Nourreddine Loutichene – Executive Managing Director, MSD Algeria

John Patrick Hourican11The executive managing director of a leading American healthcare provider offering an innovative range of products on the local Algerian market treating asthma, diabetes, hepatitis and cholesterol speaks about the company’s experience and the country’s ambition to become a biotech leader

For the pharmaceutical industry, the African continent – especially the Maghreb – is the last remaining bastion to conquer. What is your strategy on this sector?

Africa is the last bastion to be conquered, a sad reality, given that African patient is still the one most in need of the innovative treatments. Recognizing this reality, the international management of Merck / MSD has resolved to build solid and lasting impact on Africa by large investments, including in Algeria.

In Algeria, we initially developed our organization at the national level by increasing our workforce from 65 to 200 people, all were recruited in Algeria, executives included, and accompanied by an important training.

The established country team has sought to better understand the needs of the Algerian patient to better meet them. And our ongoing dialogue with health authorities helped extend our knowledge and prioritize the needs in the most useful drugs in Algeria.

“What to produce and how to live up to the expectations of our country?” this is our credo.

We are aware of the need to work with the authorities to reduce the drug import bill and to strengthen local production. Our vision is a perfectly aligned with this strategy. But beyond that, we position ourselves on the production of new therapies to offer an innovative product portfolio. On the other hand, we do not limit ourselves to the production of innovative medicines, we are committed to continuous medical education, prevention and clinical research.

The government does seem sometimes outdated on this topic and not close to the reality of the Algerian market : is it really possible to innovate in Algeria?

There is a whole vision to rethink. The government, for example, intends to cover 70% of the country drug needs this year. It is very important to set goals, it is a must for a country that, until recently, imported all of its needed drugs. But this volume strategy must be combined with a qualitative approach, by asking the following questions: do we have enough trained manpower? Do we have the capacity to produce innovative medicines? What direction do we want to give to our pharmaceutical industry?

For us, the important thing is to get out of the current model: a concentration of producers, positioned on the same productions. Some plants produced up to only 50% of their capacities in in Algeria. At Merck / MSD, we believe that we need to transfer the expertise here to produce innovative biotech molecules, for example, and to build plants to live up to this ambition. This implies drastic efforts and cooperation between the different actors, namely the government, the pharmaceutical industry and the Academy represented by universities, and other research centers.

The pharmaceutical industry has played an important role in developed countries in terms of research, training and education. Could that be the case as well in emerging markets?

For several years now, health authorities have prepared the ground for pharmaceutical companies to not only “do business” but also, and more importantly, contribute to the evolution of these different aspects: prevention, continuing medical education, clinical Research … etc. In fact, pharmaceutical companies operating in Algeria have trained continuously many Algerian practitioners on the most current aspects of the most endemic chronic diseases in Algeria such as asthma, diabetes, hypertension or hepatitis.

However, there is an area where more efforts are still needed: clinical research. The latter requires high levels of skills and commitment. Those qualities are found many of our doctors invested in improving the daily lives of our patients.

This area has been recently codified and regulated, clinical research in Algeria, is in its infancy but shows promises. But much remains to be done, particularly on approval times for early phase interventional trials, on the need of local clinical trials as requirements for registration but also in regard to the respect of intellectual property, warranty of reimbursement of innovative drugs … etc.

How can MSD put Algeria on a greater and broaded development and research plan ?

What helped to convince the international management of Merck / MSD to put Algeria in the category of countries where the company needs to make significant investments is the great work done by our team combined with the willingness of our authorities confirmed repeatedly, especially during meetings at the highest level.

MSD is the leader in technology programs. What actions are implemented in this area?

I am the coordinator of the group bringing together the different partners in the pharmaceutical industry in Algeria. Our goal is to build a relationship of trust and partnership between the industry and the government. The idea of working together on a draft memorandum to define an action plan on the Singapore or Ireland model came through during our various meetings with the Ministry of Health .

We have put together a road map: where do we want to take the pharmaceutical industry in 2020. This led to the creation of a study carried out by the firm Deloitte. The latter was very well done and allowed us to identify major areas for improvement. We realized that a global harmonization should be done in Algeria to improve the working environment of the industry: more transparent registration and reimbursement process, easier processes of recruitment, a greater independence of the government … etc .

When it comes to Merck / MSD, we innovate in many areas, primarily in the treatment of diseases such as diabetes, hypertension or cancer. We are the world leader in vaccines and have a significant expertise in hepatitis. Finally, we develop our product around the health of women, and we recently introduced the contraceptive implant in Algeria but also in anesthesia where we are preparing to bring to market the first “décurarisant”.

If we look closer at diabetes type 2 for example, this is a global scourge that is becoming a public health problem at the national level. The therapeutic solutions available in the market has been reinforced by the introduction on the market by Merck / MSD’s first inhibitor of DPP-4, a new class of oral antidiabetic drugs for patients with type 2 diabetes. This new class of drug ensures proper management of the disease with significantly less risk of adverse events such as hypoglycemia and weight gain. Although not curing the patient of diabetes type 2, we give to the patient a treatment which improves his daily lives.

Not only that, we also invest in the prevention of diabetes. In particular the eve of the holy month of Ramadan where our teams are campaigning to help doctors better explain to their patients how to combine Ramadan and diabetes. It remains difficult, but still possible.

MSD is the leader in Algeria for pharmaceutical products for woman only. What is your approach on sensitive issues such as contraception or fertility?

With regard to contraception, despite the taboo and conservatism, Algeria can be proud of having succeeded where other countries in the region are still struggling. In fact, health authorities, particularly through Planned Parenthood, were up to the expectations of the need of Algerian women. Today, the Algerian woman openly and clearly expresses its expectations and demand, even require the best contraception. With the recent introduction on the market of our hormonal implant, it is our goal to align ourselves to the objective to meetings these high levels of requirement.

In other areas, such as fertility, the vaccine against cervical cancer of the uterus, for example, the communities are hungry for information and training. MSD is committed to convey a good image on these issues.

This is especially important as the medical issue meets here delicate themes that are religion and sexuality.

What is the short-term future for MSD in Algeria?

Our roadmap for the next five years – already in place – aims at positioning Merck / MSD as a partner of choice for the health authorities and the scientific community .

We also would like to as well to expand our protfolio in therapeutic areas where we are not yet in particularly cancer where Merck / MSD can develop new partnerships with the scientific community with the hope to help save more lives by bringing to the Algerian patient the latest developments in the field.

What a program you would tell me. But we have a very efficient public health system that makes you want to move forward.

We must believe in the resources and potential of Algeria. I intend to carry out this mission with my dual role as defender of my company to the government of my country and defending my country to the leaders of my company.

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