«We have to include the developing world in the innovation cycle»

Published on 30/11/2020

Patrice Matchaba was seven years old when his father nearly died from stomach ulcers. It was a moment that changed his life forever and put him on the trajectory of an impressive international career in medicine, which seemed all but unthinkable given the hardship that prevailed in his homeland of Southern Rhodesia (modern-day Zimbabwe) in the late 1960s.   

Helpless as he was and fearing he would lose his father, who bid his family farewell when he was taken to the hospital for surgery, Patrice Matchaba decided to become a physician during this pivotal moment of his life. He would stick to his resolution even after his father returned from the hospital, where he luckily survived the intervention in which a large part of his stomach was removed.    

“When I think back to this time, all I wanted to do was help,” says Patrice Matchaba, who heads the company’s newly formed Global Health & Corp Responsibility unit and is running the revised global access-to-healthcare strategy of Novartis. “This instinct of helping has always remained strong with me and I’m glad my father supported me in my wish to become a doctor.”  

When his father developed cancer around three years ago, Patrice Matchaba and his brother decided to nurse him during the last six months of his life. Fortunately, his manager allowed him to take time off and work intermittently from Zimbabwe. “For me, there is a dignity in dying. I did not want my father to die alone in a hospital, so my brother and I decided to take care of him and repay him for all he had done for us.”    

In the 40 years since, Patrice Matchaba not only became a physician. He traveled the world of medicine, from focusing on obstetrics in Botswana in the 1980s, through the HIV crisis in Durban in the 1990s, to an interest in real-world evidence that later brought him to the Cochrane network in Cape Town, where he advised doctors about the latest medical developments and their impact on patients.  

His unique expertise prompted Novartis to approach him around the turn of the millennium. But Matchaba took his time before he decided to jump ship and work for an international corporation. What finally convinced him to make the move was “the quality, honesty and diversity that I found within Novartis,” Matchaba says adding that he has never regretted his move to the pharmaceuticals industry.

During almost 20 years at the company, he has worked in various positions, including drug development in areas such as inflammation and heart disease. He has also modernized the company’s drug safety unit and helped set up new therapeutic areas. Among his various roles, he has been Therapeutic Area Head for Immunology and Infectious Diseases and Global Head of Drug Safety and Epidemiology.  

Matchaba describes himself as a very curious person who is open to new experiences – besides medicine, he has also immersed himself in statistics and has gained a business development degree from Harvard. His latest role as Group Head of Global Health & Corp Responsibility seems to be tailor-made for him as it fittingly combines his interests and skills: A physician with many years of experience in the field and equipped with an in-depth knowledge of the industry, he has what it takes to reconcile these two worlds. 

“Access to healthcare has for a long time been defined by donations,” Matchaba says. “But as I know from my own experience both growing up in Africa and being a practicing physician, this can often lead to dependence and, worse, to corruption. If we really want to change something, we need to include the developing world in the innovation cycle. This is what will open new possibilities.”  

Since starting his new role in 2017, after the death of his father, Patrice Matchaba has worked on redefining the access strategy of Novartis and bringing its diverse access programs under one roof. 

Dating back more than 50 years to when J.R. Geigy set up a research and training center in Ifakara in south-eastern Tanzania, the engagement of Novartis in this field has since seen the launch of several large and successful access programs. This includes the Malaria Initiative in 2001 as well as Novartis Access, which was set up in 2015 to address the rising chronic disease burden in developing countries. 

While all of these programs have had a strong impact they have lacked an overarching structure. This is about to change.   

Rather than wait for years before a new drug is approved in a developed market, Novartis is working towards speeding up this process for medical breakthroughs to reach as many people as possible. “In the past, it took around 10 years on average before a drug approved in the United States or Europe reached the developing world. Now, we aim to cut this time-to-market to months,” Matchaba explains.   

Patrice Matchaba knows first-hand what this means and what positive effect it can have on the life of a patient and his or her family. “My father had to undergo surgery to treat his stomach ulcers. It was a difficult and dangerous procedure. Today, thanks to the wonders of science, we can treat such conditions with proton-pump inhibitors, available over the counter in most countries. Such innovations should reach everyone in need, irrespective of where they are. This is what our access strategy is about.”

Dr. Matchaba, Novartis has adapted its access strategy with a view to reaching more patients around the world. What triggered this new approach?

Novartis has a strong legacy in the area of access to healthcare, dating back more than half a century. We have made great strides in this respect, not only in the realm of philanthropy but also in setting up structures to allow such projects to be financially sustainable. We have had great success with Novartis Social Business and have proven that such approaches are feasible. Now we want to broaden access to healthcare and align it more closely with the business in order to live up to our mission to improve and extend people’s lives and reach as many patients as possible with our innovative drugs.

Why have such approaches not been tested earlier?

Before the millennium, most access programs were pure philanthropy. Our Malaria Initiative tested new ground by collaborating with the World Health Organization and providing our malaria drug Coartem® without profit to our partners who had the power and local expertise to distribute the medicine. This was neither a strict donation nor a profit-oriented venture. It was a way to scale the program on a global level and find an answer to the malaria crisis that prevailed at the time and was killing around 1 million people every year. Thinkers such as Muhammad Yunus and the late C.K. Prahalad brought a sea change in terms of how the poorest of the poor could be lifted out of poverty through new business models. This set in motion a whole new ball game.

