On Building an African Market Access Network - A Conversation with Olawale Ajose

Episode Transcript

Claire  00:15

Hello, and welcome to a new episode of Narratives of Purpose. My name is Claire Murigande, I am your host on this show. And my goal is to amplify social impact by bringing you inspiring individual stories of ordinary people who are making extra ordinary social impact within their communities or around the world. So if you're looking for a programme that showcases unique stories of changemakers, stories of people who are contributing to make a difference in society, and at the same time you want to get inspired to take action, then this podcast is definitely for you. This second episode of October continues to explore healthcare access in Africa. So just like my previous guest, today, I speak with yet another healthcare leader from the private sector, who has an underground experience of introducing new therapeutics, diagnostics, and medical devices in emerging markets. His name is Olawale Ajose. He is the co-founder and principal consultant at Market Access Africa, a healthcare consulting firm based in Geneva, focusing on Sub Saharan Africa. While he shares the mission of market access Africa, as well as his perspective on the future of health care on the continent, do take a moment to rate and review our show on your preferred podcast listening app. But for now, listen to Olawale endeavour to contribute to improve health care access across Africa.

 

Claire  01:58

Good afternoon, Olawale. Welcome to the podcast. How are you today?

 

Olawale  02:02

I'm doing well.

 

Claire  02:03

So today in our conversation, we're going to be mainly speaking about Market Access Africa, which is a healthcare consulting firm. But before we jump into that, I'd like to, you know, start with some introductions. So tell me a little bit about yourself. And what is your background if you'd like to share with our listeners?

 

Olawale  02:22

Sure, sure. So my background is in cell biology and genetics. I did my first degree in Nigeria at the University of Lagos. And then I went to do a master's in public health. So I'm really like a science guy. I started my career actually in construction. You know, after my first degree, the options for work were quite limited and not very exciting, the only jobs I was getting was to work in a lab in Lagos. And I decided that this is not the life I want. And so me and a friend started a business where we would basically move construction products from one side of Lagos to the other side of Lagos using barges. It had never been done before in Lagos. And it was successful for like a year and a half. And then we had issues with the government, and they shut us down. So it was after that I then went to pursue a degree in public health.

 

Claire  03:30

So you refused to stay in the lab and you went from public health? What was the motivation there for you?

 

Olawale  03:35

So I've kind of always been passionate about health care. And I think it's because my mom is a medical doctor, right? My sister is also a background in healthcare as well. So we grew up in an environment where you're always talking about health and science and what have you. So I think from that standpoint, I was always passionate about healthcare and I knew I wanted to work in healthcare. The plan was, as I was going into university to do medicine, but I wasn't smart enough to get into the medicine degree. And so my mom said "Well, if you can't get into medicine, maybe another opportunity for you to work in healthcare is to do public health."

 

Claire  04:19

Now coming back to Market Access Africa, as I said in the beginning, it's a healthcare consulting firm, which is based in Geneva in Switzerland. And I'm curious to know what led you to start this firm?

 

Olawale  04:31

So after my public health degree, I worked in a number of global health organisations, initially with the Clinton Health Access Initiative, which most people know as CHAI, they use business approaches to try and solve healthcare problems, right. I was there for a few years, and that really exposed me to the needs around product introduction and market access in Africa. Then I left CHAI, and went to work for a big funding agency in Geneva called Unitate. And Unitate is also very unique in the sense that the finance market based interventions in low and middle income countries, so unlike your traditional funding agencies that would fund, you know, procurement of condoms and all these things that we we think about NGOs, you have that in your mind, Unitate was more innovative, they would find R&D, they would find upstream interventions, and so on. And I did that for a few years. And then I left Unitate to work for DNDI, which is a product development partnership that manufactures drugs for neglected tropical diseases. And across this I guess these three companies and my experiences there, one thing was very clear to me that for us to fix the healthcare problem in Africa. One, you can't just take a purely public sector approach, right? You need to mix this great public sector thinking with all of the other amazing interventions that you find in the private sector. And this really wasn't happening. That's one thing. The second thing is that aid is... so I'm not against aid, I think aid is good. But you know, you can't build the public sector of aid. Aid documents, everything else that you're doing, the way you build the health system is in my opinion, is to treat, you bring in, you create the enabling environment, and that's the role of government. But then you also need to support the private sector, you need to support private capital into the health system. And this, if you think about the way development agencies work, you know, that private sector element is usually missing. And so basically, we found the intent around Market Access Africa was to fuse both, you know, the public sector mindset and the private sector mindset, and bring that thinking into healthcare programming in Africa, not just working with international organisations and NGOs, but also supporting companies that want to, you know, get access to the healthcare markets in Africa.

