Jul 062015

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The Millennium Development Goals Report 2015 finds that dire poverty has dropped sharply, and just as many girls as boys are now enrolled in primary schools around the world. Simple measures like installing bed nets have prevented some six million deaths from malaria. But nearly one billion people still defecate in the open, endangering the health of many others.

In fact, though, how much of those gains can be attributed to the goals is unknown. The sharp reductions in extreme poverty are due largely to the economic strides made China alone. Likewise, some of the biggest shortfalls can be attributed to a handful of countries that remain very far behind, in particular India, where an estimated 600 million people defecate in the open, heightening the risk of serious disease, especially for children.

Reducing Child Mortality

Reducing Child Mortality

The New York Times has a good report here.

Given that health is a key component of the MDGs, what can healthcare communicators read into these findings? Having worked extensively in the region (albeit moreso in China than India) and having developed communications programs in both markets, it is clear that from an organisational level China is streets ahead. And, the long-termism so evident there is in large part absent in India. The way pharma engages with stakeholders in both markets is quite different, with Indian strategy much more focused on traditional channels and being less invested in digital and social engagement. It would surely make sense for India to revisit its policies that so restrict multinationals from investing in the country and consider embracing partnership from the pharma sector.

Mar 292015

Frequently I’m contacted by recruiters casually sounding me out for names of likely candidates for their obviously hard to source positions. Fairly frequently I have agencies talk to me about starting an offering in Asia and likewise they want to understand the availability of talent on the ground or the unique qualities that might be called for to practice in the region.

First the proximate challenge, the ready availability of individuals with prior experience in Asia. It’s true that there simply aren’t many. The real reason though in my view are the blinkers that have recruiter and agency ring-fencing their candidates into subdivisions that make increasingly less sense in the real world. Health care is niche enough, without actively forcing disciplines apart.

Asia is increasingly driving the bottom line of global pharma, pharma are increasingly looking to establish themselves in the region, eg GSK Consumer’s move of its global marketing operations to Asia. Many new R&D centres have sprung up across the region over the last decade.

So with what looks to be on the surface at least a burgeoning sector, why the lack of an across-the-board spread of talent in the region. If we start by looking at the disciplines and their traditional descriptors and then pin then to an outcome-relevant framework we end up with the representation in Figure 1.

Figure 1. Integrated or Siloed?

In summary what this sets out is:

  1. Science builds the Foundation – This is the Diagnostic phase, understanding needs and gaps
  2. Creativity drives brand Recognition – This is about Exploring responses to proposed product positioning
  3. Connections create a web of BeliefConviction will follow dialogic engagement around a consistent message
  4. The economic Value story leads ultimately to commercial Success – Payers can hardly look beyond a Compelling proposition.

Siloing and hyper-specialization in any context, and as discussed in the linked piece – especially in science, diminishes effectiveness. The situation we have globally in the health care communications sector is akin to having four distinct silos with little crosstalk. In Asia Pacific in reality the situation is somewhat different given that regional and market-level work is mostly focussed on branding and PR. Figure 2 represents the state of play here. That the scientific aspects of market shaping are primarily managed globally, and health technology assessment is not yet critical to many emerging markets might explain the lack of available talent in these disciplines in the regions, but it doesn’t help with efficiently articulating a complete go to market story.

The amount of meaningful devolution to key emerging markets by pharma will ultimately shape the regional communications sector and talent availability in the region. But back to the question at the top, who’s actually struggling to hire if the sector in Asia doesn’t need full spectrum integration?

Put simply, it comes down to the big groups having a macro level perception of a pressing need for integration, which combined with any number of loose acquisitions and global networks (that are in reality so peripheral as to be in reality competitors) is seeing a knee-jerk response to get ahead of the curve. Instead of understanding the market and how they might better leverage their current regional capabilities they announce a sudden strategic imperative to ‘understand the science’ perhaps to potentiate opportunities in specialist pharma.

In the end all this achieves is a lot of over-extravagant resourcing briefs, for positions which – if they are filled – are likely to leave their new occupiers, in the absence of any realisable strategy, and any definitive uplift in client spend or strategic decision making authority, beating against an impossible wind.

Fragmented and Incomplete

Figure 2. Fragmented and Incomplete


Feb 052014

After reviewing the space, agency imperatives and some of the challenges over the last weeks, let’s take a look at some of the growth drivers… some of which might seem a bit counterintuitive

  • Inevitable increasing focus on value and rationalised access to newer more expensive therapies vs restrictions to listing on grounds of cost
  • Emerging models of universal healthcare systems, which will both constrain expenditure and call for rational prescribing of innovative tx, but grow overall volume potential
  • Increasingly complex and evidence-based messaging will be required by healthcare providers to its publics, payors and prescribers
  • Connections and value of exchange between opinion leaders are not well understood (despite intensive use of social media); this offers scope for more rationally targeted communications
  • Increasing westernisation of lifestyle-driven disease, increasing class of consumers able to pay out of pocket for unreimbursed products (private market), increasing access to healthcare through progressive move to universal access will drive growth
Jan 292014

Last week I looked at the agency as a species in the context of Asia. Today I topline some of the emerging challenges, which though nuanced are in line with the increasingly complex demands of the sector globally.

