catalyze innovation, harness the power of science and technology int/iris/bitstream/handle/10665/325755/WHO-CDS-NTD-2019.01-eng.pdf?ua=1. 20. Access

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2 | GLOBAL HEALTH PROGRESS Interventions in Neglected Tropical Diseases (NTDs) represent some of the largest public health interventions globally, and the innovative biopharmaceutical industry has always been an active partner throughout. The innovative biopharmaceutical industry™s support to NTDs is multi-faceted, and R&D activities are complemented by medicine donations and programs to strengthen health system capacities and improve public awareness on disease prevention. and I am pleased to see that R&D investment by multinational biopharmaceutical companies reached its highest-ever level. However, we are far from having all the tools we need to control and eliminate NTDs. Our industry is committed and to dedicate teams of world-class researchers and that affect the poorest of the poor. Collaboration is however, at the heart of everything: cross-sectoral cooperation and public-private partnerships are more important than ever if we want to further catalyze innovation, harness the power of science and technology, and help unlock new ways of reaching a world free of NTDs. Beyond research and development, our industry also helps endemic countries to address their NTD- related health challenges – by assisting countries to build strong health systems that are accessible and with helping to bolster the supply chain and facilitating the delivery of quality, affordable medicines and vaccines. We look forward to working alongside governments and the global health community to sustain gains and bring innovative solutions to accelerate progress towards the control and elimination of NTDs. from the Covid-19 pandemic is that countries with the ability to respond promptly are those with the most resilient and equitable health systems. Neglected Tropical Diseases (NTDs) are a litmus test for equitable health, as they impose a devastating human, social and economic burden on more than 1 billion of the world™s most vulnerable, marginalized populations. The World Health Organization™s (WHO) new road map for 2021-2030 embodies this vision. During the next decade, WHO wants to guide the world in freeing 90% of these people from the vicious cycle of disease and poverty due to NTDs. good collaboration with countries and partners across the public and private sectors, means that forty countries, territories and areas have eliminated at least one disease. Since 2015, donation of medicines have helped to scale-up programmes, resulting in the annual treatment of over 1 billion individuals for at least one NTD. WHO is committed to continue this progress and to work with every partner, particularly the biopharmaceutical industry to ensure access to quality-assured, effective and safe medicines, and diagnostics. But if we want to accomplish what we are envisioning for 2030, donation of medicines can only be one, albeit important, part of the puzzle. It is time we adopt a coherent and comprehensive approach across diseases, involving every sector in a more effective cross-cutting manner. The new WHO road map will help reshape our collaboration as we move forward. We need the industry to be part of our new vision towards 2030. The countdown has begun; let us journey together towards a healthier world free of NTDs. THOMAS CUENI DIRECTOR GENERAL, INTERNATIONAL FEDERATION OF PHARMACEUTICAL MANUFACTURERS & ASSOCIATIONS DR MWELE N. MALECELA DIRECTOR, NEGLECTED TROPICAL DISEASES, WORLD HEALTH ORGANIZATION FOREWORDS

