On Enhancing Access to Cancer Treatments - A Conversation with Ndeye Makalou

Episode Transcript

Claire  00:16

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 all 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 October, we dive into a new theme, which is healthcare access in Africa. Now, it is a broad theme, I grant you that. So I decided to address it from two perspectives throughout this month, with two different guests working in the private sector, first from the pharmaceutical industry side, and second, from a market access consulting firm's perspective. And, of course, most importantly, through the personal journeys of my guests. Today, I spoke with Ndeye Makalou. She is senior director, Product Strategy Leader for global supply chain at Roche-Genentech based in San Francisco. In our discussion, Ndeye shares her passion for developing health systems in Africa, and emerging markets, but also the work she performed driving access for cancer treatments in Sub Saharan Africa. Do take a moment to rate and review our show on your preferred podcast listening app. But for now, listen to day's journey on enhancing access to treatments to breast cancer patients across Africa. So hello Ndeye, and welcome to the podcast. It's really a pleasure for me to have you on the show today. How are you doing?

 

Ndeye  02:19

I'm doing well, Claire, and thank you so much for having me.

 

Claire  02:22

So you're joining me from California where you live. But actually your journey did not start in California, it started in Senegal, and you are a pharmacist, you have been working for the past 20 years if I'm not mistaken, in the pharmaceutical industry. And you've had roles within drug development clinical operations global supply chain. So I'm curious to know what brought you to do what you do today? Can you tell me more about your background? Or in other words, how would you like to introduce yourself to our listeners?

 

Ndeye  02:57

Thank you, Claire. And you're absolutely right. Yes, I'm from Senegal. But I'd like to define myself, first of all, as a mother, so I'm a mother of two boys, amazing boys. And I've been living here in San Francisco for the last 20 years since I joined this company that I'm in right now. Yes, I'm a pharmacist, and I have had these different roles that you had mentioned, including a role in market access, but also in the commercial sales and marketing and business development as well. How did I get to this role I am in right now? It's just you know, my curiosity has always driven me. When I went to pharmacy school, it was never in my head that after I get my degree, I will be in a pharmacy, dispensing medicine. That wasn't my plan. I was more interested in research, but also, how do we make medicine and bring it to patients, and it's that curiosity that has driven me to these different roles. And I'm really very, very lucky and very grateful to have had all of these opportunities to grow and learn about the value chain of a pharma company.

 

Claire  04:09

You just mentioned that you didn't see yourself dispensing medicine but still you had some roles in market access. So to some extent you were also you know about providing medicines to people, but just from a different angle. And you also describe yourself as someone who is passionate about market access. So how is that and where does your passion come from?

 

Ndeye  04:32

My passion really came from my years in pharmacy school, the last years of pharmacy school when I was doing an internship in an additional Hospital in Dakar. I was getting ready for my cases and as part of the programme, I had to do an internship. And so I did an internship in a couple of areas in that hospital, in the maternity ward in Senegal, and as well as in the laboratory of bacteriology and virology The Lab. And then in due situations, I was exposed to a woman's issues, and to the challenges, and also being exposed to the health system, how it is, at least in my country. And that's really where it started, right? Like that passion, like, oh, my gosh, I really would like to do something. One day, I had the opportunity to come to the US and work in different institutions. Even before I got into the pharma industry, I was at MD Anderson Cancer Centre as well. And during the time I was working there, I used to, during my lunchtime, sit at the top floor of the biggest Cancer Centre in the world. And the top floor is like a very beautiful peaceful garden place where the cancer patient will sit and just relax, and I used to just go there and sit with them. And I used to talk to cancer patients. And I'm just looking at them and even got just like solidified my passion. I just wanted to understand how we can do something? Do we make medicine to have patients? But particularly, my heart was always back in Africa.

 

Claire  06:12

You just said right now that you used to speak with cancer patients, what was that experience like? And what did you learn from those discussions that you had?

 

Ndeye  06:21

I learned a couple of things, human beings how resilient we are. And number two, and I always knew this, being grateful for what you have, and appreciating your health, because it's not something that you should take for granted. And when I was talking to those people like this, the strength, they have, and it's hard, going through cancer goes, you see patient I've ever seen young people really like kids going through chemotherapy, but the spirit they have, and I'm sitting there, and I'm looking at them talking and learning so much from them. And I'm like, "What am I complaining about?" And that always kept me going every time even like when you go through this, trying to bring access to medicine to patients. When things are hard, I always think about those people, right? Because the patient doesn't have anybody, and they don't want to know about our challenges. They just want medicine to make them feel better. And so that's what I learned from them really that resilience. And also being grateful.

