January 26, 2023 • 37 mins
Dr. Antonio Trujillo is an Associate Professor in the Department of International Health with expertise in health economics, the economics of aging, and applied econometrics. Antonio is the co-director of the Master of Health Science (MHS) in Global Health Economics degree program. He teaches an advanced econometrics course on program impact evaluation using observational data and a course on behavioral economics and public health.
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Episode Transcript
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Speaker 1 (00:00):
Welcome to the Latin MedTech Leaders Podcast, a
conversation with MedTechleaders who have succeeded or
plan to succeed in LatinAmerica.
Please subscribe on yourfavorite podcasting platform.
Apple Podcast, Spotify, GooglePodcast.
Amazon Music is teacher tuningiHeartRadio, Pandora, or these
are Welcome to the Latin MedTechLeaders podcast, a conversation
(00:25):
with leaders who have succeededor plan to succeed in Latin
America today.
Our guest is Carlos Medina.
He is the lead, uh, Mexican.
He leads the Mexican team for acompany whose core competency is
to accelerate the entry of newproducts into emerging markets
(00:45):
across the globe.
The company is hosting LLC and,uh, Carlos Managers Mexico,
central America, and theCaribbean.
Right.
Carlos.
Speaker 2 (00:55):
That's right on the Money.
Julio, thank you for theinvitation.
Speaker 1 (00:58):
Excellent, Carlos, it's great to have you here
today.
Welcome to the show.
All right.
So
Speaker 2 (01:03):
It's a pleasure having a, a chance to converse
with your audience.
Speaker 1 (01:06):
Beautiful, beautiful.
I'm, I'm, I'm very pleased tohave you, you here, um, Hasting
and, and, and, and me have knowneach other.
Uh, your founder, Uzi and I haveknown each other for quite a
while, so I'm, I'm very, um,pleased to, I'm privileged to
having you today.
Uh, ing is growing in LatinAmerica, so I'm sure it's gonna
(01:27):
be an exciting, uh, episodetoday,
Speaker 2 (01:29):
, and this,
this is one more of those
collaborations that we like somuch.
Speaker 1 (01:34):
Excellent, excellent.
Alright, Carlos, so let's getstarted with, um, your journey
to Latin America.
I understand that you're amedical doctor.
You got involved in medicalinnovation with Haston, and tell
us about your past and, andwhere you are today, how you got
to where you are today.
Speaker 2 (01:51):
Well, it all started when I went into medical school
because I went there looking todo some clinical research.
I like to do complex puzzles and, uh, solve different, uh,
difficult problems.
And when I went into medicalschool, I was fortunate enough
to be one of the firstgenerations that had full access
to the internet at the nationalUniversity here in Mexico City.
(02:12):
And that blew up a wholedifferent world of technology
that we could apply to medicalscience.
So I ended up not going into,uh, clinical research, but
rather, uh, going into medicalinformatics ever since I, uh,
finished my clinical rotations.
And I've been working on that,uh, for the past 20 plus years,
(02:33):
going through editorial projects, uh, uh, continuing medical
education, medical marketing,and now I'm working with trying
to, uh, make business happen andto get, uh, the information
flowing across the varioushealth networks, uh, in Latin
America.
Speaker 1 (02:53):
All right.
Very good.
And, uh, I just realized that Imispronounce the name of the
company.
I said Husting, it's Hasting.
Speaker 2 (03:00):
It, it really depends on which country you are at.
Uh, the company, Brazilian andmy Brazilian countryman, uh, com
, my colleagues in Brazil, theyusually call it Hasan has
Speaker 1 (03:12):
Okay.
Speaker 2 (03:12):
It may be just my, uh, us, uh, my us uh, biased
creeping into the name, but, uh,I liked Haston because that
brings the, the connotation ofdoing things faster.
Speaker 1 (03:25):
Very good.
Yeah, I like that.
I like that.
All right, so the company isBrazilian, right?
And we're gonna get to that in amoment, but, uh, uh, uh, we're
gonna speak about, uh, the, the,the genesis of the company.
Um, your founder and c e o has avery interesting, uh, story
behind how he got started, uh,in this business in Brazil.
(03:46):
Anyway, so let's talk abouttrench, uh, Carlos.
Um, what trends do you seehappening in Latin America that
are relevant to our discussiontoday?
Speaker 2 (03:55):
Well, it's kind of hard to, uh, miss the elephant
in the room.
I mean, COVID has been throwingtrends left and right, but I
think it has brought, uh, intovery sharp focus one of those
trends, which is that most ofthe medical technologies take a
little bit longer to get to, uh,the Latin American countries.
(04:16):
And any efforts that we canexpand to make that technology
get to these countries faster isgoing to be beneficial for all,
all the patients and the medicalinstitutions as well.
So that's the first one, tryingto get, uh, medical technology
to take root faster in this, uh,in these countries.
(04:38):
But other than that, I do see alot of efforts spent by the
government and, uh, by, uh, evenprivate companies like ours to
collaborate and to buildnetworks to accelerate the
development of new technologies.
I see a lot of startup clusters,uh, throughout Mexico.
I've been fortunate enough towork in most of the countries
(05:02):
in, in Latin America, and I, Isee a lot of, uh, technologies
being, being, being broughtforth to solve the inequalities
of access to the medical system,uh, which is sadly another one
of those trends that, uh, that,that is, uh, deeply etched into
(05:22):
the Latin American, uh,healthcare because, uh, you've
got some very big, uh,differences between access to
medical technology in the ruralareas and in the cities, and
even between countries.
So being able to use technology,particularly information
technology, to level the playingfield and make sure that
(05:43):
wherever you're at, you've gotyour cell phone in your hand,
and you've got access to medicalhealthcare, that it has good
quality and that can actuallysave you time, uh, and effort
going to a hospital.
I think that's another one ofthe big trends that we have seen
right now.
Speaker 1 (05:59):
Excellent.
Excellent.
And, uh, I'm very pleased to, toto hear about these trends in
Mexico.
Uh, I imagine you're referringto Mexico a lot when you're
talking about trends, since it'syour natural market, and Mexico
is one of the most, is is in thetop three, uh, of the most
attractive markets in LatinAmerica is one of the biggest
(06:20):
markets, right.
With Brazil and then Columbia.
So, and I love Mexico, by theway.
It's a, it's a beautifulcountry.
It's a country full ofopportunities.
Uh, and there's so much to do inMexico, uh, still, I,
Speaker 2 (06:33):
Uh, I'll trade you.
Uh, I will, we'll have to do a,an exchange program.
You come to Mexico, I go toColumbia and leave
Columbia dearly as well, so,yeah.
Speaker 1 (06:41):
Yeah.
Excellent.
Very good.
Speaker 2 (06:43):
I, I think that that's another thing.
Every country has a differentrole to play in the big
organization.
You have even some much smaller,uh, countries like Costa Rica or
even Republica Dominica, whichhave such a big place in medical
device manufacturer anddevelopment that, uh, it, it
(07:04):
really doesn't have to do withthe market size.
It, it needs to do, uh, it has alot of, uh, a lot of, uh,
investment into creating theright environment to make those
make those prise fruitful.
Speaker 1 (07:18):
Yeah.
Yeah.
Yeah.
It's, it's interesting that youmentioned Dominican Republic.
Uh, there are a lot of earlystage medical device clinical
trials happening in theDominican Republic.
Not, not that much aspar, why,but, uh, I see a lot of, uh,
companies going to, to theDominican Republic, and
especially because a lot of ourphysicians in the country, uh,
(07:40):
get trained in the United Statesand go back to the Dominican
Republic.
So they're, they have access totheir colleagues and, and all
that.
And
Speaker 2 (07:46):
So, correct.
And, uh, when you couple thatquality of clinicians willing to
do the, the work with, uh, easyregulations that allow you to do
the, do the clinical trialswithout sacrificing the security
of the patients, that's anotherimportant part.
I think that's a winningcombination that a lot of other
(08:08):
countries could, uh, couldfollow suit and, uh, start
implementing.
Speaker 1 (08:11):
Yeah.
Yeah.
And Comfort Breeze is makingsome changes, right?
To make it easier for clinicaltrials.
Speaker 2 (08:17):
Yes.
