Basilea Pharmaceutica AG (SWX:BSLN)

CMD 2026

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Oct 28, 2026

Summary

Strategy now centers exclusively on anti-infectives, with a target of four commercial assets by 2030. Updated plans call for CHF 650 million in 2026–2030 cash flows, supported by current products, non-dilutive funding, and partner-led development.

Ladies and gentlemen, dearest guests, welcome to the Basilea Capital Markets Day 2026. My name is Olivia Kinghorst. I am a presenter and moderator, formerly with CNN and Forbes, and it is a real pleasure to be your host for today. Today is going to be a very special day because this is, in fact, the second time that Basilea is holding a Capital Markets Day since the company was founded all the way back in 2000. Some of you may remember the first edition was actually two years ago, because I do see some very familiar faces here in this room, and that is where we really gave you a window into creating anti-infective opportunities. Today, we want to build on that story because the need for effective antibacterial and antifungal treatments is only going to increase. Despite all the progress that we have made, many of the treatments available today still face limitations. That is exactly where Basilea comes into the picture. This year, we want to show you exactly how far the company has come since we last gathered here two years ago, what is in the pipeline, and ultimately, what Basilea is doing to stay one step ahead. What can you expect from today's program? If you take a look behind us, we will bring it up there. For starters, we are going to be hearing from the CEO of the company. He is going to share an overview of where Basilea stands today and the company's vision for 2030. Next up, we will be hearing from two renowned experts coming to us externally, and they are going to be sharing their insights on some of the most pressing challenges today when it comes to infectious diseases. After that, we will give you a moment to process and digest everything with a quick coffee break before we reconvene back here, and we will be hearing from Basilea's Chief Medical Officer as well as Chief Financial Officer, and then bringing everything together in a final Q&A session with the CEO, CMO, and CFO. Of course, the discussions will not be ending there. We will be continuing the evening with networking and apéro so that you can answer any more questions with the team if needed. I am just taking a look at the audience here today, and I have to say it is quite a diverse group. We have some people coming from the pharmaceutical industry, we have someone coming from media, we have investors, we have analysts. Therefore, I invite all of you to participate in today's sessions. This is really your chance to pose any questions at the top of your mind, any burning questions. I have spoken with the management team. They are happy to take questions and answer anything that you might have. With that, you can see up here, very simple, if I can get all of you can just scan this QR code. You can submit any of your questions. Otherwise, if you are on your laptop, just go over to menti.com. With that, I think it is time to dive into the exciting part of the agenda. Let us kick things off by welcoming a very, very familiar face to the stage. I believe he does not need any introduction. That is, of course, Basilea CEO, David Veitch. Please give him the warmest of welcomes as he kicks off today. Thank you. David, first things first, before I let you get on, I mean, we stood on this stage two years ago. Time flies. Just talk to us, what has really changed the most for the company since then? If I was summarizing, I would probably say our pipeline's got better. Our products, our commercial products are sold in more countries. Our finances have got better. I think the principles of running any company, things are on the improving track versus two years ago. Okay, the trajectory looks promising. I know that today you are going to be talking about one step ahead, staying ahead of the curve, but in a very competitive industry, how exactly do you do that? Big question. I will come back to that Yeah during my presentation, but probably one thing just to tell the audience is that at Basilea, all our people are assessed on three corporate principles: innovation, focus, and teamwork. I think by keeping focused, by continuing to innovate, try and do things better, and working as a team, that is probably a good summary of one way in which we are trying to be better in the competitive market we operate in. Maybe just final thoughts. We have investors in the room, we have analysts in the room. Some of them know your company very well, like the back of their hand. What take-home message do you want them to leave with today by the time they leave this room? I think if there's one take-home message, it's that Basilea is in a good place and the future looks even better. Well, big ambitions there. I'll hand the floor over to you now, David. Thank you, Olivia. I'll just add my welcome to that of Olivia. Thank you for joining us this afternoon for our Capital Markets Day 2026. In terms of, like I said, we are probably in the best