Biogen’s manager for the Middle East, Africa, Russia & CIS, Turkey (MART), Ajai Sulekh, discusses the company’s five-pillar strategy to expand its footprint in the region, the importance of its newly established technical & scientific office in Saudi Arabia, and why the Kingdom is part of “almost every discussion” about Biogen’s future global plans. In addition, Sulekh highlighted that Biogen has begun its journey in Alzheimer’s disease and talked about the untapped opportunities for the American company’s portfolio in neurological and neurodegenerative diseases in the region.


Can you begin by introducing the professional trajectory that led you to Dubai as head of Biogen’s regional operations?

My career started in 1990 in Japan after completing my Master’s in Bridge and Structural Engineering at the University of Tokyo and can be divided into three phases. The first phase was focused on construction and industrial design, the second in strategy consulting for Andersen (now Accenture), and the third in pharmaceuticals. I worked for Eli Lilly, Abbott, and MSD at their New Jersey headquarters, before joining Biogen’s Japanese office in 2017. Today, I head up the company’s operations across the Middle East, Africa, Russia & CIS, Turkey (MART) region.


After such multi-industry experience, including over 15 years in pharma, what attracted you to Biogen in particular? Was it the company’s CNS-focused portfolio?

Biogen’s focus on neuroscience was quite relevant to me, indeed, because of the high level of unmet medical need in that therapeutic area.

As societies age, neuroscience diseases become more prevalent. However, neuroscience diseases are not only a concern for elderly people; they span rare diseases such as spinal muscular atrophy (SMA) which can affect the very young all the way to amyotrophic lateral sclerosis (ALS), stroke, and Alzheimer’s.

I was attracted to Biogen because of its aspiration to be a pioneer in neuroscience; the company has a fundamental belief in the power of science and has an unflinching focus on patients and caregivers. I strongly believe in Biogen’s mission.


How do you define Biogen’s overall strategy in such a vast region, composed mostly of emerging countries with varying levels of income, healthcare infrastructure and awareness of neurological diseases?

Although the MART region covers many different countries, all share the need to raise awareness about devastating neurological diseases. Working closely with governments and authorities is highly important to help their citizens throughout the full journey of their disease, from early diagnosis to treatment.

Biogen’s strategy revolves around five pillars that help us add value to healthcare systems.

First, we want to ensure that our strategic footprint is there to better serve patients and the local environment. Second, at Biogen we know science and we want to make sure that we bring our scientific expertise and knowledge to every part of the world, not just through our therapies and medicines, but also through the scientific research we can conduct.

Third, we want to expand our footprint and increase the scientific knowledge to better serve the patients; our purpose is to help patients live better lives. Fourth, we want to be a great partner that adds value by collaborating with local authorities and medical partners. Fifth, we hire exceptional individuals to make all this possible.


You mentioned the need to raise awareness in the MART region as a top priority. Can you elaborate on it regarding the Middle East in particular and how Biogen is looking to make an impact?

Awareness is one of the most challenging pieces of the equation. Neuroscience has been a challenging area for the pharmaceutical industry, but Biogen knows the importance of persisting in it.

In the Middle East, the awareness and diagnosis of neurological diseases is fairly low. While some diseases are better served than others, healthcare providers often lack the resources to fully serve patients in these areas. Additionally, patients are generally not aware of neurological diseases, making it hard for them to detect warning signs.

Collectively, the more we increase the awareness of patients, physicians, and authorities, the better outcomes we will see for patients and their families. This last part is important because neurological diseases take a high toll on the entire family, not just the patient. A child living with SMA needs the ongoing support of the parents and an Alzheimer’s patient needs a caregiver watching over them daily.

To put this in context, there are almost 50 million Alzheimer’s patients around the world, including a large quantity in Saudi Arabia.


Have you felt the impact of the renewed focus on mental health during the COVID-19 pandemic from the media and health authorities?

