After a successful international career, Andre Vivan da Silva recently returned to his native Brazil to become GSK’s country manager. He explains the importance of vaccination, in Brazil, and HIV in a country where GSK’s products treat at least

half of its HIV patients. He also speaks about the company’s ongoing clinical trials and the critical role that the government plays in healthcare.


You have a long career in the pharma industry and with GSK. Can you share your background?

I have been in the industry for 28 years and out of those years, I have spent 13 at GSK. During the first 15 years of my career, I worked at Lilly, Lundbeck, Organon and Schering Plough and then joined GSK in 2009. I spent three years as a business unit head in Brazil, and then ten years in Europe, which ended up including China.

To give you an overview of my responsibilities before coming back to Brazil, I managed commercial operations for emerging markets for two years, which included six months in China. Then I spent three years managing the primary care business in Italy. After that, I was the general manager in Romania for almost two years. Then I embraced the whole Southeast cluster, which includes 11 countries for another two years. Finally, I went for a global role and led a portfolio of vaccines in Belgium before coming back to Brazil a year ago.


You have moved around quite a bit and taken on varied responsibilities in diverse markets. What lessons have you learned from your vast experience in different countries?

The most important thing when you start moving around as I have is to understand the implications and manage the setbacks. Going to a different country is exciting but you need to think about the setbacks you may encounter and how you will manage them in order to avoid surprises. Apart from that, I have learned some important things on my journey: sensitivity across cultures, which has given me the ability to deal with diversity in a more natural way; context reading, which is important in a role like the one I have here in Brazil; and matrix management.


Brazil is among the world’s top pharma markets. How important is it for GSK?

To give you some perspective, Brazil is the eighth largest pharma market in the world and GSK is within the top six biggest companies in the Brazilian market. Additionally, we are the second fastest-growing multinational in Brazil with year-on-year growth above the overall market rate. GSK is very well connected with the priorities of the Brazilian government, which means that the company plays a critical role here.


What are some of the factors behind GSK’s strong positioning in Brazil?

Firstly, we have long known how to maintain our strengths here. We are now advancing an omnichannel approach; however, we do believe a certain centricity is needed on the customer side and that is why our sales representatives play an important role in Brazil. When you ask customers here, 70 percent say they prefer face-to-face contact.

Also, the product lifecycle in Brazil is longer when compared to Europe and the US. Here, companies can stretch brands and their lifecycle much further. Another important factor is that Brazil has a largely private healthcare market, which means that GSK is able to perform in either private or public markets due to our portfolio mix.


In your view, does the government need to play a bigger role in Brazilian healthcare?

After observing the healthcare systems in Europe, I would say that the government needs to pay higher attention to the incorporation of new technologies. This is especially true because 60 percent of the drugs that will be approved in Brazil, in the next five years are specialty drugs. We have 32 clinical trials running in Brazil, many of which are in oncology. If you look at the profile of these specialty products, the government will need to step in because of the cost and the burden of disease.


Is there a general awareness in Brazil of the need for greater governmental involvement in healthcare and how connected is that to the current political environment?

Over the last ten years, the agenda has remained largely the same. First of all, the Sistema Único de Saúde (SUS) [Brazil’s publicly funded health care system – Ed.] has been maintained. The priority areas for the government such as vaccination, HIV, primary care programs and to a lesser degree oncology, are separated from general funding budgets because they believe these areas are strategic ones.


You mentioned that GSK is aligned with the government on vaccines and HIV. How does the pharma industry work with Brazilian policymakers?

Firstly, we work as an association through Interfarma, which groups innovative multinational companies, and then through Sindusfarma. Those are the two main reference points we have in Brazil. Through these associations, our agenda includes three main topics: patents, regulatory timelines, and access to medicines. Then, depending on the connection between the government’s strategic agenda and the company´s portfolio, it can engage directly with the government. For vaccines, GSK represents 70 percent of the national immunization program and it is important that we manage that together with the government. For HIV, we provide better health for 500,000 people, which means that half of the population with HIV in Brazil takes a GSK product.


Does GSK have any vaccine manufacturing capabilities in Brazil?

GSK decided to invest in long-term partnerships with local public manufacturers almost 4 decades ago, strengthening local capabilities aligned with the government’s priority of being self-sufficient in that area.


Vaccination awareness varies a great deal from country to country. What is Brazil’s level of awareness?

It has one of the highest levels of awareness globally. There was a survey right after COVID that among 12 countries found Brazil had the highest level of awareness about vaccination among adults; in children, it was even higher. .. However, this is an area we are going to need to pay attention to because coverage is getting lower and lower for children. The average in Brazil used to be 90 percent coverage for children, but this now stands at 60-65 percent.