 

Claire  07:28

So coming back to access to medicine, and especially now you're speaking about cancer patients, you also mentioned that you worked within market access, but you also spent four years working across Sub Saharan Africa. So you are based in the US, and then you work for the same company, you worked this time in a different country? So tell me a bit about how that started. And what motivated you to do that?

 

Ndeye  07:51

What motivated me, you know, I spent quite a lot of time in the company working in different areas. And like I said earlier, I wanted to really understand the value chain of pharma, what is driving? What are the activities that I've been doing? Who's involved in making medicine for patients? And in that process, I got to work in different organisations. And before I went to Africa, I was into research and development doing drug development, from when we filed the initial new drug application to when we got to phase three to go for a bigger clinical trial. And that was in the department I was in. And I did it for different therapeutic areas. And I also wanted to know, "okay, well, now that I know this, how do we take the medicine to market? And how do we take it to patients?" Those are the two questions that I had. And it happened that during that time, I went back to Senegal, because my mom was very ill in the hospital. So I went on her side to help her. And in that experience, I also got to see how much worse the health system had become. And me being there as an advocate and having the resources to help her out. I could see the situation and I was really very touched by that. Unfortunately, I ended up not being able to help her. She didn't make it. And I remember promising her that one day, I'm going to do something and I want to help others that I did promise. So when I came back home, back to California to the company, I started asking questions, "what is this company doing in Africa?" I was so passionate I was asking everybody and one thing led to another, I kept talking to people and all of a sudden there's this big town holding our organisation talking about the Roche access strategy in Africa. I was like "whoa," and you know, I went to the presentation and I saw some horrible pictures of women with breast Cancer in Africa, and what was happening to them. And I couldn't just sit back and do nothing. And that was an opportunity. And I look for the role that I could play. And it required me to go back to Africa, I didn't expect that. I didn't expect that they would ask me to go back. But that was the requirement. So with the support of my husband's family, I was able to go back. And that's how I went with the company, I ended up being in Ivory Coast, and leading the implementation effort of the Roche access strategy in Africa. And that in that process it was all about working with the government with the healthcare professionals, anybody who was involved in the cancer management, and in the patient journey, and have them understand, "Okay, what's the what does the patient journey look like? What are the gaps? And what can we do together? and co-creating solutions for the patient.

 

Claire  11:05

It feels like a huge task, so to speak, because I need to engage with so many different stakeholders, and also identify the patient journey. And I absolutely assume that we're talking about a whole continent, but every country is different. And even within a country, I don't know if there are standardised systems. So can you perhaps, tell me, give me a few examples of things that you were successfully able to implement? And how did you come to bring people together to make that happen?

 

