16-year Gilead veteran, Vítor Papão, recently left Europe to take on a new role within the company as general manager of the vast Middle East & Russia cluster. He discusses the particularities of the region, and the partnerships and initiatives Gilead is actively pursuing with local stakeholders.
Can you start by giving us an overview of your career before taking on your current role as Gilead’s general manager for the Middle East & Russia?
I would like to first introduce Gilead. Being just over 35 years old, it is a relatively young company that made its mark in virology and had its first significant breakthroughs in that area, which is still very important for the company. We have been expanding our reach into other disease areas, namely, oncology, not just through the research we do in-house, but also through recent acquisitions. We are looking not only at solid tumours but also liquid tumours. Through our affiliate company, Kite, we are also working in cell therapy, and we have made significant investments in inflammation.
We are bringing forward medicines that have a transformative impact on healthcare. It is in the company’s DNA not to just bring incremental benefits, but to aim for transformative benefits. We have been able to do just that, quite significantly in the HIV area as well as Hepatitis C, and in Hepatitis B.
All of this is important to mention because it has a lot to do with what motivates me to work here. Gilead is not just about delivering therapies; the company has worked very hard to provide better healthcare for patients. That implies partnering with governmental and non-governmental organisations to make sure patients have access not just to medicines, but to healthcare. We have partnered with governmental and non-governmental organisations to bring about improvements in healthcare provision because we not only want to bring medicines to market but also make the world a healthier place. That is central to our mission.
I joined Gilead just over 16 years ago and the company’s approach has motivated me to stay with it. When I joined there were just over 3,000 employees and now there are more than 17,000. However, we are still much smaller than most of the big players in the pharma industry, and that has also been a defining characteristic of Gilead.
Since I joined the company, I have had responsibilities at a senior management level. I was in Portugal as sales director and then I became HIV business unit head.
I was fortunate to be able to work in our European hub for a number of years as well. I moved to the United Kingdom affiliate in 2013, to head the HIV business unit there, and then to Portugal as general manager for eight years.
You mentioned partnering with governments to improve access. Gilead’s Hepatitis C drug, Sovaldi, has received a fair amount of scrutiny due to its high price tag. How is the company working to improve access in that area?
It is not every day that you transform a disease area in the way that hepatitis C was transformed by Gilead. When you bring a cure for a disease to market, there will be very strong scrutiny and it is only fair that questions be asked. Over time, we have been able to explain that, and we have been able to partner with governments across the world to be able to provide access for patients with hepatitis C.
In most countries, we were able to reach agreements in order to bring a cure to patients, but what we see now is that there are still many patients who need to be treated and cured. Where we have been able to provide access, a very large number of patients have been treated and cured. The numbers that remain in those countries are still significant, but those patients are not necessarily easy to find because they are asymptomatic.
The issue is not just bringing curative medicines to market but partnering with health authorities to find patients and link them to care. That has been an integral part of what we have done with hepatitis C. We continue to partner with health authorities across the world to make sure we are helping with diagnosis.
Gilead is a pioneer in HIV. How is the company continuing to innovate in that area?
In HIV, there have been successive waves of innovation from Gilead and from other companies that have brought the disease from being a fatal disease to one where patients can aspire to a normal lifespan. Nowadays, the question is not survival, but how to bring patients a better quality of life. That is the aim of the kind of innovations we are bringing forward now. These innovations include reducing the pill burden to a single tablet regimen administered on a daily basis and long-acting antivirals that do not need to be administered every day.
That is where innovation is taking us in HIV. In addition to that, we continue to work across the world to bring treatments and healthcare to patients, understanding that the impact of HIV is not just on the individuals who live with it, but whole communities and societies.
Gilead’s Middle East & Russia country grouping is quite a broad region encompassing low-, middle- and high-income countries. Does the company have a direct presence in each country, or do you work with partners?
The region includes Russia, Saudi Arabia, UAE, Oman, Bahrain, Kuwait, Qatar, Yemen, Jordan, Lebanon, Syria, Iraq and Iran, but does not include North Africa, which is a different cluster.
We work with a number of partners and we have different partnership models in the region. In some cases, we do promotion ourselves and in others we do it through our partners. We have distributors in several of the markets where we operate, but essentially, we manage everything out of the office in Dubai.
Healthcare in the region has been undergoing some major transformations in recent years. What are your first impressions of the region and what characteristics stand out the most?
