By Neil King
Healthcare, reputation, sustainability and women in business are all on the agenda for Jane Griffiths, regional group chairman of Janssen Pharmaceutical Companies of Johnson & Johnson, as the company announces Dubai as its Middle East hub
When Johnson & Johnson’s pharmaceutical unit announced the expansion of its presence in the UAE, it was yet another signal that the country is fast becoming a regional healthcare centre.
In October, Janssen Pharmaceutical Companies of Johnson & Johnson Worldwide revealed that Dubai will be the hub of the organisation’s Middle East operations, with plans to make an impact on the region’s healthcare system through research and development (R&D), retail, devices, and more.
Group chairman for Europe, Middle East and Africa, Jane Griffiths, visits the Dubai office to meet with the branch’s team of 70, before meeting with some of the 300 other employees around the Arabian Gulf.
Her reasons for using Dubai as a base for expanding the company’s portfolio in the region are clear.
“It’s a very vibrant place,” she says as we meet in Healthcare City.
“It’s a great place for us to have a hub for our Middle East region. We already had some people here and we decided to consolidate. We’ve got three sectors, so it’s not just pharmaceuticals, it’s consumer and devices as well, and it gives you economies of scale then to work together.
“It’s accessible as well, and also from a healthcare point of view there are opportunities for the future here ,which we want to be able to participate in, benefit from, provide benefit to, to patients out here.”
One key opportunity Griffiths foresees is that concerning type 2 diabetes; one of the region’s most widespread medical conditions.
In the UAE it affects 19 percent of the population, with 803,000 people between the ages of 20 and 79 recorded as having the disease in 2014, and 1,335 people losing their lives as a result.
Worldwide, more than 4 million people died last year due to type 2 diabetes, with some 387 million people living with the condition; a figure that’s expected to rise to 592 million by 2035.
“We’ve got an emerging type 2 diabetes franchise, and there’s an opportunity here with — unfortunately — many people suffering from the disease,” says Griffiths.
“This is a play we can have across our sectors because we’ve got medicines, we’ve got testing, and we’ve also got surgical procedures that can benefit people with type 2 diabetes. So what we’re hoping to do here is work with institutions, with government, with hospitals, with insurers, to try to provide a full service for patients.
“What we’re trying to do with our pharmaceutical business particularly is look at the outcomes for patients, not just provide medicines but provide better services for testing. There are many people in the population who might not know they’ve got type 2 diabetes, and if it goes untreated that’s obviously not good for the long-term. So we’re very excited about that.”
Dubai’s, and the UAE’s emergence as a healthcare centre is another reason why Griffiths has identified the country as an important operational base for the future.
“I start to take more notice of a business when it starts to creep up the ranking in my own individual portfolio of markets and countries,” she explains.
“This region is now in the top ten, so it get my attention. It’s growing well — that also gets my attention, and the opportunities for the future obviously get my attention. When governments state intentions about putting money into healthcare, wanting to improve population health, then there are partnerships to be struck in how that’s done, and that’s how we want to work. So it’s very exciting.”
Griffiths adds that she would like to see the group strengthen its presence across MENA and beyond by building such partnerships and capitalising on the thirst for innovation.
“Where innovation is valued, which for patients should be everywhere, you’ll see us have a presence,” she says.
“We would like to formalise our hub across more countries. There are negotiations to be sorted out, but we’d like to see establishment of entities everywhere. We’ve established a legal entity here now, and our people are happy, and we’d like to do that in more places.
“This hub is not only for the Middle East. We’ve got sub-Saharan Africa using the hub as well, so we’ve opened up legal entities in Kenya, Ghana and Morocco this year. We’ll look to set up entities where we can in the future. It takes time to do these things, but that’s our future plan.”
With Griffiths’ role covering Africa as well as the Middle East, type 2 diabetes isn’t the only disease that has been high on her agenda during the past two years.
The Ebola crisis, which broke out across West Africa in December 2013, is believed to have affected 28,635 people, according to the World Health Organisation, with 11,314 dying as a result.
The themes of partnerships, collaborations, and an increased presence have been exemplified in Johnson & Johnson’s response to the epidemic, with the company teaming up with one of its peers to create a vaccine to the virus.