Ndeye  11:36

Yes. And you're right, you know, every country is different. And culture plays a big role in each of the different countries, even though there's many similarities. And each country is at a different level, in terms of the health system that they have. And for me, I've always believed that women in Africa should get the same access as women in the US and EU, within the EU, if we have a medicine and we have diagnostic testing that we can bring to that part of the world, let's work together, and find a solution. But if required, really a good understanding, first of all, from all the stakeholders of what we are talking about, and what we realised is that yes, the doctors know what cancer is, that doesn't necessarily mean that they understand how to manage breast cancer, because we don't have like many oncologists in Africa at that time. That was like four or five years ago. And when you go in there, the first thing that we need to do is educate. So educating people on the disease, even the partnership with the government, and supporting them to develop a cancer control plan, and having a budget behind that was absolutely crucial. So that's the first thing that we had done really, and helped them understand what is the economic impact of cancer in the country. So again, it all goes back to education, educating them on that, first of all, right? You know, in Africa, 16% of all cancer is breast cancer, and about 10% - 10% to 11% comes from cervical cancer, right? So because we had the medicine, we had the testing, we have the instrument to be able to address that. So that's what we focus on. But we needed to even that the statistic that I'm giving, we needed to provide it to the government and help them come up with some practical assessment to help them understand what's the economic impact of cancer, but also you have the healthcare professional, we have the doctors, you have the surgeon, if you find an oncologist, sometimes you don't find oncologist, but you have like the general doctors, we needed to teach them about breast cancer management. We needed to teach the pharmacist about our product. We also have the technician, the laboratory technicians, we needed to provide that capability building so teaching them and then sending them to training in South Africa because we have a lot there. So that's the first thing we have done. That's the second thing. The first thing was a partnership with the government, understanding why it is important to address cancer and what is the cost of not addressing cancer in the country. Right. Then, you know, engaging with the first ladies because each one of them do have a foundation and some of them are very passionate. For example, the First Lady of Kenya has always really focused a lot on cervical cancer in East Africa, right? So Margaret Kenyatta and that's really where we are much more successful, and just trying to align with her and on her strategic goals, and how this could also be helping her and she included breast cancer in it. So that was really the success factor. Some of the initiatives that we will have taken in order to do that, and from a laboratory perspective, you know, we provide them with region, we provide them with the machine they use, and train them on how to use them effectively. So that the element that we have done, but of course, you have the product, and this is like the partnership, you know, with the government to make sure that they bring the product, because one of the thing that we have to realise is that even if you bring our product to the market, and give it for free, that doesn't mean the patient we have access - and it doesn't do anything, because in the patient journey, there's a lot of steps prior to coming to our product. And this is why it is so important to define what the patient journey is and understand where the gaps are, in order to bring a solution. And sometimes it requires partnership with other companies, partnerships with NGOs.

 

Ndeye  16:23

Even had like partnership with the American Cancer Society to see how can we bring like, if patient needed radiation therapy of patient needed like chemotherapy, that's not something that we necessarily have at the company. So it needed a multi level partnership, in order to bring solutions to those patients, and at the end of the day, you know, they're able to, to get through the journey and get to the medicine and save their lives. So that's how we were approaching it.

 

Claire  16:50

Yeah, I can see that it's really, really a holistic approach where you approach every possible angle, so to speak of the patient journey to make sure that you can capture them right from from the caregivers, their healthcare professionals, all the way to the government level where you show the importance of not treating that and how that will have some effect and some incidents on the economy in the end, right.

 

Ndeye  17:18

Absolutely. And, you know, the government's you know, they may not understand cancer, but they understand numbers.

 

Claire  17:25

That's why it's important to have the data, the data is always important, do the research and show the numbers.

 

Ndeye  17:30

Absolutely, you know, like having the data and, you know, the challenges in Africa is, data is one of the biggest challenges.

 

Claire  17:38

Yes, that was our next question. You know, how did you come around that?

 

Ndeye  17:42

Yes, because what we realised that there is no case to cancer registries, in Africa, in the hospital, everything is on paper, and you can find the papers, I mean, falling everywhere, sometime, you see, even in the lab, you take a sample, you send a patient to a surgeon, they do a surgery, they collect the sample, send it to the lab, they do whatever testing they have, it's not like a comprehensive testing that sometime doesn't really conclude to anything, or like a good good conclusion that will enable an effective treatment for the patient. If a patient comes in, goes through surgery, and you have your lab and they're waiting for the result. First of all, you may lose the patient, because you know, those patients may go back 100 kilometres back to their villages. And so it's taking so long to get the result, but also the result isn't even available. So it never goes back to the doctor. Right? And then you will never know. And this is why you see some of these women and it's terrible, they just go back home after surgery, go back home, just to die sometimes. Right? And then when other women see those things, they will never have the courage to come to the hospital. Never. And this is why people with cancer. Some types of cancer in the early stage, if you capture it very quickly, something you can do about it. But if there's a fear, and there's a stigma, or seeing their other fellow women going through that there is that fear that sinks in, it's a total barrier to access, total barrier to access. So data generation was difficult. And we had at some point even provided laptops to the hospitals, hiring someone who actually can collect those electronically, at least so it can happen. It is a bigger problem than that. Right? So I think data is really a huge challenge in Africa.

 

Claire  19:45

So what other you know, challenges do you see that are perhaps something easy and that can be addressed quite quickly, but with a big impact?

