PharmaBoardroom - Ramy Koussa - Middle East, North Africa & Turkey (MENAT) Associated Vice President, Organon

Ramy Koussa shares the passion and vision of focused women's health player Organon in the MENAT region, how the organisation has adapted and improved to better serve women in the region in its first two years of operation as an independent company, and why multi-stakeholder partnerships and collaboration are crucial to ensuring healthier women, societies, and economies.

Tell us why you decided to take on your new role as Managing Director (MD) of the Middle East, North Africa, and Turkey (MENAT) as part of the divestiture of Organon into an independent company.

Organon’s purpose, vision, and values resonate deeply with me, on a personal level, As a father and someone who cherishes the wellbeing of the women in my family, including my two incredible daughters, wife, mother and sister and as a leader, my direct team representing more than 50 percent women, so advancing women’s health is a cause that is close to my heart.

What truly sets Organon apart is its unparalleled commitment to women’s health as the sole focus of its operations among companies of its scale. This unique dedication was a compelling factors that fueled my enthusiasm to become part of the Organon family. I am honored to contribute to a company that shares my passion for improving the lives of women.

I eagerly joined Organon because it offered me the opportunity to collaborate closely with the Founders who laid the foundation of the company. From the moment I became part of the Organon team, I have consistently experienced a profound resonance with the company’s mission. This alignment is not only a testament to Organon’s impactful purpose but also a reflection of my own personal and professional growth aspirations at this stage of my life.

Previously, I held leadership roles at MSD (Merck & Co.) including MD for Egypt, Libya, Sudan, Yemen, and various smaller markets. Additionally, I served as the Regional Marketing Director for Eastern Europe, the Middle East, and Africa, overseeing the largest franchise within the company at that time. As MENAT Lead, my current responsibilities cover a diverse portfolio spanning multiple regions. This includes the Middle East, North Africa, French West Africa, Turkey, Ukraine, and the CIS (Commonwealth of Independent States), encompassing a total of 48 countries.

Organon made its global debut in June 2021, and shortly thereafter, in October 2021, the company marked its entry into the MENAT region at Expo 2020, one of the most prestigious events in this part of the world. A few months later we launched our ‘Wall of Voices’ campaign through multilingual online platform, herhealthmenat.com. This platform enables women and other stakeholders interested in our mission to express their opinions, wishes, and suggestions. Our approach prioritizes active listening and understanding, allowing us to shape our focus and business around underserved areas in women’s health. We recognize that partnerships and collaborations between the different stakeholders are key to advancing women’s health across multiple domains.

What is the composition of Organon’s portfolio? Could you share some key therapeutic areas of focus?

Organon’s portfolio encompasses 60 products across three main areas of focus: established medicines, biosimilars, and women’s health. The established medicines category spans various therapeutic areas, including cardiovascular disease, respiratory conditions, dermatology, central nervous system disorders, bone health, immunology, non-opioid pain management, menopause, and much more. Within our biosimilars focus area, we offer several products that specifically address women’s health concerns, including breast cancer and osteoporosis. Finally, our primary area of focus is women’s health, encompassing a range of products related to contraception and fertility. However, at Organon, we aspire to go beyond reproductive health and expand our commitment to women’s wellbeing throughout their entire life cycle. Our goal is to challenge the status quo and advance women’s health across all aspects of their lives.

We consider the maternal and peripartum periods as fundamental pillars of women’s health. The definition of women’s health should encompass complications specific to the birthing stage, such as preterm labour and post-partum haemorrhage, as well as diseases and conditions that disproportionately affect women, including endometriosis and menopause. Recognizing these aspects is essential to understanding and addressing the unique healthcare needs of women. Organon is committed to expanding knowledge in these underexplored areas and making investments that contribute to advancements in women’s health.

Over the past two years, we have made significant global announcements regarding deals and collaborations in various areas of women’s health. These comprise endometriosis, preterm labour, postpartum haemorrhage, non-hormonal contraception on-demand, as well as biosimilars targeting osteoporosis and breast cancers. We are looking to introduce these innovative solutions to the region at the earliest, ensuring that women can benefit from these advancements in healthcare.