“J&J has been a major player in bringing forward a vaccine,” says Griffiths.
“We’ve partnered with a company called Bavarian Nordic to put two vaccines together. Basically you have one and then it’s boosted about four weeks later.
“We’ve just started phase two trials in Sierra Leone in the past four weeks, and we worked hard to make sure that there were sufficient vaccines available such that if the epidemic had grown, that we could have stocks available.
“I think it’s been a really good example of collaboration between companies, governments, and the World Health Organisation, and that’s certainly our contribution to global public health in the past 12 months.”
Collaboration between competitors is unquestionably a difficult balance to strike, with business interests still vital for each player. But it has long been — and will continue to be — an important part of an industry that relies on effective medicines to survive.
But for Griffiths, the notion of competition is just as important as collaboration; especially when it comes to innovation.
“The patient will always come first,” she says. “And one of the things about the pharmaceutical industry is that through competition comes innovation. That is sometimes a missed point.
“Yes there’s competition, but through that comes people working faster, better, with better scientists trying to understand disease mechanisms. Whoever gets to market first with the best medicine will reap some good rewards. The patients win, society wins, and the business wins.”
“But there are some areas in medical research that are very challenging and require collaboration. Alzheimer’s is one of them. Alzheimer’s is a global issue for aging populations, and in that respect there’s a lot of pre-competitive collaboration going on within the industry.
“A dementia fund was just announced in the UK in collaboration with the British government, there are several companies working together. It’s not easy — Alzheimer’s is a tough nut to crack. And that’s where you have collaboration.
“In other areas, for example infectious diseases, for example hepatitis C, for example HIV, it takes regimes of drugs — sometimes not just one medicine — to be effective, and of course there you need collaboration for clinical trials.
“So yes there’s competition but there’s also collaboration when it’s going to benefit innovation and ultimately benefit patients.”
The work of Janssen and Johnson & Johnson is, of course, just one part of a regional healthcare sector that is steadily undergoing transformation.
A recent report by Al Masah Capital estimated that healthcare spending in the Middle East and North Africa (MENA) is on track to reach $144bn by 2020, as a result of developments over the past decade.
The reports showed that government spending in 2013 nearly hit $96bn, more than treble the total in 2003, when $30.4bn was spent. The authors of the study emphasised the growth in private equity (PE) interest in the past ten years, with 91 PE deals taking place to the tune of $1.7bn. The UAE, Saudi Arabia and Egypt were cited as being the focal point for deals.
From her position as company group chairman for Europe, Middle East and Africa, Griffiths has been able see a wide spectrum of dedication to healthcare, as well as the leaps some countries continue to make, especially in emerging markets.
“There are big differences in the percentage of GDP spent on healthcare, and I suppose at the end of the day that’s what’s going to be the major determinant of huge strides in healthcare provision for the whole of the population,” she says.
“Many of the countries across the region have three to 4 percent of GDP spent on healthcare, whereas you’re looking at ten, 12, or 15 percent in some of the developed markets. So there’s an element of that that’s going to come as the economies grow further, or as people earn more and have more in terms of private healthcare insurance provision.
“Whichever way that goes, in whichever country we’re talking about, that’s going to make a difference to general populations in the future.”
In terms of the impact companies like Janssen can have on the development of a country’s healthcare industry, Griffiths is measured.
“I think it would be difficult for an industry to go to a government and say ‘I think you should be paying more than you are already.’ But as an industry I think we can help to partner in certain areas where it comes to improving the provision within the envelope that’s already spent.
“For example, with type 2 diabetes — I’ll keep referring back to that because it’s of interest to the region — if type 2 diabetes isn’t treated well and early, it can lead to long-term sequelae that could be more expensive to manage.
“So how do you identify people in the population who still haven’t been diagnosed? How can the industry — a company like us — help with diagnosing? Can it help with setting up registries? For example hepatitis C: Is it known how many people in any country suffer from hepatitis C? What is the burden going to be in the future for treating people who may go on to develop, for example, liver fibrosis or worse — liver cancer or something like that?