 

Claire  07:29

So if I understand correctly, what kind of makes you unique is you're bringing this private sector mindset into the public sector space, I'm wondering, is this I mean, unique to only you? Are you the only firm doing this?

 

Olawale  07:43

No, no. So, you have a few firms, so the big healthcare consulting firms do this already. But we know how much those guys charge, it's incredibly expensive. I think what makes us unique is that many of the people that work for us are based in Africa, right? So we exclusively use Africans, and we look for seasoned subject matter experts, people that have more than 10 years of experience doing solid work on the continent, you know, and the old look like that cost rate, you know, they're, they're black and, and they are incredibly smart. And this is one thing that you don't find in most organisations, a lot of them, and I don't want this to sound like I'm pointing fingers. But a lot of organisations fly in and fly out consultants into Africa, when we have the expertise at home. So that was one, one thing that really makes us different. The other thing is that for us, it's very important that, and it's linked to the first point that the solutions that we provide are grounded in the local context, there's no point taking on a client, providing advice that really doesn't change the reality of Africans. And so for us, the African person, the patient, whatever we want to call it is really at the centre of everything that we do. And if we're not changing lives, then there's no point being in business.

 

Claire  07:43

And going back on a few points that you mentioned before, you're speaking about your clients. Who are your clients exactly? Without naming names, you know, who are you working with?

 

Olawale  08:05

We work with a lot of for profit companies, diagnostic companies, medical device companies, pharmaceuticals, were beginning to do some work around vaccines, and also international public sector organisations, the ones here in Geneva, some in the US and we're also beginning to engage a bit more strategically with African institutions that also need help. And so, you know, you have institution missions that have, for example, they have good initiatives, but they don't have access to this side of the world. And, you know, the funding on this side and the innovation from this side. So what we're now doing is looking for ways to bridge these two worlds. And you know, just like serving as a mediator, if you will.

 

Claire  10:19

you mentioned that you work exclusively with people on the continent. So who are you working with? And what are the profiles of these people who are working as consultants?

 

Olawale  10:28

The profiles vary, we currently have a really good mix of ex-pharma people, sorts of people like you, ex, I don't want to name companies, but you know, the big diagnostic and pharmaceutical companies, we have people who used to work there, we also have people like me, you know, global health people who have worked several years in implementation and so on. Africa can also be very political, right. So if you want to get buy-in from the government or the Ministry of Health, you need to understand the politics. And so you need people that also have that expertise. So some of the people that work for us are also ex-Ministry of Health officials, or folks that have worked in government. So with most projects, you would see this mix, you'd see a business person or global health person, and in several instances, someone who is more on the political side. 

 

Claire  11:30

So it's less than a year of existence. But have you seen a certain impact of your work at this point? What can you share?

 

Olawale  11:37

A lot of the work that we've been doing has been, you know, helping companies understand their go-to market strategy in Africa, and giving them solutions that we think will help them succeed on the continent. And some of these companies have actually taken the strategy and are currently implementing it. Before Market Access, a lot of what I used to see was companies having the strategy, they try and execute this strategy, the strategies don't work. And then they say, well, Africa is a hard place to work in. So we're not going to invest in Africa. And what we are seeing, at least with some of the companies that are beginning to implement, the strategies that we've put forward is that they are happy. Again, all of these things have been translated into massive revenue. So I can't honestly tell you, three, five years from now, if they'll still want to work in Africa, but so far, they seem to be very happy. And I also need to say that our work really doesn't stop with strategy. We want to hold the hands of the client and help them engage with the government, and help them with implementation and so on, again, for some of the companies that we're working with, because we're involved in implementation - work in progress.

 

Claire  12:52

I'm curious to know from your whole experience, you know, in the global healthcare space, what other gaps or needs do you see at this point that could improve access to healthcare in Africa? How do you see this whole space evolving?

 