How do you ensure that the products in your portfolio that are not solely for women are suitable for women? Do you do any clinical trials to ensure the correct dosage for women?

The current reality is that only four percent of healthcare research investment is allocated to conditions exclusively affecting women. Our aim is to transform this statistic, which is why we initiated our mission with a focus on listening rather than merely speaking. This requires seeking active input from not only the scientific community and healthcare professionals, but also from the entire ecosystem surrounding women’s health, including government entities, healthcare providers, research bodies, and most importantly, women themselves. By incorporating diverse perspectives, we can drive meaningful change and address the unmet needs in women’s health.

Have you received any feedback through the platform that has surprised you thus far?

We have received invaluable insights from women, particularly around mental health, and menopause. First and foremost, it is evident that women often prioritize the wellbeing of others, particularly their families, over their own. At Organon, we firmly believe that women’s health should come first. We recognize the unique challenges that emerged from COVID-19, where women took on additional roles and responsibilities, acting as teachers, nurses and much more. This not only resulted in limited access to education and increased female drop-out rates^[1], but also reinforced the unfortunate tendency for women to place their own needs and health at the bottom of their priorities.

Over the past two years, there has been a decline in regular health care visits, possibly due to factors including the COVID-19 pandemic, healthcare providers prioritizing other areas, or women’s responsibilities towards their families. Feedback has highlighted the need for women to prioritize their healthcare more effectively, as many health conditions, including mental health, have been overlooked.

The average age for women to experience perimenopause is typically in the late 40s. However, with increased life expectancy from 57 to 82 years, women now have a significantly longer experience of menopause. This aspect remains largely unexplored and underdiagnosed, despite its growing significance in society. As well as the physical symptoms, menopause also affects women’s mental and psychological wellbeing, revealing a lack of support in this area.

Insights have revealed that a healthy woman means a healthy family, which in turn, contributes to a healthy society and nation. Therefore, focusing on this pillar of health will promote a better world.

Organon’s portfolio differs depending on the regions in which it operates. What is the reason for this?

We are fully committed to achieving our goals. Recognizing that each market has its own specific needs and dynamics, we approach our work with a deep understanding of these regional variations. While we maintain a global perspective, we prioritize listening to the specific needs and gaps voiced by patients in our region.

Our team of over 400 dedicated employees, who we refer to as Founders, shares an entrepreneurial mindset, driven by deep passion for improving women’s health. With their unwavering commitment, they play a crucial role in reflecting the voices and needs of each region we operate in. Embodying Organon’s core values internally and externally, our founders bring their unique perspectives to the table. Their collective expertise and shared values form the foundation of our mission to make a positive impact in women’s health.

Do you plan to collaborate with partners in other regions?

Absolutely. Our overarching priority is to ensure that women have access to a holistic healthcare portfolio that caters to their long-term needs, leaving no aspect of their healthcare needs unaddressed.

Organon actively seeks partnerships worldwide to advance women’s healthcare, whether through government, industry, or private partnerships. Our strategy is to address market-specific, patient-specific, and regulatory needs to drive progress in women’s health.

The company largest program, the Her Promise Access Initiative, is executed with the support of a network of collaborators worldwide, including UNFPA and the Bill & Melinda Gates Foundation, and aims to expand access to information, training, and cost-effective contraceptive options so that women and girls can make informed reproductive decisions – including about when and if they start a family. Working through global partnerships, Organon is directly addressing these needs and helping to deliver on its FP2030 commitment and help millions of women and girls take control of their reproductive health.

In the MENAT region, we have already started manufacturing projects in Saudi Arabia and Algeria to support localization efforts We recognize the prevalent need for healthcare products addressing chronic and non-communicable diseases, such as hypertension, cholesterol, asthma, and more, therefore our focus is to provide support and solutions that meet these specific requirements.

At Organon, we strive to address the specific needs of local communities by actively listening, embracing collaboration, and seeking non-traditional partnerships. Our approach is focused on building strategic alliances.

For example, in the first year, we partnered with a venture capital company called Flat6Labs to launch the FemTech Accelerator Programme, to help female-founded digital health start-ups across MENA succeed by providing support to build products, test market fit, and improve business models.