I believe the COVID-19 pandemic has created a sense of urgency to look at the overall well-being of society from a broader perspective. The effects of a prolonged emergency and lockdowns in the psyche of human beings has come to the forefront for the right reasons. Today, it is better understood that comorbidities of mental disorders are just as important as the disease itself.

Because of this, pharmaceutical companies have continued to invest in the science behind them. At the same time, health authorities now have a broader understanding that it is everyone’s responsibility to join hands and do their part. A collective team effort with a sense of urgency is needed to bring answers for patients and families in need of help.


Can you elaborate on Biogen’s historical presence in the Middle East and how it is seizing on the opportunities present in the expanding Saudi Arabian market?

Until very recently, Biogen operated in the Middle East through local partners, but in September 2021, the company began its own operations in the Kingdom of Saudi Arabia with a newly established technical scientific office that is supporting local health needs in the neuroscience space.

The feedback we often receive in the region is that awareness of several neurological diseases is low, that doctors do not have the necessary tools, and that patients often only have access to neurologists at large centers. Stigma is another challenge in several countries where families hide their loved ones, so they are not judged by society, making diagnosis slower.

In Saudi Arabia in particular, the current healthcare system is going through a transformation towards becoming value-based and centered on the health of patients, which is a positive development. The country’s transformation will allow Biogen to introduce its innovations directly, create value, and provide research that informs public policy. It is important for us to work hand in hand with the Saudi government to improve the quality and efficiency of health services.

The Kingdom of Saudi Arabia is a part of almost every discussion around Biogen’s future plans globally. We understand its importance as a regional hub for MENA. Right now, Biogen is at the beginning of the hiring process and hopes to attract more local talent to help us grow our scientific knowledge and work more closely with stakeholders.


You are hiring more employees for your Technical Scientific Office, what are your key aspirations ?

At Biogen we want to support patients. There are challenges, of course, but we have overcome these before in other countries. As we work to bring innovative therapies for disease areas within neuroscience, we see a need to work with stakeholders to develop ecosystems that provide better diagnosis, including opening up the genetic testing pathway.

Our aspiration in the Kingdom of Saudi Arabia is to be regarded as a pioneer and leader in neuroscience, becoming the partner of choice for stakeholders. To succeed, we must deliver on our mission by introducing new medicines for the Saudi population, working with local leaders to expand the knowledge base about neurological diseases and treatments, understanding the local patients and caregivers needs, collaborating strongly with the local stakeholders, and investing in the development of local talent.


The Saudi Ministry of Health estimates that there are 130,000 Alzheimer’s patients in the country. Some can potentially benefit from Biogen’s Aducanumab, recently approved by the US FDA. What is your strategy for that asset in Saudi Arabia considering that the Saudi FDA regularly follows the lead of their counterpart in the United States?

Alzheimer’s disease affects a large number of people, and many remain undiagnosed. While I cannot comment on our product pipeline, I can say that our hope is to help patients all over the world, including Alzheimer’s patients in the Kingdom of Saudi Arabia. Early access programs are always taken into consideration on a case-by-case basis for each product. For example, we have a risk sharing program in Saudi Arabia for SMA patients which is already benefiting many families.


Is the company looking to introduce its biosimilars portfolio to Saudi Arabia, particularly at a moment when the kingdom is aiming to balance its healthcare budget through Vision 2030?

Biogen’s biosimilars portfolio is currently expanding to more and more geographies as we try to offer relief for rising healthcare budgets, making room for innovation at the same time. Conversations with KSA authorities about our biosimilars portfolio will come at a later time.


Is there a final message you would like to communicate about Biogen in the MART region?

Our aspiration in the mid- to long-term is to continue being regarded as pioneers and leaders in neuroscience across the region and become the partner of choice. I want to underline the five key areas that will allow us to make that aspiration a reality: expanding the footprint in neurological diseases, bringing scientific innovation, focusing on understanding local patients and caregiver needs to provide answers, collaborating strongly with local partners to have better stakeholder engagements, and investing in the development of local talent’s skills and capabilities.

Saudi Arabia will become an important country as part of the MART region for Biogen and I am personally excited to visit the country soon.