Here in the Caribbean we have a number of companies that are initially successful but are unable to grow past a certain size, no matter what they do. In many cases, that size corresponds to a headcount of 150-200. which scientists tell us is the maximum number of people that can work together, and be managed closely by one person who doesn't delegate.
When companies cannot scale up to the next level, they never exit the startup phase and achieve their full potential. The cause can sometimes be traced to a CEO who behaves as if he is special (Snow White) and is surrounded by a lack of talent (his many dwarves.)
To grow, regional companies need to ensure that they train leaders, not develop personalities, and push their CEO's to delegate differently while demanding higher skills from managers.
The audio version can be heard at http://fwconsulting.podomatic.com