I think the cause of that drop is that during COVID parents were scared to bring their children for vaccinations and kept postponing them. Now we are putting a lot of energy into trying to regain the level of coverage we had before. Just yesterday, I heard some news about a meningitis outbreak in Brazil, so I think we need to have a sense of urgency.


GSK just launched a shingles vaccine. How long does it normally take for new vaccines like that to be adopted in Brazil?

It normally takes 12 to 18 months for regulatory approval, then three months for pricing approvals. What is important internally is defining a country as a strategic country, which is what is happening with Brazil today. Brazil is one of the top priority markets for any launch in this field.


What has been your experience working with Brazilian regulators? Have you seen any improvement in terms of timelines?

Compared to my experiences in other countries, the regulatory agency in Brazil is quite advanced. To give you an example, there is a project here for oncology through which Brazil’s Health Regulatory Agency (ANVISA) and the US FDA have connected with respect to timing. There is a fast track for oncology drugs, so as soon as the FDA approves a drug, ANVISA can then approve it in a matter of weeks. This is a real example of ANVISA being timely.


You mentioned clinical trials. Where does Brazil stand with respect to GSK’s global clinical trials and how would you rate the country’s clinicians?

We are running about 32 clinical trials here now. Not only that, I think Brazil is now being considered as an end-to-end country in which to engage in clinical trials. An example I can give is the primary research we are undertaking in Brazil, together with Albert Einstein Hospital and a state-led organization in immuno-oncology.

Private investment in Brazil has raised the bar and the mix of public and private investment in Brazil has created a good environment for improving education. Einstein, for example, is the biggest hospital in Latin America and has just opened a university. I also believe that medical organizations here are very well connected to global associations in the US and Europe, which keeps them up to date.


What is the split between vaccines and specialty care in GSK’s portfolio in Brazil? Will there be a shift towards more specialty care in the future?

We intend to double GSK’s business in Brazil in the next 5 years with a very healthy balance percentage among our portfolio and future pipeline.


To cover these new areas, you will need to bring new teams on board which brings us to the question of talent. How easy is it to find and hold onto good talent in Brazil?

First of all, there is a new trend we are seeing after COVID. Young people do not want to move abroad for a long period of time. They prefer to work with more flexibility, which is fair, but what is limiting in my view, is that out of six people I might speak to five that would tell me they do not want to be transferred abroad anymore. The consequence of this is less exposure to new cultures and new things, which is very relevant when you reach more senior-level positions. What we need to see here in terms of talent, movement and attraction are how are we going to bring oxygen to the company, but also make sure these people get relevant experience because otherwise, they will spend another five years behind their computers.

On the people side, it is also important to understand that Brazilians are more emotional than pragmatic s. people are moved by their sense of purpose.


GSK has a very good approval rating from employees and consumers alike. How will the company’s new branding build on that already outstanding reputation?

We are now receiving the results of a survey with Google that reached 20 million consumers and GSK stood as the second-best perceived company in the pharma industry for consumers in terms of the quality of its products, messaging, etc.

Our new branding can only improve on this because it is more linked to the organization’s culture and proposition. The new branding represents the real purpose of the organization and the team was very excited about the new logo, but the most important thing is what behaviours it will stimulate. Our goal now in Brazil is to stimulate the right behaviours in terms of leadership and leverage the new company identity to trigger this.


GSK is the second-largest pharma company in Brazil in terms of growth. How sustainable is that level of growth in Brazil?

If I look at my roadmap for the next five years, I know I will double the size of this company in Brazil simply because we have a strong footprint We have already launched a second product in oncology in August of this year and we are going to invest more on that area. So, there is a portfolio to come in Brazil, which will bring aggregated value in three to five years’ time. And the most relevant thing is that our current portfolio, especially in primary care, is already relevant. We can rely on the profile of drugs we have, and we are confident about that focusing on unmet needs.


Is there anything else you would like to share with PharmaBoardroom’s international audience to conclude the interview?

I think that environmental, social, and governance (ESG) and diversity, equity, and inclusion (DEI) are important topics. I am sure this is an agenda that any general manager should be on top of, but not because global is saying you need to do it. It is relevant when you talk about the culture of the organization. People here care more and more about the purpose of the organization and we need to connect that purpose to them. In order to achieve that, the ESG and DEI agenda is key. As a leader in the market, we must be at the front seat of this topic, the reason why we are doing continuous surveys about diversity and inclusion is in order to understand what people believe, and make sure our actions are leveraging our teams’ potential.