The Sickest Markets Get the Thinnest Medical Affairs, and Nobody Actually Decided That

Published 12 August 2026

Author(s): Jose Rafael Borbolla-Escoboza

Pull up most global medical affairs budgets and you'll find a pattern nobody really planned. The markets carrying the biggest share of the world's disease burden get a fraction of the investment that goes to markets carrying a fraction of that burden. Nobody sat in a room and chose this. It just happened, budget cycle after budget cycle, built on assumptions that were never really examined, let alone defended.

This isn't a fairness argument, and I want to be clear about that up front, because it matters to anyone sitting on a global leadership team, not just the country directors watching their affiliates lose out.