When Latvia’s airspace came under threat in Latgale, Signe Jantone, Executive Director of the Latvian Pharmaceutical Manufacturers Association, found herself thinking about something far more immediate than geopolitics: the medicines in her home medicine cabinet. Would there be enough? Would the pharmacy remain open? It is a question she believes Latvia – and Europe – must answer before the next crisis, not in the middle of it. Ahead of the international conference “First Line of Defence” (Rēzekne and online on 15 October), we spoke to the association’s new leader about Latvia’s place on Europe’s pharma map.
Medicine shortages have become a global challenge. How is Latvia addressing this problem?
Medicine shortages pose a risk to public health. However, they are also a matter of national security and resilience. During the COVID-19 pandemic, we saw first-hand that waking up to the problem only when medicines are already in short supply is far too late.
In this respect, Latvia has a fundamental advantage that we must not continue to underestimate. We already have pharmaceutical manufacturing facilities, scientists, technological expertise, export experience and decades of accumulated knowledge. Many European countries are now trying to rebuild manufacturing capabilities they lost in the past.
Crisis preparedness encompasses diversified supply chains, carefully planned reserves of essential medicines and, above all, manufacturing capacity in Europe and here in Latvia.
Europe is currently working towards these very goals. The Critical Medicines Act aims to strengthen manufacturing within the EU, diversify supply chains and place much greater emphasis on resilience, rather than price alone, in public procurement.
DG HERA, in turn, is mapping manufacturing capacity and supply chains, building up stockpiles, developing joint procurement and working with industry to ensure that critical manufacturing capacity is available before a crisis hits.
I would like Latvia to be more than just a recipient of medicines within this system. We have the potential to become a Baltic hub for pharmaceutical manufacturing and supply, enabling us to meet not only Latvia’s own needs, but also those of the wider Baltic region and Europe.
Today, the Latvian Pharmaceutical Manufacturers Association has a clear message for policymakers in Latvia and across Europe – security does not begin on the military training ground; it also begins in the laboratory, on the factory floor and on the pharmacy shelf. Coordinated cooperation at every stage of health security is essential to strengthening national resilience.
Latvia still imports most of its medicines. What incentives would encourage pharmaceutical manufacturing in Latvia?
First and foremost, we need to change the way we view pharmaceutical manufacturing. It is not simply another industrial sector; it is a strategic national asset and an opportunity to build a healthier, stronger society and, ultimately, a more resilient country. It is also about health security, export potential, commercialising scientific research and building the infrastructure that underpins national resilience.
In the pharmaceutical industry, decisions on new manufacturing facilities, technology investments and product portfolio development are inherently long-term, extending well beyond a one- or two-year horizon.
These are long-term strategic commitments that require substantial investment. The government must therefore provide a clear, long-term commitment in return – through predictable policymaking, safeguards for the country’s economic interests, the rule of law, investment incentives and access to European funding, support for research and new product development, a fast and proportionate regulatory framework, and a market that recognises the value of supply security.
Europe is increasingly moving in this direction. Under the Critical Medicines Act, strategic manufacturing projects will benefit from special status, easier access to funding and accelerated procedures. Public procurement, meanwhile, must treat resilience and manufacturing security as genuine criteria, not merely as fine words added for effect.
During a recent visit to Germany with a delegation of entrepreneurs from Latvia’s life sciences sector, organised by the Investment and Development Agency of Latvia (LIAA), I was struck once again by the fierce competition across Europe for investment, new technologies, partners and manufacturing projects. No one will bring these projects to Latvia just because we have a strong heritage in chemistry and pharmaceuticals. We have to reach out and secure them ourselves.
Latvia does not have to start from scratch. We already have the expertise across the entire value chain: science, product development, manufacturing, quality assurance, clinical and regulatory expertise, and exports. Our strategic formula is clear and specific: 100 hard-to-replicate medicines in 100 markets worldwide.
I would like to raise the bar for our association’s ambitions in the near future: Latvia must become the Baltic region’s hub for pharmaceutical manufacturing and security of medicines supply.
To what extent is Latvia prepared to ensure access to medicines during future crises?
Much better than before COVID-19. But still not as well prepared as we should be, given Latvia’s geographical location. We have a professional healthcare system, wholesalers, pharmacies and manufacturers that have already demonstrated their ability to respond in times of crisis. Work on building reserves of critical medicines has begun, albeit at a sluggish pace. However, it is important to understand that stockpiles in warehouses alone cannot build national resilience.
We need to know, in very concrete terms, which medicines Latvia would need in a crisis, how long our reserves would last, where the active pharmaceutical ingredients and raw materials come from, where the vulnerabilities lie in our supply chains and, crucially, which critical medicines we would be able to manufacture ourselves in case of need.
