Hey. Good morning, good afternoon, and good evening. I am Pam Cheng, Executive Vice President of Global Operations and Information Technology and Chief Sustainability Officer at AstraZeneca, and I am pleased to welcome you to AstraZeneca's 2023 Sustainability Highlights call. Thank you to all who have joined live. The slides are available on our website. A recording of this call will be available after the call has concluded. Next slide, please. These are our usual safe harbor statements. Next slide, please. I will begin with some prepared remarks focused on the progress we have made across our sustainability pillars in 2023. Then I will be joined by members of our sustainability leadership team, as well as some of our lead experts for a live Q&A session. As a reminder, please use the raise hand function on Zoom to ask a question.
Alternatively, you can click Q&A and submit a written question as well. Next slide, please. At AstraZeneca, sustainability is embedded in everything we do. While all board committees consider sustainability in their work, three board committees have delegated authority from the board for oversight and decision-making in connection with specific sustainability-related matters: the Sustainability, Audit, and Remuneration Committees. With a robust governance structure in place, our sustainability strategy is developed and reviewed quarterly by our senior executive team and is approved by the board of directors. Our Board Sustainability Committee, formed in September of 2021, monitors the execution and communication of our sustainability strategy and provides input to the board and other board committees on sustainability matters as needed. In 2023, we established an internal sustainability steering committee comprised of leaders representing functions relevant to our sustainability strategy.
This steering committee is responsible for monitoring key sustainability impacts, risks, and opportunities, including reporting and compliance, and ensuring cross-functional alignment throughout our business. Next slide, please. In 2023, we have made notable progress towards our overall sustainability strategy, and we are on track to deliver our near and longer-term goals. By no means is this an exhaustive list, but it highlights progress across our key areas of focus: access to healthcare, environmental protection, and ethics and transparency, each of which I will dive into further. Please advance to the next slide. At AstraZeneca, we aim to transform patient outcomes and secure a future where all people have access to affordable, sustainable, and innovative healthcare. To create truly sustainable and resilient health systems, it is essential to find innovative approaches to access through collaboration across all stakeholders, including patients, governments, public and private providers, and healthcare payers.
In 2023, we made fantastic progress, delivering on our target to reach 50 million people through our philanthropic programs, Healthy Heart Africa and Young Health Program, two years early. Looking ahead, we recognize the opportunity to do more to better understand broader determinants of health that act as barriers to care for many people around the world. We plan to broaden our scope under the access to healthcare pillar by providing a more comprehensive view of all the work we do to improve equitable health outcomes, from our science to the delivery of care. We will provide further details later this year. Next slide, please. The Partnership for Health System Sustainability and Resiliency, or PHSSR, has also made great progress in 2023. An EU PHSSR report on Acting Early on Non-Communicable Diseases was launched, providing a vision for a comprehensive approach to non-communicable diseases.
The report sets a solid foundation from where all EU-level health policy decisions can be made going forward, based on research into the sustainability and resilience of 10 EU member states' health systems. Following a recommendation from the PHSSR that stressed the importance of integrated e-health record infrastructure, Japan has included the development of a digital platform for collecting and sharing medical information and a set of guidelines used to inform Japan's economic and fiscal policy. Eventually, this platform will support guideline-based therapeutic decisions and detecting patients at early stages of their disease. Lastly, in Brazil, broad consultation of PHSSR findings, including with government representatives, resulted in recommendations for identifying financial mechanisms to strengthen primary care and improve community-based preventive and disease management healthcare services. Please advance to the next slide.
I want to take the opportunity to highlight our progress on clinical trial diversity, where our ambition is for trial populations to mirror populations affected by each respective disease. Driven by science, we are taking a systematic approach to embedding equity throughout research and development. We are focused on innovative solutions, partnership and knowledge sharing, and data-driven continuous improvement. We have recently published our review of 246 U.S. studies across phase I to phase III trials, with over 90,000 adult patients between 2010 to 2022 across 57 indications. This analysis reviewed the race, ethnicity, and sex of patients enrolled, against the 2019 U.S. census data. The paper concluded that overall representation of racial and ethnic minorities is fairly balanced with 2019 census data. Understanding the diversity of participants against disease state populations allows for more accurate understanding of disparities and gaps.
