Healthtech in the GCC Countries: Focus on Infrastructure and Export Capabilities

[00:00:00] Dear listeners, welcome to Faces of Digital Health, a podcast about digital health and

[00:00:06] how healthcare systems around the world adopt technology.

[00:00:09] With me, Tjasa Zajc.

[00:00:11] In this episode we're travelling to the Middle East, more specifically the GCC countries.

[00:00:20] You will hear from Pilar Fernández Hermida, who is an international go-to market expert

[00:00:25] with over 20 years of experience launching sales and partner ecosystem strategies in healthcare.

[00:00:34] She's based in Abu Dhabi in the UAE and says people too often only think about to buy when

[00:00:40] they think about the UAE.

[00:00:42] However, many opportunities are elsewhere as well.

[00:00:48] Pilar is focused on public-private partnerships and really has an in-depth understanding

[00:00:53] of how healthcare works.

[00:00:55] So I absolutely loved when in our prep call she said, people say that data is gold.

[00:01:02] Data is not gold.

[00:01:04] People who know what to do with the data are.

[00:01:08] Now think about that.

[00:01:13] In this discussion you will hear a bit more about the culture in the Middle East, how

[00:01:17] to interpret different styles of communication.

[00:01:22] Pilar also says that the entrepreneurial spirit here is 10 times as strong as in the US and

[00:01:29] that biotech and drug development are the next thing to watch for in the region.

[00:01:35] I hope you're intrigued.

[00:01:37] Now just before we dive in, if you will enjoy the show, do leave a rating or a review

[00:01:41] wherever you get your podcasts.

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[00:01:56] And also check out our newsletter.

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[00:02:17] content.

[00:02:19] Now let's dive in.

[00:02:22] Pilar, welcome to the show.

[00:02:35] Hello everybody.

[00:02:36] And thank you for having me here today.

[00:02:38] I'm super excited too.

[00:02:40] I've been following your podcast for many, many years.

[00:02:42] So it is an honor.

[00:02:44] If we dive straight into the topic, when one reads about the GCC countries, the GCC

[00:02:51] Council brings together six Arab countries as Bahrain, Kuwait, Oman, Qatar, Saudi

[00:02:56] Arabia and the UAE.

[00:02:58] And when we read about the digital health innovation and ambition in this space,

[00:03:02] it's pretty impressive.

[00:03:04] The investments are high.

[00:03:06] The determination and enthusiasm in tech-supported healthcare is high.

[00:03:11] The government spending is also very favorable to move things forward.

[00:03:16] If I just mentioned some numbers, from a region-wide perspective, the investments

[00:03:22] went from $2.4 billion in 2016 to more than $30 billion in 2021.

[00:03:33] And that's actually projected to go even higher.

[00:03:37] So how would you describe the ecosystem and the drive behind this positive attitude towards

[00:03:44] innovation and healthcare digitalization in this area?

[00:03:47] Yeah, thank you for the introduction.

[00:03:50] It is always good for any entrepreneur to understand why things are happening because

[00:03:57] there is always, normally, always a reason.

[00:03:59] So I would start saying, what is the drive behind these numbers, this growth, which is

[00:04:04] impressive?

[00:04:05] And if you look pre-pandemic, the region, the GCC region, when we look for instance

[00:04:10] areas like beds per 1,000 habitants, it was really lagging behind versus OCD.

[00:04:17] They were not doing so bad compared to the doctor radio.

[00:04:20] I just pulled the latest numbers.

[00:04:22] But for instance, Germany has currently eight beds per 1,000 habitants versus

[00:04:28] UAE that has 2.9.

[00:04:30] The average in the European Union is something 4.6.

[00:04:35] So doctors were, the doctor radio was not so bad.

[00:04:39] But what happened is 2020, there was a pandemic and there was a reconning that

[00:04:46] the countries needed to have more infrastructure facilities, which you could argue

[00:04:52] they had no, the GDP investment per digits, the infrastructures were in the

[00:04:58] single digits before 2018, 2019.

[00:05:03] And now it has incremented in some countries to 18% of the GDP.

[00:05:07] Yeah.

