPIA—a step that the EU itself is a long way
from making. Inevitably, it is taking some time for the culture in many of these countries to adapt to new norms, and it falls
to Bergström to push things along there.
"It all fits together, and the way that CEOs have arranged things with the leading associations is that we work together in
the policy space," he says. He points out that EFPIA has obtained from the board a slightly increased budget for next year
for the sole purpose of supporting good policy development in the emerging markets. "If China wants an HTA system we should
help them to see what's happening here in Europe. And in regulatory terms, Russia's insistence on its own clinical trials
rules, Turkey's desire to impose its own GMP, or China's particular take on biologics all pose challenges. There's a real
mission for us in Europe in helping these countries to develop suitable models. The point is we are no longer a national or
regional industry. This is a global industry, so 10 years from now Chinese companies could be EFPIA members—and we would welcome
them if they subscribe to the same philosophy on adding value to society with ethical science and innovation."