Additionally, we have developed an internal bespoke clinical trial diversity dashboard for phase III studies in the United States that allows our clinical teams to track the diversity of participants being enrolled in real time. FDA diversity plans are a central part of our efforts. We develop plans in line with our data-driven and systematic approach that is essential for high-quality clinical trial diversity planning. Next slide, please. Moving to environmental protection, we have also made strides in advancing our strategy today: accelerating the delivery of net-zero healthcare by proactively managing our environmental impact across all activities and investing in nature and biodiversity. Through our Ambition Zero Carbon program, we remain focused on delivering absolute reductions in all of our direct and indirect greenhouse gas emission sources across the value chain, while managing the risks and opportunities presented by climate change.
Today, we have seen an absolute reduction of 68% in Scope 1 and 2 greenhouse gas emissions since 2015, and are on track to achieve our target of 98% absolute reduction by the end of 2026. In 2023, our energy productivity increased by 103% since 2015, marking a significant reduction in energy use while nearly doubling our revenue. We also invested $33.7 million in energy efficiency and on-site renewable energy through the Natural Resource Efficiency Fund, together with our other capital investments. We signed Sector First deals with Vanguard Renewables in the U.S. and with Future Biogas in the U.K., and continue to progress clean heat strategic arrangements for our other sites. Beyond Scope 1 and 2, we know that the greenhouse gas emissions from our product value chains are the most significant contributions to our Scope 3 emissions.
While we saw an increase of total Scope 3 emissions in 2023, we reduced our Scope 3 intensity by 24%. We are using a data-driven approach addressing these emissions across our business and saw a significant increase in user primary data, 52% in 2023 versus 38% in 2022. 60% of suppliers have set science-based targets to date, further supporting future emission reductions. We are tackling 20% of our Scope 3 footprint through our commitment to develop a next-generation pressurized metered dose inhaler, pMDI, using a near-zero global warming potential propellant that we hope to launch from the end of 2025. Through this strategic emission approach, coupling data with action, we are on track towards our 2030 target of reducing absolute Scope 3 greenhouse gas emission by half. Next slide, please.
By integrating a circular economy approach across our value chain, we remain committed to reducing our impact on the planet and continue to invest in nature and biodiversity. We have implemented processes to develop and manufacture our medicines while reducing reliance on natural resources used in our value chains. We have leveraged our experience with lean manufacturing, including tools to enhance efficiency and eliminate waste. We have also embedded recognized best practices from partners, such as My Green Lab, into our everyday operations to support our circular economy approach. We recognize that our supply chains have the potential to impact biodiversity, so we are furthering our commitment to assess and minimize environmental impacts from our supply chains.
We are building a risk-based approach to systematically assess biodiversity risks and dependencies across our value chains during 2024, which is aligned with future reporting to the Taskforce on Nature-related Financial Disclosures framework, where we have already announced that we will be an early adopter. We continue to collaborate with key stakeholders to make positive contributions to nature and local communities where we operate, while mitigating risks from a changing climate through nature-based solutions. Our Life Cycle Assessment, or LCA, the program is essential to our environmental protection strategy in determining the type and magnitude of environmental impacts across our product value chains. Approximately 80% of our projects are in scope for LCA, and we continue to build upon this opportunity to further reduce our impact on natural resources.
Lastly, we announced an expansion of our AZ Forest Program in 2023, raising our commitment to plant and maintain 200 million trees by 2030, bringing our total investment to $400 million. This investment includes new or expanded projects that will contribute to our climate action, restore nature, promote biodiversity, and build ecological and community resilience. Since launch, AZ Forest has progressed at pace, with over 20 million trees planted across 300 million— 300 different tree species, allowing for the restoration of biodiversity and natural habitats in local communities. Next slide, please. Moving to ethics and transparency, we continuously seek to ensure ethical, open, and inclusive behavior across our organization and value chain. We foster a culture of doing the right thing, which is apparent in everything we do. In 2023, we saw significant reductions in injury rates and auto collisions across our business.