[00:05:07] So there has been a big push for infrastructure building and it has been

[00:05:12] fueled by the pandemic because in the GCC talking to several officials, there

[00:05:17] was a reconning during the pandemic that they could not be so dependent on

[00:05:22] importing everything from medications like something like vaccinations to even

[00:05:27] food security was a big concern when everything was closed down.

[00:05:31] So in the last, let's say three, four years, we have seen a radical increase

[00:05:37] in building the healthcare and the bio health and the architect infrastructure.

[00:05:45] And this is what's pushing most of the projects at the moment.

[00:05:48] You could argue that it's still in catch up mode.

[00:05:51] We look at the index of debt by a great opportunity there for infrastructure

[00:05:57] providers and it's a great opportunity as well for digital health companies

[00:06:02] because behind that drive, they want to leapfrog into the new economy.

[00:06:07] They want to be less dependent on oil revenues in the future.

[00:06:11] And part of that is the utter embrace of AI.

[00:06:15] I had to use the word and digital infrastructure.

[00:06:18] For instance, Saudi, the largest market in healthcare, 60% of the market,

[00:06:22] by 2030 they want to have 70% of all the services digitally delivered.

[00:06:30] Healthcare services.

[00:06:31] So you have the first, the biggest hospital is in Saudi already, it's called SEHA.

[00:06:37] And a lot of initiatives in the area of longevity as well that also touches

[00:06:42] digital health as we understand it.

[00:06:45] One of the characteristics of the area, especially the UAE, is the big number

[00:06:50] of expats, more than 50% of the population is actually coming from abroad.

[00:06:56] So what kind of impact do you see that has?

[00:06:59] And when you say that there's a huge drive to build things in the region,

[00:07:04] does that mean that basically the expats that come here actually build

[00:07:10] their own things and stay here for decades?

[00:07:15] Or is it more that the large number of expats is also attributed to the foreign

[00:07:21] companies that want to enter these markets and you always need local workforce

[00:07:28] if you want to succeed in any market to understand the culture, to have people

[00:07:31] on the ground to actually be present where you want your products to work?

[00:07:37] Yeah, it is a very interesting question and I'll try to give you a simplified view.

[00:07:43] It has a lot of ramifications.

[00:07:46] It is a delicate balance.

[00:07:48] Look, I know resident of Abu Dhabi where 90% of the inhabitants are foreigners.

[00:07:56] Right?

[00:07:57] So, and it's very welcoming by the way.

[00:08:00] I never felt more welcome as a foreigner and they give you a lot of

[00:08:04] facilities, etc.

[00:08:07] But again, things have changed dramatically.

[00:08:09] Did you look at all the 2030 agendas of most of the countries in the Gulf?

[00:08:15] They all want to drive out.

[00:08:16] They want to be self-sufficient.

[00:08:18] They want to diversify the economy into what they call the new economy

[00:08:21] with a very data-driven approach.

[00:08:23] Yeah.

[00:08:24] And then they want to become an exporter as well.

[00:08:27] But to do that, you need to grow local businesses.

[00:08:31] Yeah. The next Amazon of the region.

[00:08:33] Actually, you have it now.

[00:08:34] But all the companies, all the technologies.

[00:08:37] So there is a big bet now in novel therapies.

[00:08:40] There's a big bet in the computation, as we call it.

[00:08:45] And this is the CAHPS 22 slide.

[00:08:47] You need to build a supply chain in order to enable those industries.

[00:08:52] And if the capacity is not in the country,

[00:08:54] you need to keep on getting the right talent and attracting the right talent.

[00:08:58] So on the one hand, there is a drive in flexibility of visas,

[00:09:03] golden visas, things like that.

[00:09:05] And then there is a very strong agenda of how do we engage more

[00:09:10] of the local population in this industry?

[00:09:13] Because you could argue that they have been left out from the wave.

[00:09:16] Yeah. And for instance, UAE has an immunization program.

[00:09:22] Saudis has a saudiization program.

[00:09:25] They want the companies to come or the people to come here and build things.

[00:09:28] Also for the local population.

[00:09:30] They want even corporates or industries to have a shadowing program

[00:09:34] to involve Emiratis.