Olawale  13:09

The truth is, companies succeed in Africa, right? You look at the retail sector, you have billion dollar businesses in Africa that are doing well. You have billionaires in Africa that are doing well. You look at health care, and many, many companies are doing well, you know, guess what, because 70-80% of the population get their services from the private sector, so somebody must be serving them. So I guess the point is, I see a massive potential for Africa. And I think it's very, very important that companies that want to work on the continent, look beyond what they read in reports. And they really commit. They grow business the same way they would grow it in Europe and in the USA. And yes, the revenue potential is not the same, right. But the impact that you would have is much greater because the need is much greater. So yeah, I think the potential is there in terms of opportunities, I see it's a lot, and we could spend the next three hours having this conversation. Local manufacturing on the African continent is getting a lot of attention at the moment. This is one area that is going to grow. There's a lot of political will Now, given everything that happened we COVID. Many of the companies in Africa struggle to compete because they also don't have just access to low cost API's, Active Pharmaceutical Ingredients. So it's like the raw materials for manufacturing drugs or diagnostics or anything. And it's because the market is very fragmented. And I think the person or the organisation that is able to figure out how to consolidate those volumes and provide some financial guarantees and just use the economies of scale to lower the cost of API acquisition would make a big difference on the continent. So I think this is also an area and it's one that we're really excited about is how do we help manufacturers succeed? How do we help them lower their cost of production? And then further downstream, how do you help them get a higher share of the market? How do you get products from Kigali to remote parts of Rwanda near the Congo border, right? And how does that work? So I think manufacturing as a whole is getting a lot of attention and that is one area where people should be paying attention. But any view on partment fracturing, I would focus also on distribution and then also upstream around API sourcing and so on. But these are just three examples. I could mention more.

 

Claire  15:59

Any other insights from your personal experience? I would say because you started in Lagos in Nigeria, you now live in Switzerland? What is your personal view as well?

 

Olawale  16:13

I think the personal views are the same. I mean, I'd be lying if I said Africa is an easy place to work, because you don't have the enabling environment. So my personal view is and I hope someone from the government is listening to this phrase in Africa is, we need to also create an enabling environment, and companies are not going to do it for us. And many of the public sector organisations are trying, but it really is the responsibility of the government. So until we can fix things like regulation, and reduce the time it takes to register your product and reduce the cost. Some of the countries I don't want to mention names here, but they charge a lot to register your product. And then you think about having to do it in 50+ countries - it's too much. So harmonising regulation is going to be very important. And only governments can do it. And there are efforts on the way to harmonise regulation in Africa, I think they just recently got the last signature. And, you know, the African Medicines Agency will hopefully soon be up and running. And so that should hopefully streamline regulation processes in the coming years. But that has to happen. The other thing is that when you get your products into the country, distribution is really not in a good shape. And again, there's a role for the private sector to play, but there's also a role for the government. So my personal view is that governments also need to step up and make investments if they want to improve the healthcare system. And there's also a role for public sector organisations, and I'm so happy. This is why I say that I'm not against aid, because aid goes a long way, you know, billions of dollars are being pumped into low middle income countries, from organisations like the Global Fund. And if that money wasn't there, HIV patients wouldn't get drugs, because governments are dealing with several issues, right? You know, malaria patients might not get their drugs or diagnostics, TB patients and so on. My issue with aid is that it comes with a lot of vested interest. And so my personal view for the future is that we hopefully see a form of aid that really focuses on the needs of African countries, and it's less politics, it's less vested interest, it's less "we're going to keep 50% of the aid in the country that it's coming from. And only a portion goes to Africa, because we find vehicles and overhead and all these things. But in our report, we say that, you know, 95% went to Africa" it's good aid, we need good aid focusing on the patients. And Claire one last point is that the reason why healthcare is so good here is not just because they have access to the right tools, so drugs, diagnostics, and so on. But like all of the other things like clean water, and the air is fresh, and you have all these other things that keep you from falling sick. You think about the way health care is delivered in Africa and it's very vertical. You know, it's very disease focused and product focused, initiatives have, "I'm going to bring in my contraceptives. But I'm not going to think about why, you know, men or women are not using condoms, right? You know, I'm not going to talk about behavioural change interventions and look at other societal issues." I do think we need to move beyond this siloed vertical way of thinking, and just think a bit more holistically, it's incredibly difficult. And of course, as you can imagine, it's very expensive. And I can see why organisations are like, you know, what, we're just going to do our own little parts, provide this product, let someone else deal with the rest. But for us to make a difference, I think the approach needs to be holistic.

 

Claire  20:41

Yeah, absolutely. And I think he also goes to the point of, you know, making sure that education and this whole awareness as well around health care is also out there.

 

Olawale  20:52

Exactly. We're doing a project at the moment, I'm not going to mention the organisation, and it's a diagnostic project for one of the biggest infectious diseases on the continent. And we are trying to convince the client that, for you to really get uptake of this product, you need to invest in demand, demand creation, people need to know, "why do I need to go to a pharmacy or a clinic to ask for this product?" Right. And it's such a hard conversation to have. Because, again, there's already a mindset that "this is not our role to fund demand creation and demand creation" is also not sexy, you know, "let someone else do it, we want to do the sexy things". And all the analysis is showing us is that for you to really have that impact, it's less about the price of the product and getting access to a cheap product, it's how do you convince that man that doesn't want to get tested, and know his HIV status to come to the clinic? How do you convince him? Women do it, women are, you know, grid, they take care of themselves. And then you have all of these avenues through you know, antenatal care and I feel like women interface with the health system, more men, on the other hand, they use less. But yeah, it's been a difficult conversation to have,

 

Claire  22:25

I see that basically, if an organisation or a company is interested in working on the continent, they need to engage with all the different stakeholders, and making that even more or less simple, I'm not going to say more complicated. All the countries are different, right? You need to also factor in the culture aspect, and so on.

