As the COVID-19 pandemic magnifies disparities for underserved communities, Pfizer is working to address the complex issues we face as a global society and create a healthier, more equitable world for all. Through partnerships and programmes, this biopharmaceutical industry leader is seeking to expand affordable access to breakthrough medicines and vaccines, particularly among underserved communities.
1. Innovation and global health
In a year of unprecedented challenges due to the COVID-19 pandemic and the significant disparities that still exist for underserved communities, Pfizer, now more than ever, is creating a positive impact on the world. While the COVID-19 pandemic has magnified the disproportionate burden of infectious diseases on vulnerable communities, the inequity of infectious disease prevention, diagnosis, treatment and care is unfortunately nothing new. That’s why, in 2020, they increased their focus on Infectious Disease (I.D.) Impact Initiative.
Established in 2018, the I.D. Impact Initiative is Pfizer’s long-term global health commitment to redefine the way we fight infectious disease and help protect underserved people in the U.S. and around the world from these deadly threats. Building on a 170-year legacy in infectious disease, they are partnering with others to create meaningful and sustainable solutions that address today’s and tomorrow’s biggest challenges.
1.1. Contributing to SDG 3
The company’s goal is to combat infectious diseases by supporting new approaches that create greater health equity for underserved communities. To help create a world safer from infection, Pfizer colleagues around the world are working together to make progress across five key impact areas, which are related to ongoing efforts to help achieve the global health targets included in the UN Sustainable Development Goal #3: Good Health and Well-being:
3) Ridding society of neglected tropical diseases (SDG 3.3)
4) Protecting society against newly emerging infections (SDG 3.D)
5) Advancing progress toward universal health coverage by driving equitable access to care and medicines (SDG 3.8)
The Initiative includes new multiyear, multi-million-dollar investments that build on previous charitable and product donations, programming and collaborations, which are the bedrock of Pfizer’s legacy in infectious disease.
2. Breakthrough vaccines
True to Pfizer’s Purpose, the priority is bringing to market innovations that positively impact patients. As the global COVID-19 pandemic grew, they began collaborating with BioNTech SE on a COVID-19 vaccine. They have already invested about $2 billion at risk and are prepared to continue bearing the costs of development and manufacturing, in an effort to help find a solution to this pandemic. Pfizer’s at-risk investment allowed for the initiation of rapid distribution of vaccines by governments as soon as the company received emergency or conditional use authorizations in countries around the world.
The dedicated focus and efficiency with which the vaccine was developed, manufactured and distributed – always with patient safety and quality at the forefront – demonstrates how their transformation to a more focused, innovative science-based organization has positioned Pfizer for long-term, sustainable growth potential. However, their commitment to product innovation in infectious disease goes well beyond our work to try to address COVID-19 disease. For example, this year, the organisation committed $100 million ($20 million per year for five years) to the AMR Action Fund – an industry-led, groundbreaking initiative to help reinvigorate the pipeline of antibiotics that the world desperately needs due to the rapid rise of antibiotic-resistant infections.
Pfizer is also a leading developer of other vaccines that help prevent infectious diseases. In 2020, Pfizer initiated Phase 3 trials for three vaccine candidates:
1) The 20-valent pneumococcal polysaccharide conjugate vaccine candidate, 20vPnC, in infants starting at 2 months of age.
2) The respiratory syncytial virus (RSV) vaccine candidate, RSVpreF, in pregnant women to evaluate the safety and efficacy in infants born to immunized pregnant women.
3) The pentavalent meningococcal vaccine candidate, MenABCWY, in adolescents and young adults.
3. Equitable access and pricing
Through partnerships, CSR programmes and innovative strategies, Pfizer is working to expand access, including for the world’s most vulnerable people. They employ access and affordability strategies to reach additional patients through equitable pricing as well as unique commercial and non-commercial strategies, including donations. They advance novel payment and financing mechanisms and ways to partner with governments and other relevant stakeholders to broaden access for patients and help improve patient outcomes.
