Egypt’s war on diabetes is intensifying. With 7.8 million people suffering from the life-threatening illness, and with that number set to double by 2025, Egypt requires all the industry, doctors, infrastructure, and assistance that can be spared to prevent an epidemic from causing serious harm to the state, society, and the Egyptian people. In that fight, the Danish company Novo Nordisk is one of Egypt’s most loyal supporters.
Novo Nordisk is a company that specialises in the sale of high quality diabetes products across the world. Their involvement in the diabetes industry is well known, but they also sell treatment for Haemophilia, growth disorders, and obesity. With their headquarters in Denmark, Novo Nordisk employs approximately 41,600 people in 75 countries and markets its products in more than 180 countries.
Novo Nordisk has been a pioneer in insulin research, contributing an impressive annual 14%-15.8% of global sales in research and development, making Novo Nordisk one of the largest investors in diabetes treatment.
The company is ranked among the top 100 most valuable companies globally and is the most valuable in Scandinavia, producing half the world’s insulin.
Like his company, which has been active in Egypt for over 80 years, CEO Lars Rebien Sorensen exudes confidence and competence. He has been ranked by Harvard as the best CEO in 2015. He was recently in Egypt to discuss with the government the launch of new products and opportunities for collaboration in the Egyptian public health system in fighting the global epidemic in diabetes.
Daily News Egypt had the opportunity to sit down with Sorensen to discuss this new venture.
Novo Nordisk has been in the Egyptian market for a very long time. What potential does the Egyptian market have and what are Novo Nordisk’s milestones to date?
Novo Nordisk has been working in the Egyptian market for more than 80 years. The company is a pioneer in introducing insulin to Egypt, backed by its global expertise and leadership in diabetes care. Collaborating with the relevant stakeholders, Novo Nordisk Egypt is currently working on several initiatives to best serve Egyptians with diabetes.
Novo Nordisk’s approach goes beyond doing business to working in partnership with stakeholders to upgrade healthcare for people with diabetes in Egypt, building on the experience gained from its long-standing and strong presence in the country.
Key Novo Nordisk has achieved several milestones in Egypt. In1934, Novo Nordisk exported its first batch of insulin at the request of Egypt. It was in 1991 that Novo Nordisk established its first office in Egypt. In 2007, the Changing Diabetes Bus began conducting awareness and screening tests in Egypt. In 2009, Novo Nordisk sponsored 200 clinics to conduct free diabetes checkups on World Diabetes Day.
Novo Nordisk launched the NovoCare project in 2010. In 2014, Novo Nordisk signed an agreement with Vacsera and the Egyptian Ministry of Health, and in 2014 the first Diabetes Centre of Excellence opened.
What are the global and local prevalence rates for diabetes?
There are 415 million diabetic patients worldwide with an expectation that the number of people with diabetes could reach 642 million by 2040. In the Middle East and North Africa region alone, the number of diabetic patients has reached 36 million people.
In Egypt, an estimated 7.8 million people have diabetes, which is equivalent to 14.8% of the adult population. Egypt has the eighth highest prevalence of diabetes worldwide. It is predicted that by 2040 there will be an additional 7.3 million people with diabetes in Egypt, bringing the figure up to 15.1 million.
In 2015, more than 78,000 Egyptian adults were estimated to have died from diabetes related diseases, an average of 214 deaths every day. Dying young or living with long-term illness or disability has economic implications for society as a whole. Poor health can result in days off work due to illness and lower levels of productivity when at work, creating an economic burden. At the same time, growing numbers of people with diabetes who need care and treatment will place an even further strain on healthcare services already struggling to cope with the rise in chronic diseases.
The rising number of people with diabetes threatens to further burden the Egyptian public healthcare system. In 2015, diabetes was estimated to cost between $219 and $355 per person with diabetes. Through earlier intervention with education and better care, the costs of diabetes-related complications can be minimised.
Can you tell us about the Kalundborg factory?
Novo Nordisk Kalundborg is the largest insulin production facility in the world and is a cornerstone of Novo Nordisk.
The 1m sqm facility has 2,800 employees and produces 50% of the world’s insulin. It works for 24/7 nonstop. At Novo Nordisk Kalundborg, we manufacture life-saving medicines to meet increasing global demand.
Fermentation of insulin makes the factory operate like a type of brewery as it is also made with yeast.
Why does your company have an interest in preventing the increasing global diabetes burden when its profit comes primarily from insulin?
We can argue that we are doing what we can for our customers. In the meantime, please protect yourself and treat yourself; we have some products that may help you. People have their legs amputated, their kidneys removed, and die. If anything can be done to change it, it must be done.
Please tell us more about being selected by Harvard as the best CEO in 2015?
A major contributing factor in the rankings is the increased role Corporate Social Responsibility (CSR) plays in the health and image of a company. Harvard is well known intuition. When they make a ranking, it is noticed.
This year the ranking was based on 80% profits and 20% CSR, which gave Novo Nordisk a higher total score than the more profitable company, Amazon, with Novo Nordisk only being the eighth most profitable. The rating has given a lot of attention that we as a company can be proud of. Around 41,000 people can take pride in this as well as the people who worked before us.
Can you tell us about Novo Nordisk’s triple bottom line?
