Using RHSC’s platform to co-create solutions in a multipolar world

In October 2024, Dr. Frank Strelow, Head of Family Planning at Bayer, was elected as Manufacturers’ Representative to the RHSC’s Executive Committee. We catch up with him here.

RHSC: What are the most important lessons you have learned in your 30-year career in the pharmaceutical sector?

A few years into my career, I went from being a postdoctoral scientist in my early 30s, to a position in marketing and sales. That change switched my focus from a fascination with the science behind products to the importance of the user — the client or patient. This early training in patient-focused interaction set me up for my entire career, reminding me to always prioritize the end-user above everything else.

When I took on the role as business operations manager for the Middle East, I became acutely aware of supply chain issues, facing logistical challenges in low-resource settings. The Middle East is not just Saudi Arabia and other oil-rich states. It’s also Iraq, Iran, and Syria, with all their infrastructural problems. This experience was good preparation for when I started my role in Global Healthcare Programs in 2018, which then became part of Bayer’s broader sustainability and access to medicine strategy.

In that role as Head of Sustainability, you led access to family planning supplies, and most recently, you transitioned to Head of Family Planning. What are the biggest challenges you’ve noticed since 2018?

The world today is more multipolar than it has ever been, and it is not a more peaceful world — it takes more effort to keep peace and get nations to collaborate. With the increasing cost of peacekeeping — what with wars in Ukraine, Gaza, and elsewhere, we anticipate a future where fewer partners will want to cooperate, as financial pressures mount. This is unfortunate because the most crucial thing we need in global health is multilateral cooperation. To make matters worse, the pandemic showed us the limited resilience of the global health system.

In addition, the effect of our climate crisis on health is a delicate subject, creating tensions as it grows in prominence. As a result, our ecosystem feels the trickle-down stresses and strains experienced by global donors, as well as country governments.

Now more than ever, partnerships are crucial for the wellbeing of global healthcare, and RHSC has a prominent role to play in this regard.

Strategic Objective 3 in the new RHSC Strategy 25/35 is dedicated to a healthy and diversified supplier base for RH products. Over the coming years, the RHSC will implement activities to improve relationships between market actors, advance the knowledge base to support economic viability for RH suppliers operating in LMIC markets, strengthen supply chain efficiencies, facilitate dialogues, and disseminate and promote R&D resources. What unique role do you see the RHSC Manufacturers Group playing?

All improvements come at a cost. My concern is that manufacturers have faced a growing cost burden over the last two or three years. I want us to find solutions to maintain healthy competition while creating sustainable supply chains. This balance is what our Manufacturers Group members should contribute to — both in their own interest, and with the RHSC Strategy in mind.

We talk about “markets” a lot. Traditionally, a market is defined by demand and supply and managed by prices, but that is a limited definition of markets which doesn’t reflect equitable access, a hallmark of the new RHSC Strategy.

To achieve equity, we rely on international support programs, donor programs and domestic funding, which sounds good in principle. But low- and middle-income countries now, more than ever, are facing inordinate financial pressure — they are, for instance, struggling with the highest rates of debt repayment in the last 25 years. We have a system that’s under pressure. Some voices call for more domestic funding, others advocate for a total market approach, looking to the private sector to step in.

And what is this ‘private sector’ we so frequently speak of?

There is no uniform ‘private sector’. Social marketing organizations need new revenue streams, generic companies need to cover costs and make profits too, and innovators still have to invest into off-patent products to keep them affordable for low-income markets. While all these distinct entities have different requirements, commonalities prevail. They all need better market conditions to provide the best outcome for underserved communities.

What, then, should we focus our energies on? The Manufacturers Group is best placed to support the transition of a donor-dependent situation into a healthy market. RHSC is a good platform because it is pre-competitive, and it is moderated so no single manufacturer can indulge in anti-trust behavior.

In my two-year term as Manufacturers’ Representative, my vision is that we leverage the platform RHSC provides us with to co-create solutions for the challenges we anticipate ahead of us.