Nov. 17, 2022
Mauricio Berdugo, Director of Medical Affairs at Humacyte
Mauricio A. Berdugo, MD, MPH, is currently the Director of Medical Affairs at Humacyte, Inc. Mauricio has worked in different capacities within the CRO, pharma, diagnostics, and biotech industries in the USA and globally, including Latin America, Europe, and Asia over the past 9 years. His clinical and academic research stems from HIV/AIDS, cardiovascular disease, pulmonary disease, renal disease, and orthopedic spine surgery. Mauricio graduated from medical school at the Universidad Evangelica de El Salvador, completed his Master of Public Health degree from Kaplan University, and he is currently pursuing a Fellowship with the American College of Healthcare Executives.
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Welcome to the Latin MedTech Leaders podcast, a conversation with Metech leaders who have succeeded or plan to succeed in Latin America.
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Tune in.
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I heard radio, Pandora, or these are welcome to the Latin Metech Leaders podcast, a conversations with leaders who have succeeded or plan to succeed in Latin America.
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Today our guest is Mauricio Bargo, MD mph.
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Mauricio is currently the director of medical affairs at homicide.
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I hope I'm pronouncing this right,.
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And he has worked in different capacities within the cro Pharma diagnostics and biotech industries in the United States and globally, including Latin America, Europe, in Asia for, um, for the past nine, 10 years.
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So, Maurices, it's great to have you here in the show.
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Welcome.
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Thank
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You very much.
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It's a pleasure to be here with you.
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Excellent, Mauricio.
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So, I'm so looking so much, uh, looking forward to this conversation today.
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You are originally from Central America, and I'm very curious about your journey.
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Tell us about your journey to where you are today and your journey to Latin America.
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Well, interestingly enough, my journey started in the United States.
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Uh, I was raised in the United States, but I had the opportunity, uh, to go to, uh, El Salvador for medical school, uh, and which was a, you know, a phenomenal experience for me.
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Uh, learning a little bit more about my own culture, uh, you know, where my ancestors came from, my family came from.
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I was actually born there, were raised in the United States, but, uh, the, uh, important things that I got to know, uh, what the healthcare situation is outside of the United States, which is something that I'm very foreign to.
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So it was not only a, a culture shock, should I say, for an American kid to go to, uh, his country of origin, but to learn how things work, uh, politically and in the healthcare, uh, uh, industry, uh, outside of the United States.
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Uh, so after graduation from medical school, I came back to the United States and I started working, uh, in, in a different clinical, uh, positions.
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But eventually I decided to embark an academic journey, uh, in, uh, in, in healthcare, uh, principally in, uh, pulmonary, cardiovascular and spine surgery research, uh, which brought me to, to this industry.
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And that's when I started to grow, uh, within the therapeutic areas that, you know, that I now, uh, and have worked with in the past.
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So, it's been a pretty long journey.
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It's been a very interesting journey.
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Uh, and, uh, and, and maybe to answer your question about how I got involved, uh, in the Latin America, uh, you know, side of things was, uh, once I, I got into the diagnostic space, that's really where I had the opportunity to work globally.
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And I worked with different, uh, uh, people, wonderful people from different countries.
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Uh, and, and I learned a lot about, uh, you know, what the policies are in each country.
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Every country's different.
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Uh, you know, it's, there's no one cookie cutter, uh, way to, uh, to do things.
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And so you really get a good perspective about, you know, how to work in each individual region.
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Excellent, Mauricio.
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All right.
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So let's talk about trends.
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What do you see happening in Latin America from the political, economical, or social standpoint that, that is relevant to our discussion today?
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You know, without maybe getting into too many, uh, details, but I think politically there, I think just the same as the around the world, there's a lot of political unrest.
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Uh, you know, there's a lot of, uh, different ideas, different, uh, ideologies, uh, that predominate, uh, with different, uh, you know, governments and different administrations.
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Uh, I don't think it's any different than here in the United States, but I think what the most important, uh, thing in Latin America is the level of, uh, poverty, uh, and the level of angst, uh, you know, from, from different people.
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Uh, not so much, you know, about, you know, what are they gonna do, uh, with their new governments.
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But, you know, economically it's, it, it's, it's a very difficult situation, uh, politically obviously it's a difficult situation, but I think socially as well, uh, there's a lot of division and, and so that impacts, uh, many sectors of, uh, of society in Latin America.
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And, and I have personally seen, uh, that that divide.
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And so, uh, you know, it, it's really a difficult situation in some countries.
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It's better in other countries, it's not.
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Uh, but, uh, there's a lot of unrest, uh, right now all over the world.
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Yes, yes.
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Agree.