Pfizer’s ranking in the 2021 Access to Medicine Index significantly improved to fourth place, up from 11th place in 2018. The improvement was due to strong performance in access strategies and capacity building as well as access planning during R&D. Many of the approaches focus on patients with the greatest coverage gaps and patient out-of-pocket exposure. They seek to apply programmes across the patient journey and to the entire product portfolio, to all therapeutic areas and both launch phase and in-line assets.
The organisation is pursuing disruptive solutions in terms of differential pricing, cash flow solutions, business model transformation and transaction cost reduction. For example, they were able to reach nearly 700,000 patients outside the U.S. through patient assistance programmes in 2020. Additionally, they aim to follow a tiered pricing strategy for both in-line and pipeline vaccine products (once regulatory approvals are achieved). As part of that strategy, they work with partners like Gavi, the Vaccine Alliance, through which we committed to supply up to 930 million doses of pneumococcal conjugate vaccine by 2027 to infants and young children around the world.
In addition to these access programmes, the pharma company has several global product donation initiatives (for example, the International Trachoma Initiative). In the U.S., Pfizer RxPathways connects patients to assistance options that provide medicines across the company’s portfolio for free or at a savings to eligible insured and uninsured patients. Outside the U.S., they maintain active market-based patient assistance programmes for launched medicines.
3.1. International Trachoma Initiative (ITI)
In 1998, Pfizer and the Edna McConnell Clark Foundation co-established the ITI, a nonprofit dedicated to eliminating trachoma, the leading infectious cause of blindness worldwide. Repeated trachoma infection can develop into trichiasis – where eyelids turn in and lashes scrape the eyeball, causing great pain, corneal ulcers and irreversible blindness unless treated with antibiotics or a simple surgical procedure. Trachoma is both a cause and a consequence of poverty, and as of March 2020, there were 137 million people living in trachoma-endemic areas in 51 countries around the world.
The ITI manages Pfizer’s donated antibiotic and collaborates with governments and partners to implement the World Health Organization’s (WHO) recommended strategy for trachoma control. Since 1998, more than 925 million doses of Zithromax® have been donated to ITI, and more than 184 million people in 40 countries were treated. They saw a 91% decrease in the number of people at risk for blindness from trachoma between 2002 and 2020. Thanks to global partners’ efforts, Cambodia, China, Iran, Ghana, Laos, Mexico, Morocco, Myanmar, Oman and Nepal have eliminated trachoma as a public health problem with four other countries reporting elimination to the WHO.
4. Health care infrastructure
The company recognizes the important role of governments, civil society and the private health sector in facilitating access by establishing and enhancing the local health care infrastructure. Pfizer Inc. and The Pfizer Foundation also endeavour to play a catalytic role, for example, by donating $40 million (2020-2021) in medical and charitable cash grants and medicines to more than 165 partners worldwide to support frontline health needs and strengthen the global response to the COVID-19 pandemic. This included funding for 19 charitable grants to help U.S. partners address the significant and disproportionate impact of COVID-19 on underserved communities.
A portion of the proceeds from Pfizer’s Sustainability Bond was allocated to replenish The Pfizer Foundation endowment, which deployed resources in 2020 to strengthen health systems in lowand middle-income countries to help address infectious disease in these underserved populations. In 2020, The Pfizer Foundation launched a new programme in partnership with Direct Relief to support innovative approaches to improve infectious disease care in U.S. safety-net community health care settings serving underserved populations. The Foundation also launched a new grant programme to advance health equity and improve health outcomes in African American communities in the U.S., including funding for organizations working to address social determinants of health and strengthen health systems.
4.1. Sustainability Bond
In March 2020, Pfizer launched a $1.25 billion “Sustainability Bond”, the first to be issued by a biopharmaceutical company. Proceeds from the bond will help manage the company’s social impact by supporting increased patient access to medicines and vaccines, especially among underserved populations, and strengthen health care systems.