 

Ndeye  19:56

First of all, I think we need to have, at the highest level, a willingness to address this from a policy perspective, developing policy and strengthening the pharmaceutical system can improve access to medicine in the continent in my opinion. Now, if you ask me, What can we do that's easiest? In a market where the health system is so poor the infrastructure is really poor. And it's not that advanced, even in the US and other developed countries, you have market access challenges. In my opinion, I think everything, at least in those markets in Africa, we should focus, I call that the low hanging fruit, we should focus on prevention, and capturing this very early in the disease and that requires education, awareness campaigns, and capturing that in having women, because in this case, that's what's the focus, coming to their Gynaecologists on a regular basis. And education is so important, Claire, because what I have noticed in those markets is that culture is a big thing. And women with breasts, in this case, breast cancer is a part of the identity of the woman, that African woman is a huge part of it. So if something is wrong with it, they tend to hide, and they hide, because you know, like, well, it's part of their identity, and they don't want anything to happen sometime. They hide because they don't want to make their family worried. But again, when you hide, you're allowing the disease to progress, and you're getting to a point where it is going to be very difficult to treat, and is going to be more expensive to the healthcare system. So then this is why I'm saying, in my opinion, I think it's getting early. And you can do that by raising awareness, and you raise awareness, working with the community leaders, because they have such an influence in those communities. And, and helping them understand why it is important, and what's the benefits of doing that. And as you know, in Africa, you save one woman's life, you're saving a family of 15, or sometimes 20, because they're the strong pillar of the family. So it's really very important that we do that. If they come in a little bit too late, it creates a lot of pressure to the health system that is already weak. That's what can be done as a low hanging fruit, but it requires collaboration and having that widespread public awareness of cancer, and don't just be afraid. Can you imagine some people, you don't even want to hear the word cancer. If you mentioned it, it just scares everybody out. That's not okay. Because if you don't want to hear about it, but it's there, then you won't do anything about it. So this is why I'm saying that collaboration among the countries is number one, raising that widespread public awareness, and increasing the budget allocation for cancer. Because one thing we have realised is that there is no budget for cancer. So when you come and have this partnership with the government, what they do, well they understand the value they see, if somebody should die, but we don't have budget, so they will take it from a budget that was allocated to TB, for example, infectious disease is important, so they budget with that. But then all of sudden, if there is an outbreak of TB, then there will be a budget for TB because it's a public health issue. So they will go for the most impact. It's actually creating more problems because for those patients that you have started treating cancer, it's horrible to stop them in the middle of the treatment because you know, it's a cycle. Some of them if they have like an 18 month cycle, if someone already has like a four to five month cycle, and you stop because you do not have the product anymore. It's even worse than not treating them, right, because you're giving hope to someone to start feeling better, but you need to continue to get them to the other side where they are in remission. But if you do not have the medicine because there's no money, it's terrible. And this is why I think you know, having a budget allocation for it is very important. But also, I think, in Africa, we have amazing doctors, very resilient. However, the challenge is the infrastructure. And because of that you see a lot of those good doctors leaving the continent and going somewhere else. So we need to combat that brain drain phenomenon happening in the continent. And also, because of that, they have like this huge population, you know, the doctor patient ratio, we need to improve it. And so a lot of things I'm thinking, but also, now in this era where we are incorporating technology into healthcare, digital healthcare, right? Because everybody now has an iPhone or has a smartphone in Africa, I think that can help with data capture, and seeing where the challenges are. And then being able to not only to follow up those patients, but also capturing them early in the disease and solving that problem, and I think that will also relieve a little bit of the pressure from the health system.

 

Claire  25:50

Now, I'm wondering, from your perspective, right, from the experience you have, and working both on the African continent and outside, how do you see this whole COVID pandemic, everything is kind of slowed down and put on pause? And how does that affect the whole access to medicine,

 