[00:09:36] They're pushing a lot of know-how transfer with academia, bilateral exchanges.

[00:09:41] Because the idea is that, and specifically you notice that more in Saudi,

[00:09:46] because in Saudi 60% of the population is Saudi, is Saudi, is local.

[00:09:51] They need to catch up in a lot of areas.

[00:09:53] So know-how transfer and partnerships is the call of the days.

[00:09:57] Yes, they need the technologies to build disassembly lines,

[00:10:01] to build, for instance, drug manufacturing and things like that.

[00:10:04] But they don't want extractive type of approaches to the region anymore.

[00:10:08] They want people to invest in the region.

[00:10:11] I'm not sure that answers your thing.

[00:10:12] So yes, very welcoming, incredibly welcoming to innovators,

[00:10:17] to people from abroad, to add value to their agendas.

[00:10:20] But in a wind model as well, yeah?

[00:10:23] We need to also invest and transfer our skills, yeah?

[00:10:28] How would you say that the countries in the region differ?

[00:10:32] Because when we talk about the Middle East and when we talk about the UAE,

[00:10:37] usually the first associations would be Dubai,

[00:10:40] Supermultinational, there's Arab Health is usually taking place there.

[00:10:46] But what about other places, other spots in the region?

[00:10:51] It's so different.

[00:10:52] Even the Emirates, just to put it all,

[00:10:55] the foreign perspective is only 52 years old, yeah?

[00:10:58] 52, yeah?

[00:11:00] So seven Emirates got together.

[00:11:02] So when you go from Sharjah to Abu Dhabi,

[00:11:06] well, rather Sharjah to Dubai to Abu Dhabi,

[00:11:08] it's intrinsically a very different landscape.

[00:11:11] Abu Dhabi and Dubai had their own, for instance,

[00:11:13] they had their own healthcare entities, yeah?

[00:11:17] You have the federal government.

[00:11:19] So it is different players, different dynamics,

[00:11:23] different management and rulers, you have to adapt.

[00:11:27] But then Saudi Arabia is more, let's say, centralized, one kingdom, yeah?

[00:11:33] But it is decentralized and it's a thing of staying into health clusters,

[00:11:37] as they call it, 21.

[00:11:39] So I always say to entrepreneurs, it's like,

[00:11:44] before you enter a market or before you choose the market,

[00:11:48] you need to do a bit of analysis.

[00:11:50] You need to look at the trends, what's happening, what's not happening,

[00:11:53] who is there, how you could add value to that and with whom.

[00:11:58] And with whom is very important because going back to what we discussed before,

[00:12:02] we talked infrastructure, building big infrastructure projects, yeah?

[00:12:07] Which they will take shape in a lot of public and private partnerships.

[00:12:12] The big fish, yeah?

[00:12:13] So we need to understand where, if you belong there

[00:12:19] and how it's going to be viable for both parties, yeah?

[00:12:22] Procurement-wise as well.

[00:12:24] So I never, even if you are in one market like Abu Dhabi,

[00:12:29] it's very difficult, it's very different if you transact with public sector

[00:12:33] than you transact with private entities.

[00:12:36] So you need to basically be cognizant of that.

[00:12:39] But I would say one advice, and I think everybody listening that works

[00:12:43] in the region, Agri is that PPPs is really the big opportunity.

[00:12:48] Public and private partnerships.

[00:12:50] So you're a small innovator, figure out where you belong,

[00:12:54] where you go and why, with whom and how to make money,

[00:12:56] which is the go-to market.

[00:12:57] It has to be localized.

[00:12:59] Abu Dhabi has different dynamics than Sharjah or Dubai.

[00:13:05] And different.

[00:13:06] So what are some of the mistakes that you're noticing,

[00:13:10] startups or company making when either considering entering the GCC countries

[00:13:17] or already pursuing customers in the region?

[00:13:23] I would say that the top mistakes will depend on what they are looking at.

[00:13:28] Companies traditionally, they go to markets for four different

[00:13:31] non-mutual exclusive focus areas.

[00:13:33] Yes, you can want to reach new markets,

[00:13:37] such as the new markets.

[00:13:39] You might want to tap into the R&D.