position we've ever been in, and in terms of the next chapter, we think, at Basilea is very exciting. We want to share this sort of our excitement with you during the course of the afternoon. In terms of one step ahead, I should just say where one step ahead comes from. One step ahead to us at Basilea means always trying to be better, continuously improving, having a winning attitude across everything we do. Going back to the montage you saw a moment ago, more specifically, it means one step ahead in terms of trying to bring better products to the market. We look for differentiated, better products than are in the market today in our focused area of the treatment of serious bacterial and fungal infections. Not just different products, but different products that can sell in the market, so they're needed rather than just innovation for innovation's sake. Secondly, one step ahead in terms of the partnerships, the collaborations we have. I'll break that down into two areas. At Basilea, we collaborate through R&D very successfully, I think, with non-dilutive funding bodies, for example, like BARDA, part of the U.S. government, or CARB-X, a U.S.-based organization funded by governments and foundations around the world. These two organizations are critically important for us, and as you'll come on and see during the course of the afternoon, these organizations allow us to have up to around two-thirds of our R&D costs funded in a non-dilutive fashion by these organizations. In terms of one step ahead, I think you'll hear that in a moment when we hear from the external experts. We have to keep the patient central in everything that we do. We at Basilea, we start from the premise of, is there a patient need? Because if there's not a patient need, doctors won't use our drugs, and we won't get any future value. That's also central to our thinking. In terms of leadership behavior, a phrase people often hear me use is, we're a big fish in a small pond in this therapy area that we work in. We like to think, and we try and act in a leadership way in this antibacterial, antifungal space. We want to access better products. We want to do our clinical studies better. We want to spread our commercial drugs around more markets. We want to be a leader in this area. If we do all the above, then that should result in us being in a growth situation. We're in a growth situation today as a company. We think we're well set for the next chapter of growth. In case, I know there are many familiar faces, as Olivia Kinghorst said, in the room today, I'll give you one overview on Basilea in case you're less familiar with the company. We were spun out of Roche in 2000, before going public in 2004. There's an important message here is that at the time, Roche, like many big pharma, were moving out of the antibacterial, antifungal space and moving into more chronic diseases. That's left a gap for a company like Basilea to fill in terms of, when you think of it, when we compete for new assets, we're not competing with people with bigger pockets than us for the acquisition of these assets. Interestingly, these products, to give you an idea, some of you know this, but we think that a successful antifungal drug can probably peak at about annual sales of $1 billion, whereas probably a successful antibiotic globally can peak sales around $500 million. For a big pharma, that's probably not big enough. But for Basilea, with 200 employees, that's perfect. We just need to do it time and time again, and that's our objective. In terms of being one step ahead is not just moving fast or moving forward. It's moving fast with purpose and with direction. I just want to go back to, some of you know this, but in 2022, we came up with a new strategy. Prior to 2022, Basilea was a company that worked in oncology and worked in anti-infectives. In 2022, we announced that we would no longer be in oncology. We thought there was better value for us in the long term if we focused on the anti-infective area. We set some objectives back in 2022. We set ourselves a clear path to do some different things. Let me just give you a few examples of what we said and what we did from 2022 onwards. First of all, let me show you, we wanted to build a pipeline. When we made this decision to move into just anti-infectives, we actually had just Cresemba and Zevtera, and we had no anti-infective compounds behind that in the pipeline. So we had set the objective of building a clinical pipeline. What we did from 2023 to 2025, we brought in-licensed to acquired, four assets which are now in the clinic between phase I and phase III. So they are our next future commercial products. We also said we wanted to be financially sustainable back in 2022. When you look at what we've done, 2022 to 2026, we have shown continual financial sustainability. We've reduced our debt, we've increased profitability, and our net cash balance, we've become net cash positive, and our net cash balance has increased year-on-year. We also said, those of you who've followed the company a long time, ceftobiprole, Zevtera, has been with us a long time. We wanted to access the most important commercial market for an MRSA brand, which is the U.S. What did