We also achieved our target, launching our Supplier Diversity Program in 10 countries outside of the U.S., with programs in Switzerland, Ireland, and Canada launched most recently. Lastly, we remain focused on ethical business culture and reiterate our commitments to prioritizing positive sourcing and replacing, reducing, and refining our use of animals and research. Next slide, please. We take a holistic approach to identifying, assessing, and managing material cybersecurity risk at AstraZeneca, which is integrated within our overall approach to risk management. Our approach to mitigating cybersecurity risks is threefold. We focus on trust by design, embedding the principles of cybersecurity within all areas of our business. We prioritize workforce awareness, which is reinforced by annual trainings and simulated phishing testing. And lastly, we are supported by AI-powered defenses that combine our IT solutions with business continuity plans, with all of our extended partner technology relationships.
Globally, we are supported by both internal and external teams that are dedicated to our ongoing data protection around the clock. We track our mitigations to manage cybersecurity risks through KPI dashboards, which are provided to management and the audit committee. Ethics and transparency are at the very core of our artificial intelligence approach. We utilize AI across the whole R&D progress through to commercialization of key assets, from designing and developing molecules to running the most efficient clinical studies and optimizing our customer engagement. We were one of the first pharmaceutical companies to publish and commit to principles for AI and data ethics. Our use of AI is fair, explainable and transparent, private and secure, human-centric and socially beneficial, and accountable.
We have developed and are implementing and embedding a robust global AI governance framework to ensure the risks of AI development, deployment, and use are effectively understood and mitigated, and that our AI ethics principles are applied in practice. We are closely tracking AI regulatory and policy development worldwide and are aligning our frameworks to these regulations and standards for best practice. Please advance to the next slide. In light of the new upcoming reporting requirements in Europe and the United States, we are preparing for changes to our sustainability reporting in accordance with the CSRD, ESRS, and EU taxonomy, SASB standards and IFRS sustainability disclosure standards, and SEC Climate Change Rule Amendment. To address these requirements, we have multidisciplinary working groups in place that continuously assess our current preparedness levels to comply with upcoming changes to regulatory requirements.
We are also progressing to capture data, processes, systems, and controls to drive enhanced integrity and sustainability reporting across our business. We have recently completed a gap assessment between the EU ESRS and IFRS sustainability disclosure standards against our internal and external reporting policies and standards to underpin further projects to address any new requirements alongside internal subject matter experts. Lastly, we have initiated a double materiality assessment in compliance with the EU CSRD to inform our future strategy, and we look forward to sharing our findings of this assessment once finalized. Before we move to the Q&A session, I want to take a moment to reflect on the progress made in 2023 and reiterate our commitment to contribute to a more sustainable future for people, society, and the planet.
We continue to harness the power of science and innovation and leverage our global reach to make a positive impact on society, healthcare systems, and the environment. This starts with us but matters to everyone, everywhere. I am proud of our efforts to address climate change, our focus on increasing equitable and affordable access to our medicines, and our continued cultivation of an inclusive environment that recognizes the power of diversity in driving innovation. In 2024, we remain focused on our commitments, and we look forward to sharing more about our progress in due course. With that, we will now move to our Q&A session. As a reminder, please use the raise hand function on Zoom to ask a question. Alternatively, you can click Q&A and submit a written question as well. At this point, I would like to hand over to our IR colleagues. Lauren, over to you.
Thanks. Yeah, we've had the first question in asking about Scope 3 emissions. You're doing very well in Scope 1 and Scope 2, but Scope 3 still looks to be increasing. What gives you confidence that you can achieve your targets?
Yeah, great question. I'm going to give my remarks and ask Juliette White to jump in as well. So, as a reminder, we have bold ambitions on our Scope 3 emissions. By 2030, we aim to reduce absolute reduction of Scope 3 emissions by 50%, and we aim to achieve net zero before 2045. So, we have actually delivered on quite a few actions in 2023. We are now working with our supplier groups, and we aim by 2025 to have 95% of our spend, so our key suppliers, to adopt SBTi targets for GHG emissions.