[00:13:42] You might want to tap into the talent.

[00:13:45] Or you might want to tap into funds.

[00:13:47] All together they make entrepreneurship, right?

[00:13:51] And I think that number one misconception is that any time you say UAE,

[00:13:56] people think people are throwing money at you to do anything and it's not true.

[00:14:00] Meaning that it is hard to raise funds for early stage companies.

[00:14:05] It might come as a surprise.

[00:14:07] Yes, the big sovereign entities, they invest in growing up more solid business.

[00:14:13] There is IPO market that's recently launched, but it's not really the market for

[00:14:18] startups is maturing.

[00:14:20] It's still evolving rather than maturing.

[00:14:23] For instance, in Saudi you have PIF is putting a lot of money into that.

[00:14:27] So it's being created because let's remember what we said before.

[00:14:32] This market traditionally was important technology.

[00:14:36] To start creating and exporting technology requires a bit of a shift.

[00:14:41] That includes the funding mechanisms.

[00:14:44] Having said that, this is the first thing.

[00:14:46] They are not throwing money at you.

[00:14:48] But having said that, if you do your homework, if you know who you're talking to,

[00:14:56] and you actually position your company in the right way,

[00:14:59] there might be money at the end of the discussion because there is a lot of liquidity.

[00:15:04] But another thing that also is very important, especially for

[00:15:07] the area of biotech, which is key for this market.

[00:15:11] They want to start creating their own drugs.

[00:15:15] Everybody's building the assembly lines, let's just speak.

[00:15:18] It's a lot of people knock at the door because they think I can produce a drug.

[00:15:23] So I come here to give me money, I bring my technologies, I do it.

[00:15:26] And actually, people are very surprised to find out that

[00:15:33] the focus of some of the markets here is to attract FDI, foreign direct investment.

[00:15:38] So they're asking for your money rather than you coming here to get their money.

[00:15:43] So yes, there are PPPs, you could get there if they're already cooked,

[00:15:48] and you can tap into that.

[00:15:50] But if you want to create your own PPP, they might actually ask you to bring

[00:15:54] money to the tables.

[00:15:55] And you find very funny statistics like Germany, France,

[00:15:58] a lot of European countries are the main FDI investors in healthcare at the moment.

[00:16:03] And you can't call that a hospital.

[00:16:05] But finally, on the cultural perspective, the hospitality of this region is incredible.

[00:16:13] So people sometimes confuse giving you the car and say they're interested in you.

[00:16:17] Okay, that's it.

[00:16:18] Danville, but no, here is very much about building solid, long-term relationships.

[00:16:26] Yeah?

[00:16:27] I think the model of the tourist repair is a bit away.

[00:16:30] If you think about it as an entrepreneur, the only thing that will never be accommodated

[00:16:35] is your relationships, the quality of relationships.

[00:16:37] It's the only thing that's not replaceable.

[00:16:39] And here you have to work on that.

[00:16:41] Don't confuse hospitality and shape it.

[00:16:45] You have to work and you have to be here and you have to work on the relationships

[00:16:49] and this is something extremely important,

[00:16:51] more important than most countries outside of the region.

[00:16:55] That's interesting.

[00:16:57] Yeah, so basically you have to give the impression that you're not just in the region

[00:17:03] for one or two years but that you actually are there for a long time

[00:17:07] and are planning to make an impact.

[00:17:09] Yeah, it's an impact. We're talking value.

[00:17:12] Relationships are about bringing value to each other.

[00:17:15] It's a possible transaction of things.

[00:17:18] You could end up being two years but here is not a thing.

[00:17:22] This is a cool thing I'm doing.

[00:17:24] I'm selling and your country will benefit.

[00:17:27] It's more how can I help you with your plans?

[00:17:30] How can I add value?

[00:17:32] If you're thinking about what we said before,

[00:17:34] FDI, people investing in the country,

[00:17:37] it's a big drive for companies to set up shop here.

[00:17:40] And by here every country has a program to attract the companies.

[00:17:46] And then because they want you to create jobs,

[00:17:49] they want you to start paying, okay, tax is very limited but still some tax.

[00:17:53] Be part of the ecosystem because at the end of the day,

[00:17:56] in the long term, these are the relationships that matter for them as well.