PAGE – 3 ============ | 3Global health research and development (R&D) has transformed since the turn of the 21st century, giving new hope to hundreds of millions of neglected patients across the globe. What shifted? The proliferation of cross-sectoral partnerships. Stakeholders across sectors are acknowledging that the pharmaceutical industry cannot solve complex global health challenges alone. This acknowledgement was a catalyst for GHIT™s creation fund for global health R&D. Japanese and global life- science companies have demonstrated unparalleled to the Fund, sharing their technologies, expertise, and networks to develop innovative tools for the have incentivized industry, academia, and research institutions to utilize their assets to help develop innovative tools for neglected patients through collaboration with a global network of partners. necessary to drive innovations, we also need to strengthen synergy between funders to fully leverage investment impact. The London Declaration is one of the greatest must continue to build better, more sustainable approaches to deliver medicines to patients more The good news: the R&D, access and delivery communities have already initiated dialogues to bridge gaps and solve challenges by aligning their strengths and unique positions. Cross-sectoral partnership is not a magic bullet. It requires continuous leadership, dialogue, and passion. Ending the neglect is possible. Let™s get it done, together. NTDs affect more than one and a half billion people each year and are particularly prevalent among Declaration on Universal Health Coverage (UHC) adopted at the United Nations (UN) High-level Meeting on UHC in 2019 reinforced growing global political commitment, with Heads of State and Government agreeing to take ambitious actions to institute UHC in their countries. With such a high burden of NTDs, addressing them must be at the core of that commitment. UHC and strong health systems provide a critical foundation for NTD interventions. UHC means quality health services are available for everyone, no matter who you are or where you live, and crucially it ensures that people are not pushed into poverty by healthcare costs. We know that the most vulnerable and poorest people are those worst affected by NTDs. At the heart of UHC and in line with the Sustainable Development Goals (SDGs) is a dedication to ‚leave no one behind™. This commitment to equity, non-discrimination and a human rights approach to health is therefore fundamental for interventions in NTDs. Strong health systems play a core role in ensuring that people and communities receive the prevention, treatment, care and rehabilitation they may need for NTDs. UHC2030 promotes the strengthening of health systems worldwide, including primary health care, to ensure that everybody™s health needs can be met. One thing we say loudly in the UHC movement is the need to ‚move together™. This means engaging other sectors and the whole of society for a healthier world. Strengthening health systems and related public health actions extending beyond the health sector forms the foundation and core of tackling NTDs. Likewise, good NTD control is a powerful contributor to realizing UHC. CATHERINE K. OHURA CEO & EXECUTIVE DIRECTOR, GLOBAL HEALTH INNOVATIVE TECHNOLOGY FUND PROF ILONA KICKBUSCH CHAIR OF THE INTERNATIONAL ADVISORY BOARD OF THE GLOBAL HEALTH CENTRE AT THE GRADUATE INSTITUTE OF INTERNATIONAL AND DEVELOPMENT STUDIES AND CO-CHAIR OF UHC2030

PAGE – 5 ============ | 5PROGRESSING THE FIGHT AGAINST NEGLECTED TROPICAL DISEASES NEGLECTED TROPICAL DISEASES TARGETED BY THE WHO: Buruli ulcer Chagas disease Dengue and Chikungunya Guinea worm disease Echinococcosis Foodborne trematodiases Human African trypanosomiasis (sleeping sickness) Leishmaniasis Leprosy Mycetoma, chromoblastomycosis and other deep mycoses Onchocerciasis (river blindness) Rabies Scabies and other ectoparasites Schistosomiasis Soil-transmitted helminthiases Snakebite envenoming Taeniasis/Cysticercosis Trachoma Yaws 1234567891011121314151617181920Strong progress has been made towards tackling Neglected Tropical Diseases (NTDs) over the past decade, although notably a number of NTD donation programs began much before this. In 2018, for the fourth consecutive year, more than one billion people were treated for at least one of the 20 NTDs that are being targeted for control or elimination by the World Health Organization (WHO). 1 However, over 1.6 billion of the world™s poorest people cut short, by NTDs, highlighting the need for a continued, concerted focus on tackling these diseases. 22020 is a landmark year for NTDs. The London Declaration Š a collective commitment to eliminate NTDs which has supported over 12 billion treatment donations Š launched in 2012 and is coming to an end, with a new chapter being forged. 3 In addition, this year marks the 10-year countdown for the achievement of the Sustainable Development Goals (SDGs), which includes SDG target 3.3 to ‚End the epidemics of AIDS, tuberculosis, malaria, NTDs and other communicable diseases™. The political will to address NTDs Level Meeting on Universal Health Coverage (UHC), which recognized that access to NTD interventions is integral to achieving ‚Health for All™. Commitment from national governments towards addressing NTDs is a critical part of achieving UHC and the SDGs is all the more critical. NTDs affect the poorest and most vulnerable parts of communities, especially in resource-constrained no-one behind. Global health actors need to continue to mobilize attention towards NTDs, using platforms and convening to highlight the cross-sector support needed from policy makers, community leaders, civil society, industry and others to advance our journey to control, eliminate and eradicate NTDs. The WHO believes that if countries consistently treat and protect more than 75% of people needing care, soil-transmitted helminthiasis, schistosomiasis, and onchocerciasis), we will be on track to beat these diseases. 2 Great progress has already been made by many countries Š Malawi, Sierra Leone and Togo have reached the 75% average target Š but more needs to be done. 4 Control, elimination and eradication is not in sight for all NTDs and emerging global health challenges, such as antimicrobial resistance, mean that new prevention and treatment approaches are needed. = NTDs included in the London Declaration 520As the innovative biopharmaceutical industry, we recognize that to achieve an NTD-free world we need to work together to sustain current initiatives and develop new, innovative approaches. Our industry™s NTD work, and that of the private sector at large, is central to helping countries to address their NTD-related health challenges. By assisting countries to build strong health systems that are accessible and staffed bolster the supply chain and facilitate the development and delivery of quality, affordable medicines and vaccines, we will ensure no-one is left behind on our collective journey to reach the SDGs and achieve UHC.