We have also partnered with SMI, the Sustainable Markets Initiative, across the healthcare sector to set minimum standards for suppliers on sustainability as well. We have built sustainability requirements into our contracts, new and existing, with the suppliers that we are working with. We are collaborating. We are not just telling our suppliers to adopt the SBTI and reduce their emissions, but we are also collaborating with our suppliers, sharing best practices, and supporting them to reach their goals so that we can deliver on our Scope 3 emissions. So, perhaps, Juliette, over to you for additions.
Yeah, that's great. Thank you, Pam. So, maybe to build with three specific points. If we look at the challenge in that extended supply chain, we know that sources of heat and power are significant contributors.
So, being very specific on that, firstly, through an industry-wide collaboration, we are working with our suppliers to help them access renewables through the use of a program called Energize, where we have partnered with Schneider Electric and multiple other pharma companies to engage with and get suppliers to sign up to both first, understanding how renewables can impact, secondly, transitioning at scale to renewable, predominantly electricity. Secondly, as Pam mentioned, through the SMI, we announced at the beginning of this year a program to access renewables in China, first for our own sites. We are now opening that up to suppliers. Again, we are doing that in collaboration with other pharma companies, but we recognize that accessing renewable, predominantly wind and solar, in China is a challenge. So, actually, we are taking the pain out of that system by going to our suppliers with an agreed framework.
Thirdly, I think we are also now exploring heat. So, we have some great examples internally, which Pam shared with you, in terms of how we have transitioned to new sources of heat in our manufacturing. We are looking and working with how we establish some of those partnerships at scale to allow our suppliers to access early new innovation in terms of sources of heat and power. So, I'll stop at that point, Pam, and hand to the IR team.
Lovely. Thanks, Juliette. So, Peter Welford, you've got your hand up. We'll just unmute your line now. Please go ahead.
Thanks so much. I've got two questions if I can please. Firstly is on the NextGen inhalers. Curious on that with regards to what sort of the path from a regulatory perspective has been agreed to be able to get these approved. Is it simply just showing, basically, comparability to the existing inhalers or other sort of more longer-term requirements? And I guess the launch target by the end of 2025 seems fairly aggressive. Is that in specific markets, or would that be in both, I guess, all the major markets that you currently sell the inhaler devices in? And then the second question is just the shift that we're seeing in your portfolio towards biologics over time. Overall, is the shift from small molecules to biologics, is that a favorable or an unfavorable trend with regards to ESG targets? Thank you.
Excellent. Both great questions, Peter. Thank you. Let me address the next-generation propellants first. You know, a reminder, we partner with Honeywell to develop the next-generation propellant, which is HFO-1234ze. It has up to 99.9% less global warming potential than the propellant currently used in respiratory medicines.
We have two phase III trials ongoing. We started that phase III trial in Q2 of 2023 from part of our registration NGP development program, which also includes other trials announced late last year, including safety studies for the propellant. So, Breztri, which is our triple combination therapy for chronic obstructive pulmonary disease, COPD, would be the first medicine to transition to the next-generation pMDI, subject to regulatory approval. We have aligned our regulatory strategy and pathway with the FDA closely along the way for the past few years that we've been working on this. We expect first approval late 2025, starting with the U.S. market. Then we will be moving to the EU markets and ultimately China as well. So, ultimately, our goal is to completely replace the current propellant with this NGP to eliminate the emissions.
On your second question of increasing our portfolio of biologics, large molecules, we continue to see, as you know, we have one of the most robust pipelines in the industry, and we continue to see a good balance of small molecule and large molecule assets in our pipeline. Now, in terms of is it better or worse from a sustainability perspective, I think the answer is, depends. I apologize. I cannot give you a specific sort of conclusive answer here. It really depends on the process, right? We've got small molecule processes that are sort of next-generation processes that are quite sustainable. We are now building green chemistry, sustainability into our product and process development. So, the outcomes are quite sustainable now. Biologics tend to be and small molecules tend to be smaller volumes, so it's got that advantage. However, some of the process can also be quite complex as well.
So, it really depends on the process itself, but we continue to see a good balance of small molecules and large molecules in our pipeline. Hopefully, that answers your question, Peter.