[00:18:00] So first time I came to the region was 20 years ago or 20 plus years ago.

[00:18:05] It was very different landscape.

[00:18:07] It was very trans, not transactional.

[00:18:09] You go there, shake hands, give some business cards,

[00:18:12] things will happen sometimes but now it is basically here by the way.

[00:18:16] Another misconception.

[00:18:17] You're not the first one to discover GCC.

[00:18:20] You have incredible talent and entrepreneurship coming from India,

[00:18:24] a lot of from Africa as well.

[00:18:26] So it's going to be busy.

[00:18:28] Actually it's very good.

[00:18:30] I always say to entrepreneurs in the West,

[00:18:33] to come to this region not so much to bring your valuable IP,

[00:18:37] but also to learn what other people are working on

[00:18:41] because I get the feeling that we're going to end up,

[00:18:43] for instance, I'm originally from Europe from Spain,

[00:18:45] we will end up importing some of those innovations.

[00:18:50] I am bullish on that.

[00:18:53] You just got me thinking how the cultural aspect is very specific in the region

[00:19:01] because we mentioned that 50% or even more percent of the population are expats

[00:19:07] and it's not just expats from one country,

[00:19:10] but it's actually expats from different countries.

[00:19:12] So I still remember an interview that I read with a woman who worked in Dubai

[00:19:17] and she mentioned that basically they got like an instruction or recommendation

[00:19:24] in terms of how to communicate with the different cultures

[00:19:28] because that's something that can get very tricky when you work with different countries

[00:19:33] and people just express themselves differently in different cultures

[00:19:38] and different things mean different things.

[00:19:41] You might be offended by some things even though they were not intended to be offended

[00:19:46] by the one that said them.

[00:19:47] So how do you see that the navigation of that goes

[00:19:50] and how does that impact the whole innovation landscape

[00:19:53] and how solutions are then built for the population here?

[00:19:57] This is a very interesting point because in our techie or technology world

[00:20:02] we always think technology, always think humans

[00:20:05] because we are building for humans,

[00:20:08] maybe some people might disagree these days

[00:20:10] and humans choose to use this or not.

[00:20:14] So going back to the misconception,

[00:20:16] this is a culture like in some Southeast Asian cultures as well

[00:20:20] for instance in India where people will not say no to you.

[00:20:24] It's very rude to say no which goes against a lot of countries in Europe

[00:20:29] where we can be a bit more abrupt.

[00:20:32] We say this is no where I used to live in Holland if it isn't all right.

[00:20:36] Here it's never going to be a no.

[00:20:39] But they might be telling you a big no,

[00:20:42] you just have to be able to read that culturally

[00:20:44] and that's why I say everybody gets,

[00:20:46] oh everybody is so welcoming everybody wants to do things with me

[00:20:49] because now this is no, it doesn't mean that they said yes.

[00:20:53] They said yes, it's a different matter.

[00:20:55] So always clarify the yes.

[00:20:57] Don't hang on to the no.

[00:21:00] And India, Pakistan a lot of different cultures,

[00:21:04] they have a very strong impact here as well.

[00:21:09] There are also cultures that they do not give you a frontal no as well.

[00:21:12] So that's number one.

[00:21:14] But when it comes to entrepreneurship and this is the area that I'm very passionate about,

[00:21:20] there is another factor that the country needs to come to terms with

[00:21:25] the GCC region is failure is normally frowned upon here very much.

[00:21:33] You do not only look bad when you fail,

[00:21:38] you made your family look bad too.

[00:21:41] So I've been talking to some academia and institutions,

[00:21:46] how do we, because to innovate, to become innovative,

[00:21:51] you have to crash and you have to fail so many times.

[00:21:54] What we call growth mindset and you have to get used to failing because in innovation

[00:21:59] is about the one thing that you will do right versus the 95 or 98 things that fail.

[00:22:04] But then that's where we something good to the question

[00:22:08] because in the younger generations,

[00:22:10] the very young population in the average in the mid 30s,

[00:22:14] you can counteract the growth, the risk averse mindset with a bit of FOMO

[00:22:21] because it's very cool now to be entrepreneur right?