While it was previously believed that diabetes was a First World disease only, it has since become an intractable problem in developing countries as a result of urbanisation and lifestyle changes associated with capitalist development. This compels organisations active in diabetes prevention and treatment to formulate more effective strategies by working with different partners in society and address the individual, social, and economic burden of the condition.
Novo Nordisk’s Harvard ranking was a result of our corporate philosophy of the triple bottom line. We believe that a healthy economy, environment, and society are fundamental to long-term business success, and that it is our responsibility to help create conditions for prosperity. That is why we always take social, financial, and environmental considerations into account when we make decisions and strive for solutions that generate shared value.
Are there new products that have recently been or are expected to be launched in Egypt?
We are always keen to provide our best in class products to all different markets, that fits different cases and make life much easier for people with diabetes. We have recently launched in Egypt in 2016 NovoMix® 50. This provides better PPG control and is as effective as basal bolus regimen with fewer injections. NovoMix® 50 represents the simplicity of one insulin in one device and provides better glycaemic control than human premixed insulin. Additionally, NovoMix® 50 is suitable for Egyptian eating habits, which include large meals and high carbohydrate content, as such a 50:50 mix is needed.
Tresiba® is expected to be launched in 2016. It is a once-daily basal insulin with a flat and stable ultra-long duration of action beyond 42 hours. Tresiba® successfully reduces HbA1c providing glycaemic control with a lower risk of nocturnal hypoglycaemia than insulin glargine and provides patients with flexibility in their day-to-day dosing time when needed.
Are there certain products especially for patients who insist on fasting during Ramadan?
Actually yes. We did a study called Lira Ramadan study specifically for Muslim patients who insist on fasting during Ramadan.
Recent studies have revealed that 57% of diabetics don’t adhere to their treatment regimen if it is taken more than once a day, as such treatments that are prescribed once daily, such as Victoza, improves patients’ compliance. Studies showed that only one third of the people with type 2 diabetes can achieve the targeted results and control their blood sugar levels.
People with diabetes should normalise their blood sugar levels before Ramadan to be able to fast without any complications by following the recommended medical instructions. On the other hand, patients who are advised not to fast are those who suffer from diabetes complications affecting blood vessels, heart and kidneys or patients who receive high and multiple doses of insulin throughout the day. People with type 2 diabetes using Victoza during Ramadan managed to reach their target HbA1c levels with no confirmed hypoglycaemic episodes and no weight gain by more than double the comparator treatment.
People with diabetes who plan to fast should use drugs that don’t cause hypoglycaemia after consulting their physicians, especially that the above mentioned risks force one of each three patients worldwide to break their fasting. On the other hand, obesity from eating foods with a high glycaemic index and a sedentary lifestyle are considered as type 2 diabetes risk factors, so the availability of an effective treatment such as Victoza, which helps in weight loss compared to the other diabetes treatments, is considered an important step in fighting diabetes.
What does Novo Nordisk offer diabetics and doctors?
In 2014, Novo Nordisk signed an agreement with the Ministry of Health to establish Diabetes Centres of Excellence across the country which were inaugurated in 2015 by the former minister of health. The centres aim to improve quality of care for people with diabetes.
Novo Nordisk provides the Centres of Excellence with the equipment needed for the treatment of diabetes as well as a patient management system for smooth and swift administration. Novo Nordisk will also ensure the continuous training of the staff. The centres are operated by the Egyptian Ministry of Health and technical assistance is provided by the National Diabetes and Endocrinology Institute.
Each centre of excellence will offer medical services ranging from early detection of type 1 and 2 of diabetes, patient tips, and treatment. The centres will also feature specialised departments for endocrinology, and prenatal diabetes, in addition to specialised doctors for the treatment of diabetes-related complications and will also accommodate medical labs for necessary tests, which help prevent amputations and death associated with the disease.
How does Novo Nordisk support underprivileged patients?
The latest researches and studies confirm that high prevalence rate are a result of unhealthy lifestyle and diets, genetic factors, and simply ignorance or not following physicians’ advice, which put patients at extreme health risks.
As a result, Novo Nordisk mainly focus’ itself on education such as their mobile education and awareness centres launched in 2007 called The Changing Diabetes Bus, used around the world, which brings equipment to villages capable of screening and diagnosis.
The bus is a joint initiative between Novo Nordisk, the Egyptian Ministry of Health, and the National Diabetes and Endocrinology Institute. The launch of the NovoCare project in 2010 put two centres in Cairo to support and educate people with diabetes. Five years later, there are now 30 centres across Egypt that work to educate and support those with diabetes. From 2013 to date, NovoCare provided education and support to around 102,000 Egyptian patients through individual health care planning and group awareness sessions.
In 2014 we teamed up with the Masr El-Kheir Foundation in providing Iftar for 10,000 people over five governorates throughout Giza and Upper Egypt and their “Take Action” initiative gives our employees a chance to engage in these projects and contribute to society beyond their usual responsibilities.
We also began a summer camp for children with diabetes called “Changing Diabetes in Children” organised with the Diabetes Youth Care Association. During the camp, Novo Nordisk Egypt provided an innovative and interactive atmosphere for the children to teach them the best ways to manage their diabetes and information on insulin, healthy diets, foot care, exercise, and other advice so that they can enjoy a better, longer, more productive life.