we do? In 2025, we launched in the U.S. through our partner, Innoviva Specialty Therapeutics. So, we actually got the approval with the FDA after a long, tortuous journey, then we launched the product. We'll come back to this during the course of the afternoon. This is going to be a long-term benefit for the company at the time when we really need it. In terms of then, if I was summarizing, as I said in my introductory comments to Olivia Kinghorst, I think we've delivered on the goals we set back in 2022. This now creates the foundation for the future. One other factor that I just wanted to remind everyone, because we think it's really key to the success we've seen and will be key to the success going forwards, is our business model. Let me just briefly try and explain on a very big screen our business model. We actually, as I said, we don't compete with large pharma generally for the acquisition and bringing in of external products. Remember, we don't have a platform technology as a company, right? In this area, it's not been proven actually, a platform technology to work. So it also gives us the flexibility. We're agnostic about the technology we bring in. We're agnostic about where it comes from. So, we can literally scour the world and bring in the most exciting assets into our portfolio. Then we add our well-proven capabilities in R&D, which aren't just literally research and development, clinical operations expertise. It's like building a supply chain, the quality aspects. It's all the various functions that contribute to developing products through research and development. Then, before we file for regulatory approvals, the important point I would just mention, which is quite unique to this area, is this ability to access non-dilutive funding, which we have done for our whole clinical portfolio. So all our four clinical portfolio assets are all funded on average around two-thirds of the R&D costs are funded by BARDA or CARB-X. This is obviously critically important, and Adesh will come back to this during the course of the afternoon. Then we commercialize through partnerships. We would not do this if the peak year sales were $5 billion. Clearly, we would not do this. But actually, with the peak year sales potential of these types of products, we think in this market, this therapy area, our partnership model makes sense because we are cash flow positive the moment the partner starts selling one pack of our product. Then we obviously participate through royalties, through milestone payments, and for some of our smaller partners, we also participate because we sell them product that we manufacture because for economies of scale reasons, we pool manufacturing. So, there is an element of product sales, there are royalties, there are milestones, and this is how we participate. Basically, we think this model in this marketplace actually is the right model, and it has proven it to be the case now, and we think it is the right model moving forward. So, as I said, my view is that today we are in a position of strength as a company. A position of strength because we have these, as I mentioned a second ago, we have a pipeline, so we have late-stage compounds, fosmanogepix, ceftibuten, and delafloxacin. Then we have earlier-stage compounds. By the way, for your information, below this, there are a number of preclinical programs which are not even on this slide, which we are pushing towards the clinic future phase I programs. Then just indicative of the financial sustainability of the company, this is the revenues, total revenues, year-on-year-on-year, and obviously, Adesh will come back to this, but in 2026, our forecast is a lot bigger than 2025. So, the company is on a good trajectory of revenue growth, and that obviously drives the financial strength of the company. What I would just probably allude to is the two figures on the right. That is just at the bottom, the cash in the bank, effectively. The top number, the net cash, which is just the cash in the bank less the outstanding piece of debt, which is the CHF 71 million convertible bond. So, Adesh will come back to these numbers, but the important thing is we are in a financially strong place for our next chapter of growth. As I said a moment ago, actually what is really important for us is, and what we are really proud of, is that our products today are sold in around 80 countries around the world, Cresemba and Zevtera. So our commercial products sold around the world. On the right-hand side, you see the various commercial partners that we have who sell our products around the world. To give you a sense of the numbers, I mentioned a moment ago that BARDA and CARB-X together cover about two-thirds of the costs of the R&D of our clinical-stage pipeline. We have got commitments of around CHF 440 million, but that is over a long time period. And then of those commitments for these four programs that we have in clinical development, we have already been awarded CHF 165 million of that, and Adesh will come back to the point about how much is still outstanding and still to come going forward. That is about the past and about where we are today. What we want to spend most of the meeting now on is