Uh, step by step, they're goingin that direction.
So, uh, they're trying to fasttrack, uh, the clinical trials,
uh, and they're also trying to,uh, uh, standardize the way that
they evaluate things to be morein line with international
regulations.
I think that was, uh, uh, alittle bit, uh, a long time, uh,
(08:40):
incoming, but, uh, it'shappening now with the new
administration.
Speaker 1 (08:43):
Yeah.
Yeah.
All right.
Yeah, we can talk aboutclinical trials in Latin America
, uh, uh, for hours.
Uh, that's probably a topic ofanother episode, but let's,
let's get, um, uh, uh, in, in,let's speak in more detail about
, uh, Hasting, right.
Uh, and, and, uh, the originingof the company and, uh, what you
(09:05):
guys are doing in Latin America.
Speaker 2 (09:07):
Yeah.
Well, the company, as I said,was founded in Brazil, uh,
founded by, uh, one of, of myformer bosses, uh, Eduardo
DeMelo, who has had a tremendouscareer.
He's been in pharmaceuticalcompanies.
He's done research.
He's been, uh, working in, uh,uh, clinical decision support
system, which is actually wherewe met.
(09:27):
We both worked that up to date,and then he left off to date and
started working in otherprojects.
And he started seeing andgetting this idea of trying to
do exactly what I described atthe beginning, trying to get
medical technology to take aroute and to come to developing
countries much faster than itcurrently was, because as I
(09:49):
said, if, uh, if you got a greatblockbuster drug or medical
device, but if it won't beavailable in your country for
two or three years after itstarts being offered in the main
market, that really limits theoptions of the patients and the
doctors to provide the best carepossible.
And, uh, he started, he startedbuilding a network of, of
(10:13):
collaboration throughout, uh,many countries, starting in
Latin America.
And then he started working with, uh, China.
Now we've got affiliates inEurope, in South Africa.
We're working on opening up, uh,operations in India, and we're
building this collaborationnetwork so that we can work with
both medical, uh, devicemanufacturers and medical device
(10:38):
distributors, as well asregulatory companies to make
sure that we can actually speedthings up and make those, uh,
those technologies available assoon as possible, uh, in
emerging countries where they'remostly needed.
Speaker 1 (10:53):
Sure, sure.
As you correctly said, Carlos,our patients in the region have
delayed access to medicalinnovation, and a lot of it has
to do with, uh, lack ofinformation, ignorance about
Latin America and, and, and notseeing the region as a, as a, as
a land of opportunity.
I think there's so much to do inLatin America, and right now,
(11:15):
uh, correct me if I'm wrong, butI think, uh, the countries like
Mexico, Colombia, Chile, uh, arebecoming leaders in the region,
and, and they are O E C Daligned, even Costa Rica, they
just became an O E C D country.
So these countries are maturing.
They are part of the global, um,economy, and they're important
(11:39):
players.
Uh, now they're part of thePacific Alliance, which is a
very, very, uh, strong block of,of, of forward-looking countries
, uh, adopting internationalpolicies, best practices.
Speaker 2 (11:51):
And I think, uh, uh, that's part of the, uh, of what
led to this situation of delayedmedical innovation availability.
But the other part is that, uh,when these companies start
making it big, they areobviously and naturally, uh,
attracted to the large marketsin the US and Europe.
So they're gonna be focused onachieving as much business as
(12:13):
they can there.
And, uh, a lot of the times theydon't have the resources,
whether they are material or, orhuman resources to, to be able
to focus on expansion oncountries that they see a
secondary markets.
So we can provide them an a, anopportunity to, uh, start
working on those markets withouthaving to distract themselves or
(12:37):
their resources for that.
So I think that's a big part ofwhat's, uh, allowed us to be
successful right now.
Speaker 1 (12:44):
That's your, your value proposition, right?
So they don't, they don't haveto invest much time and money
and in, in, in these markets,you guys will take care of all
the, the, the, the ugly work that needs to happen,
and investment and allthat.
Speaker 2 (13:00):
It's necessary work.
And, uh, we'll do it.
And, uh, we'll build, uh, whatwe hope to be a long-term
partnership with both theoriginators, uh, the
manufacturers and thedistributors with us acting as
catalysts in between to makething, to make sure that things
happen and they happen faster.
Speaker 1 (13:21):
That's a great word, catalyst.
I like that.
.
Alright, Carlos, I'm very, verycurious to hear what you think
about Nancy.
And, and you and I spoke aboutthat in our initial conversation
, uh, before the recordingtoday.
Uh, and what Namsa is doing inLatin America.
(13:41):
I understand you guys are, um,are friends with Lansa, NAMSA
have a collaboration with them.
Can you elaborate on that,please?
Speaker 2 (13:50):
Sure, of course.
Uh, NAMSA, uh, for those thatdon't, that are not familiar
with, with that, they'reprobably not on the regulatory,
uh, uh, arena, but NSE is a verybig company in the US which now
has, uh, uh, presence in atleast, uh, three continents.
Uh, right now with, uh, theyprovide both consulting and, um,
(14:14):
testing services, laboratoryservices, as well as, uh,
clinical, uh, they act as a C RO, uh, in many countries as
well.
So they, they actually callthemselves, uh, medical research
organization and, uh, we've beenworking with them for, uh, quite
a few years right now to makesure that we can actually
provide those quality servicesto our customers in Latin
(14:37):
America.
And I keep seeing them grow andgrow because they've been
offering, uh, exactly what, whatthey, what is needed in the
region.
So, uh, for companies that arelooking to solve their
regulatory, uh, issues for entryin the US and in Europe, those
(14:58):
are the two markets where they,uh, where they are focused
mostly.
Uh, they've got consultants forevery aspect of, uh, of the
product development,specifically for medical
devices.
They don't do pharmaceuticalsand, uh, they can provide end to
end coverage.
So, uh, it's a very goodpartnership, uh, for us.
(15:18):
And that's been the backbone of,uh, a lot of our expansion to be
truthful.
Speaker 1 (15:23):
Excellent, excellent.
And also, they just acquired,uh, clean Logics, right?
And Clean Logics had a strongpresence in Colombia.
Speaker 2 (15:31):
Yes.
So they just acquired CleanLogics, that's the latest, uh,
the, the, the latest, uh,acquisition that they made, but
they also acquired aps.
And so they've acquired threemajor players in the regulatory,
uh, and clinical research, uh,areas, uh, just in, this is
Gerald alone.
So they are, they are investingheavily in growth.
(15:55):
And, uh, that's one of the otheraspects that I really like, uh,
about, uh, about theorganization because they, they
acquire technology to expandthemselves.
That's the nature of thebusiness.
That's one way to grow, but theydon't lose the essence of those
businesses.
They keep what has made thosebusinesses great companies, and
(16:15):
they allow them to continueoperating and to provide the
services they have become, uh,known for.
And they do that not only withthe, uh, with the companies that
they acquire, they also do thatwith partners like Haston
because they, they know, we knowthe market.
They know that we can providethe, the local know-how on how
things should be done, and theyreally listen.
(16:38):
So they're able to provide allof that information to their
customers as well.
Speaker 1 (16:42):
Beautiful.
Beautiful.
Excellent.
Yeah.
I also understand they hadanother collaboration with
somebody in Argentina, right?
That was initial collaborationthat they had in Latin America
Speaker 2 (16:51):
That's still going?
Yes.
Uh, uh, Haston, we work withthem to take care of, uh,
customers in, uh, most of LatinAmerica except for the Southern
Cone.
So, Chile, Argentina?
No.
Why they handle with anothercompany ly.
I can't remember the name ofthem.
If I remember, I'll let youknow.
(17:12):
Uh, but yeah, the, they, theyhave multiple partners and
they're working, uh, with ushere.
And, uh, they're working withother local partners in other
parts of the world as well,particularly in Asia.
Speaker 1 (17:24):
Excellent, excellent.
All right.
So Carlos, let's, um, talk aboutyour practical experience in
Mexico and elsewhere in LatinAmerica.
Um, uh, the uc relevant for thediscussion today.
Um, how are things going inMexico in terms of regulatory
approvals for, uh, innovativetechnologies?
Uh, any challenges you canmention?
