Boehringer Ingelheim’s Marianne Abou Elkheir, General Manager and Head of Human Pharma for Levant, Iraq and North-East Africa (LINEA) and Sub-Saharan Africa (SSA), walks us through her career trajectory and her experiences in leading pharma and medtech organisations. In addition, she dives into Egypt’s healthcare transformation and trends in the pharmaceutical markets in the Iraq and Northeast African region.
Looking at your career in healthcare, it is noteworthy that you spent more than 11 years with Janssen before switching to the medtech industry with Medtronic, later coming back to pharma with Boehringer Ingelheim. Can you walk us through that journey?
Over the last 20 years of my career, I have worked in a variety of industries, including pharmaceutical, automotive, electromechanical, and sales services. In these industries, I have taken on leadership roles across different departments such as finance, operations, sales and marketing, as well as management. Taken apart, it is easy to wonder what the connection is across all these sectors. The connection is that they all involved in the development and marketing of products to improve human lives. Working across these diverse sectors has its advantages and some of the key benefits I have acquired are a broader perspective and out-of-the-box thinking and approach I am able to bring to achieving personal, team, and company goals. Of all these different sectors however, I believe working in the healthcare industry has given me the most satisfaction. This largely explains why I have spent most of my career working in the pharmaceutical and medtech industries.
My journey in healthcare started with my 11-year stint at Janssen, followed by almost four years with Medtronic, and now at Boehringer Ingelheim. At Janssen, I took on many leadership roles including those of regional marketing director and later managing director for Sub-Saharan Africa. At Medtronic as well, I was the head of emerging Africa which consists of North and Sub-Saharan Africa, leading a sub-region of 47 markets. So, it is not a surprise that I have come to take on the position of general manager and head of human pharma covering Levant, Iraq, Northeast Africa and the Sub-Saharan Africa regions at Boehringer Ingelheim. These roles have provided opportunities to contribute to developing and increasing access to innovative solutions to health problems – either via the use of technology or prescription medicines.
What motivated you to make that last move to Boehringer Ingelheim, and to get back to pharmaceuticals?
Boehringer Ingelheim is a company dedicated to providing the best possible care to patients. I am driven to bring innovative treatments in different disease areas where there is an unmet need. The close alignment between my interests and the company’s vision is a key motivating factor to want to be part of Boehringer Ingelheim. I knew that working in this environment would enable me to leverage the skills and experiences I have built, over time, across different industries and roles to drive the company’s business strategy and operations across LINEA and SSA.
Also, considering that I had worked at Janssen for quite a long time and moved on to medtech for a while, the decision to join Boehringer Ingelheim was not a difficult one. With my experience in the industry, I knew that it was an opportunity to lead purpose-driven and experienced professionals, create environments for people to perform at their best, and more importantly, support the development and execution of strategies that ensure that people living within the countries and regions I am responsible for are provided with healthcare solutions that can transform their lives. Boehringer Ingelheim’s presence in Egypt and other countries in Northeast Africa is of strategic importance. Being there as the head of Human Pharma is a critical role that I knew I was ready for, particularly within the context of ensuring that there is a reliable supply of vital and effective medicines for the patients who need them.
Which elements of the portfolio give you confidence that the team will be able to take Boehringer Ingelheim to the next level?
One of the main objectives for Boehringer Ingelheim is to become the preferred partner within the pharmaceutical industry. This means becoming the number one in animal health, biopharmaceutical contract manufacturing, and value share for all brands in One Human Pharma. To ensure the achievement of this objective, Boehringer Ingelheim has been working very closely with the ministries of health, top private healthcare facilities, and healthcare professionals to facilitate the provision of breakthrough therapies to more patients that can ultimately improve treatment outcomes.
At the moment, there are a number of treatments is areas such as cardiovascular, respiratory, and metabolism. Considering the huge burdens that these conditions have posed over the last few decades in these countries, my team is well positioned to leverage these products to transform patient lives. For instance, one of the major components of Egypt’s health pillar in its Vision 2030 is to improve health conditions through early intervention. This is similar to the interest by other governments in Northeast Africa to advance universal healthcare and help citizens have access to quality care. Everything we do converges towards the core objective of improving lives through innovative solutions, which in turn ultimately pushes us towards expanding our activities in the region and reinforcing our position as a leading research-driven biopharmaceutical company.
