Ronda Dean of Afaxys: “Keep low-income communities top of mind”

Treat reproductive healthcare as a right, not a privilege. Expanding access to contraceptives, and the impact of our work, is about offering patients the freedom to make decisions about their personal lives. A key factor in achieving economic equality is economic empowerment; without control over reproduction, people have little control over their economic future. As a […]

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Treat reproductive healthcare as a right, not a privilege. Expanding access to contraceptives, and the impact of our work, is about offering patients the freedom to make decisions about their personal lives. A key factor in achieving economic equality is economic empowerment; without control over reproduction, people have little control over their economic future.

As a part of our interview series called “5 Things We Must Do To Improve the US Healthcare System”, I had the pleasure to interview Ronda Dean.

Ronda Dean is the President, CEO and Co-Founder of Afaxys, a first-of-its-kind socially-conscious healthcare company inspired by the need to solve a public health crisis. Afaxys uniquely partners with the U.S. community and public health sector and private industry to ensure healthcare providers have stable pricing and reliable access to the products and services they need to care for their patients seeking reproductive and sexual healthcare. Under our CEO Ronda Dean’s leadership, Afaxys has profitably launched 10 oral, two emergency and one injectable contraceptives, and has become a leading provider of oral and emergency contraceptives in U.S. clinics.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?

Absolutely! I grew up in a small town in Ohio, in a working-class family, and I was always passionate about math and science, particularly biology. When I was fortunate enough to be able to go to college, which was not an opportunity many people had or that anyone in my family had had before, I fell in love with healthcare.

My first job out of school was as a clinical microbiologist in a hospital. This was a formative experience for me as I witnessed firsthand how the healthcare system treats people differently, sometimes for reasons you would expect, like symptoms or their health history. But I also witnessed that sometimes it seemed to be based on their sex or the color of their skin.

I then became interested in the business side of healthcare and went on to have a successful career in the pharmaceutical industry. Eventually I became the head of the women’s health division at a large pharmaceutical company. In that role, I felt like someone had pulled back the curtain, and suddenly my professional experience in healthcare and my passions for feminism and reproductive rights aligned.

That led me to Planned Parenthood in New York City, where I saw firsthand the challenges that providers in the community and public health sector — and their patients — have in getting reliable and affordable healthcare. This is what drove my desire to help solve that problem. My solution was to create a company that would focus on doing the right thing by making healthcare affordable, and accessible, for all.

Can you share the most interesting story that happened to you since you began your career?

I once had the privilege of meeting Justice Harry Blackmun, the author of the U.S. Supreme Court’s opinion for Roe v. Wade, which prohibits many state and federal restrictions on abortion. The discussion I had with him that day inspired how I view the issue of access to contraceptives, and the work I’ve done since then.

I asked Justice Blackmun what inspired him to write the majority opinion for Roe v. Wade, and he told me that for him, it wasn’t about abortion per se. He had worked at the Mayo Clinic, had a wife and two daughters, and his experience had shown him that women were not given the same right to privacy about healthcare decisions as men. He viewed this issue through the lens of women’s right to privacy, and their right to be treated the same as men.

His words really resonated with me: women’s ability to choose if, when, and how to have a baby is a matter of privacy. If women can’t manage their reproductive life, then that affects their ability to manage most everything else in their life. It isn’t about politics, but about giving all patients control over their own lives, their destiny.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I have definitely made some mistakes, especially in the beginning when I first started reaching out to investors for the funds to get Afaxys up-and-running. I once got in touch with a former mentor of mine, someone who had been immensely helpful to me as I was growing in my career, because I thought he would be a good fit for the board of Afaxys. We met and he kept asking me why I was doing it — why I was targeting poor patients as my customer base and how I would make money. I explained that — to me — it wasn’t about money, it was about doing the right thing. There comes a point in your life when you feel it’s time to make a difference.

In the end, I didn’t ask him to join the board, and from this experience I learned to target social impact investors, investors with a heart, who are not focused on big returns or getting acquired, but people/organizations who want to see us succeed at serving people who would otherwise slip between the cracks.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I try to live by Eleanor Roosevelt’s quote, “no one can make you feel inferior without your consent.” From my first sales position to most of the promotions that came after, I was usually the first woman “in the room.” Most of the men that I worked with were great — peers who became my friends and bosses who became my mentors. But there were also some male colleagues who resented my presence and tried to minimize my effectiveness or diminish my confidence. Ultimately those who were my friends and mentors — and this quote from Eleanor Roosevelt — inspired me to spend my career working to empower women to have more management over their own healthcare and their lives.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider is one who listens, one who puts patients first by collaborating with others to make healthcare affordable and accessible. As a healthcare company, our highest priority is to ensure that all providers have access to the essential products and services they need to properly care for their patients. I co-founded Afaxys with Susan Overly to ensure that community and public health providers, no matter who they were, could purchase the contraceptive products they want and need to care for their patients. That’s what drives all our decisions at Afaxys, and that’s what we think about every day: how to ensure that contraceptive care is always reliable and affordable for everyone, because access to sexual and reproductive healthcare should be a right, not a privilege.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I generally like the tips in the Harvard Business Review; especially throughout the pandemic when it was nearly impossible to predict anything, they had fabulous articles that provided great insights on managing change and uncertainty. I also find the Innovation Series National Association of Corporate Director’s (NACD) monthly journal very helpful when rethinking new challenges in front of us.

Are you working on any exciting new projects now? How do you think that will help people?

Right now, our focus at Afaxys is on growth; we have a five-year growth plan that will broaden our presence in the marketplace. Our growth strategy will further deepen and expand our therapeutic areas of focus, broaden the number of health providers we can reach and patients we can serve, as well as introduce exciting possibilities for new alliances.