In this respect, DG HERA’s approach is particularly valuable. HERA is not waiting for the next crisis: it is already mapping supply chains and manufacturing capacity, identifying critical manufacturing sites, developing procurement and stockpiling mechanisms, and working with industry to ensure that production can be scaled up rapidly.
The European Medical Countermeasures Strategy is an initiative that Latvia would do well to study closely and engage with more actively. It envisages flexible, scalable manufacturing, the RAMP-UP initiative, HERA Invest, new development centres, and closer cooperation between the civilian and military health sectors on preparedness.
For Latvia, situated on the European Union’s eastern border, this debate is not theoretical. We should be among the best-prepared countries in Europe. Pharmaceutical manufacturing capacity must be part of that preparedness.
Where does Latvia sit on Europe’s pharmaceutical map?
Latvia is a small market. But I flatly reject the idea that this condemns us to being a small player. We have more than a century of chemistry and pharmaceutical heritage, companies that operate internationally, strong scientists, universities, manufacturing infrastructure and export expertise. That is a very good place to start from.
As I mentioned, my meetings in Germany with representatives of the life sciences ecosystem have made it abundantly clear that competition across Europe is fierce. But Latvia has a great deal to offer. We cannot hope to replicate Germany’s scale. What we do have, however, is speed, expertise, flexibility and the ability to specialise. It would be a grave mistake not to capitalise on these advantages. Our aim should not be to compete on volume, but to win through knowledge, technology and products that are not easily replaceable.
The Critical Medicines Act, the work of DG HERA, the Critical Medicines Alliance and the new Medical Countermeasures Strategy all point in the same direction: Europe needs to rebuild its own manufacturing capacity.
What role do research and collaboration with universities play in the future of the pharmaceutical industry?
Fundamental. But the traditional line that “science needs to work more closely with industry” is no longer enough. We need to build a system in which the scientist, the clinician, the data scientist, the engineer and the drug manufacturer sit down together over a single problem from day one, rather than meeting once the research is finished and someone starts wondering what to do with the results.
NXTin.Health very precisely covers one of Europe’s problems: we have brilliant ideas and world-class science, but too many innovations get stuck somewhere between research, pilot project and real-world rollout.
Here, Latvia can actually use its small size as an advantage. We can connect people and institutions much faster than the larger countries can.
Why couldn’t Latvia build a single ecosystem in which pharmaceutical companies, the National Research and Innovation Institute (NIRI), universities, hospitals, biotech firms, start-ups and artificial intelligence expertise all work side by side?
DG HERA’s approach is also very interesting: HERA Invest funds high-risk health innovations, and the Medical Countermeasures Accelerator, a European diagnostics hub and other mechanisms are being developed so that innovation reaches practical use faster.
The visit to Germany confirmed it too: what counts is not business cards but precisely matched partners. If we know what we want to create, international cooperation can rapidly turn into a tangible project.
How can policymakers better balance innovation, affordable medicine prices and patients’ access to treatment?
It is finally time we stopped pitting these things against each other. Without innovation, there will be no new therapies. Without economically viable manufacturing, there will be no stable supply. Without competition, there will be no sensible prices. And without an accessible reimbursement system, even brilliant innovation will never reach the patient.
That is why smart medicines policy does not look only at the price in a single tender. It looks at the total value to the state and to the patient over the long term. Generic and off-patent medicines are a very good example. They generate huge savings for the health system. But if prices are pushed so low that a manufacturer can no longer produce a given product economically in Europe, a short-term saving can turn into a shortage of medicines and a new dependence on outside suppliers.
That is exactly why I find the approach of the Critical Medicines Act so significant: in public procurement of critical medicines, it enshrines the principle that the resilience of supply chains must also be assessed, and it encourages manufacturing in Europe.
The cheapest medicines are not the cheapest if the patient cannot get them. Good medicines policy creates competition, access, innovation, stable manufacturing and security all at once.
What needs to be done to encourage more young people to choose careers in pharma, biotech and the life sciences?
First, we ourselves need to be far bolder in telling people what this industry actually is today. Pharma is not just a lab chemist in a white coat. It is biotechnology, AI, data science, robotics, engineering, medicine, molecular biology, manufacturing and international business. And I very much like the idea that a young person in Latvia can work in a laboratory or a plant in Riga and create a product that a patient in Berlin, Paris, Tokyo or anywhere else in the world will then use. Europe is in a fierce battle for talent. If we do not offer our young people big challenges in Latvia, someone else will offer them theirs.