Interest on the notes will accrue at the annual rate of 2.625% and the 10-year bond will mature on April 1, 2030. Sustainalytics, a leading global provider of environmental, social and corporate governance research and ratings, issued an opinion in March 2020 that the Pfizer Sustainability Bond Framework was credible, impactful and aligned with the four core components of the Green Bond Principles 2018 (GBP 2018) and Social Bond Principles 2018 (SBP 2018). Pfizer’s Sustainability Bond framework of eligible investments is aligned with the International Capital Market Association Sustainability Bond Guidelines 2018. As of December 31, 2020, $43 million in net proceeds from the Sustainability Bond issuance have been allocated to environmental projects supporting green design and construction of new office and manufacturing facilities.
4.2. Patient-centric design
Pfizer recognizes there are many ways we can streamline efforts and enhance operational efficiency to ultimately realize a greater global impact on behalf of the patients they serve. In 2020, the company’s Chief Patient Officer introduced a new enterprise-wide patient centricity framework to empower key stakeholders to collaborate as one team to co-create and implement a comprehensive and impactful approach to patient-centricity. One of the goals of this effort is to develop and implement a health equity roadmap designed to reduce health care disparities and advance their core value of equity.
Through Pfizer’s Multicultural Center of Excellence (MCoE), they are working in partnership with key groups across the U.S. to address health disparities among the historically disregarded populations through grassroots community programming and outreach. Building upon the trust that has been established over six years of partnership, the MCoE conducted educational briefing sessions with these organizations on the COVID-19 vaccine investigational clinical trial, which reflected the diversity of the world we live in and is inclusive of communities that have been disproportionately affected by COVID-19. They took the lead to help co-create and customize these engagements to meet the needs of the organizations and the needs of their constituents. Examples include: Culturally appropriate content translated into multiple languages; regular one-on-one briefings with trial clinicians and their leadership; educational video series on clinical trials.
5. Environmental impact
Pfizer seeks to leverage its strengths in scientific innovation to reduce the environmental impact of the medicines produced throughout the product life-cycle. Unleashing the power of the team’s scientific core on the environmental sustainability challenge has enabled the development of effective decision-making tools and selective investment in contemporary manufacturing technologies, increasing efficiency and reducing time to market.
Pfizer established commitments in 2012 to reduce water withdrawal and waste disposed of by operations. They exceeded their 2020 water withdrawal goal, delivering a 19% reduction from a 2012 baseline, and achieved a Leadership rating (A-) for the 2020 CDP Water Security disclosure. They delivered their 2020 waste disposal goal, achieving a 15% reduction from a 2012 baseline.
Additionally, they implemented a multistep process to assess and mitigate water-related risks within their direct operations and supply chain. They also continued to pursue opportunities to reduce waste generated by their operations despite increases in production and the acquisition of Hospira midway through the goal period. In this next phase of the company’s sustainability journey, they aim to develop sustainable medicines criteria to help demonstrate the social and environmental value of their products. The intent is to demonstrate a reduction in environmental footprint, addressing areas such as GHG emissions, water, waste management and circular economy, substances of environmental concern, and allow for targeted goals to facilitate improvement, transparency and accountability.
5.1. Application of Green Chemistry
Through the Green Chemistry programme, which is grounded in Paul Anastas and John Warner’s 12 Principles of Green Chemistry, the company is dedicated to promoting the selection and use of environmentally preferable materials, eliminating waste and conserving energy.
One such example is the application of Green Chemistry principles to abrocitinib, a late-stage development candidate for the treatment of moderate and severe atopic dermatitis. A life-cycle assessment comparison of the early abrocitinib synthetic route to the current innovative enzymatic process1 demonstrates significant environmental impact reduction. The enzymatic process reduces process mass intensity by 68% in addition to a 60% reduction of CO2 emissions (kg CO2e/kgA). The enzymatic process also eliminated the use of two inherently hazardous substances and replaced halogenated solvents with lower-impact alternatives, reducing solvent and aqueous waste.
