A big dose of innovation for pharmaceuticals in SA

The role that pharmaceutical companies play in improving the health and welfare of the general population is one that is often overlooked.

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The role that pharmaceutical companies play in improving the health and welfare of the general population is one that is often overlooked. Not only do their medicines save lives, improve health, and prolong and enhance the quality of life, but medicines also have the potential to reduce overall healthcare costs by speeding up recovery times, as well as the need for surgery and hospitalisation.

While researching and developing new medicines form a large part of their operation, pharmaceutical companies are also working to improve medicines, ensuring better adherence and compliance due to simpler dosage regimens, improved delivery systems and fewer side-effects.

The Innovative Pharmaceutical Association South Africa (IPASA) was established in April 2013 to represent and provide support to these companies, creating a respected association uniquely positioned to engage with stakeholders in both the private and public sectors. IPASA currently represents almost half of the big pharmaceutical companies operating in South Africa, and it aims to build a sustainable environment for these companies while ensuring better access to innovative research-based healthcare.

“In April 2013, Innovative Medicines South Africa (IMSA) and the Pharmaceutical Industry Association of South Africa (PIASA) integrated to form IPASA. It was a necessary move as they were essentially two associations serving the same industry. Both organisations covered the same interests and issues; from intellectual property protection to regulatory delays of products’ registrations. Historically, the industry association was called the Pharmaceutical Manufacturers Association (PMA), and it was a difference of opinion over taking legal action against the Department of Health that split the pharmaceutical companies into these two groups. Over the years, there was a growing need to form a united body, one that represented the interests of all stakeholders,” explains Dr Konji Sebati, IPASA’s CEO.

“As a voluntary association, our primary aim is to promote the research and development of innovative pharmaceuticals, contribute positively to a patient-centred health system and bring the benefits of these breakthrough treatments to patients across South Africa,” she adds.

Spanning the entire pharmaceutical value chain—from research and development, safety and pharmacovigilance, continuing medical education to manufacturing and distribution—IPASA also supports initiatives in both the public and private healthcare sectors to help develop practical solutions to address the country’s most pressing healthcare challenges. IPASA’s philosophy is one of collaboration with other role players in the healthcare sector to achieve maximum benefit from the latest discoveries and technologies in the field of pharmaceuticals.

“By promoting significant investment in research and development, advancing ethical conduct and setting the bar for excellence in the pharmaceutical industry, we believe we are improving patients’ access to more effective, convenient and safer drug therapies. These research-based organisations spend billions annually trying to discover new medicines for unmet medical needs, and all that research is done worldwide, including South Africa. SA offers some of the best medical facilities in the world, and we boast a highly respected scientific community; and some researches are internationally recognised and respected. We have a few world players.

I think it’s important for our local scientists to have the opportunity to be a part of international research. These companies also provide educational opportunities for young scientists and help us to continue to shape the environment in SA as one of excellence in research and development. I think we are already a force to be reckoned with but we are still growing and there is still a lot that is being done to improve this,” she says.

IPASA currently has 26 members, including well-known names like Pfizer Pharmaceuticals, Bayer, GlaxoSmithKline (GSK), Merck, Roche and Lilly and Novartis, where each one has their own unique focus on a specific disease area. While many of these companies are considered competitors, their research and results are still invaluable in assessing patients’ responses and ensuring the best outcome.

“They are also expected to abide by our code of ethics. And while we are not a regulatory body, there are still ethical standards to ensure self-regulation. This speaks to everything from their marketing and advertising to their sales reps’ behaviour, as well as their social responsibility to each other, the environment and the community around them. We promote the spirit of Ubuntu and expect our members to behave accordingly.

“I think it’s also important to grow this industry locally and build on our expertise here; we can’t always depend on research from abroad as there are certain biological, environmental and even genetic nuances that need to be considered for the final product. We are also, as a country, able to put more emphasis on research for disease areas that affect us most, like multi-drug resistant tuberculosis (MDR-TB) and HIV,” adds Dr Sebati.

Finding the right medicine

Although much progress has been made in developing new medicines in the last few decades, innovation remains an essential component of the global healthcare industry. Unmet medical needs, the emergence of new infectious diseases and the so-called superbugs that are due to increasing resistance to existing treatments; this brings new challenges to the world of research.

“We believe that it is critical to continually gather the commitment and support of all our pharmaceutical stakeholders and to establish effective networks and partnerships that will continue to boost innovation, improve treatment and save lives.