(17:46):
Any, any tips, any bestpractices that you, you can
share with us so that, uh,companies that are listening
can, can learn from, from, fromthat?
Speaker 2 (17:55):
Sure.
So I think that, uh, when youasked me what the situation is,
uh, right now, of course, COVIDhas brought a lot of delays in
the administrative side of theregulatory affairs.
Uh, you mentioned Coffee Priest,for those that might not be, uh,
as familiar with Mexico CoffeePriest is the, uh, decentralized
(18:16):
organ from the Ministry ofHealth that handles all
regulatory, uh, uh, issues formedical device and drug and food
, uh, uh, kind of like theMexican F D A, if you wanna look
at it.
I think that's the, the, theeasiest way to understand it.
And, uh, they startedprioritizing, uh, the evaluation
(18:37):
and approvals of technologiesthat were covid related, like
many of, uh, of the regulatoryagencies did.
And right now they're workingoff cleaning up their backlog of
, uh, submissions.
And they're doing that with avery, with a, uh,
well-structured program thatthey have.
They're actually keeping us inthe loop and, uh, giving us
information on how that'sproceeding, uh, week after week.
(19:00):
Uh, so they're slowly but surelymaking, uh, making headwind
there.
Uh, it's still, uh, a long, uh,along, uh, response time on
their part.
So we're talking at a close to ayear, uh, on response times.
So, uh, we have a lot of medicaltechnology that's just waiting
(19:20):
for answers.
Uh, but, uh, in the meantime,while they're doing that, uh,
and dealing with the newleadership in place, they just
had a change in their director,and that brought changes
trickling down the line.
Uh, but, uh, I think that hasbeen a good change because, uh,
they're starting to, uh,digitalize most of their
(19:42):
processes.
And with the current, we justtell, we also just had a, a
digital agenda, uh, released forMexico, which is going to bring
a lot of digitalization of theprocesses so that, uh, things
will happen faster and can beautomated in many, in many of
those arena.
So things will get better.
(20:03):
Uh, regarding the, the trendsthat you, uh, were mentioning,
uh, we do, I, I have to, tobring to attention that we do
have a lot of players in themedical devices and medical
technology arena that have hadto close because of, uh, the
demands on their business.
(20:24):
But I see another very big groupof companies that have thrived,
uh, as I mentioned, by using,uh, the technologies available.
We've seen right now, uh, the, alot of, uh, telemedicine
companies providing, uh, videoconferencing and providing
secure communication with thepatient so that they can be
(20:46):
tended to, to, uh, from home.
And I've seen in the past year,I think I've seen more new
insurance and cooperative healthplans, uh, so, uh, a lot of, uh,
innovation as well in, inInsureTech, uh, to take up the
demand that a lot of the majorand, uh, classical health
(21:07):
insurance companies maybe had toput a break on, on taking up,
uh, health policies, becausethey expected a lot of expenses,
uh, from Covid, which I think isnatural for the, uh, for the
dynamic of that business.
But that meant there were a lotof people looking for, uh, other
avenues to get healthcarecoverage.
And, uh, these other companiesstarted to, uh, to invest and to
(21:30):
develop them.
And I think a couple of them arepretty good.
Speaker 1 (21:34):
Okay.
Okay.
And how do you see the currentgovernment and the outlook for
the new government?
Because Lopez obor right, is thenew, is the current president,
how many more years does hehave?
Speaker 2 (21:47):
He just finished his third year, three years, uh, uh,
and, uh, his, he has three moreto go, so he sent
Speaker 1 (21:54):
Three more to go.
Wow.
So we're in the middle of
Speaker 2 (21:57):
.
Yeah, he's right in the middleof his presidency.
Mm-hmm.
Uh, one thing I like about his,uh, his administration is that
he has a lot of very good ideason how to get, uh, how to
enhance and, uh, uh, make allthe processes that have been
held up by bureaucracy and by,um, a corruption faster and
(22:23):
cleaner.
I think he needs, uh, a littlebit of work and a little to
listen a little bit more to his,uh, advices on how to get those
done.
Those have been hit or miss forme.
Uh, but I, uh, I don't want topoliticize this too much, uh,
but, uh, the, the part that I,that I am most excited about is
(22:45):
this, uh, digital, uh,digitalization act that just was
proclaimed last month, becausethat's going to bring, uh,
digitalization not just tohealthcare, but to every aspect
of the government.
So, uh, a lot of the things thatyou formerly needed to go to an
office and maybe, uh, uh, spenda lot of time, uh, cutting red
(23:10):
tape, those should be enhanced,uh, in the next, uh, in the next
few years.
And particularly on theeducation and the access to the
internet and to online services.
I think they're going to beinvesting heavily.
Uh, I'm not gonna go into detailon how those contracts will get,
(23:30):
will get assigned, but,uh, at least we'll start to see
a lot more people get access tothe internet and be able to, to
be more autonomous in thatsense.
Speaker 1 (23:40):
Sure.
That's only matters that, thatthe country, uh, modernizes,
it's, uh, it's, um, the, thedramatists, how do you call it?
The processes and, andeverything, uh, with the
government, uh, and all that,the cities, the procedures and
the, the citizens have access,uh, faster access to the
government.
That's something that Columbia,uh, is probably, uh, leading
(24:04):
Mexico.
Uh,
Speaker 2 (24:05):
You've been working on that for years
Speaker 1 (24:07):
Now?
Yeah, for years now.
Yeah.
Alright.
I'm very happy to hear thosenews.
And, uh, what about the rest ofyour territory?
You also manage the Caribbean,central America.
Can we speak about what'shappening there in terms of
challenges, in terms of newthings coming up?
Speaker 2 (24:23):
Well, you, you've got the, uh, the essential
challenges, uh, of, uh, budgetand, uh, political
administration like you do inmost, uh, in most countries.
My work is, uh, currentlyfocused mostly in Costa Rica and
Dominican.
Uh, so those are, those are thetwo countries because most of
(24:43):
our projects are related tomedical devices, and that's
where the development ishappening right now.
Uh, but I think, uh, uh, both ofthose countries are making a
very good, uh, very good play inmaking it easier for companies
to not only go and startproducing devices there, but
also invest in the local talentto produce medical devices and,
(25:08):
and, and innovate in, in that.
Uh, we've also been in contactwith, uh, some other companies
in Argentina and in Uruguay,which are creating amazing
devices.
Some of them self simple that Idon't know why other companies
did not think about thatearlier, and I'm not gonna say
what it is, just so nobodysteals their idea.
(25:29):
They're still at the IPprotection state.
Uh, but I've seen others makewonderfully complex, uh, uh, uh,
devices for telemedicine.
I've seen, uh, think of aRubik's Cube, a device about
that size with a pulse imeter, atemperature sensor, a a, uh,
(25:53):
heart rate sensor, and a, amicrophone that you can use to
listen to, uh, lung and to heartsounds.
So that brings another new levelinto telemedicine because you
can actually start exploring andit start, start doing a physical
examination to the patient, evenif you're not in the room.
(26:15):
And all it needs is for you totell the patient where to put
it, and then it'll pick up thesignal transmitted safely and
you can analyze it to, toprovide patient care.
So a lot of Italian technologycoming down from Latin America.
Speaker 1 (26:29):
Yeah, yeah.
Argentina particularly hasalways been a kind of a
innovative, uh, country.
Uh, it has a long history ofcars, airplane, military,
airplanes and, and weapons andthings of that nature.
They,
Speaker 2 (26:40):
They have had a, a very rough couple of decades
trying to get that technologyout.
Uh, sadly, uh, and getting othertechnology into the country has
been tough because of thetariffs on, on external
payments.
So trying to import anytechnology to provide the, the,
the baseline so that you cancreate the next, uh, the next
(27:04):
generation of technology is notthat easy, but they're doing it
and they're doing it
Speaker 1 (27:07):
Really well.
Okay.
Carlos, I'm very curious to hearabout manufacturing medical
devices in Latin America.
You mentioned something that Ididn't know about, which
is the Dominican Re Republicbecoming a player in the
manufacturing of medicaldevices.
Is that right?
If,
Speaker 2 (27:24):
If you look at the, uh, at the market of medical
device exports, DominicanRepublic is currently the number
three country in the world in,in Latin America.