[00:22:24] And that could change a bit but still you have a big name.

[00:22:29] You come from a big family.

[00:22:31] Failing on something is not something that people would publicly talk about

[00:22:37] and that is a problem not only here,

[00:22:40] it's a problem in a lot of countries,

[00:22:42] even in Europe you could argue compared to the US

[00:22:45] and we need to take away the stigma of that

[00:22:49] because without that we will not have the true innovations

[00:22:53] because people, what they do when they have this fear of failing,

[00:22:58] they start copying models elsewhere and try to adopt it

[00:23:01] because it's been proven.

[00:23:03] But you could argue that's not the best innovation.

[00:23:06] Yeah, yeah, yeah.

[00:23:08] That's a very interesting point because when we were on our prep call for this discussion,

[00:23:14] we were talking about how ambitious different countries are in terms of the innovation

[00:23:21] and one of the things that I mentioned is that it's great to be in Europe,

[00:23:27] the access to public healthcare systems is great

[00:23:31] but with all the regulation and all the thinking that we put into making sure

[00:23:37] that solutions are really good for everyone and regulated,

[00:23:42] this can also hinder innovation and it often feels that less is possible

[00:23:48] than we would wish it would be possible

[00:23:51] and it's therefore really great to go to the US from time

[00:23:55] to get that optimism, to get that positive entrepreneurial spirit

[00:24:00] that basically change is possible.

[00:24:02] And when I said that, you mentioned that the real enthusiasm is in the Middle East

[00:24:09] and in the GCC countries.

[00:24:11] So can you talk a little bit about that?

[00:24:13] So that basically added to change.

[00:24:15] Yeah, it's a very different contradictory but it's not

[00:24:18] because also let's think about it, the Miratti population is still one portion of the population.

[00:24:25] We have all the experts coming with a growth mindset so to speak.

[00:24:30] The energy and the ambition of this region is nothing I have seen,

[00:24:36] maybe because it's a new country, maybe because it's a new paradigm that is changing

[00:24:42] the young population that don't have any hangouts or legacy to deal with

[00:24:46] but from there to materializing all that into entrepreneurship

[00:24:54] into the new innovations that will power the country.

[00:24:57] There is still a bit of a legwork to do.

[00:25:01] And capacity building is one of the areas that they are at a disadvantage compared to the US

[00:25:08] because there's no supply change, there's no assembly lines for drug manufacturing.

[00:25:12] There's a lot of pieces missing like a very solid grant system

[00:25:16] like we have in Europe, I'd be creating a system here in Europe in the US

[00:25:20] and then the mindset is going to come to hunt those homeworld Miratti entrepreneurs

[00:25:28] unless the society starts to shift a bit.

[00:25:31] It is shifting, I know incredible entrepreneurs in Saudi, UAE that are breaking those barriers

[00:25:38] but it still is not something that you will see.

[00:25:42] They are very energetic, ambitious but from that to launching something that's really heartbreaking

[00:25:52] there is a bit of falling to do and this is the area where we need to do

[00:25:57] but having said that you have a lot of foreign entrepreneurs also coming from the MENA region

[00:26:03] that they don't have that problem and they are launching a lot of incredible businesses

[00:26:07] so then there is a very thriving market at the moment because there is a lot of need that they need to work on

[00:26:14] this is what we say, the biotech, a lot of infrastructure for hospitals, digitalization programs

[00:26:21] and also let's not forget that the big opportunity of GCC might not necessarily be GCC per se

[00:26:29] it's the immediate one, GCC Inc.

