Mexico is number one in child obesity and number two in adult obesity in the world. This is one of the reasons that diabetes is rapidly increasing and the Mexican government has made its treatment a priority. Do you think Mexico is adequately equipped for this phenomenal prevalence?
There has been a massive increase in diabetes prevalence, and due to the size of the problem it requires the participation and work of many different stakeholders in order to combat it; it is not something that can be overcome by a single entity. Mexico is prepared only if we work together, we need more participation from the government; private industry; medical community, and the general population. In terms of the effort behind the solution, we will require many more resources in terms of dedicated time, knowledge and expertise, and last but not least, a lot of passions in order to change diabetes.
How does Novo Nordisk fit into this structure of diabetes in Mexico, what are the biggest opportunities and challenges that faced the company over the last few years?
In Mexico and in the rest of the world, our main strategic objective is to beat diabetes. So in that sense it is our main concern- how we can make a change and how we can participate and provide knowledge, expertise, education, and be a factor of change in terms of finding a solution and finding better ways to treat diabetes, to ultimately beat diabetes.
As you just mentioned, education about diabetes is essential. On the other hand there are services that can be provided in order to provide that education. Have you seen any need for value-added services alongside your products in order to retain market share?
Most definitely; there are many different options on the market to treat diabetes, and they all hold a lot of benefits, but they are not enough to solve the problem. Education is a key factor in making a change, and at Novo Nordisk we believe in it on different levels: education for the patients, family members, medical community, and for public institutions. We need to make the population aware of the huge problem we are facing, and the consequences of not treating diabetes properly. The main message is that diabetes is a condition that can be treated successfully but requires some discipline and effort in order to overcome it: this is why education plays such an important role.
Please can you give us a few examples of the kind of education that Novo Nordisk provides?
At Novo Nordisk we like to work a lot with the patients: they are at the center of our activities and of our decisions. We have developed a lot of value-added programs in order to educate patients on general health, but also on good food and grocery shopping habits. We provide information to the patients’ families about the disease, what it means to a patient, and what is required to control it. We educate patients about how to take basic care of themselves, provide basic information about the treatments, and about exercise. We also have a second level of education which involves the Mexican medical community: both public and private. In order to provide them with the most updated scientific and clinical information about products and diabetes developed a series of congress-like platforms in which we bring the latest knowledge available from the top world-wide speakers on the subject, into the country. Novo Nordisk works hard on tailor-making continuous medical education programs for the Mexican community, be it professionals, patients, or their families.
How do you actually change the mentality of the Mexican population when it comes to diabetes and healthy living habits? Is the Mexican government getting involved?
If I had the answer to your question, we would have the solution to the problem! At the moment we are seeing a trend in Mexico’s lifestyle habits, specifically when it comes to food, and that is that we are moving towards a more industrialized and processed diet, which is generating a bigger problem in terms of obesity and diabetes. The government has made diabetes and obesity the highest priority on their health agenda, but given the size of the problem, the current efforts in activities and education is not enough. For this reason, we have to find a solution that involves every single different stakeholder in the market, and not just the government and pharmaceutical industry. In recent years, the government has increased efforts in educating children in healthy eating habits and helping adults to be more active and to lose weight, but given the speed at which diabetes is rising we need stronger collaborations and partnerships in order to change the mentality of the Mexican people. If we do not do this, we will not achieve the common goal of changing the face of diabetes and tackle the problem in the most effective way. We should beat diabetes before it beats us.
In terms of working with the government, have you seen any more significant business opportunities now that diabetes is priority number one on the health agenda, and that Seguro Popular has grown enormously in the last few years?
Yes, we have seen more opportunities, but it is a double-edged sword: these opportunities have arisen both due to the rapid growth of diabetes in Mexico, and also because the public institutions have put a lot of work into providing coverage for the disease and making treatment products more accessible to the patients. The biggest growth in terms of population coverage is through Seguro Popular, but IMSS and ISSSTE are also developing specific programs for diabetes with the aim to give better care and more comprehensive treatments that include nutritional education, psychological support, and a larger range of medications so that people can take care of themselves.
How do you assess today the importance of the Mexican subsidiary of Novo Nordisk globally? Do you use Mexico as a platform to launch new pilot programs?
