3 How are pharmaceutical companies leveraging collaboration?
Collaboration has always played an important role in the pharmaceutical industry, and COVID-19 has sparked a number of high-profile collaborations to accelerate the development of potential treatments and vaccines. It is testament to the power of collaboration that as of July, seven of the twelve vaccine candidates which are in phases II or III of clinical trials were developed between small biotech companies, biopharma giants, and academic institutions11 – entities which can leverage each other’s strengths.
GSK is an example of a pharmaceutical company which excels at collaboration. In April it was announced that GSK had joined forced with Sanofi to develop a COVID-19 vaccine candidate. Both companies have significant manufacturing capacity and a long history of making vaccines available to people in low- and middle-income countries. GSK is also collaborating with the University of Queensland, Clover Biopharmaceuticals and Xiamen Innovax Biotech because it believes that more than one vaccine will be needed. Indeed, a number of successful vaccines could be developed with GSK’s pandemic adjuvant technology, which can decrease the amount of vaccine protein required per dose, potentially enabling more doses to be produced.
With regard to treatments, a key milestone was the launch of the CTA (COVID-19 Therapeutics Accelerator) in March12. This collaborative initiative, funded by the Bill & Melinda Gates Foundation, Wellcome and Mastercard, is working with the WHO, the research community, governments, private sector organisations and global regulators. Several major pharmaceutical companies have agreed to share their proprietary libraries of molecular compounds (which already have some degree of safety and activity data) with the CTA to rapidly screen them for potential use against COVID-19. We are hopeful that pharmaceutical companies will continue to build on their collaborative efforts to accelerate drug discovery and development, thereby continuing to improve public health.
The path to recovery and the need for broad-based innovation
Although the pharmaceutical industry has been relatively unscathed by COVID-19, a mixed picture has emerged. At the beginning of this year, some pharmaceutical companies, including Eli Lilly, Novartis, Pfizer, and Sanofi, benefitted financially from drug stockpiling and/or patients filling prescriptions earlier than normal, whereas both Johnson & Johnson and Merck and Co were negatively affected due to lower demand for medical devices as a consequence of medical procedures having to be delayed and drugs which are usually administered in clinical settings, respectively.
Unfortunately, all pharmaceutical companies have faced some degree of disruption to clinical trials. It seems that studies in the start-up phase or the planning phase have suffered the most, and there have been challenges in recruiting patients. In order to minimise disruption, AstraZeneca has increased recruitment in areas less severely affected by COVID-19, and is offering home-based treatment and monitoring. Novartis is planning to permanently use remote monitoring visits (where possible) to increase the efficiency of its operations. This is a good example of innovation in response to a significant challenge posed by COVID-19. We will use engagement to explore other strategies to ensure clinical trial continuity.
When the pandemic subsides, pharmaceutical companies will need to re-focus on their drugs in development, because innovation is key to the pharmaceutical industry’s reputation and success. But innovation has to be broad-based. COVID-19 has shone a light on difficult, unresolved issues, including a lack of sustained R&D in EIDs (emerging infectious diseases). Research by the Access to Medicine Foundation revealed that R&D in EIDs comprised only 1% of R&D projects in 2018, and no reported projects targeted coronaviruses13.
The other conundrum we are continuing work on is antimicrobial resistance (AMR) – the natural phenomenon in which microorganisms develop resistance to antimicrobial agents. It is a serious cause for concern that this pandemic could further exacerbate AMR because a high proportion of patients admitted to hospital with COVID 19 are being given antibiotics to treat or prevent secondary bacterial infections. A comprehensive review of COVID-19 cases, mostly in Asia, found that more than 70% of patients received antimicrobial treatment despite less than 10%, on average, having bacterial or fungal coinfections14. The pipeline of new antibiotics remains worryingly dry, partly as a result of major pharmaceutical companies having largely abandoned antibiotic R&D due to low return on investments. In order to mitigate the risk of more global public health crises, we think that major pharmaceutical companies have to take more responsibility for both EIDs and antibiotics, two areas we will prioritise engagement on.
COVID-19 has provided the pharmaceutical industry with a platform which comes with significant risks and opportunities. It is undoubtedly positive that pharmaceutical companies have largely adopted a “whatever it takes” mindset to combat COVID-19 and maintain access to their existing products. However, our engagement and research have revealed that approaches to broadening access are on a spectrum. In order to restore public trust and clearly demonstrate their underlying commitment to improve global health, pharmaceutical companies need to consider all facets of responsible business conduct during this pandemic. Specifically, they must consider how employees are being treated; how products are reaching and will reach people in countries of all income levels; and how collaboration can accelerate progress.
We have confidence that pharmaceutical companies will outride this storm, and are optimistic about the benefits of enhanced supply chain resilience and the prospect of greater collaboration. However, we are concerned about companies being distracted from other storms, most notably EIDs and AMR. We recognise that our engagement will have to continue to stress the importance of long-term thinking.
Responsible Investment – a glossary of terms
Its wide-ranging nature means that responsible investment involves a host of associated language and jargon. Here we explain some of the most commonly used terms.
- Active ownership – Discharging responsibilities as investors and owners in a company through engagement and voting to influence the management of environmental, social and governance (ESG) issues.
- Stewardship – The responsible allocation, management and oversight of capital to create long-term value for clients and beneficiaries leading to sustainable benefits for the economy, the environment and society.*
- Environmental, Social and Governance (ESG) – A framework that breaks the broad concept of sustainability down into these 3 key issues.
- Engagement – Entering dialogue with companies after investment, to support and encourage positive change in the management of key ESG issues.
- Proxy voting – Exercising the right to vote on resolutions at company shareholder meetings. It compliments engagement as a key tool for influencing change.
- Sustainable Development Goals (SDGs) – The 17 goals set by the United Nations in 2015 are a global framework for achieving a better and more sustainable future. They address the global challenges we face, including those related to poverty, inequality, climate, environmental degradation, prosperity and peace and justice. The UN is targeting completion of all 17 interconnecting goals by 2030.
3 https://www.astrazeneca.com/content/dam/az/PDF/2020/covid19-toolkit/COVID-19_Employee_Toolkit_ _External.pdf
4 https://www.astrazeneca.com/content/dam/az/PDF/2020/covid19-toolkit/COVID-19_Leadership_Toolkit_ _External.pdf
11 https://blogs.deloitte.co.uk/health/2020/07/coalitions-andcollaborations-are-driving-covid-19-tests treatments-and-vaccines.html