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6 | GLOBAL HEALTH PROGRESS CATALYZING COLLABORATIONS IN SUPPORT OF A NEGLECTED TROPICAL DISEASE-FREE WORLD We work closely with multi-sectoral stakeholders as we believe this collaboration is essential to addressing NTDs. The WHO™s Executive Board report in February 2020 recognized the value our industry recognition of the support provided through medicine donations. 6 As the timeframe for the London Declaration draws close, emphasis is being placed on a more sustainable approach towards achieving control and elimination of NTDs that encourages greater endemic country ownership and improved domestic resource mobilization. Governments need to create demand, commit resources to the elimination of NTDs and play a more active role in improving accurate forecasting of treatment needs. Investment in diagnostic methods and tools is a critical gap in meeting NTD targets, and it has been noted that mass drug administration (MDA) can have unintended consequences on the development of targeted diagnostics. A fiOne Healthfl approach, that integrates efforts with water, sanitation, nutrition and education into intersectoral initiatives, are all considered essential for ensuring that important gains are sustained, and unattained targets are met. These factors have been taken into account in the development of the WHO™s second NTD Roadmap Š developed in partnership with the global health community to set targets and milestones beyond 2020 which are ambitious, evidence-based and realistic. The roadmap also acknowledges a need to avoid long-term over-reliance on medicine donations. 7 To achieve these goals, the entire NTD community needs to work together using holistic patient-centered and inter-sectoral approaches so that countries can better integrate interventions into national healthcare systems and reinforce linkages between health and other sectors. All actors have a role to play in the journey to 2030; we are committed to supporting governments to identify priority areas that relate to their needs and to increase their stewardship of related health issues. As the commitment under the London Declaration draws to a close, stakeholders will come together to craft the next phase of cross-sector support. The innovative biopharmaceutical industry is committed to being active participants in achieving an NTD-free world and helping to ensure that gains are sustained beyond donor support and deliver impact.

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8 | GLOBAL HEALTH PROGRESS MULTI-SECTOR ACTION SUPPORTING THE FIGHT AGAINST NTD sThe journey so far 2030 SDGs deadline 2011 WHO published their 2012Œ2020 NTD roadmap , prioritizing 17 NTDs112012 The London Declaration on NTDs was formed 2012 Uniting to Combat NTDs was established 2012 The NTD Supply Chain Forum was formed 2013 A declaration for the control and elimination of NTDs in Ethiopia was signed by Ethiopian National NTD Symposium participants 2014 The Addis Ababa NTD commitment 2015 G7 Heads of State recognized NTDs as a major challenge and the need for research and interventions 122016 The Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) was launched 2017 The NTD drug donation program broke the world record for the largest mobilization of donated drugs 2017 The Geneva Commitment , signed by NTD Declaration commitment 132017 WHO added three new NTDs to the NTD portfolio (chromoblastomycosis and other deep mycoses, scabies and other ectoparasites and snakebite envenoming) 2018 The ALMA NTD indicator launched at the African Union summit 2018 An NTD resolution was adopted by 57 countries at the XVIIIe Summit of the Organisation internationale de la Francophonie (OIF) 2020 World NTD Day was held on 30th January 2020 Submission of the WHO new NTD Roadmap for 2021Œ2030