going forward. Where is the company going? We have coined the phrase Agenda 2030. This is what it is not the end game, but we think it is a good strategic milestone to say to people, to communicate to people where we think we will be in 2030 and how we will get there, what our priorities are to get to a successful company in 2030. As I said, it is a midterm, it is not the end game. It is a midterm value creation sort of focus for the company. Let me just go back a step and explain that you would have seen this, those who follow the company closely. In February of this year, it is easiest on this chart if you start on the right column and say, "Right, what are we trying to do by 2030?" What we are trying to do is bring our late-stage assets to the market. We have what we call two late-stage assets. One is fosmanogepix, one is ceftibuten-ledaborbactam. We want to bring those to the market by 2030. We also want to advance our earlier stage pipeline, and we want to keep on in-licensing, acquiring additional assets. That is what we are trying to do. That is what our objectives are in the next five years. How we will do it, how we will pay for it, is on the left side. At the beginning of the year, we talked about the money we had in the bank at the end of 2025, which is CHF 160 million. The CHF 600 million of cumulative cash flow from our own forecast we think we will generate from Cresemba and Zevtera alone, no fosmanogepix revenues, no ceftibuten-ledaborbactam revenues, just Cresemba and Zevtera, for in this period 2026 to 2030. The outstanding amount of non-dilutive funding in our current commitments that would be due if our programs progress, during this period, 2026 to 2030. By the way, you probably know this, but just to be clear, if the programs do not progress, you do not get the money, but obviously, you do not spend the money either. The two go together. That is what we said in February of this year. If I was to boil it down then to give you three messages, and we will come back to this during the course of the afternoon, we have got three priorities as a company. One is to make sure Cresemba and Zevtera deliver this cash flow, and we continue to get the non-dilutive funding. That is the finance side of the equation. That is one priority. The second priority is to, and this is what the organization is absolutely focused on, delivering fosmanogepix, ceftibuten-ledaborbactam to the market in this 2030 time period. Currently on this chart, you see fosmanogepix, 2029, we are assuming this could be on the market. Obviously, this is all contingent on the studies being positive and the regulatory approval being gained, but we are targeting fosmanogepix in 2029, ceftibuten-ledaborbactam in 2030. The idea being, the objective, we want four commercial stage assets in our portfolio by 2030. Currently, well, obviously, we have two. We want four by 2030. Obviously, at that point in time, three of them will be growth drivers, and one of them, Cresemba, will be declining. The third element, the third priority is to basically, like I said earlier, accelerate or push forward the earlier stage compounds in development and continue to do BD&L, business development, to acquire more assets, which we are definitely focused on. That is the third priority. Agenda 2030, think of it as trying to put four products, commercial products in the market by 2030, advance and continue building the pipeline, and generate the cash in order to do that. That's really what Agenda 2030 is. As I said, hopefully, it's quite a clear, simple plan to hopefully communicate. The other point I wanted to mention and remind you of is that it's not the end game. I don't know if this visual exactly does it, but what this visual is trying to show is that 2030 is a key milestone, but as I said, that gives us then the platform to continue growing as a company beyond 2030. There are various elements of the Agenda 2030 strategy and data readouts along the way, but this is just to remind you that this is not the end. This is just a key milestone in Basilea's journey. In terms of what's important, I think I've probably said that, so actually I'll move on to this and just say, for me, the key thing is, all this might sound hopefully clear, but it really adds weight if you believe there's opportunities in the anti-infective space. Okay? This is sort of a segue to our external experts because, do anti-infectives matter? I remember when we made our strategic refocus into anti-infectives in 2022, some people thought we were mad because the general trend was, it's all about oncology, yeah? Anti-infectives, you can't make any money. It's not a great place to be. We got quite a lot of pushback, I think, in 2022 when we made the strategic decision. What we're trying to explain to you is we think we found a way of making it work, and we think the future is positive for Basilea. Coming back though, does it matter, anti-infectives? I think I'll just share a couple of comments, and then I'll hand over to the experts in this area who can give their perspectives. Our view, the view of Basilea, is that severe bacterial and fungal infections continue to carry a high burden, and there is significant unmet medical