“So there’s partnerships that can exist. And sometimes by using certain medicines you can offset costs elsewhere in the system. Similarly we’ve been partnering regarding R&D (research and development) — offering trips to our headquarters in Belgium to talk with our research scientists. I know that in the Middle East in general there’s a desire to move beyond an oil economy to a knowledge-based economy, and of course all of this can help grow that part of the economy as well.
“So we’re very happy to exchange know-how in that respect, to move provision of healthcare further forward and science further forward.
“Our competencies extend beyond the obvious. We are also about people development, managing projects, and moving things along quickly. All things that are good to share as well.”
The pharmaceutical industry, however, is not without its critics.
Among the accusations levied at companies is that their pricing is too high; aimed at earning high profits rather than providing affordable medicine for patients.
This particular issue was thrust into the foreground in September this year when Martin Shkreli of Turing Pharmaceuticals obtained the licence for a drug used to treat patients with malaria, some cancers and AIDS, and promptly increased the price of the drug in the US from $13.50 to $750 per pill. Widely criticised by those within and outside the industry, Shkreli later announced he would lower the price of the drug.
Outlining her take on the situation, Griffiths voices her disappointment that the public’s perception of the industry can be so heavily influenced by such situations.
“If you look at that particular case, it doesn’t look as though there was much justification for raising the price that much. I mean, that company’s percentage investments to top-line sales is much lower than the innovative pharmaceutical industry.
“J&J invests about 20 percent of its pharmaceutical top line in R&D — about $5.8bn in lastest figures — and there are three aspects that we look at when it comes to pricing in our company.
“One is the value that it brings, the unmet need. The other is the costs, and third is stimulating innovation. You have to have an incentive for innovation, otherwise what’s it all about?
“There is a lot of criticism levelled at the industry and from my own perspective I feel it’s getting a little bit out of kilter because of these one-off episodes that have happened that have dragged everyone in the wrong direction.”
For Griffiths, the negative effect on the industry’s reputation is one of the most damaging aspects of such events. Something she is particularly careful to guard against, as well as counter.
“I take it very seriously,” she says.
“Having a bad reputation basically gets in the way of everything we do. If you take a step back, we do a huge amount of good.
“Life expectancy has increased 35 years since the early 1900s and it’s estimated that 40-50 percent of that is due to pharmaceutical innovation. In the last 20 years 75 percent of increase in life expectancy is attributed to pharmaceutical intervention.
“If you look at those things, people with HIV now who really were going to die in their 20s in the 1980s, can now be expected to live a relatively healthy life until they’re 70. One out of three people diagnosed with cancer since the 1970s/80s would survive, now that’s double — now that’s two out of three.
“Cardiovascular risk has been dramatically reduced thanks to the use of statins. Hepatitis C, which we’ve involved with, can now be cured, and somehow all of these great things get lost in the mist around pricing. And it’s a great regret to me because if we can start to have a dialogue about what outcomes pharmaceuticals can bring rather than just the cost, I think we will move forward a lot.”
Addressing another criticism of the industry, Griffiths explains that Johnson & Johnson is taking steps towards greater transparency when it comes to publishing clinical trial data.
“Now J&J has a web portal that’s hosted by Yale University, where all of our data is posted. And if a scientist wants to ask a legitimate scientific question of the data, and Yale University — not us — deems that to be ok, then they can analyse the data. We we’re starting there, and it’s my hope that we start to improve our image where people don’t hold us in high esteem. I hope that a greater understanding of what we bring to society can be put into perspective.”
Away from medicine, pricing, and data, Griffiths is active in ensuring Janssen takes the lead in two increasingly prominent areas for companies across the breadth of sectors: sustainability and women in business.
Heading up the sustainability council, she and her colleagues look at not only environmental sustainability, but also access to medicines.
“We have some pretty audacious goals globally to reduce water use by 20 percent and to reduce our CO2 emissions,” she explains.
“We look at the use of solvents in manufacturing as well. In fact, with one product that we brought in a while ago, our manufacturing group looked at the manufacturing processes and managed to significantly reduce the solvent use, just with their particular know-how.
“Another area is around the footprint of our packaging. If you look at the carbon footprint of your product, because there’s such a small amount of medicine in each pack, the footprint is mostly around the packaging. So we’re looking at how we can improve the packaging design.