Ndeye  26:08

I mean, the pandemic has really created unprecedented challenges. And created huge disruption in the production of certain medicines. Because now, all of a sudden, we have an expected increase in demand for certain critical medication that the system wasn't ready for. Because manufacturing a product takes a long time, there is a lead time to it, it's not something that we just open the tap and fill the bottle with. So that's what the pandemic had done, there's challenges and so that, first of all, that unexpected increase in demand for certain medication, the disruption of that production of those products. And even from a regulatory perspective, there is a delayed regulatory oversight of medication production, because everything is focused on the pandemic, and we need to address it. So there's a lot that health authorities are dealing with, so they have to prioritise. All of those impact access to medicine. And even for patients with regular diseases, for example, a cancer patient was going to the doctor on a regular basis every three weeks to get the infusion. But because now the hospitals are all overwhelmed because of all of these COVID patients coming in, they're not going in. So that's the Access Challenge right there. And also the shortages, right in certain medicine, as well as a result of the pandemic. And because we also don't have the supply chain, planning and management is really very inadequate, due to the pandemic. And the other thing, you know, that we have been noticing is because of the COVID, and the vaccine preparation, some raw materials that are critical to any manufacturing process are being directed to COVID or to the vaccine. So then we have raw material shortages. And if we don't have that much material, then we cannot be making certain medicine because as part of the manufacturing processes are absolutely critical. So it's a huge disruption that COVID has made. And it's really a dire situation, but you know, we're trying to find solutions and like include, including digitalization accelerated that digitising everything, that's the other side of it, the disruption has created a lot of creativity.

 

Ndeye  26:21

Now trying to link back to your experience for these four and a half years that you were working on the continent. What would you say is your biggest learning and what would be like the message you want to, you know, give to our listeners on your whole journey and the whole discussion that we've had today.

 

Ndeye  29:08

You know, when I left, I was super excited. And my passion was just like, off the roof really wanting to go and help. What I have realised is that maybe I was a little bit naive, because I went in with the mindset, with the perspective of what I've left, you know, when I left the continent, my understanding of culture, my understanding of challenges, but it wasn't true. Right. So I think the first learning is like going with an open mind. And don't assume anything and be very flexible. Because the challenges are dire. And the challenges are different, very diverse, and in every continuum, because I worked in different countries. What you learn here, and what was successful for you in the past doesn't necessarily make it successful for the next country that you go to. So you're going to have to work with locals, and you're going to have to listen. And to be able to understand really what the challenges are in order to bring the solution to it, that was really the biggest learning for me, because what made me successful in the US, doesn't necessarily make you successful in Africa. But it's feasible and it's doable when you work, when you listen, let go of assumptions, and listen, and find a solution together with the locals. And it's that and that collaboration is absolutely crucial. It's been an amazing experience for me. Africa is amazing. It's very dynamic. Yes, the challenges are great, they have great challenges. However, I think we have what it takes to solve those if we work together. And that teamwork and collaboration is absolutely crucial. But again, I think it's also our governments that need to be more aware and have that willingness to solve this problem. And it's all about leadership, right, Claire. If you ask me, the places where we're more successful is when there was that willingness to sit down, come up with solutions.

 

Claire  31:43

And so to finish on a positive note, because you just mentioned leadership there, how would you qualify, in the end your legacy? Or at least would you have been able to put together with the teams on the continent? How did that transform patient access to cancer treatment?

 

Ndeye  31:59

That's really one of the things I'm most proud of, right? Because when we went at that time, no patients were getting access to our innovative medicine that can actually save lives. So they were never put in treatment, and I don't think it's extremely expensive. And there's no health care coverage, like in most countries for cancer treatment, for example. So everything is out of pocket. And you can imagine, people had to make the decision between feeding their family or treating their wife for cancer, which is horrible, right? So, for me, what happened as part of that journey is working with all the work that we have done with different stakeholders, building that capability, raising awareness, being patient, we came from zero to 2000 patients being put on treatment. And number two, it's like we put the foundation with that holistic health care approach into the system. And now it is continuing and taking it to the next level, the work is still ongoing, yes, I came back. But there's so many other people working very hard on the continent, engaging every single day to help patients. So that really makes me happy. Because myself and my team were on the ground and doing that we really laid the foundation and opening up the door and even had the basics that can help the patient, and also the doctors. And even the government's right, so now we're expanding it to other countries, and they're seeing the benefit. So that's really the legacy. And also like helping people, and developing capabilities, even for those employees of the company that was in the continent, and they were focusing on other products in the past, but now bringing that innovation, developing those leadership capabilities, so that they can take it to the next step. Those were other things I'm really very proud of. And that's really the highlight, you know, of my career. And during this journey, it hasn't been easy all the time. But I always think about that picture I saw back in April 2015 in Basel, when somebody showed me a picture of a woman with her breasts cut off and sent home and I just couldn't, I couldn't stop anymore. And even when things were hard, that's what I was thinking about. And it was what kept me going. I would encourage others to think about those patients. There's nobody advocating for them. And think about the impact you can have on others because it's beyond that woman. You are helping, even if it is one, think about the family that you're helping and those kids, that the situation if their mothers are not there anymore. For me, that's what it is. And I have learned a lot. I learned a lot about myself, but they know my intent. My goal is really to go back. So I'm going to encourage everyone who's listening, don't be afraid. There's a lot that can be done in Africa. But it requires all of us to work together.