What this will look like depends on our customers: as a company, we are pursuing a pull strategy, not push — our customers tell us what they need and that’s what we work to provide. Once we have the pipeline to further broaden our scope, we’ll see what else is needed. Access to contraceptives is only the tip of the iceberg; there’s so much more to do to help people gain access to essential care.

Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  • Inaccessibility of affordable care. Every year, more than 31 million Americans rely on community and public health centers to get essential care. Without these providers — many of whom depend on politically vulnerable government funding, grants and donations to keep their doors open — millions of people across the U.S. would have nowhere to turn for their healthcare. Yet many of these providers struggle to serve their patients because they can’t reliably access the cost-effective products they need.
  • Pharma companies do not sufficiently consider underserved populations. Most pharma companies are under pressure to continuously meet profit targets — this usually makes low-income populations an afterthought.
  • Inequities in how healthcare is dispensed. When I landed the role of VP in a women’s healthcare organization, I learned about the inequities across women’s healthcare, and saw first-hand how healthcare, economics, politics, religion and advocacy intersect. Certain patients are treated differently based on their gender, the color of their skin, or their income, and this impact reverberates across society, deepening existing inequalities and affecting whole communities.

As a “healthcare insider”, If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

  1. Increase investment in the public health sector. Millions of patients depend on public and community health centers to access essential care, and greater investment in this sector would improve health outcomes across the country.
  2. Keep low-income communities top of mind. This historically underserved segment of the population is large enough to provide the revenues needed to sustain a business and deliver on a much-needed mission. For more than a decade, Afaxys has proven that healthcare can be sustainable with a business model that is focused on higher volume of sales rather than high margins. We grow our business while keeping prices as low as possible and by serving the many millions of patients who have traditionally been overlooked by the broader system for decades.
  3. Use telehealth technology to expand access to care. One positive outcome of living and working through the pandemic has been watching the amazing innovations it has spurred, specifically, the advancement of telehealth and telemedicine technology. Providers have found ways to continue to offer contraceptive products and it has been truly remarkable to witness how much progress this field has made in just one year. These technologies promise to be powerful tools for expanding access to care.
  4. Treat all patients equally. By limiting access to funding that supports the use of contraceptives, for example, childbearing people are not given the same right to make private healthcare decisions as non-childbearing people. All people should have a say in healthcare decisions that impact their future.
  5. Treat reproductive healthcare as a right, not a privilege. Expanding access to contraceptives, and the impact of our work, is about offering patients the freedom to make decisions about their personal lives. A key factor in achieving economic equality is economic empowerment; without control over reproduction, people have little control over their economic future. At Afaxys, we support efforts that make contraception more accessible and more affordable.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Individuals: One way to manifest change is to share your experience through mentorship, and help others turn their ideas for change into reality. Mentoring young people is something that really excites me; it gives me great pleasure to reach out to young female entrepreneurs and support them as they chart their path forward and realize their vision. I think sharing our experience and insights with the younger generation is something that we should all should strive to do.

Corporations: Pharma corporations should put a higher emphasis on serving low-income populations. With this demographic, it’s important to focus on access and volume, over margin. It’s also important to focus on the right type of investors. There are social impact investors who are focused on mission as well as margins. Selling them your vision and a credible plan on how to maintain profitability is an achievable goal.

Leaders: Leaders should support policies which ensure affordable access to healthcare is available to all who need it. Millions of low-income Americans depend on a safety net of health centers for essential care, and without these, our nation’s health, especially for our most vulnerable populations, is in danger of slipping backwards. We encourage leaders to continue supporting and improving policies that expand access to affordable healthcare.

The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?

At Afaxys, we saw how healthcare providers struggled to serve their patients in the early months of the pandemic due to COVID-19 lockdowns. Yet I was also inspired to see how quickly they were able to adapt to and overcome these new challenges; providers found ways to continue to offer contraceptive products for patients by expanding their usage of telehealth services. Afaxys was already working with telehealth providers prior to the pandemic, and the past year has proven just how important this sector is and has solidified this service as a permanent part of our business model. I think continued investment in telehealth technologies can help increase access to vital services moving forward.

How do you think we can address the problem of physician shortages?

There is a growing gap between the country’s healthcare demands and the supply of doctors necessary to address these needs, a gap that COVID-19 has really exposed. I expect this problem will be exacerbated as the country’s population ages and grows, and it highlights the need for greater attention and investment in the public health sector to make sure lower-income patients don’t fall through the cracks.

How do you think we can address the issue of physician diversity?

I believe that representation matters. When I took on my first executive position, so many other women at the company reached out to share how excited they were. There were a few other women executives in HR and operations, but I was the first woman with P&L (profit & loss) responsibilities — and this was a big step forward. I’m truly touched when other businesswomen tell me that my leadership has inspired them, and I think this is a lesson that can be applied to physicians as well: hiring and promoting physicians from diverse backgrounds can create a positive cycle and encourage more diversity in the medical profession. It’s critical that we solve this problem so that patients see themselves reflected in the doctors caring for them.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

This is a great question — physical health and mental health are deeply connected, and at Afaxys we strive to be both patient- and employee-centric and consider the full spectrum of health for the best outcomes. I think we need to continue to educate medical professionals about how mental and physical health interplay with one another and encourage them to look at the health of patients holistically.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I would like to see a movement to protect patients’ right to control their reproductive destiny and access essential healthcare. It would truly change lives. At Afaxys, we are working every day to turn this vision into reality by making contraceptive options affordable and accessible to all.

How can our readers further follow your work online?

Right now, you can follow me on LinkedIn, and Afaxys for updates on the work we are doing.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.

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