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Well, you're bringing up an interesting point,, I don't know if it is a curse or, or, or, or a blessing for Latin America, but, um, you see a lot of populist governments in the region, Argentina, uh, now Peru, uh, of course, Venezuela in, in, uh, Mexico, et cetera, in, in, in Columbia is about to have an election.
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And there is a populist, um, candidate, very strong.
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So what this means is that, uh, you see a lot of government programs, including healthcare programs that benefit the whole population in, you know, one way or another.
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So, as I said, I don't know if it is a course or a blessing, but, uh, but the train in Latin America, or the historic, um, behavior of the region has been universal healthcare system for everybody.
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So I guess that, that, um, facilitates, uh, the, the, the access, uh, to the system and, and then the, uh, increases the coverage and, and also makes it attractive for companies to, um, to sell products, uh, to, to national healthcare systems.
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Yeah.
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Yeah.
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No, I agree.
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And, and actually in some countries you'll have the universal healthcare system, but then there are also private systems that, that, that also work, and then also the social security, uh, healthcare systems that some countries have.
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Uh, and so there is a little bit of a, I'd say, benefit, you know, to having, to being, uh, able to afford into those programs.
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But for the most part, you're right, it's universal healthcare, and whether it's good or bad for the population, uh, you know, I'm sure that they're improve, you know, improvements that can be made, you know, all around.
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Yeah, yeah.
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Yeah.
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And also something that I've seen happening in the region just happen in Columbia recently, is that, um, recently, we're probably talking about three, four years ago, uh, it's, uh, that healthcare is a constitutional right.
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So, um, you have the, the, the right as a Columbian citizen to, to have access to the healthcare system.
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And, uh, reimbursement is pretty much a guarantee for any product that you wanna, that, that you need for your medical care.
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So, um, that's, that's certainly a trend that is increasing in, in, in the region.
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Yeah,
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Definitely.
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All right.
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So Mauricio, let's speak about your, uh, practical experience, your field experience in the different countries in the region.
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Let's, let's, uh, speak about Mexico, Columbia, and, and anywhere else in Latin America where you travel and, and you were able to, to, uh, work and, and, uh, experience how to do business in each country.
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Yeah, interestingly enough, the, uh, countries that I worked, uh, with the most, uh, were in Columbia, uh, Argentina, uh, Chile, uh, and with Mexico, I, I did some work indirectly, worked with a lot of great people, uh, didn't, uh, I didn't have the opportunity to go, uh, to, uh, Mexico physically, but I was there virtually quite a lot,.
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Uh, but, uh, interestingly enough, uh, in South America, the markets, uh, have, uh, been very, uh, diverse, especially in Columbia, uh, where you have, uh, different medical systems that, uh, that are, are, are working.
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Regulatory agencies are very different, uh, in Columbia, where, uh, if you wanna bring a product there, you really do have to show, uh, the regulatory agencies, uh, the, the benefits, uh, in, in the clinical trial outcomes, uh, for the product.
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And they, you know, if, if everything looks good, they really, they, you know, they ex they approve things pretty quickly.
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Uh, and, uh, without so much delay, uh, in other countries, it might be a little bit different.
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Uh, Chile, for example, it's, it's a pretty fast, uh, system.
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Argentina is a, is a, is a relatively fast system.
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I know Mexico, uh, is moderate.
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It could take a couple of months, but, you know, if things look good, they, they're pretty good in Brazil, uh, which is another market that I've, uh, worked in, uh, is, is a little bit more delayed, uh, because they're just very careful about what, uh, is being brought to their population.
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And they wanna make sure that, you know, they, they, they do a very, uh, detailed, uh, look at, uh, at all the information that's being brought to them for the product.
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But for the most part, if everything looks good, they approve it to
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Yes.
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Yeah.
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Yeah.
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Mexico and Brazil are kind of the, the, the ugly countries in Latin America for regulatory effort.
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Everybody's scared of these two countries because it is time consuming is labors and expensive.
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And, um, as you said, Columbia is pretty straightforward.
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Uh, in, in about 90 days, you can have your, your high risk device approved and for lower risk devices, uh, class one and class two is automatic, it's just a notification.
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Yeah.
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Which is great.
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And, and, and, and I was just recently, um, uh, listening to, um, uh, a presentation from, uh, the director of the medical device committee in Arvi in Columbia.
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And, uh, she was saying that, uh, they did benchmarking, uh, and they compare colo to the rest of the countries in Latin America.
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And Columbia definitely has the fastest approval time except for Chile.
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Right?
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Chile is a different animal.
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Yeah.
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Chile.
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Chile, you don't need, regulatory approval is voluntary.
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Uh, which is interesting because I create a, a, a kind of a, a market driven, uh, regulatory system.
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In other words, if you don't have fda, you see market approval, uh, the government doesn't care about it.
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The government will let you import the product.
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Uh, they want, um, they, they don't require you to file any applications or anything.
