Only a 100 percent ethical business is the right business to be conducted.

Pius Hornstein, Country Chair, Sanofi China


Some key themes arose when asked about qualities that are considered important for a country manager in Brazil. Pius Hornstein of Sanofi believes the first and foremost priority is for a country manager to have a strong value system, explaining that for Sanofi, “The first priority was to establish the highest standard of ethics and integrity. This was driven by a deeply engrained positive culture of training and full comprehension of all employees that only a 100 per cent ethical business is the right business to be conducted.”

The general consensus between the three country managers is that strategic agility and adaptability are essential qualities. Rolf Hönger, Area Head of Latin America at Roche, believes that it is important to have “good strategic agility with very good adaptability to a changing environment, proven resilience, and good at stakeholder management due to an extensive focus on the outside world.” César Rengifo of GSK turns the focus to understanding the needs of patients and adapting accordingly: “This leader has to understand the different realities of our patients, and how our products enable people to live better lives. He or she also has to be able to communicate with the different stakeholders, understanding what is the best way to approach them, being aware of the local dynamics and how to ensure the successful delivery of our messages and build trust. He or she has to understand the healthcare system and be a player within it. Become a key partner and healthcare system stakeholder.” 





We need a leader who can manage a broad portfolio of products that span across different therapeutic areas that help and support the health needs of different populations.

César Rengifo, SVP and Area Director Emerging Market West, GSK



Another key to country manager success, according to these seasoned professionals, is a deep business and market understanding. Rengifo stated, “It is important that a candidate for the country manager position has vision and understands how to take GSK Brazil to the next level. Our company is shifting, we are strengthening our innovative portfolio, we will become more robust in the area of oncology and specialty medicines, therefore this person has to understand this market and how to become a leader in it.” Rengifo went on to explain how understanding products and patients is crucial, “We need a leader who can manage a broad portfolio of products that span across different therapeutic areas that help and support the health needs of different populations that are crossed by different dimensions or exposed to different realities impacting their health: life stage, life preferences, geography and social environmental conditions, among others.”  Hönger is of a similar opinion, elaborating that a qualified leader has a “thorough understanding of the pharmaceutical business and due to the internal and external complexity we prefer somebody with a good network within the company.” 


Hornstein and Rengifo agree that performance and ambition are key attributes. Hornstein said, “We were fully committed to building a high-performance organization with clear accountabilities, rewarding those teams and individuals very distinctively who contribute and make a difference.”  Rengifo considers ambition among the top strengths of a country manager: “The person has to be an outperformer. Our goal is to always beat the market, so the person has to be moved by ambition. GSK is the fastest-growing company in Latin America, according to IQVIA, and Brazil is our main growth driver.”


Hornstein, Hönger and Rengifo commented on what an ideal professional pathway to becoming a country manager might look like. All three agree that experience is key for leadership success in Brazil. Hönger explained, “I do not see an ideal pathway, however, I think the country manager has to have previous general management experience and a good understanding of Emerging Markets.” According to Hornstein, culture and market experience is most valuable. “In my view, there is no such thing as an ideal profile or pathway. People should have different experiences and styles and we put great value on diversity. However, certain experiences are important in order to succeed in fast-moving and complex markets like Brazil: for example, experiences with other markets, including emerging and mature markets, would be a necessary preparation. Take soccer as an example, you can’t win a world cup without experiences at club or country levels. Rich experiences working in other countries, and the necessary cultural openness are required to enjoy working and win in Brazil.”  Rengifo believes that experience in commercial roles is useful, but not mandatory: “People performing commercial roles are classical candidates for a country management position. However, I am convinced that leaders can come from all kinds of backgrounds.”





“The Country Manager for Brazil has to have a good outside focus as he will have to address the many access issues the country has.

Rolf Erik Hönger, Area Head of Latin America, Roche



Finally, the three elaborated on the challenges a potential country manager in Brazil might face, saying that the country’s market size presents the biggest challenge. Speaking about the sheer geographical size, Hornstein stated, “Brazil offers great opportunities that come with important challenges for leaders. Firstly, the size and complexity of the market: Brazil is fifteen times bigger than France in geographical size and three times more populous.” Hönger spoke more about market access, saying that “The Country Manager for Brazil has to have a good outside focus as he will have to address the many access issues the country has. The size of the operation and the importance of the market as well makes it complex within the company and he needs to be able to work well with the headquarters.” Rengifo mentioned additional market issues such as “pricing pressure, fierce competition, the typical dynamics all countries face in Latin America: inflation, recession, devaluation.” Hornstein spoke on the maturity of the market, “Brazil also stands as an imperfect non-mature market, with some parts of the Brazilian pharmaceutical value chain not matured, such as distribution and pharmacy chains… the Brazilian healthcare landscape is expected to go through a fundamental transformation in the upcoming years.” 


Internal and external culture issues present another kind of challenge.  Hornstein advised that “one needs to be able to truly connect with the local culture and people, which are rich and warm in nature. This is an enriching personal and emotional experience. It is definitely not a command and control culture, but a culture where you can get the best of your teams if expectations are clearly defined, managed by collective aspirations and clear accountabilities, and achievements are collectively celebrated.” Rengifo added that internal company culture is an adjustment for some: “Supply issues are sometimes in the equation, time to market for some products. GSK is a company with the highest compliance standards, for instance in terms of the interaction with HCPs, GSK cannot pay speakers or fund travels to medical congresses, our relationship with HCPs is purely based on science. For people already in the company, this is easily understandable and manageable, but for people coming from the outside this could be a challenge they will need to learn how to address.” 



Pius Hornstein counts over 20 years with Sanofi, currently working as General Manager and Country Chair of Sanofi China. Hornstein served as Country Chair of Sanofi Brazil for four years, focusing the company’s efforts Sanofi Genzyme, Medley, Specialty Care, Diabetes, and established Care. Prior to Brazil, he focused on leading teams in the Middle East and in Europe.


Rolf Erik Hönger has worked for 26 years in varying capacities at Roche. Hönger is currently the Area Head of Latin America in Sao Paulo, Brazil, having been appointed in September 2018, and counts over 20 years of experience in Latin American pharma markets. His aim is to ensure Latin American patients access to innovation in healthcare.  


César Rengifo started his career with GSK in 1998 as Vaccines Business Director and counts many years of experience working as a general manager in Latin America. Rengifo currently serves as SVP and area director Emerging Market West in Rio de Janeiro, Brazil.