So you've got Mexico, you've gotCosta Rica, the second one,
those are the two mayor.
But number three, you wouldthink it might be Brazil or
(27:44):
Colombia, but no, it's theDominican Republic.
Ah, and they, they're setting upa, uh, I know it's a little bit
counterintuitive because whowould've thought that big
companies would invest in, inbuilding factories in an island
where they have to take all ofthe, uh, all of their raw
material scene and then exportthe, the medical devices, but
(28:04):
it's working really well becausethey've got very good, uh, uh,
fiscal conditions formanufacturing,
Speaker 1 (28:11):
For incentives.
Yes.
Wow.
Hmm.
Because, uh,
Speaker 2 (28:15):
Columbia number four, by the way.
Speaker 1 (28:16):
Yes, Columbia.
I was just about to say thatColumbia is really, really
pushing this agenda to bringmore, uh, investment in
pharmaceutical and medicaldevice manufacturing into the
country because they, they haverealized, as Costa Rica did and
other countries in Latin Americathat, uh, exporting raw material
(28:38):
and commodities and soccerplayers in the case of Columbia,
it's not gonna cut it.
Speaker 2 (28:42):
Columbia, I think, has an interesting, uh, an
interesting angle on themanufacturing because you've got
very, uh, very interestingconditions for biological
medical device manufacturing.
Uh, it's one of the fewcountries where, uh, for
example, bone, uh, derivativesare not considered and are, uh,
(29:04):
are not, uh, marked as, uh,class three, uh, medical
devices.
Speaker 1 (29:11):
Is that right?
Yeah.
Speaker 2 (29:12):
Huh.
Vema actually handle, does nothandle those approvals.
They're handled by, uh, adifferent part of the government
because they are, they're notmedical devices.
They're, they're implants, butthey're made out of their
remains of bone and otherbiological agents.
So there's, there's, there's nomoving parts, there's no
(29:33):
electronics.
So that gets shunted to, to adifferent, uh, administration.
Speaker 1 (29:39):
Interesting.
I'm gonna do some research onthat because that's, yeah,
that's a curious, uh, fact.
Yeah.
Speaker 2 (29:44):
Yeah.
We've seen a lot of, uh, a lotof companies in the Medellin
area and in Cali, uh, coming upwith, uh, uh, with nice implants
in that arena.
Speaker 1 (29:55):
Beautiful.
Beautiful.
The, the issue with, uh,innovation in Latin America is
that, uh, they're still local.
They don't really think, andcorrect me if I'm wrong, but,
uh, I, I, it is been myexperience, at least Carlos,
that they think very small, theythink about solving a local
problem.
And these countries are so smallsometimes, I mean, Colombia,
(30:19):
it's 50 million people.
Yeah, I maybe large for somestandards, but as compared to
Bolivia or, or Paraguay orPanama.
But still, it's a small country.
I mean, the population ofFlorida is, is, is, is is around
that number.
That's one state of 50 states inthe United States.
So my point with this is thatthey don't think globally.
Speaker 2 (30:39):
Yeah.
And I think that's, that's beenone of the other aspects that
has allowed us to, to beeffective partners for, for a
lot of these companies because,uh, both Eduardo, we, we, our,
uh, chief operations officerbased out of Hungary, uh,
myself, we've got another personfrom South Africa, uh, uh,
(30:59):
working with us, David, and, uh,all of us have worked with
various international companies.
So amongst all of us, we've got,uh, close to 60 years of, uh,
experience dealing with businessin different parts of the world.
So helping these companies thatare initially thinking about
(31:23):
solving a, a, a local problemand about overcoming the local
regulations, uh, regulatorydemands, and, uh, working out
how they can go to market intheir country, that that's like
working with, uh, advisor, uh,and, uh, not looking at the big
picture.
So what we do is we help themlook at that, uh, local
(31:47):
situation, but plan at a laterdate and, and, and do all the
regulatory work from the startupto be able to launch later at,
at a global scale.
And we'll help them get businesspartners on the other countries
so they don't have to wait untilthey make it big in their own
country to start businessoutside.
(32:09):
And I think that, that thinkglobal and that local, uh, uh,
modus opera, opera, Brandi, isactually what sets us apart.
Cuz we, we act locally toachieve results in each country
without losing be the, withoutlosing sight of the big picture
and being able to provide thesupport, uh, that they would
(32:31):
need for that.
Speaker 1 (32:32):
Very good.
Very good.
Alright, Carlos, we're close tothe end of the episode.
And, um, what would be yourfinal words of wisdom?
What would you say to the c e oof a medical technology company
that is just starting to look atLatin America as a place to do
trials or to sell innovation?
So,
Speaker 2 (32:51):
Well,
Speaker 1 (32:51):
Any final words?
Speaker 2 (32:52):
I, I, I think I just said my, my first
recommendation, which is, yeah,think global.
You have to, but act local.
So work with companies that knowthe local environment, that know
how to do business in thecountries that you want to go
into and listen to them.
One of the main errors, one ofthe biggest mistakes that I've
(33:14):
seen international multimilliondollar companies is that they
want to do everything in othercountries the way that they have
been doing it in their homecountry.
And that just doesn't work,particularly in Latin America.
It doesn't work.
You need to be able to beflexible to, uh, be, to think
(33:35):
that your pricing method work,your, just one big example, your
marketing, you might be a bigcompany that's easily recognized
in your home arena, but ifyou're just getting here, nobody
knows who you are.
So you have to start from theground up, build up your
presence, get marketrecognition, get key opinion
leaders on your side, but thatpeople will actually start
(33:57):
taking up your products.
If you don't do that and youjust rely on the very small
percentage of doctors that gettrained in the US or in Canada
or in the Europe, then you areonly pitching, uh, you, you're
only promoting to a very smallpercentage of the population.
Same goes for language.
Uh, a lot of companies thinkthat having everything in
(34:19):
English works okay because thedoctors, uh, a lot of the time
are fluent in, in English, butthey might not have used it for
maybe 20 years since they went.
Speaker 1 (34:29):
It's under natural language.
Yeah,
Speaker 2 (34:30):
Correct.
So if you can have somethinglocalized in Spanish, and even
with Spanish, Spanish inColombia, in Mexico, in
Argentina, it's completelydifferent.
And that goes for medicaltechnologies as well.
So listen to the, to the localcompanies and be humble enough
to think that you might have todo things a little bit different
(34:54):
without compromising your corevalues and without, uh,
necessarily having to create adifferent product line.
But you, you will need to listento the way things are, uh, are
best done, listen to the bestpractices your partners can give
you.
And, uh, uh, beyond that workwith your local association.
(35:17):
I've been working with theHealth Tech Association in
Mexico.
Uh, I know there's also, uh,health tech, uh, uh,
organizations.
You've got the clusters inMedellin in Colombia.
You've got the, uh, the, uh, uh,Argentinian Medical Informatics
Association.
So all of those are working tomake these, uh, commercial
(35:39):
environments a better place.
They probably have a lot of theinformation that you've been
looking for, just go over there.
They're happy to collaborate andlisten to what they have to say.
You might be surprised at howlittle you need to change, but
how much big impact littlechanges can make.
Speaker 1 (35:59):
Excellent.
Uh, Carlos, great advice.
Thank you for that.
All right.
So how can people get in contactwith you on Hasting?
Speaker 2 (36:04):
Well, my email at Hasting is, uh, SIM Medina for
Carlos medina sim medina hastenllc.com.
And you can find me in socialmedia, both Twitter and LinkedIn
as Dr.
Noir D R N O I R.
Speaker 1 (36:21):
Okay.
Nice.
Nice handle,.
Speaker 2 (36:22):
Thank you.
Speaker 1 (36:24):
Alright.
Carlos, thank you so much forbeing here.
I appreciate your presence andyour, my pleasure.
Your sharing, uh, your knowledgeand, and your plans in Latin
America.
I'm very excited about thefuture of Mexico with this news
that you just shared with us.
I didn't know that, that wasfantastic.
So, um, yes,
Speaker 2 (36:40):
We're, we're about to see big changes.
Speaker 1 (36:42):
Excellent, excellent.
I'm so happy about it.
It's one of my dear countries inLatin America in the world.