  • How is or will value be created through deployment of new healthcare technology/therapeutics?
  • How will healthcare systems need to restructure/adapt to facilitate deployment of new technology/agents in a way that enables their value-extraction?
  • How will different demographics be satisfied? Populations differ constitutionally within markets, and they differ across markets, but they increasingly share the convergent aspirations of an increasingly homogenous ‘middle class’?
  • How to translate increasingly available – but not necessarily easy-to-use, and often fragmented – data into meaningful quantifiable value messages?
  • How to respond to the fact that payers, providers and patients will determine the value of healthcare – physicians will no longer be the sole – or even decisive – arbiters of what’s best?
  • How to communicate the genetic aspects of targeted drugs, personalised medicine, small and dispersed patient cohorts?
  • How to marry the changing status of the frontline practitioner with the growing concept of wellness, increasing consumer choice/activism, and active engagement in treatment selection vs the traditionally unengaged patient?
  • How to respond to the gradual shift of specialist treatment and primary care into integrated practice units, while providing a seamless continuum of care?
  • How to measure healthcare outcomes in the context of the real world setting? As the dominant lever for extracting value, the complexity of science+economics+multiple publics’ opinions will make messaging increasingly complex.
Jan 222014

I wrote last week about the changing demands on communicators in healthcare. How does this frame up from the perspective of the Asian region?

  • Some of the critical challenges in AsiaPac are the same as anywhere else; an increasing need to determine insights into an ever more specialised and fragmented environment for pharma and healthcare providers
  • To find these insights means understanding increasingly complex networks – compared to the social network mapping of physician insights and physician-patient connectedness happening elsewhere it’s still a bit desk-based and ultimately hierarchical/deferential in Asia
  • In my experience in AsiaPac though there is a determination to achieve the notional ‘integrated’ agency, this is a rare beast. An agency that can communicate cross-disciplinarity in the key areas described above (ie not dominated by a visual creative/overwhelmingly advertising heritage) has a potential space to occupy
  • Agencies, regardless of their networks tend to focus on their heritage business and do not maximise use of either their local cross-discipline networks, nor globally leverage their peer set within discipline
  • Networked agencies have recognised opportunities in the space for more market-shaping science-oriented comms, but they have not historically effectively activated their acquisitions – ‘integrated network’ descriptions tend to be capabilities presentation rhetoric
  • Within pure play medical communications the independents are relatively strong in their niche –leveraging their global intellectual therapy area value to maintain reasonably consistent business in Asia – they are the right size to be firewall-free
  • Boutique independents in med comms survive on project-based business – hard to sustain
  • In advertising, the networks have the lions share of the business, reflecting their heritage
  • Digital is a space competed for ever more vigorously by independents, ad agencies and generalist networked digital agencies
  • The recognition of the value in data insights and examples relating to health is starting to come to the fore, as per the example here http://www.dextra.sg/ in Singapore
  • For an agency to position itself successfully in Asia it needs to disrupt both the networked and specialty agency categories – in a sense create turbulence, the ripples of which speak to the new entrant’s energy more than its size
  • How capability to deliver is established is critical – it tends to mean a core of implementers on the ground combined with transferable global strategic insight. Developing a network of partners as the business grows is important
  • Must be able to demonstrate genuine and tangible integration of its components – larger independents are probably in the sweet spot. Sitting within the the walls of an acquisitive network is increasingly showing stymied growth
Independent firms, meanwhile, continue to outperform the holding companies in terms of growth, with Edelman only the most prominent example. Overall, independent firms submitting information to the Holmes Report 250 experienced growth of better than 12%, compared to average growth of around 4% for the public relations operations of the major holding companies. – See more at: http://worldreport.holmesreport.com/top-10#sthash.r4KFtmFX.dpufPharma spend is often – and perhaps increasingly – determined by globally-led strategy; without effective joined-up global-Asia engagement, opportunities will be smallerAgency-side cross-discipline talent in healthcare is not widesprea

“Independent firms, meanwhile, continue to outperform the holding companies in terms of growth, with Edelman only the most prominent example. Overall, independent firms submitting information to the Holmes Report 250 experienced growth of better than 12%, compared to average growth of around 4% for the public relations operations of the major holding companies.”

  • Pharma spend is often – and perhaps increasingly – determined by globally-led strategy; without effective joined-up global-Asia engagement, opportunities will be smaller, perhaps unsustainable
  • Agency-side cross-discipline talent in healthcare is not widespread
May 212012

As imprecise a geographic concept as Asia-Pacific is, however its boundaries are defined it is home to something like 40-60% of the world’s population in an area comprising 20-30% of the global landmass. Within these boundaries just two nations combined account for some 38% of the global population. However it is dissected the notion of AsiaPac often remains rather nebulous, a bit unhelpful for service sector businesses arriving in the region. Whereas no-one seriously contemplates a unified Europe – despite it being by value the world’s leading trading bloc – as a culturally integrated unit, thirty years after China opened up and the Asian tigers first roared there is still a tendency (often from afar) to be casual with the term AsiaPac as a meaningful geographical and socio-political construct. This is careless and results in an internationalization strategy getting off on the wrong foot or with no real focus. The fact is there is little that tangibly connects a region that cuts across all strata of economic development and includes countries with some of the most progressive and cost-effective healthcare systems and standards. It’s partly this lack of uniformity that makes working in the environment so stimulating but developing a strategy here takes significant consideration. Break it down and Australia is too Western to be ‘Asian’, India is too indecisive about policy and foreign direct investment and seemingly focused on blowing its demographic advantage, Japan is just too different, the post-industrial economies of Singapore, Hong Kong and Korea are all well on their well-established tracks and the rest of Southeast Asia is pretty small beer economically. Cutting through what AsiaPac means in meaningful terms to pharma, there will continue to be one driving force for growth in the foreseeable future and that driver is China. Answering the question posed, in 2012 AsiaPac is China.