We received an overwhelming response from more than 300 applicants and carefully selected the top 10 participants. For over a year, we provided extensive support including expertise, knowledge sharing, skill development. In the end, we announced three female winners from the UAE, Lebanon at an event in Cairo, two of them were focusing on mental health, one general and other focusing on mental maternal health.

Organon firmly believes that empowering women financially is a crucial aspect to of improving healthcare for them. By promoting their independent decision-making abilities, women are less likely to neglect their own wellbeing and recognize the value they contribute to their communities. This exemplifies the non-traditional partnerships we invest in.

We also call for other ways to partner and engage with the community, we took a proactive stance in supporting our employees by granting them paid leave on International Women’s Day. This initiative serves as a motivation for employees to prioritize their health and encourages them, including male employees, to take care of their female family members. Our aspiration is for International Women’s Day to eventually become a nationally recognized occasion as we continue to grow and make progress and we call other organizations to do the same to support the cause of prioritizing women’s health.

Last year, Organon had a revenue of USD 6.2 billion. Could you describe the role of the MENAT region in this, and its contribution to that overall revenue?

Organon, as a US-based company listed on the New York Stock Exchange, stands out as one of the rare global companies with most of its revenue generated from outside the US. This not only underscores our global presence, but also highlights our commitment to growth. Notably, the MENAT region plays a significant role in Organon Growth.

Despite the significant challenges faced in this region, including COVID-19, economic challenges in Lebanon, hyperinflation in Turkey and Egypt, natural disasters such as the earthquakes in Turkey and Syria, and political unrest in Sudan, our region has demonstrated remarkable resilience and achieved strong growth in its first year and I am confident that in 2023 and the upcoming years we will achieve a double-digit growth. In return, the number of Founders has also increased, reflecting our commitment to making a meaningful impact in the face of adversity.

In this region, we recognize the significance of reputable and well-established brands that enjoy widespread acceptance and recognition. In the first year, we focused on revitalizing and introducing women’s health product lines that may have been overlooked in the past. We successfully launched these lines in Egypt, Lebanon, Saudi Arabia, the Gulf countries, and Turkey, catering to the unique needs of women in these markets. Moreover, we are currently gearing up for the launch of an innovative solution in an area that has been traditionally neglected – postpartum hemorrhage – a leading cause of maternal mortality, which accounts for roughly 35 percent of all maternal deaths, most of which are preventable.

Many of the countries in your portfolio such as the UAE, Saudi Arabia, and Turkey, do not have biosimilars legislation at all or have unclear legislation. How does this affect your portfolio?

Biosimilars, as a relatively new concept, are gradually being integrated into healthcare systems, necessitating adaptation. The value they bring to healthcare systems is enormous, enabling significant budgetary savings can be reinvested back into the system. In the MENAT region, the significance of biosimilars is growing, with established operations in Ukraine and recent approvals in Saudi Arabia, the UAE, and Qatar. In some MENAT markets with more stringent regulations, we have successfully introduced biosimilars, despite the challenges. Given the value they bring to the system, our biosimilars were granted exceptional early access prior to the completion of the full approval process, demonstrating the growing importance of this field. While Organon MENAT’s growth projections primarily rely on our robust portfolio of established brands, we are also optimistic about the future growth prospects of our women’s health and biosimilars portfolios.

What type of functions do you deploy in the central office here, and how do you establish and cultivate the culture of such a young company?

As Founders, we are guided by a shared set of values; ‘Bring your fire,’ ‘Own it,’ ‘Be real,’ ‘Rise together,’ ‘We all belong,’ and ‘Keep moving.’ We acknowledge that as entrepreneurs striving to introduce new ideas and challenge the status quo, we will inevitably encounter obstacles that require innovative solutions. It is imperative for us to embrace flexibility and agility, constantly exploring different approaches and remaining lean in our operations.

Our MENAT division comprises 12 offices across 48 countries, each with a dedicated country lead. We provide support through our virtual teams located across MENAT, encompassing various enabling functions such as HR, finance, policy, market access, and communications, marketing, and commercial operations. Our team members are strategically placed throughout the region, allowing us to maintain agility, mobility, and timely support whenever needed. For example, the head of supply is based in Morocco, the head of HR in Cairo, and the head of legal in Turkey.