I will say, if I were to choosea country to live, I would
probably choose Mexico.
To be honest
Speaker 2 (36:53):
With you, I, I've had the, the opportunity to move to
any other country in LatinAmerica, and I'm still here.
Speaker 1 (36:59):
Yeah, yeah, yeah.
, small guy,.
Alright.
Carlos Chow.
Welcome to the Latin MedTech Leaders Podcast, a
conversation with MedTechleaders who have succeeded or
plan to succeed in LatinAmerica.
Please subscribe on yourfavorite podcasting platform.
Apple Podcast, Spotify, GooglePodcast.
Amazon Music is teacher tuningiHeartRadio, Pandora, or these
are Welcome to the Latin MedTechLeaders podcast, a conversation
(00:25):
with leaders who have succeededor plan to succeed in Latin
America today.
Our guest is Carlos Medina.
He is the lead, uh, Mexican.
He leads the Mexican team for acompany whose core competency is
to accelerate the entry of newproducts into emerging markets
(00:45):
across the globe.
The company is hosting LLC and,uh, Carlos Managers Mexico,
central America, and theCaribbean.
Right.
Carlos
Speaker 2 (00:55):
That's right on the Money.
Julio, thank you for theinvitation.
Speaker 1 (00:58):
Excellent, Carlos, it's great to have you here
today.
Welcome to the show.
All right.
So
Speaker 2 (01:03):
It's a pleasure having a, a chance to converse
with your audience.
Speaker 1 (01:06):
Beautiful, beautiful.
I'm, I'm, I'm very pleased tohave you, you here, um, Hasting
and, and, and, and me have knowneach other.
Uh, your founder, Uzi and I haveknown each other for quite a
while, so I'm, I'm very, um,pleased to, I'm privileged to
having you today.
Uh, ing is growing in LatinAmerica, so I'm sure it's gonna
(01:27):
be an exciting, uh, episodetoday,
Speaker 2 (01:29):
collaborations that we like somuch.
Speaker 1 (01:34):
Excellent, excellent.
Alright, Carlos, so let's getstarted with, um, your journey
to Latin America.
I understand that you're amedical doctor.
You got involved in medicalinnovation with Haston, and tell
us about your past and, andwhere you are today, how you got
to where you are today.
Speaker 2 (01:51):
Well, it all started when I went into medical school
because I went there looking todo some clinical research.
I like to do complex puzzles and, uh, solve different, uh,
difficult problems.
And when I went into medicalschool, I was fortunate enough
to be one of the firstgenerations that had full access
to the internet at the nationalUniversity here in Mexico City.
(02:12):
And that blew up a wholedifferent world of technology
that we could apply to medicalscience.
So I ended up not going into,uh, clinical research, but
rather, uh, going into medicalinformatics ever since I, uh,
finished my clinical rotations.
And I've been working on that,uh, for the past 20 plus years,
(02:33):
going through editorial projects, uh, uh, continuing medical
education, medical marketing,and now I'm working with trying
to, uh, make business happen andto get, uh, the information
flowing across the varioushealth networks, uh, in Latin
America.
Speaker 1 (02:53):
All right.
Very good.
And, uh, I just realized that Imispronounce the name of the
company.
I said Husting, it's Hasting
Speaker 2 (03:00):
It, it really depends on which country you are at.
Uh, the company, Brazilian andmy Brazilian countryman, uh, com
, my colleagues in Brazil, theyusually call it Hasan has
Speaker 1 (03:12):
Okay.
Speaker 2 (03:12):
It may be just my, uh, us, uh, my us uh, biased
creeping into the name, but, uh,I liked Haston because that
brings the, the connotation ofdoing things faster.
Speaker 1 (03:25):
Very good.
Yeah, I like that.
I like that.
All right, so the company isBrazilian, right?
And we're gonna get to that in amoment, but, uh, uh, uh, we're
gonna speak about, uh, the, the,the genesis of the company.
Um, your founder and c e o has avery interesting, uh, story
behind how he got started, uh,in this business in Brazil.
(03:46):
Anyway, so let's talk abouttrench, uh, Carlos.
Um, what trends do you seehappening in Latin America that
are relevant to our discussiontoday?
Speaker 2 (03:55):
Well, it's kind of hard to, uh, miss the elephant
in the room.
I mean, COVID has been throwingtrends left and right, but I
think it has brought, uh, intovery sharp focus one of those
trends, which is that most ofthe medical technologies take a
little bit longer to get to, uh,the Latin American countries.
(04:16):
And any efforts that we canexpand to make that technology
get to these countries faster isgoing to be beneficial for all,
all the patients and the medicalinstitutions as well.
So that's the first one, tryingto get, uh, medical technology
to take root faster in this, uh,in these countries.
(04:38):
But other than that, I do see alot of efforts spent by the
government and, uh, by, uh, evenprivate companies like ours to
collaborate and to buildnetworks to accelerate the
development of new technologies.
I see a lot of startup clusters,uh, throughout Mexico.
I've been fortunate enough towork in most of the countries
(05:02):
in, in Latin America, and I, Isee a lot of, uh, technologies
being, being, being broughtforth to solve the inequalities
of access to the medical system,uh, which is sadly another one
of those trends that, uh, that,that is, uh, deeply etched into
(05:22):
the Latin American, uh,healthcare because, uh, you've
got some very big, uh,differences between access to
medical technology in the ruralareas and in the cities, and
even between countries.
So being able to use technology,particularly information
technology, to level the playingfield and make sure that
(05:43):
wherever you're at, you've gotyour cell phone in your hand,
and you've got access to medicalhealthcare, that it has good
quality and that can actuallysave you time, uh, and effort
going to a hospital.
I think that's another one ofthe big trends that we have seen
right now.
Speaker 1 (05:59):
Excellent.
Excellent.
And, uh, I'm very pleased to, toto hear about these trends in
Mexico.
Uh, I imagine you're referringto Mexico a lot when you're
talking about trends, since it'syour natural market, and Mexico
is one of the most, is is in thetop three, uh, of the most
attractive markets in LatinAmerica is one of the biggest
(06:20):
markets, right.
With Brazil and then Columbia.
So, and I love Mexico, by theway.
It's a, it's a beautifulcountry.
It's a country full ofopportunities.
Uh, and there's so much to do inMexico, uh, still, I,
Speaker 2 (06:33):
Uh, I'll trade you.
Uh, I will, we'll have to do a,an exchange program.
You come to Mexico, I go toColumbia
Columbia dearly as well, so,yeah.
Speaker 1 (06:41):
Yeah.
Excellent.
Very good.
Speaker 2 (06:43):
I, I think that that's another thing.
Every country has a differentrole to play in the big
organization.
You have even some much smaller,uh, countries like Costa Rica or
even Republica Dominica, whichhave such a big place in medical
device manufacturer anddevelopment that, uh, it, it
(07:04):
really doesn't have to do withthe market size.
It, it needs to do, uh, it has alot of, uh, a lot of, uh,
investment into creating theright environment to make those
make those prise fruitful.
Speaker 1 (07:18):
Yeah.
Yeah.
Yeah.
It's, it's interesting that youmentioned Dominican Republic.
Uh, there are a lot of earlystage medical device clinical
trials happening in theDominican Republic.
Not, not that much aspar, why,but, uh, I see a lot of, uh,
companies going to, to theDominican Republic, and
especially because a lot of ourphysicians in the country, uh,
(07:40):
get trained in the United Statesand go back to the Dominican
Republic.
So they're, they have access totheir colleagues and, and all
that.
And
Speaker 2 (07:46):
So, correct.
And, uh, when you couple thatquality of clinicians willing to
do the, the work with, uh, easyregulations that allow you to do
the, do the clinical trialswithout sacrificing the security
of the patients, that's anotherimportant part.
I think that's a winningcombination that a lot of other
(08:08):
countries could, uh, couldfollow suit and, uh, start
implementing.
Speaker 1 (08:11):
Yeah.
Yeah.
And Comfort Breeze is makingsome changes, right?
To make it easier for clinicaltrials.
Speaker 2 (08:17):
Yes.
Uh, step by step, they're goingin that direction.
So, uh, they're trying to fasttrack, uh, the clinical trials,
uh, and they're also trying to,uh, uh, standardize the way that
they evaluate things to be morein line with international
regulations.