[00:26:32] but you have Africa as well, they are the biggest investors in Africa

[00:26:37] United States last year invested $10 billion in Africa, UAE, $60 billion

[00:26:44] UAE only, I don't have the data for the rest of the countries

[00:26:48] and now they are signing free trade agreements

[00:26:52] so you have all of a sudden like an European Union but Grossmenna and MESA

[00:26:57] because India is also part of that

[00:26:59] so I don't see the pictures only GCC, I see GCC as a nice HQ or place to be based

[00:27:07] and then that opens the rest of the countries

[00:27:09] so I always say to anybody an entrepreneur out there that wants to have a bit of a global strategy

[00:27:14] like founders should follow the money but the money will always follow demographics

[00:27:20] so follow the demographics corridor, 80% of the population is in this area

[00:27:24] call me as I mean the least Africa or Southeast Asia

[00:27:28] it is asynchronous, it is messy at times

[00:27:34] it will be very contradictory even because then we have going back to one of your questions before

[00:27:41] we have to go and look, zoom in to country per country or even segment per segment

[00:27:46] and you will see what the dynamics are

[00:27:51] where's the wind blowing and whether or not there is a place for you there in the ecosystem

[00:27:57] so it has to be very sniper oriented but not targeted

[00:28:01] you worked across several different markets and even now you mentioned not just the GCC countries

[00:28:07] but also the MENA countries

[00:28:09] so how would you actually compare these ecosystems in terms of the different approaches

[00:28:15] that one must take to tackle these markets

[00:28:18] you can't compare really at best

[00:28:21] why especially in healthcare because it is the most fragmented market

[00:28:26] because how we receive, pay or cover healthcare changes from country to country

[00:28:33] and even within the country

[00:28:36] so in that sense you need to understand to go and say okay got this product where do I go

[00:28:41] what is this product good for

[00:28:43] and I would say you have to sometimes go backwards, deconstruct it

[00:28:47] look at the market and choose where you should go in that shape, in that framework

[00:28:52] going back to MENA such a diverse Africa has 55 I think it's now 55 countries

[00:28:59] different dynamics you have high income, low income, middle income

[00:29:03] but however they all have the same problem to a certain extent

[00:29:08] is access to services

[00:29:12] and the need maybe especially now with novel therapies more precision medicine type of medicine

[00:29:19] they need to develop their own therapies as well yeah

[00:29:22] I would say when you choose those markets follow very much the geopolitics

[00:29:28] because it does impact

[00:29:31] follow the regulation as well because it does impact a lot of your choices

[00:29:35] on the regulation bit for instance in terms of data transfers

[00:29:39] and AI regulation this is extremely important because it could mean that you are not allowed

[00:29:47] to market in one country in that shape yeah

[00:29:51] because data knows no boundaries

[00:29:55] but government regulations do have boundaries, every country is doing their own thing

[00:30:01] so this is something that you need to follow

[00:30:04] and of course I would also encourage people to look at the level of digital maturity as well yeah

[00:30:10] it could be an opportunity if the digital maturity is not there of course

[00:30:16] but it could be a big problem if you are relying on that

[00:30:20] because the other day what matters for an entrepreneur is adoption

[00:30:25] and for adoption you need to have something that the market can access, can approve

[00:30:31] and can afford

[00:30:34] so how are you, where are you accessible, approvable and affordable

[00:30:42] you just got me thinking we mentioned how the technology is there

[00:30:47] the infrastructure is there there's new hospitals that are being built

[00:30:51] there's technology that's being implemented because of this hunger to be at the forefront of innovation

[00:30:58] but what exactly does that mean in terms of good data strategies

[00:31:04] knowing what to do with the data and having a clear vision on how you need to build the infrastructure

[00:31:11] to be able to leapfrog other countries and actually be future proof

[00:31:17] not just solving the immediate challenges at hand

[00:31:22] so going back to GCC, high income countries in GCC

[00:31:26] as I said there might not be that many cars in my cars

[00:31:29] therapy solutions, homegrown solutions but it's a great moment for motorway builders

[00:31:35] yes, pick and shovels, tech enablers

[00:31:38] anybody that will take, that will enable for instance discovery platforms or life science platforms

[00:31:44] or any data driven type of, here we're talking aggregators

[00:31:49] we're talking anything that is playing part with tech enablers

[00:31:52] that people can build on, yeah, so pick and shovels

[00:31:56] it is also a good moment for some tech enabled solutions

[00:32:02] there is a big try for virtual hospitals and telemedicine

[00:32:08] KSA wants to have 70% of all the services like the provision of healthcare services

[00:32:14] digitally delivered by 2030 yes

[00:32:17] you have appetite to try new crazy things as well

[00:32:21] the first holograms I saw they were in this region yes

[00:32:24] you have the virtual hospital SEHA that has already seen virtually like 400,000 patients