“Trying to reduce waste locally is something we look at too — reducing the amount of waste that goes to landfill.”
In terms of access to medicine, Griffiths explains it’s an area the company takes extremely seriously.
“There’s something called the access to medicine index, and I think we’re ranking third at the moment,” she says.
“It’s a huge undertaking that’s done where they look at not just access to medicines, but what our working practices are, and how we’re enabling access to medicine in some of the world’s poorest countries.
“One of the biggest contributions we’re making there is having research programmes in the area of neglected diseases. So recently our contribution to multidrug-resistant TB, with launching a new compound there, has really focussed on what ordinarily would be considered a neglected disease, and there are other areas that we will go into, particularly with a focus on sub-Saharan Africa.”
Janssen set up a new group at the beginning of 2014 called Global Public Health to focus on areas where the company has no commercial presence, targeting unmet health needs in underprivileged communities.
“It’s really crystallising what we’re doing — adding some focus,” says Griffiths.
“This won’t be a business play, it will be a public health play in neglected diseases in some of the most underprivileged areas in the world. And I’m really proud of that because it’s something that says we absolutely take the global nature of healthcare seriously — it’s not just about where you have a for-profit business.”
The role of professional women is also an important issue for Griffiths, who rose through the ranks at Janssen, starting as a sales representative to become the first female company group chairman.
“I hope it’s a signal to women,” she says of her journey to the top job.
“It’s not as if I came in in a senior role. I hope it tells women about the possibility that you can get there. I see my role as trying to enable that more.
“When I first came into the business I was often the only woman in a meeting. I was the first woman to have kids who was a manager. You feel you’re blazing a trail to start with. But my objective now is to get more women into senior positions, so we have metrics that we look at every year.”
Griffiths speaks of creating an environment where it’s possible for women to continue to work after starting a family. An environment she wasn’t able to enjoy earlier in her career.
“If you have kids, you’re sat in a board meeting, you know you’ve got to get home for something whatever it may be, you’ve got to make it ok for people to do that,” she says.
“At one time it was like ‘I can’t tell them that I’ve got to go home to the kids’. That was 20 years ago. Now it’s fine. And it’s not only fine for women to do it, it’s fine for men to do it too. By improving it for women, you’re also improving it for men.
“Also, when you take time off to have a baby, you’re worried that when you get back you’ve slightly de-skilled yourself. If they are feeling that way, what can we do to bring their confidence back?
“Another thing is, if you’re going outside and using head-hunters, telling them you’ve got to bring me more women onto slates to bring more women into the company. I’ve appointed two women leaders in my biggest markets — Germany and France. And that’s a signal again that it’s not just the softer skills that you have on board, it’s real business skills that you have on the board.”
Cultural traditions in the region provide Griffiths and Janssen with some additional challenges when it comes to promoting women in the workplace, especially in more conservative countries such as Saudi Arabia.
But unbowed, the company has devised ways to work within the culture and still afford women career opportunities.
“Different countries are at different stages on that journey, for sure,” says Griffiths.
“In Saudi we’ve been working with the women’s university to sponsor pharmacy graduates to come in to work in Saudi. It’s obviously very different there, there are different working arrangements, but it’s about trying to develop more female leaders to bring forward in the future.
“You have to work within the cultural norms whatever they are, but on the other hand I’ve always been one for pushing the limits a little bit, so how can we push the boundaries where women want to work? How can we make it easier for them to work?
“We’re thinking about all of these things that can maybe bring more women into the workforce and bring more women into senior positions. And we’ve seen great progress in the organisation by being really purposeful about it.”
With so many initiatives in place, as well as building a greater presence in the region, Griffiths is understandably positive about the future of Janssen in the GCC.
“It’s a very exciting time, and we look forward to contributing to the health of people here,” she says, before ending our conversation with a reiteration of what she believes is the key element to success on that front. The important thing is partnering with institutions and government here,” she asserts. “For me that has to be a pre-requisite for us being successful — that those partnerships are developed locally, and that we’re not pharmaceutical industry and J&J on one side, and then the healthcare provisions on the other side. It has to be more integrated.
“Collaboration is key, and not just here but everywhere. Of course when you have a fast growing and evolving environment, then it’s the time to build those collaborations for the future.”