Juan Cruz Álvarez García is the director and general manager for the Healthcare Business Division at the German science and technology company Merck, for Central America and the Caribbean. With more than 20 years of experience in the sector, the Argentine executive has worked in the health and biotechnology branches of Latin America. In this context, he spoke with Espacio Gente about the brand’s projections and stated that “if all goes well”, in 2022 a new immunoncological treatment will reach our market. It is “a very promising therapy for patients, where we will have two indications: for bladder cancer and for kidney cancer,” he explained. “What we will do in early 2022 is definitely going to be a very positive therapeutic novelty.” Merck has been operating in the health, life sciences and electronics sectors for more than 350 years, around the world.
As part of its growth plan, Merck established the Central American headquarters in Panama, starting in 2021. With what prospects are you laying foundations in the country?
It is important to note that Merck has been present in the region for 50 years. This obviously is an extremely important region for Latin America, in that sense, our initial operations began in the year 71 in Guatemala. The decision to come to Panama is part of the expansion process. Meanwhile, we are going to maintain operations in Guatemala, because it continues to be a strategic market for us; Coming to Panama implies going one step further to reaffirm our presence in the region. Additionally, having access to a critical business center such as Panama for the region is one of the most relevant points. And second, to have access to the talent that Panama can give us, where in addition to Merck, there are many other established pharmaceutical companies. The country has become a very relevant pole for the region and the pharmaceutical industry, and we want to accompany and be in this process.
How has Merck adjusted to the entire contingency of the pandemic?
It has taken us by surprise like everyone else. When you work in a company where the patient is at the center, the first question you ask yourself is how do we ensure that our patients – ranging from those in treatment for diabetes or hypertension, to those who have other more serious conditions such as cancer or multiple sclerosis – remain in treatment. It was to put the entire company, together with the health systems and distributors throughout the region, to guarantee the continuity of these treatments and, therefore, that of the businesses; not to stay and not to stock the markets. That has been the first point; the second and most relevant was taking care of our employees. We had started a home office process overnight, seven days a week. It was an interesting and intense process, but one that left us a lot. Synthesizing a bit, it was taking care of our patients, our employees and working hand in hand with our business partners.
In the company they work on developing health solutions going through everything that has to do with the pharmacological part. Which sectors were most affected by the covid-19 crisis?
It is a very good question, because in terms of product it has been quite heterogeneous. In those patients who are diabetic or hypertensive, it has been easier to maintain the treatment because the pharmacies have continued to work. Perhaps where there was an interruption, it was mainly in those treatments that require cancer patients to be mobilized to do their infusion; That is where, perhaps, some institutions or hospitals overflowing with Covid-19 patients had problems. The year 2020 was one of the great challenges; the fact of seeing patients in cancer treatments … or for patients with infertility, where fertility or assisted fertilization centers have closed their operations 100% for a couple of months. As you will see, we are talking about very different conditions, but what I want is to share a little with you that it has been so diverse, and in turn the diversity in the therapeutic areas where we operate, where there are some that had a more conscious patient, not because the patient with other conditions it has not been but, due to operational issues: hospitals, closed clinics, etc., this caused the treatments to eventually be delayed or a little longer.
According to information from the Reuters agency, Merck would increase the supply of lipids to the BioNTech company to alleviate the shortage of a key ingredient in some vaccines against covid-19, while many countries struggle to accelerate their vaccination programs. out this process?
Merck is a science and technology company where we have a diversity of products ranging from electronics to traditional pharmaceuticals; but there is an area that is life sciences or life science that has become a key player. With regard to guaranteeing these lipids for the production of vaccines, not only BioNTech, which is the company that has had an agreement with Pfizer at a global level for the development of the covid vaccine, but has also become a player to global level as a supplier to several of the companies that are currently in the process of producing covid-19 vaccines. For the company it has been a piece of mind to be able to guarantee this supply, because we are talking about vaccine production in record time. So guaranteeing and having that supply makes us feel proud and we continue working from the point of view of expanding our production, from the research centers, mainly in Boston; where what we are doing with these investments is to continue working to guarantee the supply of this very important element for the production of vaccines.
The pandemic has exposed the fragile structure of the health systems in our countries, especially in the Central American region. Have Merck had conversations with the local government in order to supply, improve and strengthen the health infrastructure in Panama?
We have not had the opportunity, for the moment. We, like many of the research and development companies in the region, are associated under Fedefarma, which is the union to which we belong, but particularly in the case of Merck, as you said, we are the new player in Panama. We are establishing ourselves and surely as we walk our way here, we will have an approach with the authorities to see what we can contribute or how we can help to develop the greatest possible access to health, by citizens in Panama.
One of the great concerns of international organizations such as the Organization of American States (OAS) and the World Bank is unequal access to vaccines, especially in Central America. What are your considerations?
It is a very important question. Definitely what we saw was the beginning of a vaccination process that was quite uneven. Latin America at some point has been the region with the highest infections per million inhabitants, but I am seeing it is a recovery process where the United States is planning a donation of 500 million vaccines globally. We are seeing a system that is being accommodated, where the voice has been heard and the importance of vaccination has been made aware of all the countries of the world. We well know that if a virus is not controlled globally, it will be a never-ending story. There is a lot of awareness and it seems to me that it has been a process in which improvements are being seen in recent months and how countries in the region are beginning to accelerate their vaccination rate.
In Panama there are sensitive issues such as the prevalence of cancer, whose diagnosis has slowed down with the pandemic. In terms of oncology, how close are we to new treatments compared to the world?
At Merck we are celebrating exactly 50 years in the region and we have a history in the world of oncology, where today we have existing therapies and, as far as innovation is concerned, we are going to have the launch of a new immunoncological therapy ; They are new generation therapies and if all goes well, it will be available by early 2022 in Panama and other countries in the region; it is definitely going to be a very promising therapy for patients, where we will have two indications, for bladder cancer and for kidney cancer. Today, in the case of bladder cancer, there are still unmet needs and we have come to cover a very important space for those who today have treatment, but who may be several years old. In the case of the launch, what we are going to be doing in early 2022 is definitely going to be a very positive therapeutic novelty for these patients.
In Panama, according to official data, multiple sclerosis is the main cause of neurological disability, what type of therapies do you develop for this pathology?
We have an interferon beta-1a that is one of the treatments that we had for several years until 2018, where we launched a new therapy in the segment, which is an oral treatment for patients. Multiple sclerosis is a chronic disease where the patient has to inject or take a tablet every day, and in this case what we have is a novel therapy that implies for the patient to have to take 20 tablets during year 1 and 20 tablets during year 2; then you do not have to take any medication for the next two years. This really shows our commitment to patients with multiple sclerosis, to the therapeutic area, and it is an innovation at the service of time and the burden that patients often have.
One of Merck’s most interesting bets is prevention-oriented immunoncological therapies. Is there a preventive culture in our countries?
Unfortunately I would say no. If one talks about prevention in oncology, it is quite a challenging term for the whole system, not only from a pharmacological point of view. How do we get people to eventually detect any abnormalities? In a cancer patient, the earlier it is detected, the greater the possibility of prolonging life and being cured. We have to start from a base with the early diagnosis and the knowledge on the part of the patient of those possible symptoms; the sooner the consultation is and the system is also agile and has openness for the patient, I think that is what will help us prevent not so much cancer, but other more serious situations, such as the fatality of patients who arrive with a advanced level of the disease, which is what takes away the longest life expectancy. Much work has to be done on prevention and education. That is where we can get to have a better prospecting while the pharmaceutical industry innovates and brings therapeutic alternatives that help the patient in the prolongation and eventual cure of their disease.