I think that was, uh, uh, alittle bit, uh, a long time, uh,
(08:40):
incoming, but, uh, it'shappening now with the new
administration.
Speaker 1 (08:43):
Yeah.
Yeah.
All right.
Yeah, we can talk about
, uh, uh, for hours.
Uh, that's probably a topic ofanother episode, but let's,
let's get, um, uh, uh, in, in,let's speak in more detail about
, uh, Hasting
Uh, and, and, uh, the originingof the company and, uh, what you
(09:05):
guys are doing in Latin America.
Speaker 2 (09:07):
Yeah.
Well, the company, as I said,was founded in Brazil, uh,
founded by, uh, one of, of myformer bosses, uh, Eduardo
DeMelo, who has had a tremendouscareer.
He's been in pharmaceuticalcompanies.
He's done research.
He's been, uh, working in, uh,uh, clinical decision support
system, which is actually wherewe met.
(09:27):
We both worked that up to date,and then he left off to date and
started working in otherprojects.
And he started seeing andgetting this idea of trying to
do exactly what I described atthe beginning, trying to get
medical technology to take aroute and to come to developing
countries much faster than itcurrently was, because as I
(09:49):
said, if, uh, if you got a greatblockbuster drug or medical
device, but if it won't beavailable in your country for
two or three years after itstarts being offered in the main
market, that really limits theoptions of the patients and the
doctors to provide the best carepossible.
And, uh, he started, he startedbuilding a network of, of
(10:13):
collaboration throughout, uh,many countries, starting in
Latin America.
And then he started working with, uh, China.
Now we've got affiliates inEurope, in South Africa.
We're working on opening up, uh,operations in India, and we're
building this collaborationnetwork so that we can work with
both medical, uh, devicemanufacturers and medical device
(10:38):
distributors, as well asregulatory companies to make
sure that we can actually speedthings up and make those, uh,
those technologies available assoon as possible, uh, in
emerging countries where they'remostly needed.
Speaker 1 (10:53):
Sure, sure.
As you correctly said, Carlos,our patients in the region have
delayed access to medicalinnovation, and a lot of it has
to do with, uh, lack ofinformation, ignorance about
Latin America and, and, and notseeing the region as a, as a, as
a land of opportunity.
I think there's so much to do inLatin America, and right now,
(11:15):
uh, correct me if I'm wrong, butI think, uh, the countries like
Mexico, Colombia, Chile, uh, arebecoming leaders in the region,
and, and they are O E C Daligned, even Costa Rica, they
just became an O E C D country.
So these countries are maturing.
They are part of the global, um,economy, and they're important
(11:39):
players.
Uh, now they're part of thePacific Alliance, which is a
very, very, uh, strong block of,of, of forward-looking countries
, uh, adopting internationalpolicies, best practices.
Speaker 2 (11:51):
And I think, uh, uh, that's part of the, uh, of what
led to this situation of delayedmedical innovation availability.
But the other part is that, uh,when these companies start
making it big, they areobviously and naturally, uh,
attracted to the large marketsin the US and Europe.
So they're gonna be focused onachieving as much business as
(12:13):
they can there.
And, uh, a lot of the times theydon't have the resources,
whether they are material or, orhuman resources to, to be able
to focus on expansion oncountries that they see a
secondary markets.
So we can provide them an a, anopportunity to, uh, start
working on those markets withouthaving to distract themselves or
(12:37):
their resources for that.
So I think that's a big part ofwhat's, uh, allowed us to be
successful right now.
Speaker 1 (12:44):
That's your, your value proposition, right?
So they don't, they don't haveto invest much time and money
and in, in, in these markets,you guys will take care of all
the, the, the, the ugly work
Speaker 2 (13:00):
It's necessary work.
And, uh, we'll do it.
And, uh, we'll build, uh, whatwe hope to be a long-term
partnership with both theoriginators, uh, the
manufacturers and thedistributors with us acting as
catalysts in between to makething, to make sure that things
happen and they happen faster.
Speaker 1 (13:21):
That's a great word, catalyst.
I like that.
Alright, Carlos, I'm very, verycurious to hear what you think
about Nancy.
And, and you and I spoke aboutthat in our initial conversation
, uh, before the recordingtoday.
Uh, and what Namsa is doing inLatin America.
(13:41):
I understand you guys are, um,are friends with Lansa, NAMSA
have a collaboration with them.
Can you elaborate on that,please?
Speaker 2 (13:50):
Sure, of course.
Uh, NAMSA, uh, for those thatdon't, that are not familiar
with, with that, they'reprobably not on the regulatory,
uh, uh, arena, but NSE is a verybig company in the US which now
has, uh, uh, presence in atleast, uh, three continents.
Uh, right now with, uh, theyprovide both consulting and, um,
(14:14):
testing services, laboratoryservices, as well as, uh,
clinical, uh, they act as a C RO, uh, in many countries as
well.
So they, they actually callthemselves, uh, medical research
organization and, uh, we've beenworking with them for, uh, quite
a few years right now to makesure that we can actually
provide those quality servicesto our customers in Latin
(14:37):
America.
And I keep seeing them grow andgrow because they've been
offering, uh, exactly what, whatthey, what is needed in the
region.
So, uh, for companies that arelooking to solve their
regulatory, uh, issues for entryin the US and in Europe, those
(14:58):
are the two markets where they,uh, where they are focused
mostly.
Uh, they've got consultants forevery aspect of, uh, of the
product development,specifically for medical
devices.
They don't do pharmaceuticalsand, uh, they can provide end to
end coverage.
So, uh, it's a very goodpartnership, uh, for us.
(15:18):
And that's been the backbone of,uh, a lot of our expansion to be
truthful.
Speaker 1 (15:23):
Excellent, excellent.
And also, they just acquired,uh, clean Logics, right?
And Clean Logics had a strongpresence in Colombia.
Speaker 2 (15:31):
Yes.
So they just acquired CleanLogics, that's the latest, uh,
the, the, the latest, uh,acquisition that they made, but
they also acquired aps.
And so they've acquired threemajor players in the regulatory,
uh, and clinical research, uh,areas, uh, just in, this is
Gerald alone.
So they are, they are investingheavily in growth.
(15:55):
And, uh, that's one of the otheraspects that I really like, uh,
about, uh, about theorganization because they, they
acquire technology to expandthemselves.
That's the nature of thebusiness.
That's one way to grow, but theydon't lose the essence of those
businesses.
They keep what has made thosebusinesses great companies, and
(16:15):
they allow them to continueoperating and to provide the
services they have become, uh,known for.
And they do that not only withthe, uh, with the companies that
they acquire, they also do thatwith partners like Haston
because they, they know, we knowthe market.
They know that we can providethe, the local know-how on how
things should be done, and theyreally listen.
(16:38):
So they're able to provide allof that information to their
customers as well.
Speaker 1 (16:42):
Beautiful.
Beautiful.
Excellent.
Yeah.
I also understand they hadanother collaboration with
somebody in Argentina, right?
That was initial collaborationthat they had in Latin America
Speaker 2 (16:51):
That's still going?
Yes.
Uh, uh, Haston, we work withthem to take care of, uh,
customers in, uh, most of LatinAmerica except for the Southern
Cone.
So, Chile, Argentina?
No.
Why they handle with anothercompany ly.
I can't remember the name ofthem.
If I remember, I'll let youknow.
(17:12):
Uh, but yeah, the, they, theyhave multiple partners and
they're working, uh, with ushere.
And, uh, they're working withother local partners in other
parts of the world as well,particularly in Asia.
Speaker 1 (17:24):
Excellent, excellent.
All right.
So Carlos, let's, um, talk aboutyour practical experience in
Mexico and elsewhere in LatinAmerica.
Um, uh, the uc relevant for thediscussion today.
Um, how are things going inMexico in terms of regulatory
approvals for, uh, innovativetechnologies?
Uh, any challenges you canmention?
(17:46):
Any, any tips, any bestpractices that you, you can
share with us so that, uh,companies that are listening
can, can learn from, from, fromthat?
Speaker 2 (17:55):
Sure.
So I think that, uh, when youasked me what the situation is,
uh, right now, of course, COVIDhas brought a lot of delays in
the administrative side of theregulatory affairs.