“We are a member of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), which allows us the benefits of being part of the international pharmaceutical world—new trends, new research, new ideas etc. Our biggest and most important objective is to continue to strengthen and build on our relationship with the Department of Health, a relationship not only based on solving problems, but on trust and transparency,” says Dr Sebati.

South Africa’s pharmaceutical industry does more than provide health-promoting medicines to South Africans. It also makes a substantial contribution to the region by investing in local healthcare and ensuring the continued access to new medicines. In addition, pharmaceutical companies stimulate the local economy through employment, taxes, skills development and technology transfer.

“It’s also important to remember that, should these research-based pharmaceutical companies fade away; this would prove disastrous for the generic companies who would no longer be able to continue to exist without the innovative companies and the research they carry out. IPASA also understands that as an industry, we also have to do our part, acting as partners in healthcare. While we do acknowledge that some of the newer medicines are prohibitively expensive, an environment of collaboration and partnership can ensure that these medicines are made available to most, even in the public sector,” she says.

According to Dr Sebati, as much as there is currently a lot of research being conducted worldwide on a wide range of diseases, including TB, HIV and malaria, it remains important to continue to invest in research and development for non-communicable diseases like diabetes, cancer, hypertension etc., and other neglected diseases, Neglected Tropical diseases, which we fortunately do not have a problem with in South Africa.

“Vaccines are also a strong focus in R&D because, if you can prevent disease completely, ultimately, it is less costly to a country. The HIV vaccine may still be evasive, but it’s something the pharmaceutical industry has been working on for many years. We are not there yet, but pharma is hellbent on finding a solution,” she says.

She also reiterates that it can take a lifetime for a research team to come up with just one treatment. It takes almost eight to 10 years to come up with a medicine that is safe and efficacious, with thousands of molecules falling by the wayside, and millions of dollars spent already. Sometimes, however, some of these medicines are discovered inadvertently—researched for something only to find out that some of the side effects are effective for something else, like the story of Viagra, a great example of a chemical that was initially being researched for a heart condition, only to find that one of its side effects was a possible cure for erectile dysfunction,” Dr Sebati says.

South Africa is not unique, but faces many of the same challenges other developing countries do, where we are faced with low-income areas and people are more vulnerable to certain diseases as a result.

“But we also see diseases of the First World, like obesity as well as lifestyle diseases that stem from the nature of our economy and education. What really makes us different is how these challenges are diagnosed and treated. We need to put efforts into educating our communities, increasing awareness and a better understanding of the implications of certain lifestyle choices. The response from the community itself is equally as important as the government’s,” she says.

Biotech—a new playground for pharma

With South Africa working to grow and develop their biotechnology industry, IPASA was proud to co-host the inaugural BIO Africa Convention—Africa’s Biotech Indaba—in August last year, a first of its kind in Africa, with the aim of supporting and boosting the bio-economy across the continent.

Under the theme “Africa: Open for Business —Together building the Bio-Economy”, the BIO Africa Convention provided a platform to network and unlock the potential from Africa’s unique microbial biodiversity, offering opportunities for the strategic and consistent investment in cutting-edge technologies to enable the discoveries for new, industrial and relevant bio-molecules.

Biotechnology has been identified as an area with great potential for the growth of the South African economy and the development of society in general, and four bioprospecting and product development flagship projects have already been launched involving traditional medicines, cosmeceuticals, nutraceuticals and ceramics.

“We got involved because we wanted to encourage and build on health biotechnology and become more involved in the Department of Science and Technology, which has already developed a biotechnology economic strategy that looks at how biotechnology can contribute to the economy while highlighting the advances made in South Africa on biotech research. Overall, the convention was a great success, there was a lot of African interest, and we are hoping to grow this convention in future. I, personally, was also surprised by how much research is already taking place at universities on this topic, so it may still be a small area, but it is definitely growing,” Dr Sebati enthuses.

A colourful career

The current CEO of IPASA, Dr Sebati has over 25 years’ experience in the public and private sectors. She started her career as a Medical Officer in paediatrics and child health for several years before managing 21 primary healthcare clinics in the peri-urban rural areas outside in Pretoria.

She then joined the private sector, working first with Roche as a Medical Advisor and then with Pfizer Laboratories as a Senior Executive in Medical and Corporate Affairs, in South Africa and at the Pfizer headquarters in New York.