Boehringer Ingelheim is committed to research and is investing heavily in the generation of evidence in areas of significant medical need. The resulting data helps us position ourselves strategically, identify ways we can help reduce the burden of major chronic illnesses, and design and implement patient disease awareness programs where most needed.
What about the Egyptian pharma market? What is your view on the transformation that has emanated from the approval of the universal health insurance law?
The approval of the universal health insurance law is one of the best things that have happened to the country, particularly within the context of health and development. It solves many problems including fragmentation of the healthcare system, huge costs of care, out-of-pocket healthcare payments, and poor access. In addition to increasing citizens’ access to quality care, there have been a number of new policies and reforms that came with this universal health insurance law. For instance, there was the establishment of the Egyptian Drug Authority which now facilitates product registrations and eases the process of importing medicines. Similarly, the United Procurement Agency was also put in place to enable shorter timelines in access to new and innovative medicines.
For companies in the business of developing and providing effective treatments, this is a huge opportunity. The Egyptian pharmaceutical market has been recording significant growth over the last five years mostly due to the universal health insurance law. With this expansion, a major priority for us at Boehringer Ingelheim is to continue to support the success of initiatives and programs that optimizes patient access to needed medicines. We have been working closely with the Ministry of Health and key healthcare organizations to ensure patients have improved access to treatments. For example, we have developed strong partnerships with Egypt Drug Company and Poly Pharm with focus on effectively regulating commercial ties, ensuring access to innovative drugs in Egypt, and diversifying our distributor base locally. We have established other similar partnerships that ensure that key medications within the Boehringer Ingelheim portfolio can get to hospitals and pharmacies and serve patients in a way that meets their treatment needs.
Egypt has the ambition of taking a leadership role on the African continent with respect to regulatory and supply chain issued related to medicines. You have worked directly in many African countries- personally do you see this as possible?
The country leadership has this aspiration and vision, along with projects to support that agenda, and yes, it is possible, but prior to speaking about this, which is a great aspiration, I would rather ask about the unification of requirements when it comes to registration across the continent. Why do we not accept that products can receive automatic registration after being approved in another market? We have been speaking about this in the East part of Africa for years. The African Union can play a great role in this. In some markets you have a timeline of two years to register a product.
Today, we are witnessing a huge effort by the government to deliver this innovation. A change in dynamism, appreciation and understanding of the value of innovation – and of agility. In my humble opinion, we are now experiencing the best time of healthcare in Egypt in terms of positive change, understanding of the value of innovation and genuine interest from decision makers to improve patients’ lives and I believe there is still a lot more to come.
To conclude, what are the things that concern you about the markets under your leadership and others that make you optimistic?
The forecasts predict that the pharmaceutical market will continue to grow for several years into the future. With regards to Lebanon, I think the market is going to eventually recover and we hope it does so quickly. As you know, pharmaceutical products are split into subsidised and non-subsidised medications, and I hope that the market will evolve to ensure patients have access to non-subsidisation medications. We hope that the ministry of health can free the subsidy for non-essential products for them to be available for patients who can afford them but, at the moment, are unable to find the desired medication.
In Egypt, unfortunately, the currency devaluation remains a big concern because market prices are fixed. However, I am very optimistic that with our strong government, our company portfolio and robust team locally and regionally, we will be able to have a positive impact on ensuring we provide breakthrough therapies that can ultimately improve treatment outcomes.
Another market with high potential is Iraq. After years of turmoil, the Iraq pharma market is expanding. There are big gaps that need to be filled in terms of access to life-saving medical products. There are still issues with counterfeit medicines, prolonged drug approval processes, complex logistics, and the potential for political disruptions. We understand the challenges, but I believe that there is a big role for Boehringer Ingelheim to play in supporting measures to strengthen standards of safety and compliance, create awareness of major chronic diseases, and improve access to innovative medicines in the country.
Across all the countries under my leadership, I am aware of potential challenges that may stand in our way of achieving our goals. This is why my role is critical, that is, to lead the development of tailored and context-specific strategies that enable us to penetrate each market, develop relevant partnerships, and strengthen relationships. All of these are based on an in-depth knowledge of the terrain, experiences in similar markets, and the backing of a pharma leader like Boehringer Ingelheim. I am optimistic about our ability to work with governments, healthcare professionals and major stakeholders in the healthcare sector to bring breakthrough therapies that will change and improve patients’ lives for generations.