PAGE – 9 ============ | 9COMPREHENSIVE AND HOLISTIC EFFORTS TO FIGHT NTD sOur approach Building healthcare worker capacity, and supporting disease prevention and awareness WE PARTNER WITH A DIVERSE RANGE OF ACTORS TO STRENGTHEN HEALTH SYSTEMS. We support initiatives. We provide hospital and healthcare facilities with equipment and resources. Our healthcare professional training programs help strengthen local capacity. We support the provision of safe water and sanitation .Our disease prevention programs educate target populations and increase disease awareness .STRENGTHENING HEALTH SYSTEMS WE KEEP INVESTING IN R&D TO ENSURE NEW GENERATIONS OF MEDICINES, VACCINES, AND DIAGNOSTICS AS WELL AS TECHNOLOGIES TO CONTROL TRANSMISSION ARE DISCOVERED: Our collaborations take many forms including product development partnerships, research consortiums and technology transfers .We facilitate access to intellectual property compound libraries, technical expertise, know-how and data, and regulatory assistance. OUR R&D PIPELINE INCLUDES: 15 pharmaceutical companies conducting R&D on 14 NTDs 90 R&D projects in progress In 2018, 83% of NTD R&D projects involved an external partner BOOSTING INNOVATION AND RESEARCH & DEVELOPMENT Ensuring the long-term, quality supply of affordable medicines WE HELP COMMUNITIES IN NEED TO GET THE TREATMENTS THEY NEED. WE SUPPORT COUNTRIES TO BECOME SELF-SUSTAINABLE AND INCORPORATE NTD MANAGEMENT INTO THEIR UHC PLANS. Our strategies to increase access to treatment include management and drug donation. Over eight years, 12 pharmaceutical companies have donated 12 billion treatments. In 2018, for the fourth consecutive year, more than one billion people were treated for at least one of the WHO™s 20 prioritized NTDs. We are working with partners to fast-track current initiatives and better integrate interventions into national health care systems. SCALING UPACCESS TO EXISTING TREATMENTS

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Progress has been made to control, eliminate and eradicate NTDs that are treated through regular preventive chemotherapy (PC) via Mass Drug Administration (MDA). LYMPHATIC FILARIASIS Eliminated in 16 countries in 2018, including Cambodia, the Cook Islands, the Maldives, the Marshall Islands, Niue, Sri Lanka, Thailand, Tonga and Vanuatu. Seven additional countries have successfully implemented the recommended elimination strategies, no longer delivering large-scale treatment and started elimination surveillance. 14 ONCHOCERCIASIS (RIVER BLINDNESS) Š Colombia, Ecuador, Guatemala and Mexico. Additionally, three countries no longer delivering MDA and completed three years of post-treatment surveillance in at least one transmission area. 1.8 million people now live in areas that no longer require MDA. 15TRACHOMA Eliminated as a public health problem in Cambodia, China, Morocco and Oman. 16SOIL-TRANSMITTED HELMINTHIASES (SHT) The 10 highest burden countries have started deworming Š a major step in the global deworming program Š and 531 million children were reached in 2016 by this program. New guidance from the WHO means that treatment will be extended to women of reproductive age, supporting an estimated 688 million women. 17SCHISTOSOMIASIS There has been steady growth in population coverage with and 70.9 million children are covered by schistosomiasis programs Š a 27% increase between 2015 and 2016. 18 Global target to treat 75% of school-aged children is on track, with 70% coverage reached globally in 2017. 19NTD CONTROL, ELIMINATION AND ERADICATION Disease progress

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explore over 250 programs working across diseases areas at Our interactive knowledge hub collates information on our industry™s Neglected Tropical Diseases (NTDs) .THE PARTNERS WE COLLABORATE WITH MOST ARE: Drugs for Neglected Diseases Initiative (DNDi) Liverpool School of Tropical Medicine (LSTM) World Health Organization (WHO) THE TYPE OF PARTNER WE COLLABORATE WITH MOST ARE: Academia and Research Institutes 114 partners working on 19 programs Global Non-Governmental Organizations 37 partners working on 12 programs Governments 16 partners working on 10 programs of our programs target NTDs 30+partners are working with us on our NTD programs 370 +

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