The mission of creating a ‘healthier and better day for every woman’ is likely easy for your female employees to support. How do you ensure that this is equally supported by your male employees?

Organon is a highly diversified company, and we prioritize gender diversity in our leadership. Globally, 70 percent of our board members are women, reflecting our commitment to inclusivity. When establishing our ‘Thought Leadership Group,’ a group of leaders from different organizations interested in supporting Organon, it was initially composed of only women. However, we quickly recognized the importance of including balanced and diverse perspectives in our discussions and have consequently engaged men to contribute to finding solutions and addressing the issues at hand.

In addition, we value diverse representation in our spokespeople, which includes both male and female voices. Our Global CEO, along with several country and cluster leaders, including myself, contribute to representing Organon across various platforms. This balanced representation allows us to effectively communicate our vision and engage with stakeholders from different backgrounds.

In the MENAT region, our leadership team is more than 50 percent women, and we are committed to further increasing gender diversity across our teams in all countries across the region. We have successfully built predominantly female teams in some countries like Ukraine, while in others, such as Saudi Arabia, we are actively working to foster a more balanced representation. Our ongoing efforts demonstrate our commitment to adapt and promote inclusivity as we progress.

Diversity and inclusion are fundamental values that we embrace at Organon. In a large region like MENAT, it is important to ensure that everyone feels a sense of belonging and inclusion. Our commitment to these values extends to both women and men within our organization. We believe that when all individuals, regardless of their gender, feel motivated and aligned with our mission and purpose, we can collectively achieve our goals and make a meaningful impact.

How confident are you that the governments of Saudi Arabia and the UAE will be receptive to, and provide the necessary changes to the standard of care, to improve women’s healthcare?

I am confident and optimistic as we have already seen governments, in particular UAE and the Kingdom of Saudi Arabia, make great strides toward advancing the health of women.

In the UAE, there are various initiatives in place that are focused on supporting women, such as the Gender Balance Council, Foundation for women and children, and the General Women’s Union, just to name a few.

There have already been several changes to policies and legislation that provide a positive environment, with the UAE passing 11 laws in just two years, focused on empowering women.

A notable milestone for Organon in the UAE was our partnership with UAE University, the country’s national university. This partnership focused on advancing women’s health and wellbeing and is a testament to the commitment of the country. When this partnership was announced, various distinguished guests and speakers joined and highlighted the women’s health landscape in the UAE, and their commitment to further advancements.

In Saudi Arabia, we have witnessed an incredible transformation of the country, in line with Vision 2030, and with that has come rapid transformation for women. Organizations like Nusf and Rofaida are not only supporting women’s empowerment and improving women’s health, but they are also driving policy change.

My confidence is further bolstered by the growing trend of countries like Lebanon, the UAE, Saudi Arabia, and Kuwait establishing dedicated women’s healthcare units instead of solely focusing on gynaecology. These developments affirm that we are moving in the right direction.

Moreover, my optimism stems from the overwhelmingly positive response we receive when we share our opportunities, vision, and motivation. Instead of encountering opposition, we consistently find enthusiastic stakeholders who are eager to join us as partners in this journey. The broad ecosystem is brimming with potential collaborators. I am genuinely optimistic about the future of women in this region.

Do you have a final message you would like to send to our global audience?

Considering the audience, and because our purpose is bigger than one company can achieve, we want to extend to embark on this mission together. We understand that addressing women’s healthcare requires the involvement of the entire healthcare sector, not just a single segment.

Expanding beyond the healthcare sector is essential for us as well. Women’s health represents more than just the wellbeing of 50 percent of the population; it has far-reaching effects on the overall health of a nation. When women are healthy, they become empowered, resilient, and prosperous, leading to positive impacts on their communities, societies, and economies for generations to come.

At Organon, we firmly believe in the possibility of change, and we are actively seeking collaboration to advance this cause. We invite all stakeholders to join us in creating a healthier future for women through collective efforts and shared expertise.