Lovely. Thanks, Pam. So, the next question we've had is, can you explain more about how you're addressing the opportunity areas in Access to Medicine Index?
Excellent. Thank you. So, perhaps I will turn it over to Stefan to opine on that.
Sure. Thank you, Pam. Thank you for the question as well. So, first, maybe I'll take a step back and just reiterate, our goal in the Access to Medicine Index is to always improve, iteration by iteration, to enhance our score, our absolute score, showing the progress of our own performance, be it in the governance of access or R&D and our product delivery.
In terms of the specific opportunities that we have, in terms of those areas highlighted in the 2022 ATMI report, on the R&D side, planning for access is a big area for us where we've taken significant steps, including, as you mentioned, Pam, also in planning for diversity in our clinical trials. And we can go into that in a bit more depth. But then also scaling our programs that enable access to our oncology and our diabetes or cardiovascular disease medicines. So, we've made great advancements in the reach of our existing access programs and new access programs. Finally, always improving the quality and the sustainability of our programs, such as Healthy Heart Africa, a flagship program where, as it says in the sustainability report, we've already reached our target to identify 10 million patients with elevated blood pressure.
We reached that 22 months ahead of target, and we're not stopping there. So, now to go into a bit more specifics, what we're doing on Healthy Heart Africa, we are now pivoting or adding also the detection of patients with diabetes and chronic kidney disease to not stop at elevated blood pressure, knowing that the burden that African countries are facing from these diseases is only getting larger and larger. That enhancement in terms of the diagnostic capabilities comes with a cost. Also, our partnership approach is evolving in Healthy Heart Africa, and we are, yeah, bringing more partners on board, different funding sources, and also the choices that we're making in terms of our expansion within Africa, which countries to go to.
So, a strategic rehaul or enhancement of Healthy Heart Africa is underway and will be launched and communicated as part of the World Health Assembly in May. One comment on the R&D side, on clinical trial diversity, which was already mentioned, but it doesn't stop there. We have really the benefits of having an industry-leading pipeline. And so, improving access to AstraZeneca trials across the globe is of significant importance. And that's why we invest heavily in local capabilities of research centers. But the overall health system strengthening work that was mentioned before with regards to the PHSSR, the Partnership for Health System Sustainability and Resiliency, is quite critical to make sure that there's a fertile environment for doing clinical studies across the globe.
And lastly, as part of the R&D and planning for access, we must remember there are always people that would like to have access to trials, but there is no trial available for them for different reasons. And so, for people with life-threatening conditions, there are early access programs that we have scaled also in the reach. And we have harmonized our programs across Alexion, biopharmaceuticals, and oncology with regards to post-trial access as well. So, when a trial stops but still there's no regulatory approval or no reimbursement of the medicine in the country to ensure that patients can continue on treatment. So, those are just a few examples.
Lovely. Thanks, Stefan. So, another question that's come in. Can you please comment on the reasons why the total reportable injury rate has gone up year on year from 2021 to 2023? Yeah, Lauren, would you like? Oh, sorry, Pam.
No, no, no. Go ahead. I just want to, before we answer that question, I just want to, as head of global operations as well for AstraZeneca, safety is one of the is paramount in terms of our culture and the way we work. So, Juliet, go ahead, and you can share the details on this question.
Yeah, thank you, Pam. Firstly, to reinforce Pam's comment, across the entire business, the safety of our employees is absolutely paramount and our number one objective. Actually, what this measures is injury rate per hours worked. So, it's actually as we have more hours worked through more employees, it is not that individual injuries per employee is increasing. Actually, if you look at our glide path since 2015, we have seen a reduction in absolute number of injuries.
But as we have rapidly grown as a business, particularly with acquisitions and therefore a larger employee base coming in, this particular metric looks at the hours worked and the injury rate that occurs. I do want to underscore, again, what Pam said. We have a number of programs that are looking at protecting against injuries, specifically driver safety programs, programs on our manufacturing sites, and importantly, designing in safe systems of work and using technology to help protect employees. Lovely. Thanks so much, Juliette and Pam. Another question. In terms of biodiversity, what impact drivers and dependencies have you assessed are the greatest areas for AstraZeneca to work with?