[00:32:31] and then it's also a very good moment for those providing services or therapies

[00:32:39] for disease and for areas that are very prevalent here disease wise

[00:32:44] metabolic disease for example is a big problem

[00:32:47] you have the highest percentage of the world diabetes here for example

[00:32:51] you have cardio issues as a plus so there is a big push at the moment of prevention

[00:32:56] because a lot of people have chronic disease

[00:32:58] then on genomics side there is also a lot of push on CGT's technologies as well

[00:33:04] because there is a lot of like genetic inheritance disease for instance

[00:33:09] but that has opened the door as well to providing and creating the first CAR-TIV treatments in the region

[00:33:16] like hearing a good avicetorist. There is some windows of opportunity as well

[00:33:20] you operate on the tech-enabled therapies but the biggest opportunity of course

[00:33:24] is for the tech builders at the moment

[00:33:26] the ones building the machines that will enable others to build on their own solutions yeah

[00:33:34] okay interesting so if I asked where do you see the biggest potential in the future

[00:33:42] I would say the next 10 years what would your response be

[00:33:47] you talked a little bit about biotech the Dubai industrial strategy for 2030

[00:33:53] and the Abu Dhabi vision for 2030 actually considered the pharmaceutical industry

[00:33:57] as one of the main sectors to develop with its future growth prospects

[00:34:02] as you mentioned supply chains and the desire to bring to build

[00:34:07] and produce pharmaceuticals locally what would you say is an opportunity here

[00:34:15] especially from the digital health perspective

[00:34:19] I would say that the digital health also has a role to play in this tech bio

[00:34:27] let's call it tech bio that's the new password

[00:34:30] the tech enablers for drug discovery manufacturing of these things

[00:34:34] because you can aggregate data workflows clinical medical records with a lab information system

[00:34:41] with you can do a lot of things in cybersecurity, traceability, automation

[00:34:45] we're talking the same thing right so you see a shift of some digital health companies

[00:34:51] that are going into the biotech world

[00:34:55] because I would say to for me this division of different sectors digital health

[00:35:01] it's something I always struggle with because my definition of health technologies

[00:35:06] is I only define health technologies in a very simplified way

[00:35:10] technologies that can be used to provision beta services for all of us

[00:35:15] or technologies that help develop beta therapies for us

[00:35:20] you could argue that by this symbiosis of technology with science

[00:35:26] or technology with medicine is leading it will lead to new ways to treat patients

[00:35:33] digital therapy this is one example and new ways to even conduct R&D, digital biology

[00:35:40] but these are the very early stages of in silico etc

[00:35:44] but how does that you think about it I see as a continuum

[00:35:47] digital health can add those interfaces to collect anything from prompts

[00:35:52] to health, clinical trials to this

[00:35:55] you are very good at workflows, data workflows, aggregation, interoperability, semantics

[00:36:00] you can add a lot of value because for instance something like cell and gene therapies

[00:36:04] one of the biggest issue is in a cardiotherapy the time is how do you coordinate

[00:36:09] all the different parties have systems speak to each other

[00:36:13] this could be an interoperable play for anybody who operates in the clinical side

[00:36:19] so I don't see that division so the question to the listeners there

[00:36:24] do you see that division because I don't so maybe we could argue on that

[00:36:28] but I do see follow the data if you are a digital player it's data dream

[00:36:34] follow the data and follow the journey of each of us

[00:36:37] when we are not sick, it's prevention, when you are sick, it's clinical

[00:36:43] when we need a drug, it's the lab or when you need to make more research to cure

[00:36:49] more people and then the answer is there

[00:36:54] and going back to GCC I think they will leapfrog

[00:36:58] this is a big bet to start creating life science platforms

[00:37:02] but teaming that up with computing, AI, deep tech

[00:37:06] and that leapfrog will drive the digital health market as well

[00:37:12] and depending agendas of digital health market like interoperability

[00:37:16] so I think this is where the wind is going

[00:37:20] this is where the money is going, this is where the attention is going

[00:37:24] so I would definitely recommend to find your place there

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