 

Olawale  22:47

All the countries are different, the culture is different. I mean, I'm Nigerian, and even as a Nigerian that grew up in Lagos, Lagos is so different from northern Nigeria. And the cultural practices are so different. So I can't even imagine the difference between like Nigeria and Eastern African countries, or southern African countries. So I totally agree, I think, you know, that local context is very important. And this is why if you go on our website, you see that interventions or strategies need to be really grounded in the realities of the ground, you need to speak to people, you need to understand why people don't do what they're meant to be doing, you need to think about what the pathway is for the patient. You know, if a mother has to walk several hours to access care, she has to choose between, "do I work and feed my family, or one sit down in a hospital for for a day, because there's a long queue" she's gonna go unless it becomes life threatening, right, and it's serious. So it's thinking about that patient journey and things that you need to put in place to improve it.

 

Claire  23:58

And about the patient journey. Now I'm thinking, especially with, you know, with the whole COVID situation we've seen, as well, the role of digitization, taking up more and more space in the discussion. I am wondering from Market Access Africa's perspective, how do you factor in digitization in the work you do with your clients?

 

Olawale  24:20

So it really depends on the client. I mean, I think digitization is maybe the most untapped opportunity on the continent to reach patients. It's funny, you raise this point, because, you know, the same project I was just talking about, so the demand creation recommendation was also to think about how you can tap into platforms like mobile phones, everybody has a mobile phone, some people have three, and so it's such a massive opportunity. And I think there's a lot to be done there. How you do it, I guess is the question. I think the way to do it is through partnerships, because many of these telecom providers or social media companies are also hungry for partnerships. They know they have a good platform, and they want to help. But I feel like these two worlds are not speaking. Where we are at the moment is thinking about how do we get telecom providers, digital companies to be more aware about the needs of patients in Africa and then linking them with organisations that do good work thinking about, you know, organisation in Geneva, organisations in the US, that could really benefit from the platforms that we have.

 

Claire  25:43

So Olawale, at the end of the show, what I like to do is to ask a short set of questions to my guests, just to have a little sneak preview into what type of books they read, or what type of music they like to listen to? My first question is, what are you listening to at this moment? Or what book are you reading right now?

 

Olawale  26:03

I'm listening to a lot of big music. That's what I'm listening to. And a lot of French ones because we have a 13 month old baby and he's really into French, baby songs. I do like rap, though. I'm a massive 90s Rap person. So when I'm having a rough day, I put on my headphones, and I listen to some Tupac or any 90s music. Books at the moment. The one I recently finished was The Subtle Art of not giving an F and by Mark Manson, and I would highly recommend it.

 

Claire  26:47

And then the second question actually is there a book perhaps if you're really like a bookworm, or if you love music, that was special for you at a specific time in your life, something that you really remember?

 

Olawale  27:00

I went through a phase where like, Christian music really helped me. When I ran the barging business, and we were going through issues with the government, I remember just like constantly listening to Christian music and it would calm me down.

 

Claire  27:18

I'm happy to have caught up with you, after realising that we basically know a lot of people in common. Thank you for the insight on Market Access Africa, I really wish you all the best. My mic is open if you ever want to come back and share a bit of, you know, progress on what you've done. So thank you very much.

 

Olawale  27:38

Thank you so much for having me on the show. I'm you know, I'm impressed by what you're doing. And I would definitely love to come back and speak when we have a few more results to share.

 

Claire  27:55

That was episode 23. A Conversation with Olawale Ajose. It was an interesting insight into the solutions his consulting firm offers to clients throughout Africa, with our team of seasoned global health and life science experts based on the continent, but also to get his point of view on which essential aspects to tackle and what role various stakeholders need to play in order to improve healthcare in Africa. Thank you so much for tuning in today, and listening to this new episode. Join me again in two weeks for another conversation with a new guest. Don't forget to follow us on social media for previews on upcoming guests, episodes, but also our new live events. Check us out on Facebook, at Narratives of Purpose on Instagram, at narrativesofpurpose_podcast, and on LinkedIn at Narrative of Purpose Podcast. If you liked our show, and do share it within your network and leave us a review wherever you listen to your podcasts. Make sure you also sign up for our newsletter on our homepage so you can stay informed about all our activities. Until the next episode, take care of yourselves, stay well and stay inspired.