Uh, you mentioned Coffee Priest,for those that might not be, uh,
as familiar with Mexico CoffeePriest is the, uh, decentralized
(18:16):
organ from the Ministry ofHealth that handles all
regulatory, uh, uh, issues formedical device and drug and food
, uh, uh, kind of like theMexican F D A, if you wanna look
at it.
I think that's the, the, theeasiest way to understand it.
And, uh, they startedprioritizing, uh, the evaluation
(18:37):
and approvals of technologiesthat were covid related, like
many of, uh, of the regulatoryagencies did.
And right now they're workingoff cleaning up their backlog of
, uh, submissions.
And they're doing that with avery, with a, uh,
well-structured program thatthey have.
They're actually keeping us inthe loop and, uh, giving us
information on how that'sproceeding, uh, week after week.
(19:00):
Uh, so they're slowly but surelymaking, uh, making headwind
there.
Uh, it's still, uh, a long, uh,along, uh, response time on
their part.
So we're talking at a close to ayear, uh, on response times.
So, uh, we have a lot of medicaltechnology that's just waiting
(19:20):
for answers.
Uh, but, uh, in the meantime,while they're doing that, uh,
and dealing with the newleadership in place, they just
had a change in their director,and that brought changes
trickling down the line.
Uh, but, uh, I think that hasbeen a good change because, uh,
they're starting to, uh,digitalize most of their
(19:42):
processes.
And with the current, we justtell, we also just had a, a
digital agenda, uh, released forMexico, which is going to bring
a lot of digitalization of theprocesses so that, uh, things
will happen faster and can beautomated in many, in many of
those arena.
So things will get better.
(20:03):
Uh, regarding the, the trendsthat you, uh, were mentioning,
uh, we do, I, I have to, tobring to attention that we do
have a lot of players in themedical devices and medical
technology arena that have hadto close because of, uh, the
demands on their business.
(20:24):
But I see another very big groupof companies that have thrived,
uh, as I mentioned, by using,uh, the technologies available.
We've seen right now, uh, the, alot of, uh, telemedicine
companies providing, uh, videoconferencing and providing
secure communication with thepatient so that they can be
(20:46):
tended to, to, uh, from home.
And I've seen in the past year,I think I've seen more new
insurance and cooperative healthplans, uh, so, uh, a lot of, uh,
innovation as well in, inInsureTech, uh, to take up the
demand that a lot of the majorand, uh, classical health
(21:07):
insurance companies maybe had toput a break on, on taking up,
uh, health policies, becausethey expected a lot of expenses,
uh, from Covid, which I think isnatural for the, uh, for the
dynamic of that business.
But that meant there were a lotof people looking for, uh, other
avenues to get healthcarecoverage.
And, uh, these other companiesstarted to, uh, to invest and to
(21:30):
develop them.
And I think a couple of them arepretty good.
Speaker 1 (21:34):
Okay.
Okay.
And how do you see the currentgovernment and the outlook for
the new government?
Because Lopez obor right, is thenew, is the current president,
how many more years does hehave?
Speaker 2 (21:47):
He just finished his third year, three years, uh, uh,
and, uh, his, he has three moreto go, so he sent
Speaker 1 (21:54):
Three more to go.
Wow.
So we're in the middle of
Speaker 2 (21:57):
Yeah, he's right in the middleof his presidency.
Mm-hmm.
Uh, one thing I like about his,uh, his administration is that
he has a lot of very good ideason how to get, uh, how to
enhance and, uh, uh, make allthe processes that have been
held up by bureaucracy and by,um, a corruption faster and
(22:23):
cleaner.
I think he needs, uh, a littlebit of work and a little to
listen a little bit more to his,uh, advices on how to get those
done.
Those have been hit or miss forme.
Uh, but I, uh, I don't want topoliticize this too much, uh,
but, uh, the, the part that I,that I am most excited about is
(22:45):
this, uh, digital, uh,digitalization act that just was
proclaimed last month, becausethat's going to bring, uh,
digitalization not just tohealthcare, but to every aspect
of the government.
So, uh, a lot of the things thatyou formerly needed to go to an
office and maybe, uh, uh, spenda lot of time, uh, cutting red
(23:10):
tape, those should be enhanced,uh, in the next, uh, in the next
few years.
And particularly on theeducation and the access to the
internet and to online services.
I think they're going to beinvesting heavily.
Uh, I'm not gonna go into detailon how those contracts will get,
(23:30):
a lot more people get access tothe internet and be able to, to
be more autonomous in thatsense.
Speaker 1 (23:40):
Sure.
That's only matters that, thatthe country, uh, modernizes,
it's, uh, it's, um, the, thedramatists, how do you call it?
The processes and, andeverything, uh, with the
government, uh, and all that,the cities, the procedures and
the, the citizens have access,uh, faster access to the
government.
That's something that Columbia,uh, is probably, uh, leading
(24:04):
Mexico
Uh,
Speaker 2 (24:05):
You've been working on that for years
Speaker 1 (24:07):
Now?
Yeah, for years now.
Yeah.
Alright.
I'm very happy to hear thosenews.
And, uh, what about the rest ofyour territory?
You also manage the Caribbean,central America.
Can we speak about what'shappening there in terms of
challenges, in terms of newthings coming up?
Speaker 2 (24:23):
Well, you, you've got the, uh, the essential
challenges, uh, of, uh, budgetand, uh, political
administration like you do inmost, uh, in most countries.
My work is, uh, currentlyfocused mostly in Costa Rica and
Dominican.
Uh, so those are, those are thetwo countries because most of
(24:43):
our projects are related tomedical devices, and that's
where the development ishappening right now.
Uh, but I think, uh, uh, both ofthose countries are making a
very good, uh, very good play inmaking it easier for companies
to not only go and startproducing devices there, but
also invest in the local talentto produce medical devices and,
(25:08):
and, and innovate in, in that.
Uh, we've also been in contactwith, uh, some other companies
in Argentina and in Uruguay,which are creating amazing
devices.
Some of them self simple that Idon't know why other companies
did not think about thatearlier, and I'm not gonna say
what it is, just so nobodysteals their idea.
(25:29):
They're still at the IPprotection state.
Uh, but I've seen others makewonderfully complex, uh, uh, uh,
devices for telemedicine.
I've seen, uh, think of aRubik's Cube, a device about
that size with a pulse imeter, atemperature sensor, a a, uh,
(25:53):
heart rate sensor, and a, amicrophone that you can use to
listen to, uh, lung and to heartsounds.
So that brings another new levelinto telemedicine because you
can actually start exploring andit start, start doing a physical
examination to the patient, evenif you're not in the room.
(26:15):
And all it needs is for you totell the patient where to put
it, and then it'll pick up thesignal transmitted safely and
you can analyze it to, toprovide patient care.
So a lot of Italian technologycoming down from Latin America.
Speaker 1 (26:29):
Yeah, yeah.
Argentina particularly hasalways been a kind of a
innovative, uh, country.
Uh, it has a long history ofcars, airplane, military,
airplanes and, and weapons andthings of that nature.
They,
Speaker 2 (26:40):
They have had a, a very rough couple of decades
trying to get that technologyout.
Uh, sadly, uh, and getting othertechnology into the country has
been tough because of thetariffs on, on external
payments.
So trying to import anytechnology to provide the, the,
the baseline so that you cancreate the next, uh, the next
(27:04):
generation of technology is notthat easy, but they're doing it
and they're doing it
Speaker 1 (27:07):
Really well.
Okay.
Carlos, I'm very curious to hearabout manufacturing medical
devices in Latin America.
You mentioned something that Ididn't know
is the Dominican Re Republicbecoming a player in the
manufacturing of medicaldevices.
Is that right?
If,
Speaker 2 (27:24):
If you look at the, uh, at the market of medical
device exports, DominicanRepublic is currently the number
three country in the world in,in Latin America.
So you've got Mexico, you've gotCosta Rica, the second one,
those are the two mayor.
But number three, you wouldthink it might be Brazil or
(27:44):
Colombia, but no, it's theDominican Republic.