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You can, as long as you have a, a distributor, an importer, you should be able to sell the product, uh, tomorrow.
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Uh, it's just that the local doctors will not accept anything that's
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Ex that's exactly what I was about ready to say.
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So, uh, so that the regulatory part is very easy, but, uh, trying to convince people to use, uh, new products is a challenge.
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And so that's, that's where a lot of training and education, uh, come in very handy.
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And sometimes you ha uh, if you convince, uh, the elder, uh, professor or the elder physician in, in the facility, and if that person has, or he or she has a, you know, significant influence in, in the hospital or healthcare system, then other people will follow and adopt.
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But it takes some time to, to get that to happen.
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Exactly.
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Exactly.
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Yeah.
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No, nobody will risk, uh, the reputation.
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Any, any q p leader will carefully guard to use her reputation and will not, uh, risk, uh, his patients, uh, or her presences, uh, with, uh, Chinese or some, uh, products that do not have, uh, FDA or C mark approvals.
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So, yeah.
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So Marisa, let's speak about your, uh, past experience.
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In what capacity were you working in Latin America?
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I, if I remember correctly, you were a medical director also.
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You were medical affairs?
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Yeah, I was in medical affairs.
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I was, uh, the, uh, global medical affairs actually at, uh, uh, at a diagnostics company.
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And so, uh, my, uh, my job was to, uh, was essentially, I was in charge of, uh, three disease states, uh, and, and, and, you know, and in the product that was, uh, that was being used for those disease states.
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And so, uh, my, uh, for example, sepsis and acute kidney injury were the two big ones that I, that I was working on.
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And so, uh, what I, I had to do, uh, was, uh, train people, you know, talk to physicians, talk to different hospital systems about, uh, sepsis.
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Uh, interestingly enough, we, uh, in the healthcare, uh, you know, field, we, everybody knows about sepsis, but at the same time, not very many people know about sepsis.
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And, and, and that's something that's very, you know, it's an infectious disease.
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It's, it's a most multi-systemic, uh, uh, you know, a problem that, that happens when, uh, you know, as a result of an infection, uh, where the, you know, multiple organs can fail.
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Uh, and, uh, and, and it could be very deadly.
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But, uh, the interesting thing was that, uh, there are different ideas about how to manage the septic patient.
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And so, but there really is no consensus.
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And so, uh, my job really was to not only talk about, uh, the, the diagnostic tests that, that we had, uh, for use in sepsis, but really educate and train people about the management of sepsis.
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And the same thing was for acute kidney injury.
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So, uh, it's just very interesting to see different colleagues when, when you talk to them there, those that you know, that listen, uh, that, uh, are, are very appreciative of the, the new updated information.
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Because many times in many countries, uh, some of the information that they have is very old.
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So when you bring something new, they really do appreciate that.
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Uh, you know, in other cases, there are some guys that are just set in their ways, they don't wanna change.
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And, you know, that's, that's how, and that's okay,, but for the most part, bring, you know, bringing new information has been, uh, quite a, a, a very, uh, interesting, uh, thing to experience because people do appreciate that.
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And because they do, uh, genuinely wanna, uh, want to, uh, improve patient lives.
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So, so that was my experience there.
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Okay.
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Okay.
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Interesting.
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And you're bringing up another point, um, which is education information and all that.
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And you are in a unique position because you went to medical school in El Salvador.
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Yeah.
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Right?
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Yeah.
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So it's a, it is a central American country.
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Many people talk about now it's kind of in fashion with the president, right?
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I think you, you paused for a minute.
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Sorry,.
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Yeah, you're back.
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You're back.
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Okay.
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I'm here.
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Yeah.
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So
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Top of the world is in fashion now because of the crypto currency.
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Bitcoin, yeah.
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, yeah.
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Bitcoin is the first country in the world to adopt Bitcoin as a, as a national currency.
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And the president is, uh, he's unique, to say the least.
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.
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Yeah.
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He's, uh, some people like him, some people don't
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See.
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Yeah.
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Yeah.
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I'm sure, uh, you talk a lot about this with your, uh, family members and your friends from Salvador.
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But the, the, the question I wanted to ask you, Mauricio, is how would you compare the medical education that you've received and, and, and that doctors, uh, in general receive in, in a country like Salvador with the education of somebody who, who went to medical school in the United States?
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You know, interestingly enough, and I mean, it's a very good question.
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Uh, uh, you know, just, uh, as a, you know, point of reference for me, I mean, I, I went to medical school, you know, over 20 years ago.
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And so, uh, the educational system, I'm sure has changed since, uh, I was there.
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Uh, but what I will tell you is that, uh, at least from my own experience, uh, in medical school, I mean, we used the same books.
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We used a lot of the same references.
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Uh, you know, our professors, uh, were very good, very knowledgeable about, uh, their specific specialties.