The priority of the Mexican affiliate for the worldwide corporation of Novo Nordisk is increasing rapidly, as is the whole of the Latin American region. The European markets are much more mature, so more growth is expected to come from less developed markets; mainly in this case Brazil and Mexico. In Mexico we have a huge diabetic population that requires better treatments and better care. On top of this there has always been a cultural factor involved in that diabetes has a stigma attached: people don’t like others to know that they have diabetes and they don’t like to talk about it. This created a lot of myths around the treatments, and now slowly but surely, Mexicans are becoming more open to receiving treatment, going to the doctor to get diagnosed, and more open to actively taking charge and making the changes that they need to in order to combat the disease.
How would you explain this cultural stigma surrounding diabetes in Mexico?
The stigma has been generated from a general lack of understanding amongst the general population, the natural fear that Mexicans have for specific treatments involving needles, and there is also a very strong emotional factor involved: there is a strong emotional connection to food in Mexico because most family and social events in revolve around eating. If people have to take care of their treatment and comply with their physician’s advice, for example going on a diet, it will require not eating the food that they like, and not being able to have the meals that their family prepares for social events. This emotional connection is preventing a lot of patients from making small but crucial changes in diet and lifestyle habits that would enable better treatment compliance.
As a stakeholder in the Mexican diabetes market, Novo Nordisk has had to overcome this emotional factor and teach patients that there are treatments that can be implemented they don’t require a dramatic life change. They can continue with their normal lives, but just take care in following their doctor’s prescribed treatment, following healthy food habits, and especially taking care of portion size. If they do these basic things, they can live just as healthy and long a life as a person without diabetes.
Education is a key factor; but how do you feel about collaborations with educational institutions here in Mexico. Do you feel there is enough of a partnership between the pharmaceutical industry and higher education and research organizations?
I would like to see cooperation between the two areas. In Novo Nordisk we have a specific program for physician education in the College of Internal Medicine; we also have education programs with IMSS and ISSSTE, and some educational initiatives with the Mexican Diabetes Association for patients. I would definitely like to see more of this: not only for Novo Nordisk, but for all the stakeholders in the diabetes market. I also think there is a need to better train students on the issues associated with diabetes while they are going through medical school.
Novo Nordisk is similar in every country that we go to, in terms of corporate culture. What is it like to work in Novo Nordisk Mexico: what are the specificities of the Mexican market, and how easy is it to apply a global corporate culture?
Around eight months ago when we were updating our cultural values, I was talking to a colleague of mine who worked in Mexico but then got promoted to the Brazilian office. She said something that answers this question perfectly: “When I was in the Mexican office I got to know the Novo Nordisk Way, but now that I am working I the Brazilian office I realize that the Novo Nordisk culture is the same in every country: I feel comfortable and happy”.
This is something that I have personally seen and felt in the last three to four years working in the organization. I think the fact that the culture and values of the Novo Nordisk Way are written in ten very simple and clear sentences helps everybody understand how the company expects us to behave, and how to deliver results- regardless of in which country we operate.
When we spoke to Gustavo Mizraje in Novo Nordisk Brazil, he told us that it had been a challenge hiring people with “the right vision and values in line with our Novo Nordisk Way”. Is that the case with recruitment in Mexico, because you mentioned earlier that it was key to have passion behind the people working in the industry?
Passion in Mexico is everywhere, so that is not one of the issues here! I can understand why Gustavo might have said that, it is not easy to find the right combination of expertise and values, but it is critical to find it. This is because we believe that a successful career in Novo Nordisk depends on how good the fit is between somebody’s personal values, and the company values. If this fit is almost perfect, then I can bet you will have a long and successful career with Novo Nordisk. The reason is simple: this person will be happy working for the company.
If we come back in four to five years’ time, where will we find Novo Nordisk positioned in the Mexican market?
We will be the leaders of the diabetes market in Mexico, and a key player in providing a positive change in how diabetes is treated. We will be an important partner for national public institutions to provide educational initiatives on self-care, and bringing knowledge into the country to develop clinical investigations. We will be the preferred partner for every stakeholder in the diabetes market. In short, we will have helped to change diabetes.