/ 24 October 2020

Q&A Sessions: ‘My north star is the patient’

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On trial: About 800 people are part of a coronavirus vaccine trial by pharmaceutical giant Pfizer, headed by Rhulani Nhlaniki in South Africa. (Paul Botes/M&G)

Rhulani Nhlaniki is Pfizer’s cluster lead for sub-Saharan Africa. As Pfizer starts phase III of the clinical trial of their Covid-19 vaccine candidate, he tells Malaikah Bophela that if it is successful, the company will ensure the vaccine will be available to everyone who needs it

Why did Pfizer decide to conduct a phase III clinical trial of its Covid-19 vaccine in South Africa?

South Africa has a lot of scientific expertise. It has the capability to conduct clinical studies, which is one of the key criteria that we looked at wherever the trial is. Are we able to make sure that the standards we’re expecting are being met? 

South Africa has that. And it also has a history of other studies that were conducted [here]. 

When we do clinical trials like this one we need to look at where there might have been a diverse population that will allow us to really understand and learn about this new virus. 

We’re conducting a clinical trial to really understand the effect of the vaccine, how it works and whether it’s safe and effective. So when we do get the vaccine, and it’s successful, it’s proven correct, we have an advantage of saying we had it tested. 

What are the protocols to ensure the safety of the trial participants?

How we go about a clinical study: you get the necessary approvals from the regulatory agency, which in our case is SAHPRA [South African Health Products Regulatory Authority]. 

But we also have an ethics committee that looks at the trial protocols. So our trial for protocol gets approved by SAHPRA and also by the ethics committee, which then says all the things that we need to look at from a safety point of view for the trial participants. 

So there are regular visits that the trial participants will be provided with to make sure the trial investigators will follow up with the study participants to take care of their health.

In a recent interview with the Sunday Times, you said Pfizer would not manufacture a Covid-19 vaccine in the country. What is the reason for this, given that phase III is here?

Can we discover this vaccine first? We’re busy with the development process for the vaccine and that has been our focus at the moment. So while this is happening, we have been working to build capacity and capability within our existing manufacturing facilities, and also build a distribution infrastructure to make sure that we get this vaccine as quickly as possible out there … because we’re on record saying that we believe that we have the potential to produce about 1.3-billion doses by the end of 2021. That’s been our focus.

Pfizer has said it’s building capacity to produce other vaccines in South Africa. Which vaccines are these?

In about 2015 Pfizer went into a partnership with Biovac Institute, which is a private-public partnership, for them to locally produce what we refer to as the pneumococcal vaccine — the vaccine gets used to vaccinate kids. 

We are in that journey with them and … we hope … that by the end of 2021, Biovac will be in a position to produce a Pfizer vaccine in South Africa. Those are the types of partnerships we are referring to when we say we are building local capacity.

Big Pharma is criticised because of patent laws. How does Pfizer position itself in this instance?

If our vaccine is successfully identified and goes through the clinical trial process, our commitment is access for everyone. While working with governments [we] make sure that … it should be available to the people that need it the most. 

We’re talking about a potential innovation. Strong intellectual property enables innovation because every­one is able to go and try find these new innovations. So we intend to protect our patents. 

When you say there will be equitable access, does this mean the price of the vaccine is low?

So what we’re saying is that our pricing mechanism during this pandemic, based on us working with governments, [is] that at least there should be no cost to the public — or in the event there is a cost, it’s a minimal cost. That’s our objective as we work with governments.

In Pfizer’s quest to expand its vaccine capacity in South Africa, what is it doing to ensure that more scientists are being produced locally?

That partnership that I was referring to involves government, the Biovac partnership. Biovac has grown 10 times. They started with about 30 employees, there are now over 300. 

And the majority of the people have been hired because of the technology transfer partnership with Pfizer and other companies as well. They are employing highly skilled people who happen to be women. That’s number one, that’s the first thing. 

Pfizer is also contributing to the Public Health Education Fund. And the fund focuses on doctors who are qualified and they want to get a master’s. I think, I stand corrected, about 60 graduates have come through that programme. And it’s not just about science or being a scientist, [it’s also] what impact we’re having in the South African economy.

We sponsor Unjani Clinics. [It’s] about equipping nurses to run their own clinics. And to support them for five years. Then afterwards they are able to stand on their own. The clinics are in communities that don’t have access to healthcare facilities. 

So I think last year, we’ve given sonar machines to those clinics. So instead of pregnant women going to a tertiary hospital far away, they can get checked with the clinic. So those are things that I think when we look at Pfizer’s contribution in South Africa. It’s from an educational point of view and skills, but also being socially relevant. 

What are you doing to ensure that there’s transformation at Pfizer?

Pfizer’s demographics in terms of gender — about more than 70% of the people we have are women. My executive team is predominantly black and women. I’m the first black CEO of Pfizer in South Africa and one of the values is equity. 

One of the things we say within our equity value is every colleague being heard and cared for. On a regular basis, we’ll look at our EE [employment equity] matrix. Our focus is on inclusion because diversity of not only people but also ideas are imperative for a business to succeed.

Recently, in the eighth Gender Mainstreaming awards, we were recognised for our achievements in how we drive what you’re referring to as transformation. We are intentional in how we recruit, who we recruit … because that builds the culture of the company. We are intentional in how we partner with the government. 

What legacy do you want to leave?

My north star is our purpose. The patient needs to be at the centre of the decisions we’re making. If I say I am successful, it is to see more people in South Africa being treated by Pfizer products. That’s kind of my success — for not only me, by the way. It’s about the South African team, the collective that is doing the work.