Ah, and they, they're setting upa, uh, I know it's a little bit
counterintuitive because whowould've thought that big
companies would invest in, inbuilding factories in an island
where they have to take all ofthe, uh, all of their raw
material scene and then exportthe, the medical devices, but
(28:04):
it's working really well becausethey've got very good, uh, uh,
fiscal conditions formanufacturing,
Speaker 1 (28:11):
For incentives.
Yes.
Wow.
Hmm.
Because, uh,
Speaker 2 (28:15):
Columbia number four, by the way.
Speaker 1 (28:16):
Yes, Columbia.
I was just about to say thatColumbia is really, really
pushing this agenda to bringmore, uh, investment in
pharmaceutical and medicaldevice manufacturing into the
country because they, they haverealized, as Costa Rica did and
other countries in Latin Americathat, uh, exporting raw material
(28:38):
and commodities and soccerplayers in the case of Columbia,
it's not gonna cut it.
Speaker 2 (28:42):
Columbia, I think, has an interesting, uh, an
interesting angle on themanufacturing because you've got
very, uh, very interestingconditions for biological
medical device manufacturing.
Uh, it's one of the fewcountries where, uh, for
example, bone, uh, derivativesare not considered and are, uh,
(29:04):
are not, uh, marked as, uh,class three, uh, medical
devices.
Speaker 1 (29:11):
Is that right?
Yeah.
Speaker 2 (29:12):
Huh.
Vema actually handle, does nothandle those approvals.
They're handled by, uh, adifferent part of the government
because they are, they're notmedical devices.
They're, they're implants, butthey're made out of their
remains of bone and otherbiological agents.
So there's, there's, there's nomoving parts, there's no
(29:33):
electronics.
So that gets shunted to, to adifferent, uh, administration.
Speaker 1 (29:39):
Interesting.
I'm gonna do some research onthat because that's, yeah,
that's a curious, uh, fact.
Yeah.
Speaker 2 (29:44):
Yeah.
We've seen a lot of, uh, a lotof companies in the Medellin
area and in Cali, uh, coming upwith, uh, uh, with nice implants
in that arena.
Speaker 1 (29:55):
Beautiful.
Beautiful.
The, the issue with, uh,innovation in Latin America is
that, uh, they're still local.
They don't really think, andcorrect me if I'm wrong, but,
uh, I, I, it is been myexperience, at least Carlos,
that they think very small, theythink about solving a local
problem.
And these countries are so smallsometimes, I mean, Colombia,
(30:19):
it's 50 million people.
Yeah, I maybe large for somestandards, but as compared to
Bolivia or, or Paraguay orPanama.
But still, it's a small country.
I mean, the population ofFlorida is, is, is, is is around
that number.
That's one state of 50 states inthe United States.
So my point with this is thatthey don't think globally.
Speaker 2 (30:39):
Yeah.
And I think that's, that's beenone of the other aspects that
has allowed us to, to beeffective partners for, for a
lot of these companies because,uh, both Eduardo, we, we, our,
uh, chief operations officerbased out of Hungary, uh,
myself, we've got another personfrom South Africa, uh, uh,
(30:59):
working with us, David, and, uh,all of us have worked with
various international companies.
So amongst all of us, we've got,uh, close to 60 years of, uh,
experience dealing with businessin different parts of the world.
So helping these companies thatare initially thinking about
(31:23):
solving a, a, a local problemand about overcoming the local
regulations, uh, regulatorydemands, and, uh, working out
how they can go to market intheir country, that that's like
working with, uh, advisor, uh,and, uh, not looking at the big
picture.
So what we do is we help themlook at that, uh, local
(31:47):
situation, but plan at a laterdate and, and, and do all the
regulatory work from the startupto be able to launch later at,
at a global scale.
And we'll help them get businesspartners on the other countries
so they don't have to wait untilthey make it big in their own
country to start businessoutside.
(32:09):
And I think that, that thinkglobal and that local, uh, uh,
modus opera, opera, Brandi, isactually what sets us apart.
Cuz we, we act locally toachieve results in each country
without losing be the, withoutlosing sight of the big picture
and being able to provide thesupport, uh, that they would
(32:31):
need for that.
Speaker 1 (32:32):
Very good.
Very good.
Alright, Carlos, we're close tothe end of the episode.
And, um, what would be yourfinal words of wisdom?
What would you say to the c e oof a medical technology company
that is just starting to look atLatin America as a place to do
trials or to sell innovation?
So,
Speaker 2 (32:51):
Well,
Speaker 1 (32:51):
Any final words?
Speaker 2 (32:52):
I, I, I think I just said my, my first
recommendation, which is, yeah,think global.
You have to, but act local.
So work with companies that knowthe local environment, that know
how to do business in thecountries that you want to go
into and listen to them.
One of the main errors, one ofthe biggest mistakes that I've
(33:14):
seen international multimilliondollar companies is that they
want to do everything in othercountries the way that they have
been doing it in their homecountry.
And that just doesn't work,particularly in Latin America.
It doesn't work.
You need to be able to beflexible to, uh, be, to think
(33:35):
that your pricing method work,your, just one big example, your
marketing, you might be a bigcompany that's easily recognized
in your home arena, but ifyou're just getting here, nobody
knows who you are.
So you have to start from theground up, build up your
presence, get marketrecognition, get key opinion
leaders on your side, but thatpeople will actually start
(33:57):
taking up your products.
If you don't do that and youjust rely on the very small
percentage of doctors that gettrained in the US or in Canada
or in the Europe, then you areonly pitching, uh, you, you're
only promoting to a very smallpercentage of the population.
Same goes for language.
Uh, a lot of companies thinkthat having everything in
(34:19):
English works okay because thedoctors, uh, a lot of the time
are fluent in, in English, butthey might not have used it for
maybe 20 years since they went.
Speaker 1 (34:29):
It's under natural language.
Yeah,
Speaker 2 (34:30):
Correct.
So if you can have somethinglocalized in Spanish, and even
with Spanish, Spanish inColombia, in Mexico, in
Argentina, it's completelydifferent.
And that goes for medicaltechnologies as well.
So listen to the, to the localcompanies and be humble enough
to think that you might have todo things a little bit different
(34:54):
without compromising your corevalues and without, uh,
necessarily having to create adifferent product line.
But you, you will need to listento the way things are, uh, are
best done, listen to the bestpractices your partners can give
you.
And, uh, uh, beyond that workwith your local association.
(35:17):
I've been working with theHealth Tech Association in
Mexico.
Uh, I know there's also, uh,health tech, uh, uh,
organizations.
You've got the clusters inMedellin in Colombia.
You've got the, uh, the, uh, uh,Argentinian Medical Informatics
Association.
So all of those are working tomake these, uh, commercial
(35:39):
environments a better place.
They probably have a lot of theinformation that you've been
looking for, just go over there.
They're happy to collaborate andlisten to what they have to say.
You might be surprised at howlittle you need to change, but
how much big impact littlechanges can make.
Speaker 1 (35:59):
Excellent.
Uh, Carlos, great advice.
Thank you for that.
All right.
So how can people get in contactwith you on Hasting?
Speaker 2 (36:04):
Well, my email at Hasting is, uh, SIM Medina for
Carlos medina sim medina hastenllc.com.
And you can find me in socialmedia, both Twitter and LinkedIn
as Dr.
Noir D R N O I R.
Speaker 1 (36:21):
Okay.
Nice.
Nice handle,
Speaker 2 (36:22):
Thank you.
Speaker 1 (36:24):
Alright.
Carlos, thank you so much forbeing here.
I appreciate your presence andyour, my pleasure.
Your sharing, uh, your knowledgeand, and your plans in Latin
America.
I'm very excited about thefuture of Mexico with this news
that you just shared with us.
I didn't know that, that wasfantastic.
So, um, yes,
Speaker 2 (36:40):
We're, we're about to see big changes.
Speaker 1 (36:42):
Excellent, excellent.
I'm so happy about it.
It's one of my dear countries inLatin America in the world.
I will say, if I were to choosea country to live, I would
probably choose Mexico.
To be honest
Speaker 2 (36:53):
With you, I, I've had the, the opportunity to move to
any other country in LatinAmerica, and I'm still here.
Speaker 1 (36:59):
Yeah, yeah, yeah.
Alright.
Carlos Chow.
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