Can you expand on this?

When we look at the global income pyramid, the pharmaceuticals industry in the past targeted the top percentile, catering for patients and healthcare systems that were ready to stem the costs associated with innovation. The poorest were able to benefit from donations. By developing a business model for low- and middle-income countries through our Social Business ventures, we are now in a position where we can broaden access to all those people in between who still lack regular access to healthcare. Our Healthy Family ventures in India, Vietnam and Kenya, which are financially sustainable, prove that such an approach can work well. Now, in a third step, as we gain in experience, we also want our innovative drugs to reach developing markets as quickly as possible to broaden patient access.

Can you provide an example?

In 2013, our colleagues in India started to look into how they could better address age-related macular degeneration, AMD, in the country. Novartis had a potent drug in other markets but nothing in India, in particular no solution for those people who had to pay for drugs out of their own pocket. After running a series of market tests, the team asked regulators to approve our therapy and launch it in India with a version that was adapted to the medical needs of patients and was delivered at a price that allowed access to as many people as possible. Today, it is one of our most successful products in India.

How will the new access strategy be implemented?

As much as this is a strategic choice to integrate access strategies in all our new product launches to help ensure that our medical breakthroughs reach as many people as possible, it involves a cultural change that requires our associates to think about these aspects early on as part of the research and development process. At the same time, we are also working hard to ensure that the drugs we launch in Europe and the United States reach developing markets much faster than in the past. The industry average for the launch of a drug approved in the United States and Europe on other markets is something between 4 and 12 years. We are aiming to bring this down to 12 months. In some instances, we have been able to reduce this timeframe to 5 months and now are aiming to get there even faster.

Did this experience help you accelerate your COVID-related efforts?

Definitely. Given our expertise and understanding of patient needs, we froze prices for some essential generics right at the outbreak of the pandemic and created a COVID-19 portfolio with 15 Sandoz drugs that treat key symptoms of the disease - offering the package at zero profit in many low- and middle-income countries. Also, we started working on a series of projects aimed at supporting access to and the development of new medicines against COVID-19 and coronaviruses in general. This includes our collaboration with the Bill & Melinda Gates Foundation as well as our recent partnership with Swiss biotech Molecular Partners.

Besides bringing innovative medicines to patients in need around the world, what is Novartis doing in areas where business models and market strategies don’t work?

One important area of our access strategy is to focus on so-called areas of market failure, in which the economic and societal framework conditions are too weak to set up sustainable market strategies. Two fields in which we have been working for years are, of course, malaria and leprosy. In the case of malaria, we are not only providing access to our therapy Coartem, but are also working actively to develop new treatments. We want to be part of the global effort to eliminate malaria. Likewise, in leprosy, we are working to eliminate this disease together with many partners, including Microsoft, which will support us in adapting the latest digital technologies. In addition, we are also launching two new projects in the areas of Chagas disease and sickle cell disease.

Can you expand on the Chagas and sickle cell disease projects?

Chagas disease affects millions of people in South America and, although the disease was first described more than a century ago, there is still no targeted treatment available. As 30 percent of patients with Chagas disease develop heart failure over time as a result of this condition, we have started the first ever clinical trial to test our heart failure drug Entresto® as a potential treatment. In the area of sickle cell disease, where we have recently submitted a new biologics treatment in the United States, we are launching a unique program in Ghana, where we will work with the government to tackle this crippling condition, which often affects children, and make hydroxyurea accessible.

Can you give more details about the approach in Ghana?

Treatment options and also diagnostic procedures for sickle cell disease, which affects the red blood cells, are weak, especially in Africa, where most people affected by this disease live. To change the situation on the ground and pave the way for future improvements, we have started a three-pronged approach: We have licensed a generic drug that can be used for treating sickle cell disease in Ghana and have entered a partnership with US-based start-up Hemex Health, which has developed a very efficient diagnostic test. At the same time, we are starting a clinical trial in Africa for our new sickle cell treatment and have applied for its registration in Ghana.

What kind of outcomes do you expect?

We are very confident that our access strategy, especially in areas of market failure, will enhance healthcare systems and help those people who currently have no treatment options. Even though we have only just begun our sickle cell initiative in Ghana, a number of African states have already shown an interest in participating in this program and Uganda, Tanzania and Kenya have recently joined. Generally, I believe we are well on track to making a real impact on global health through our programs, which have the size and team power to make a difference for patients around the world.

Where do you see Novartis’ global health efforts five years from now?

Our strategy is to build a leading, focused medicines company powered by advanced therapy platforms and data science. One of the five strategic priorities we have is to build trust with society. We want to achieve this, for example, by having, a clear pricing and access strategy, offering solutions to some of the most pressing global health challenges and maintaining strong relations with our key stakeholders. Over the past few years, we have risen to number 2 from number 7 in the Global Access to Medicine Index thanks to our access principles. We aim to continue working on this path by bringing innovative therapies to as many patients as possible and continue with our efforts to strengthen health systems. I hope that within the next five years we can work towards eliminating diseases such as malaria and leprosy and build the basics to combat widespread problems such as Chagas disease and sickle cell anemia. These would be great achievements and would mean that millions of people would receive treatments who today have limited or no medical options. This is a goal worth fighting for.