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Roche's Marcus Gerund is working to bring healthcare to some of the poorest areas of the world.
Pharm Exec recently spoke with Marcus Gemuend, the head of the sub-saharan African region for Roche. He talks about the extensive programs the company is working on in the region, the barriers they have faced and the progress they have made.
PE: Tell us about your current role with Roche.
GEMUEND: I am the head of the Sub-Saharan African region for our Roche Pharmaceuticals Division. This is a region covering 30 countries – including some of the poorest in the world-and our aim is to create a new and sustainable business model to ensure that patients in the region have access to our medicines.
PE: Let’s take a quick look back at your career. Before you were in your current position, you played a number of key roles at both Genentech and Roche, as well as the Lonza Group in Switzerland. That included a number of c-suite positions where you were responsible for everything from procurement and manufacturing to technical operations. How have each of these positions helped you be successful in your current role?
GEMUEND: I have been lucky enough to have some fantastic opportunities in my career and each one, in some way, has helped shape my experience and success. I began in a global contract manufacturing company, Lonza, as a legal counsel. Even though I chose not to pursue a career in the law, that role gave me exposure to many different parts of the company and that experience helped me define my career path.
Every step-at Lonza, then Genentech in San Francisco and onto my current role in Roche Sub-Saharan Africa-has helped me develop a deeper understanding of our business and develop my leadership skills. The interest in and exposure to different business and cultural environments was critically important to jump into new, unknown areas of business along my career.
I was constantly challenged and had to learn, adapt and expand my leadership style. And all of this experience comes into play today-both directly and indirectly-in addressing the challenges of access to our medicines in Africa.
PE: The work you are currently doing centers around working to improve each step of a patient’s journey by removing barriers to quality healthcare, from diagnosis through treatment for those in the sub-Saharan region of Africa. The goal is to bring quality healthcare to all Africans, regardless of where they live or their ability to pay. What compelled you to want to lead this project?
GEMUEND: Ground-breaking innovation in medical science is only meaningful if it reaches the patients who need it. And in Africa, access to life-saving medicines for diseases like cancer, is extremely limited. I love Africa and I am passionate about trying to change this situation. I want to create a new business model that can sustainably-and this is very important-create access for patients.
It is certainly no mean feat. Much of Africa’s healthcare development has been donor funded and this is not a long-term solution. I believe that if we work with governments, step by step, we can build and support healthcare systems and capabilities and ensure that those who need our medicines have access to them.
PE: I know last year, you made a lot of strides when it came to various programs in Kenya, Nigeria, Ghana and French West Africa. You shifted from sort of a planning stage to an implementation stage and now accessing the impact. Could you give us an example of how one of these programs were developed, executed and now the impact they are having?
GEMUEND: Access to healthcare is a multidimensional challenge and key to addressing the barriers, is really understanding them. A great example of this is what we have been able to do in Kenya. Access to treatment for one of the very aggressive kinds of breast cancer, HER2 positive, was close to non-existent. Awareness of breast cancer is low in Kenya; diagnostic capability is limited and many women do not see one of the few oncologists until it is too late.
Working closely with the Ministry of Health, we identified areas where we could support improvements in diagnosis, training and medicine, always from a patient journey perspective. In our first year, we installed two diagnostic machines and trained five technicians and pathologists in their use; provided five scholarships for oncology nursing; increased screening and enabled 82 women to access state-of-the-art biologic treatment.
We have significantly reduced the time from diagnosis to treatment, which can mean the difference between life and death in the most aggressive forms of cancer. We want to increase this scope in Kenya, make it sustainable and replicate it all over Sub Sahara Africa, giving hope to many patients and their families.
PE: What has been most challenging for you about the role and leading this initiative?
GEMUEND: It is a truly rewarding role. Even when progress is sometimes frustratingly slow, seeing the difference we are making to people’s lives makes it worthwhile. Some of biggest challenges in the role so far have been to rally and align the different stakeholder and players in the field, from governments, hospitals, HCP’s, private industry, to NGO’s and many others, to make investments into NCD’s a priority. And then finding innovative access and funding solutions in a part of the world where to a large part no health insurance exists.
PE: As an outsider in such a sometimes-turbulent region, how have you worked to gain the trust of the stakeholders, such as the government, as well as the patients there? What are some of the barriers that you run into?
GEMUEND: Being based locally has been critical. The more time we spend with our stakeholders – really understanding their issues and their perspectives – the more trust is built up and the more successful the partnerships.
Although I am not from Africa, most of my team and country leadership are, and with their support we have been able to build that trust. Most important is to always have the patient at the center at everything we do, and address the challenges together with our stakeholder from the patient’s perspective.
PE: Given the region your dealing with and some of the challenges you’ve told us about, how do you keep your team motivated?
GEMUEND: I am very lucky in that the teams are very engaged and driven to create access for patients. They understand that their role is to actually bring good cancer diagnosis and care to Sub-Saharan Africa and sustainably improve the health system.
They and their families could be a patient tomorrow, and this motivates and inspires them even more to give everything to change the situation, and give hope and life to people in Africa, who in the past had no chance once they were diagnosed with cancer. We have started to change this, our people are doing it, and that is what keeps them going. They are changing the narrative, and are the generation that truly changes the outlook for cancer patients in the face of so many obstacles and barriers.
PE: So, a lot of the people we talk with for Pharm Exec tend to have a medical or business degree. You, interestingly enough, have a law degree. How do you think that training has given you an edge in the pharmaceutical industry?
GEMUEND: As I mentioned earlier, it gave me exposure across many areas of different businesses early on in my career than I would have done otherwise. This broad exposure helped me to find the path that led me to be in Africa now, where leveraging on all the experience, while constantly learning new things, I can make the biggest impact.
PE: Final question, we are going to ask you to pull out your crystal ball and look 10 years into the future. What does the healthcare landscape in sub-Saharan African look like? And, what strides have you and your team made?
GEMUEND: I can answer this question in two ways:
First, in terms of a specific goal, I would like to see all women who have breast or cervical cancer have access to the right treatment; African patients should have survival rates in line with Europe and the US; and health systems recognizing the value that their investment in healthcare is bringing. And I want my team to be a part of making that happen!
Second, what I’m already seeing and anticipate will be the model of the future, is increased multi-stakeholder collaboration. Improving access to care requires listening and adapting, and I’m optimistic that the health and well-being of Africans will improve tremendously in the next 10 years based on the types of smart investments and partnerships that we – collectively – are making together.
One example of this is Access Accelerated, a unique cross-industry collaboration. For the first time, 24 global biopharmaceutical companies, including Roche, have come together to bring their global reach and local expertise in partnership with countries, civil society, multilaterals and NGOs to support cross-sectoral dialogue and drive on-the-ground implementation and action plans to address non-communicable diseases, like cancer.
In Africa, for example, Access Accelerated is working with the World Bank and the Kenya Ministry of Health to develop scalable solutions for non-communicable diseases in primary care in Kenya. This is the kind of work that I believe will play a critical role in coming together to improve access to medicines for all Africans.