Perfect. So, perhaps Juliette and Dave?
Yeah, absolutely. So, let me start, and then I'll hand to my colleague, Dave. If we look more broadly across biodiversity, the areas particularly are around forestation and ensuring that we are not taking in our supply chain from any areas that are under threat or have been impacted under deforestation. Secondly, we are making sure that we fully map our supply chains as we look at things like lactose, etc. We are not an organization, by the nature of what we do, that typically has huge volume of nature products within our supply chain. But, Dave, I know your team have worked on a number of critical areas and are able to provide a bit more detail.
Yeah, thanks, Juliette. I think, first of all, it's important to say that we continually assess the interdependencies and the potential risk and opportunities. That's part of our commitment, actually, to TNFD.
We've been doing it for years with the TCFD, but we're now moving into TNFD. So, I think we're still in the process of completing those activities, although we have been running double materiality this year as well. So, we have a good understanding of where things are. And we will report in 2025 more information about this around our 2024 areas. But I think it's important to also recognize we've been doing a lot of this kind of work already. So, we are an active participant looking at pharmaceuticals in the environment, which is clearly one area of potential challenge in the water basins. And again, we are industry-leading in that space. We actually report our API safe discharges, which is more transparent, the most transparent of the industry. And you can access that in our dashboard.
We also run ecopharmacovigilance, where we're looking at reported scientific assessments of medicines in the environment. So, we are actively pursuing that. We're actively looking at biodiversity around our sites, and we're working our way through that to understand where the areas of most significant risk are. But I'd also just go back to some of what Pam presented as well and just highlight that we've been making significant progress with our water reductions, so -19.5% against our 2015 target, and our waste, where we've made significant reductions as part of our activities around circularity. Then finally, I'd just mention that, as Juliette was alluding to, you can access our raw materials sourcing framework, where, again, we're actively looking at the sources of materials we use in our supply chains, understanding their provenance, and understanding and making sure that they're appropriate for our use. I'll finish there.
Lovely. Thank you so much. We've had a question on clinical trial diversity. Our comments were mostly focused on U.S. FDA. Why was that, and what is AstraZeneca doing outside of the U.S.?
Thank you. Thank you for the question. So, maybe I can start it and then pass it over to Stefan. So, as mentioned, we are committed to ensuring that our trials represent the diversity of communities we serve, right? And we do this by embedding diversity and inclusion parameters into the entire clinical development lifecycle and defining enrollment goals as early as practical in clinical development for a given indication. So, this includes a diverse geographic selection for clinical trial development as well as early access and continued post-trial access for the participants.
Now, we are starting in the U.S., obviously, given the sense of urgency tied to the FDA requirement, but that's not the only area where we're going to work on. We're going to prioritize information sharing with global R&D leads across therapeutic areas to better account for regional differences for future work. Stefan?
Yes, thank you, Pam. Indeed. So, our efforts, they start in the U.S., but they don't stop there. Maybe people are aware that in the U.K., also draft guidance is underway, and AstraZeneca is working with the Medicines and Healthcare Products Regulatory Agency for that matter. It is also our aim to support in the same way as guidance is developed in other countries. Guidance is really important to get clarity on the format and content of diversity action plans, for example.
To give you the example of Europe, what constitutes an underserved or an underrepresented group of people in clinical trials will be different from the United States of America. The definitions and the goals pursuant to clinical trial diversity in Europe have yet to be established. Europe, there is maybe a step or two behind the U.S., and that is also why it makes sense for us to start in the U.S. and that we've established such a robust baseline understanding through the publication that you mentioned, Pam, before in Contemporary Clinical Trials that was just released, where we studied 246 trials in phases I and III in the U.S.
So, this is a starting point that we're using to then be really ready as guidance comes through in other countries to ensure that we can collaborate with stakeholders and governments on enhancing clinical trial diversity globally.
Excellent. Thank you, Stefan. And it looks like I'm getting word that this was the last question. So, at this moment, I would like to close the call. We reiterate AstraZeneca's commitment to contribute to a more sustainable future for people, society, and the planet. We thank you for your support, and we thank you for taking the time to join us today. Thank you very much. Good day.