That is why we need even closer links between schools, universities and companies: internships, industrial doctorates, mentoring programmes and the chance for students to work on real industry projects. And perhaps we also need some internships for politicians and civil servants, so they can get to know Latvian science and the medicines manufacturing industry as it really is (smiles).
Another good example is Olpha’s programme “There’s Chemistry Between Us!”, which invests in the development of future STEM teachers. When you really think about it, you could even say that health security starts with a teacher who sparks a child’s interest in chemistry, biology or mathematics, economics, history and languages.
To what extent is Latvia able to turn scientific research into commercial products?
We have outstanding scientists. I would urge people to pay attention to the young scientists at the NIRI and their research. But we must be honest: we still lose too much value in the gap between the laboratory and the market. That is where the hard part begins: intellectual property, validating the technology, preclinical and clinical stages, pilot production, scaling up, regulatory requirements, capital and international commercialisation. Too often in Europe we fund the creation of an idea superbly, and then wonder why it is commercialised in the United States. Latvia does not have to accept that as inevitable.
We need to build the funding and infrastructure for the whole journey, from laboratory to factory and from factory to the global market. This is where I see a particularly big role for the pharmaceutical industry. Companies cannot simply wait to see what scientists invent. Industry, together with universities and the state, must define the problems that need solving and build the path to a product together. DG HERA, HERA Invest and Europe’s new approach to medical countermeasures innovation show that this way of thinking is also becoming European policy. Latvian scientific excellence must become a patent, a technology, a medicine, a factory or a new Latvian company.
What motivated you to take on this leadership role?
The chance to really change something. I haven’t worked in pharma before, but chemistry has had me hooked since my schooldays. And in everyday life I keep bumping into the oddest use of the word: “Ugh, don’t eat that, don’t touch it, it’s all chemicals!” I’ve always found that baffling. With one phrase we take everything we know about substances, their properties and their reactions, and turn it into something suspect or unhealthy. But chemistry isn’t the opposite of nature. Chemistry is nature. The very same compounds can be the basis of life-saving medicines or turn into poison. What makes the difference is knowledge, dose, how they’re used and human responsibility. That’s why chemistry has always struck me as a great lesson in balance.
The principle of balance applies to public policy too. We need manufacturing. We need investment. We need competitiveness and exports. But patients’ interests, safety, science, access, the rule of law, the protection of economic interests and public trust must matter just as much. Strong policy is the ability to balance those interests.
What’s more, pharma is a very special environment. It is one of the most tightly regulated, most capital-intensive and most sensitive industries there is. A new product cannot be created here in a few months. It takes several years of research, technology development, stability studies, validation, regulatory procedures, investment and a very high degree of professional responsibility.
This is not an industry that produces a slick new social media clip every day to celebrate the latest achievement. Much of the work happens in laboratories, plants, quality systems and paperwork: more quietly than the public sees it, but with an enormous impact on people’s health and national security.
Furthermore, Latvian manufacturers operate in an especially difficult competitive environment. Latvia still imports most of its medicines, and our companies must compete every day with international pharmaceutical groups whose markets, capital and resources are vastly greater.
That is exactly why I see my role not as idealising the industry, but as helping people clear their vision of the usual constraints and see both the reality and the opportunities. To be realistic, but not cynical. To see the risks, but not let them become an excuse for doing nothing. To keep a bright view of what Latvian medicines manufacturers are already capable of, and of what they could achieve if the state, science and industry pulled much more purposefully in the same direction, without introducing unnecessary barriers and administrative burdens.
I see part of my role, therefore, as that of a challenger: asking questions where the answers have been taken for granted for far too long. Asking: Why not? What is holding us back? And what, specifically, needs to be done to make it happen?
Through this work, it did not take me long to realise just how closely the pharmaceutical industry is linked to national security. Recently, when Latvia’s airspace came under threat in Latgale, this became a very personal matter. At a moment like that, there is little room for abstract discussions about health resilience. Your thoughts become very straightforward: will there be enough medicines in the medicine cabinet at home? Will the pharmacy remain open? Will supplies continue to arrive? Where will I get reliable information, and will we be able to help people?
We must also not lose sight of the reality of hybrid warfare, including real and persistent attempts to undermine and disrupt pharmaceutical manufacturers and medicine supply chains.
Our position on the European Union’s eastern border places a greater responsibility on us. But it also presents a very tangible opportunity: to become a place where Europe’s health resilience is not merely discussed in policy documents and initiatives, but actively built in manufacturing plants, laboratories and supply chains. The pharmaceutical industry is one of the sectors in which Latvia can excel on a European scale. My role is to help ensure that we do not merely recognise this opportunity, but seize it.
Photo: U.Freimanis