 

Claire  32:19

And so just before we close our conversation, what I like to do with all my guests, I always like to ask them a bit about what they like listening to in terms of music, or what books they read. So I have three very short questions for you. The first one is, What music are you listening to very often these days? Or if you're not a person who listens that much to music, but rather a bookworm, what book are you reading right now?

 

Ndeye  35:54

Well I love listening to music. And recently, I've been listening quite a bit to just like uplifting music. I love you know, Bobby McFerrin and he does this song called, "Don't worry, be happy." And in the song, he says, "Every life, we have some trouble. And if you worry, you make it double" Every morning, especially with the pandemic, with all the challenges that we all have been through, there's something about that, I just like putting it on in the morning and listening to. I also love "flavour. He's a Nigerian singer. And because he's really very upbeat, and I love dancing, if I want to de-stress and that's the music that I listen to. It's a great De-stressor and there's one "so it's time to party," and he has a list of songs, but his name is "Flavour" . I love to listen to him. I also love Beyonce that I listen to sometimes, and then when I'm homesick, I like to listen to Youssou N'Dour, my home country man.

 

Claire  37:15

My second question is, do you have a specific song or even perhaps a band or a singer? That was special for you at a specific time in your life, something that you really, fondly remember?

 

Ndeye  37:28

Yes. And is back in Africa and is Salif Keita.. I don't know if you've heard of that. I love Salif Keita. Salif Keita is from Mali, and my mom is from Mali, as well. And that's the song that was always being played in my household when I was growing up. And my mom just loves Keita and was always listening to him. And of course, she understands the language better than we do. And that's the song I always remember. And I remember on my wedding day, that was my entrance.

 

Claire  38:07

That's beautiful. And then last question, do you have an all time favourite, either song or an album that you would recommend for everyone to listen to?

 

Ndeye  38:17

I listen to all sorts of music. And the old time favourite for me is really Bob Marley. "No Woman, No Cry". That's my all time favourite.

 

Claire  38:31

Thank you so much for taking the time to join me today. It has been such a beautiful conversation. I know, we've been speaking already in the past. But today, it brought me to another level. I get to know you as well a bit better and to understand your background and your journey as well. So thank you so much for spending that time with me. And I really look forward to staying in touch with you.

 

Ndeye  38:52

Thank you so much, Claire, this has been a really amazing conversation. I totally enjoy it. And I'm so grateful for the opportunity of sharing my journey with you and to the listeners. And hopefully that will inspire others, you know, to think at least you know about the journey.

 

Claire  39:10

Absolutely. That's the goal of this whole podcast series and your story is quite exceptional as well. Thank you so much for sharing that.

 

Ndeye  39:18

Oh, you're very welcome. You're very welcome. Thank you.

 

Claire  39:25

That was episode 22. A Conversation with Ndeye Makalou it was really insightful to understand the issues she faced when she set off on her mission to challenge the status quo for access to innovative cancer care, and the learning she got from it, such as be open minded, listen, let go of assumptions and find solutions together with local stakeholders. Because in the end, every country's situation on the continent is unique. Another important learning is how this experience made her stronger and more passionate. That's simply amazing. Thank you so much for tuning in today and listening to this new episode. Join me again in two weeks for another conversation around market access in Africa with a new guest, who recently co-founded a healthcare consulting firm, specifically focusing on Sub Saharan Africa. Don't forget to follow us on social for previews of upcoming guest episodes, but also for our new live events. Check us out on Facebook, at Narratives of Purpose on Instagram, at narrativesofpurpose_podcast and on LinkedIn at Narratives of Purpose podcast. If you like our show, 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. And to the next episode, take care of yourself, stay well and stay inspired.