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And they, uh, and they taught very, in a very anecdotal way.
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Right?
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Uh, so, so you, you're really trained to be a physician in, in that country, which is, you know, that that's why you're there, right?
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But, uh, I think what the difference between, uh, some Latin American countries, I know I can't speak for all Latin American countries, but just from my own experience is that, uh, in the United States, there is a little bit more of an academic, uh, focus then in Latin America.
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And, and, you know, we're they here in the United States, uh, we encourage medical students and residents and fellows to participate in clinical research, uh, you know, to test new, innovative, uh, ideas, to test innovative products, and to participate in, in some of those activities, you know, not only to, uh, uh, encourage people to do something new, but maybe discover something better.
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Uh, and so, uh, I did not have that experience, and this was 20, 25 years ago, so I'm sure things may have already changed, but nonetheless, uh, that's probably the biggest difference between, uh, the, the, the two regions.
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Yes.
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Yes.
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I, I think, uh, things have not changed that much, to be honest with you, because I hear that from, uh, a few other people, uh, including my brother.
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My brother went to medical school in, in Columbia.
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And by the way, there's a significant difference, um, medical school in Latin America, it's an undergrad degree, right?
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.
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So right after high school, you get into medical school and you spend five, seven years with the internship, and you also have to do social service.
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That's the same case in Salvador.
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Yes.
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That's the case.
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Okay.
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Yeah.
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Yeah.
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So social service where you spend a year in a rural area helping people, which is great.
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I think that's a great experience for a very humbling experience.
00:17:40.420 --> 00:17:49.839
Cause regardless of your socioeconomic level, and you know that Latin America has very, uh, marked, very bold differences.
00:17:50.529 --> 00:17:51.839
Uh, you have to go through
00:17:51.839 --> 00:17:52.039
That.
00:17:52.069 --> 00:17:52.559
Yeah.
00:17:52.759 --> 00:18:03.599
And, and actually, uh, I mean, I've been, uh, uh, you know, given gifts, you know, from, from patients when I did my social service here, I've been given, uh, uh, food chickens, uh, fruit cats.
00:18:03.660 --> 00:18:09.839
And I even had one lady offer me, uh, to marry her daughter,.
00:18:09.980 --> 00:18:11.720
But, uh, I did not marry her.
00:18:11.721 --> 00:18:18.279
But, uh, but it's, it's very humbling, you know, that, that people really do appreciate, uh, uh, what, what you do for them.
00:18:19.118 --> 00:18:24.519
Uh, you, uh, you get to see a side of, uh, society that you normally wouldn't get to see in the bigger cities.
00:18:24.520 --> 00:18:32.599
And so it really was a humbling experience, uh, and you develop a, a high sense of compassion, uh, for, you know, impoverished people.
00:18:32.599 --> 00:18:33.319
Definitely.
00:18:33.320 --> 00:18:34.559
Yes, yes, yes.
00:18:34.769 --> 00:18:36.960
Uh, I heard that a lot from my father.
00:18:37.009 --> 00:18:41.480
He was a, a neurologist and a radiologist, and my brother, who is a cardiologist.
00:18:42.019 --> 00:18:53.390
And, um, you also mentioned that the way your professors teach, uh, a thought in your case, uh, is through anecdotes.
00:18:53.608 --> 00:18:56.670
And, and I also heard that from my father and my brother.
00:18:57.009 --> 00:19:04.450
And, and, and the reason for that is probably because, um, the way medicine is practiced in these countries is very practical.
00:19:04.809 --> 00:19:06.089
You have to solve issues.
00:19:06.230 --> 00:19:10.890
You have to solve whatever case you have in front of you with little resources.
00:19:10.891 --> 00:19:20.490
You don't have the$20,000 piece of equipment that you have at your disposal on your desk in, in the United States, uh, as a doctor.
00:19:21.019 --> 00:19:30.809
So, um, in, in Columbia, I, I heard all these stories about, uh, you know, hospitals, they don't even have cotton, uh,.
00:19:31.009 --> 00:19:31.809
They don't even have alcohol.
00:19:32.089 --> 00:19:34.089
So you have to come up with creative solutions.
00:19:35.160 --> 00:19:57.410
Well, you know, interestingly enough, and some of the things that we take for granted here in the United States, for example, is, uh, if you need a CT scan, they just take you from the emergency room to the CT scan room in, uh, El Salvador, for example, if you needed a CT scan, they would put you in an ambulance, take you to a different location, and you need, you would need to have$2,000 to get a CT scan.
00:19:57.809 --> 00:20:06.170
And, and so, uh, you know, so that, that's another disparity that we see a lot there, that a lot of the technology that we have in the United States is not as available in other countries.
00:20:06.170 --> 00:20:07.009
Absolutely.
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