There are several things that stand out. If you look at the current environment first, healthcare authorities are very ambitious and we can see that by the way they want to improve the quality of the healthcare they provide to people. There is also a strategic goal behind that ambition and the authorities are not looking just at providing better healthcare for the sake of it. There is clearly an aim to bring innovative thinking and state-of-the-art innovation and technology to the region and put the Middle East at the forefront of innovation in the area of healthcare. These two things feed into each other.
Within that context, what we see is a desire on the part of healthcare professionals, and of the authorities to partner with pharma, because of the expertise, knowledge and technology we can provide. Through these partnerships, they can enhance not just the level of expertise of healthcare providers, but they can also link the region to other parts of the world.
Moreover, they have the desire to connect and engage with the industry with respect to public health measures. They understand that we can help them to achieve public health goals by designing and developing programmes that help them achieve those public health goals. We have a number of initiatives in the region, which really pay testimony to that. We conduct medical education activities across several countries, and we partner with medical societies in some cases, or with hospitals or healthcare authorities to provide patient support, patient education or physician education, and to help with programmes that lead towards greater diagnosis and linkage to care in certain disease areas. For instance, in Saudi Arabia, we have a cancer initiative as well as one for HIV.
There is work to be done and there is room for improvement. We have been very successful when it comes to partnering with healthcare providers because they see patients and are very keen to provide better care. That is where we have a role to play and through some of the work we do we can then also start impacting the broader public health system.
Perhaps as part of the eagerness for innovation you mentioned, certain countries in the region are stepping up approval rates. How fast is the speed to market in the Middle East?
We see the Middle East as an area where, in several of the markets we cover, speed to market is very high and we can bring medicines quickly to patients. Especially where the authorities identify an unmet medical need, such as in breast cancer. We were able to bring our medicine for the treatment of triple-negative breast cancer to market very early and prior to registration in some cases because the unmet medical need was clearly identified by the authorities.
We have also, since registration, achieved access in several countries in the region and we have launched in several markets. This is a part of the world where we know we can gain access quickly and where governments are keen for there to be fast access. So again, as part of the intent to provide increasingly better care to the citizens in the region, there is an understanding that access to innovation is a critical part of that.
What are your objectives for the region going forward and do you foresee further growth?
In terms of our strategic goals for the region, we want to make sure all eligible patients can be treated with our medicines. That depends, of course, on a clinical decision and whether a doctor decides to use a Gilead drug or use another drug. However, we want every patient who is eligible to have the opportunity to be treated with our medicines. That means working with healthcare professionals and healthcare authorities to ensure there are no barriers to access.
Beyond that, we will continue to launch our future portfolio and make that investment in the region. Through those two approaches, our expectation is to continue to grow. The huge growth we saw in 2021 and 2022 was due to the COVID-19 pandemic and our COVID-19 medicine, but we are very confident that we can maintain sustained growth going forward because of what we have to offer patients in the region.
The Middle East & Russia cluster currently has a multinational team of over 120 people. What are your plans for the team going forward? Do you expect it to grow?
Our expectation is that the size of the Middle East team is going to grow. It will grow in a way that enables us to achieve or deliver strategic goals in each of the areas we work in. One of the things the company is putting a lot of emphasis on and I firmly believe in and work towards, is providing opportunities for people to develop within Gilead. To give you an example, one of our lawyers moved to a position in government affairs, which is a great opportunity for both that person to develop competencies in different areas, and for Gilead to bring somebody with a different perspective to another part of our operation.
I am impressed with the quality of the people from the region. Still, I think that whether it be here or anywhere else, companies benefit from having a multicultural ecosystem and that is one of our core values. At Gilead inclusion and diversity are important to us because we understand the benefits that come from that. We are made much richer by having colleagues from Egypt, Lebanon, Argentina, France, Serbia, India, and other countries here. The mix of people is part of what makes us strong.
Is there anything else you would like to share with our global audience?
We are committed to our presence in the Middle East, and by that we mean we are committed to supporting patients in this region, in the disease areas in which we work, and we are committed to supporting healthcare systems to provide care for those patients. We will work with health authorities and healthcare professionals to ensure the best possible care is given to patients in this region. That implies not just providing our medicines, but also working across the board and partnering with various stakeholders to work on public health goals and public health outcomes. That commitment is one that we maintain now and expect to maintain in the future.
