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‘Fighting future pandemics needs sustained attention’
Dr Vas Narasimhan, the chief executive officer of pharma firm Novartis, shares insights on his learnings from the Covid-19 pandemic, the technologies of medicines of tomorrow, and the need to tackle health emergencies
The world tends to lose focus on science and research in between health emergencies, one of pharmaceutical industry’s top executives has said, flagging the lack of consistent funding and effort that hobbles the ability to prepare for pandemics. Speaking on the fourth day of the 20th Hindustan Times Leadership Summit, Dr Vas Narasimhan, the chief executive officer of Novartis, shared insights on his learnings from the Covid-19 pandemic, the future of the Swiss-American pharma behemoth he heads, the technologies of the medicines of tomorrow, and how more needs to be done to tackle health emergencies.
“I led the vaccine pandemic response in 2009 during the H1N1 swine flu pandemic for Novartis. It is very challenging to maintain investments in between black swan events like a pandemic. What usually happens is there is a lot of interest and a lot of efforts, but as the world moves on, the investments move on,” he said during a conversation with HT’s editor-in-chief, R Sukumar.
Dr Narasimhan said partnerships between the government and the industry can overcome this problem. “[Such] consortia will keep the work going even when we don’t know if there is a market for these products in the future. Those are starting to form in the industry with government support but more needs to be done.”
The need to invest in science in the long term was one of the most important lessons from the pandemic, Dr Narasimhan said, citing the breakthrough coronavirus vaccines made on the mRNA platform. “In mRNA, investment started in late 1960s and really matured over 30-40 years, so [the pandemic showed] you need to invest in long-term in science to come up with critical breakthroughs,” he said.
The others lessons the last two years presented were in how the world became more comfortable with medicines based on new technologies — “it has opened doors for us to explore these new technologies to create new therapeutics” — and the improvements in the ability to provide vaccines and medicines to the world in a crisis, although, he added, “we didn’t do it as well as we would have liked to”.
The Novartis chief executive counted mRNA as among technologies that he was most keen on for future drug-making. “What is most exciting about some of these therapies are drugs like the ones that can be used as a single dose to treat cardiovascular diseases every six months. You can start to imagine a world where we have a vaccine-like approach to cardiovascular diseases.”
Other future medicine technologies on his radar are gene and cell therapies. “When you look at the world of gene therapies, you have the opportunity to take really debilitating genetic conditions in children, and with a single injection early in life, you can restore normal function when they would have otherwise faced the possibility of death,” he said.
Cell therapies, he said, bring the ability “to take cells and reprogramme them to, say, fight cancers”. “We have to remember that it was only in late 1800s or early 1900s that we first understood that giving a chemical to the body would fight disease. Before that, we thought diseases were caused by spirits,” he said, as he sought to put progress in medical science in context. “It took us 60-70 years before we discovered the world of biologics, like insulin, which are now one of the biggest segments of the biomedical research industry. What happened in the last 8-10 years is the discovery that we can get inside of a single cell to start to change how things work,” he explained.
Dr Narasimhan has worked at Novartis for 18 years, and took over as the chief executive in 2018. Earlier this year, Novartis announced sweeping restructuring — roughly 8,000 people are expected to be laid off in a year-long process aimed at saving $1 billion annually by 2024. The broader context of the restructuring, Dr Narasimhan said, was the disruptive nature of technology. “Historically we have been a conglomerate, we were in areas ranging from baby food to medical devices. Five years ago, we made a decision to be more focussed, so we exited public health, eye care devices, and now, we have exited the generics business. What we are left with is what we are great at and what I believe we will be great at in the future, which is discovering novel medicines,” he said.
In August, Novartis announced it would spin-off its generic division Sandoz as a separate entity and list it on the Swiss stock exchange. In Novartis’s shift, Dr Narasimhan, the son of India-born American immigrants, said the company’s office in Hyderabad played a key role. “India is at the heart of Novartis. Almost everything we do runs through our Hyderabad corporate centre. What we consistently discovered is talent is outstanding and when you go there, I am always inspired by so much energy to reimagine medicine,” he said, adding that the most of the company’s global clinical trials data processing happens at the Telangana office. Dr Narasimhan, who is a trained physician, also shared his assessment of the Covid-19 pandemic at present: “Is the pandemic over? That is a tough question. I think these viruses tend towards endemicity, where they adapt to the human population and the human population adapts to them. I suspect that is the direction where this virus is headed, as has been the case with other coronaviruses that cause the common cold.”
But, he added, “you never know” on the possibility that the coronavirus could evolve. “I do, however, believe it is important to let society move forward from restrictions and lockdowns”.