In 2004, she was appointed as South Africa’s Ambassador to Switzerland, the Vatican and Liechtenstein, and in 2008, she was appointed as the Ambassador to France, the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Organisation for Economic Co-operation and Development (OECD). She later became an International Civil Servant for a United Nations agency, the World Intellectual Property Organisation (WIPO), based in Geneva, as the Senior Director heading the Department of Traditional Knowledge and Global Challenges.

Dr Sebati holds a Bachelor of Science degree from the University of the North (now the University of Limpopo), an MBChB degree from the University of Nairobi, Kenya, a Diploma in Child Health from the College of Medicine, South Africa, a Diploma in Hospital Management and Health Planning from the Technion in Haifa, Israel, and a Diploma in Public Health Planning and Health Services Management from the University of the Witwatersrand.

“I really wanted to be a Paediatrician but I found it very depressing, even heart-wrenching to lose a baby in your hands, and so I decided to study hospital administration, public health administration and health planning instead. I found that very interesting and truly enjoyed public health as a core to any efficient health system. When I became frustrated working for the government, where a lot of those same challenges still exist today, I joined the pharmaceutical industry. I loved working for Pfizer and understanding first-hand the world of research and development, and the ideals that drive the pharmaceutical industry. Being transferred to New York was a highlight in my career.

“I was appointed as an Ambassador during Mbeki’s presidency and, at that time, he wanted a mix of ambassadors from various professions. When my time came to leave WIPO and Geneva in 2014, I was recruited by IPASA, which had just been formed in 2013, as the CEO. It was interesting that I got this job because at that time I was thinking of running a consultancy for pharmaceutical companies. I recognised that the pharmaceutical companies and the government, especially the Ministry of Health, weren’t working optimally, let alone with service providers, funders and patient groups. This job really just landed on me and in the end, it was exactly what I wanted to do,” she recalls.

A big part of Dr Sebati’s job is to build relations with various stakeholders, making an effort to depict the industry in a different light—as part of the healthcare value chain and not just a provider of medicines. And while she acknowledges that, at the end of the day, they are businesses that need to make money, what they deliver in return cannot be ignored.

“One of the things I am most passionate about is working with the government to provide our medicines to all South Africans—in the private sector and public sector, irrespective of the price of the medicine. Legislation plays a big role in this but because of the current policy, the public can’t access a number of our lifesaving drugs. We need to begin to talk about this with the government, and I can assure you pharma is willing and ready.

“As regards public health activists; they play a very vital role in healthcare delivery in this and other countries, and it is important that they too regard us as healthcare partners than see us on the other side of the fence. I would much rather we work together to make medicine accessible. It’s not a smooth road and there are still lots of hurdles for me, but until we are able to build a trusting relationship with the Department of Health, these problems will continue,” she says.

Dr Sebati also believes that having such a global experience, and of the African continent, has given her a different perspective on life.

“I’m grateful to the different working environments I have been exposed to. I have been enabled to think very globally and very differently. I’ve also come to learn to appreciate the differences and nuances about people, countries, governance and leadership. This has really helped because I’m still working with different types of people culturally, as well as different personalities. My journey has opened the world up to me, and I can use and do apply what I’ve learnt as much as possible,” she says.

According to her, the industry is still very male-dominated; the scientific world is still very male-dominated, but women have made great strides in the field and even in IPASA, we have a good representation of female CEOs/general managers.

“How I have survived and grown in my career over the decades has been because I am an amicable person, but with very strong views on some issues, while not being an aggressive or abrasive person.

“I always manage to find a way of putting my point across firmly and gently. I also give people a long rope at times, the benefit of the doubt; but when I detect arrogance, subtle racism or feminism, I respond differently and can be quite firm.

”As a leader, I like to see my colleagues progress and do well and I encourage them to improve their skills all the time, be confident, be determined and be focussed, because this is how I have been throughout my life,” she says.

Her passion comes from seeing improved health, one of the biggest reasons for her choosing a profession in the medical field. Besides that, her mother was a Nursing Sister at the then Baragwanath Hospital (now Chris Hani Hospital) and her father was a Fort Hare graduate with a Bachelor in Health Sciences. “If I could live in an ideal world with empty hospital beds, less disabilities and ailments, people not dying from preventable diseases, pharma that continues to pump money into finding cures and an environment that supports innovation, effective and efficient partnerships with the Ministry of Health and all its divisions, and trust and collaboration with healthcare providers and funders; it would be a pharmaceutical career well worth followed and etched in my heart,” Dr Sebati concludes. 

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