5.2. Pharmaceuticals in the environment and antimicrobial resistance
Pharmaceuticals in the environment is the signature environmental issue for the industry. Recognizing the threat to human health from antimicrobial resistance (AMR), the organisation remains committed to the AMR Industry Alliance (AMRIA) roadmap demonstrating the responsible manufacturing of products and to providing greater transparency to actions. Their progress in driving a responsible manufacturing strategy, including risk assessments against science-based discharge targets, was positively recognized through the 2020 Access to Medicine AMR Benchmark. They remain committed to the goal of meeting industry targets no later than 2025.
As a next step, and aligned with their commitment to transparency, Pfizer is leading the development of a consensus-based standard with the sponsorship of AMRIA. The development process includes input from many interested stakeholders, including governments, academia, private companies and non-governmental organizations. The standard will be the forerunner of a certification scheme to demonstrate responsible manufacturing of antibiotics.
6. Disaster relief and humanitarian measures
Disasters can strike at any time in any corner of the globe for many reasons. The UN’s Intergovernmental Panel on Climate Change and the World Health Organization agree that the frequency and severity of humanitarian emergencies generated as the result of impacts of climate change (such as more severe storms, droughts, wild fires, disease outbreaks, population displacement) will continue to increase unless global carbon emissions are reduced and temperature rise is stabilized.
Recognizing the critical need in settings requiring relief and emergency humanitarian assistance, Pfizer has a three-part approach: cash grants, product donations and other access solutions. Using this approach, Pfizer colleagues around the world work collaboratively with governments, non-governmental organizations (NGOs), Civil Service Organizations (CSOs), and health care providers (HCPs), to enable prevention and treatment of disease by making medicines and vaccines available to as many people as possible.
6.1. Cash Grants
In an effort to reach as many people as possible, CSR of Pfizer supports a number of organizations working on providing relief and emergency humanitarian assistance. The Pfizer Foundation and Pfizer Inc. have provided cash grants to various NGOs providing assistance during humanitarian emergencies, such as the refugee crisis in Europe and the Middle East, the Zika outbreak, and Hurricane Matthew in Haiti and the United States.
6.2. Product Donations
Product donations play an important role in supporting defined public health programmes and also urgent needs in relief and humanitarian emergencies. Most of Pfizer’s product donations, which are managed centrally within the company and focused on specific diseases or emergencies, are designed to address patient needs in a coordinated manner. These programmes help provide underserved communities with access to important, potentially life-saving medicines and vaccines during times of significant challenge. The company works through established NGO partners with expertise in managing product donations in connection with humanitarian emergencies.
Pfizer’s approach to product donations is based on an expressed need. They work with partners to assess existing local government and NGO programmes, so that any donations they make effectively support ongoing initiatives. Non-governmental organization partners provide general needs assessments, which permit them to respond to a country’s requests for aid, to maintain contact with organizations in the field, and to obtain the relevant information necessary to plan a medicine or vaccine donation.
Pfizer donates a variety of products to assist with humanitarian emergencies, including essential health and over-the-counter (OTC) medicines. For example, in response to Hurricane Matthew and the cholera outbreak in Haiti, the company donated antibiotics and sterile injectable medicines to various NGOs providing healthcare to affected populations. To support efforts to stem the Zika outbreak, they provided in-kind donations of up to 170,000 doses of long-acting contraceptive product for the Zika Contraception Access Network (Z-CAN) in Puerto Rico. Pfizer regularly donates products from our United States and European distribution centres to NGOs working to pre-position relief kits to respond to natural disasters and provide ongoing support for protracted humanitarian emergencies.
Pfizer’s purpose is grounded in its commitment to fund programmes that provide public benefit, advance medical care and improve patient outcomes. All people deserve to live healthy lives. This belief drives the biopharma company’s desire to provide access to medicines that are safe, effective, and affordable.
Disclaimer: This report contains extracts from the Pfizer Environmental, Social and Governance (ESG) Report 2020.