They estimate that the pharmaceutical industry must work on its future

THE UNIVERSAL
“The pharmaceutical industry, like many others, has been characterized by taking quantum leaps, and all this has been due to the advances that have been made, in terms of research and development, on different scales. But a large part of them creating a very important base on what has been built or discovered”.
This is the opinion of Dr. Oswaldo Santana Blank, pharmacist, and with marketing studies at the Kellogg School at North Webster University, as well as finance at the same university.
Santana has a clear point of view about the industry in the world, its past and especially its future.
As president of Janssen Cilag in Venezuela, and as director and later president of the Venezuelan Chamber of Medicine (Cave-me), he has managed to accumulate extensive experience that has allowed him to make an X-ray of the entire industry and its potential.
He considers that it is essential to look at the development achieved, the goals achieved and the pending tasks, in order to have a roadmap that will take humanity to better places in the production of medicines.

Since a time ago
“We go to the end of the 19th century and the beginning of the 20th century so as not to go much further back and we see that doctors and researchers appear in the world, as well as chemists, who would publish their discoveries, and that they would be of total relevance until the present day. today”, says Santana to make an overview of the time.
He explains that Louis Pasteur (1822-1895), for example, as a French chemist, and equally notable microbiologist, made discoveries that were focused on vaccines, as well as the fermentation of microbes and processes known as “pasteurization”, which are fully in force today.
“On December 11, 1843, Robert Koch was born in Germany, a doctor and microbiologist, who discovered that tuberculosis is caused by a bacillus, which was called by his name: Koch’s bacillus. He also discovers the one responsible for cholera and Anthrax”, he points out, emphasizing that “Koch is still remembered today as one of the main founders of modern bacteriology”.
He was awarded the Nobel Prize for Medicine in 1905 and died at the age of 57, on May 27, 1910 in Baden-Baden, Germany.
“Pasteur and Koch lived through a period of contemporary research, and established some of the first quantum leaps in research and development, as well as two separate awards with respective Nobel Prizes in Medicine,” he says.
Santana recalls that all these investigations “had a slow repercussion in Venezuela, because only due to the incursion of specialization of some doctors and researchers did they begin to have notions of the advances of the time.”

from other latitudes
“The influence of medicine was referential to the French academy, at that time. Students concerned about the scientific curiosity of the time, such as doctors José Gregorio Hernández and Luis Razetti, among others, seek to improve their knowledge to replicate it later in Venezuela”, he says.
They, he explains, “go to Paris, where advances, especially in microbiology and even pharmacology, were much greater than local knowledge, and even more influential than those of other latitudes.”
“Already at the beginning of the 20th century, a great accidental discovery was made in London. Scientist Alexander Fleming leaves some loaves of bread forgotten in his laboratory. And when he finds them, some time later, they were totally covered by a fungus”, he recounts.
It was the Penicilium notatum and there scientific curiosity makes Fleming start some tests, in which this fungus killed some bacteria, or “prevented their growth. A short time later, penicillin had been discovered, which has saved countless lives and continues to be a fundamental basis in the development of medicine.
“Alexander Fleming is also recognized with a Nobel Prize in Medicine (1945) for such a significant finding.”

By leaps and bounds
The next quantum leaps, Santana explains, are being developed by the pharmaceutical industry, but many of them come from very old primary research bases.
“From there it derives would be another issue: How to get distribution for these products?
For Santana, it is key to mention that in Venezuela the pharmaceutical environment was managed in the well-known “Boticas”, and a large part of the “preparations” that were made were manufactured in the so-called recipes. “Patients improved with some magisterial formulas, which were not always effective,” he points out.
“The first apothecary was founded in Nueva Cádiz, Cubagua, in 1528, and the first one founded in Caracas appeared at the end of 1649, unbelievably 121 years after the first apothecary recorded in historical annals,” he says.
But setting aside the subject of anecdotes and returning to contemporary times, “medicines since the discovery of penicillin, vaccines, and pasteurization, have reached several essential leaps,” he says.

Saviour table
“The creation of synthetic antibiotics. One of them, ampicillins, penicillanic derivatives, cephalosporins, some macrolides, such as Erythromycin and Azithromycin, much more recent, are part of the advances recorded in history”, recalls Santana.
“Aminoglycosides and a whole range of products that have been developed and marketed worldwide have been key to a large number of infections. But products have also been developed in the field of cardiology, and today there is a variety of products and molecules that are extremely useful in controlling blood pressure, as well as metabolic syndromes, controlling cholesterol levels, controlling triglycerides, heart failure, etc,” he says.
He says that in the past we can refer to treatments that were very traumatic, for example in schizophrenia. “Patients were treated, in some cases that doctors considered refractory to the drugs of the time, with electroshocks.”
Through the administration of controlled electrical waves at the brain level, the aim was to try to “control the patients”, highlighting the cases of schizophrenics or depressive manics.
“Obviously these treatments, although they could be effective in some cases, were also quite traumatic and invasive,” he adds.
“Today advances in psychiatry, through modern medicine, have managed to keep patients with an active and controlled life,” he highlights.

The present and its challenges
Dr. Santana mentions that, despite there being a very important evolution in research and development, “there are a number of new challenges that the industry must face.” There are “new technologies in research, nanotechnology and biotechnology,” he adds.

Some considerations about specialties
-What is the situation of the pharmaceutical industry in Venezuela?
-In general terms, there is supply for some primary care conditions, and a list of essential products to cover these conditions. But the absence in Venezuela of the global research and development industry is a great concern, because it means that we are and will be even further behind in obtaining the latest generation of pharmaceutical products.
– Is it at adequate levels?
-Although it is true that the national industry is serving the largest number of pharmaceutical specialties, this is really not enough. Venezuela today is probably one of the few countries where doctors manage the products they have available, and they do not see an issue of such importance as bioequivalence, because there are simply no options.
“If we make references to the past, we see that the Venezuelan market was the third largest in size. Brazil number 1, Mexico number 2 and Venezuela number 3”, he says. Until 2010 the market “exceeded 8,000 million dollars. And today it does not reach 500 million. In that market of 8,000 million, the market was dominated by foreign investment”, he affirms.
Account that approximately 80% of research and development was affected. When the research and development companies left, so did the opportunities to “be able to have therapeutic innovation, and even for national companies to improve their portfolios due to competitiveness,” says Santana.
“This opens up, from a strategic point of view, some opportunities for the national industry, which are not being properly exploited,” he says.
“Although the pharmaceutical industry in Venezuela has gone through very critical times, and on the other hand there has been an exodus of valuable talent from the country, there are still great opportunities for companies involved in chronic use conditions. And this is done, as much as possible, in the right way, to the benefit of both doctors and patients,” he stresses.

– Is it about looking for those opportunities to serve public health in the best possible way?
-All future trends, in therapeutic terms, are turning to go to biogenetic products. That is the way.