need in this antibacterial, antifungal space. A couple of numbers, and you can pick on different publications, different probably data sets, but there's one publication, I think it was a Lancet publication, that said that basically in terms of bacterial infections, 7.7 million people die every year due to bacterial infections. If you're wondering, I think that, yeah, if you're wondering why the picture, because that's roughly the population of Switzerland. That many people die each year due to bacterial infections. Fungal infections, about 6.5 million people a year are affected by invasive fungal infections. That sort of the population of central Rio de Janeiro, hence the picture, huh? Almost 4 million people die of fungal infections each year. These are not small numbers. That is why Basilea believes that there is a burden. It is, if anything, rising, and that is why we think the root of all our work is the foundation, is a solid foundation to work on. That was my introduction. I just wanted to set the scene, give you a flavor. We are going to come back to some of these topics during the course of the afternoon. I think I am now handing back to Olivia, who will introduce our global experts, and you can hear from them. Thank you very much. Thank you. Warm thank you to David for laying the foundation for us. It gives me great pleasure now to welcome our internationally renowned experts. They are going to paint a picture of the medical backdrop of what we are seeing today. Our first guest is Professor Oliver Cornely of the University of Cologne. You might remember him because he did in fact join us two years ago at the first Capital Markets Day. He is a clinical hematologist and an expert in clinical mycology. In his keynote, Professor Cornely will give us a closer look at the changing landscape of invasive fungal infections and the areas of unmet medical need. With that, please give him a very warm welcome and just a bit any questions you might have. Thank you very much for your kind introduction and for saying a word on 2024. Back then, some may remember that I scared people, like that we are all exposed to Aspergillus and other fungi, et cetera. I basically told you not to leave home. Today it is a different perspective. Today it is more the patient perspective or the clinician's perspective that I can only give. Making the case of why we need antifungals still, so to say. We still need differential options, and I will lead you a bit through why that is with cases and with background. Five questions for the next 25 minutes are, how big is the problem? We just heard some numbers, and what still holds us back? What does change practice, and where do we need to be active? What do I think what is coming in terms of pipeline and new treatment options? What does it all look like at the bedside? You can see, it looks like an order, but actually it is all intertwined. All the issues that are being addressed here then focus in the individual patient, and we have to deal with several in the individual patients. We heard numbers, 6.5 million invasive fungal infections per year, and the death rate is tremendous. For many of these patients, because they come with a burden already, so they have some underlying disease or more than one underlying disease, then comes fungal infection on top, and that is one reason why the death rates are so high. Many are directly then attributable to the death rate. You survive your allogeneic stem cell transplant procedure and all the chemotherapies that you had before, and then comes a fungal infection and kills you, or causes that you need treatment for months or two or three years. That's what we face clinically every day. This is one example. It's sinusitis, a CT scan in that plane. It's sinusitis, but if you are immunosuppressed like this patient, then sinusitis is not good news because you cannot really treat it successfully. This is mucormycosis. It's a mold fungus that primarily is there to cause decay on dead material. It's not intended to be in the nose of anybody. But if you are that deeply immunosuppressed, then you will have that, you can develop that sinusitis, and as you see on the other image from that same patient, it causes necrosis. It grows through the bone and reaches the skin, and the skin goes necrotic. In these cases, you need surgery, but actually that is Don't want to dramatize it, but there are patients where you, if you find that they have metastatic disease and cannot be cured by surgery, then that's good news as well, because surgery here means you need to take everything away which is affected by the fungus, and that is devastating, and nobody wants to do that really. Another example, another immunosuppressed patient with leukemia. No stem cell transplant, just leukemia, deeply immunosuppressed because of the disease, then on top the drugs that we give to the patient, and you see what I call the fastest fungal disease. Actually, being a hematologist, there is no tumor and nothing in hematology oncology which is as fast as that fungus. Day one, day eight, day 15, three CT scans of the lung, and what you see, this is something that people would not understand. Usually you don't, you say, "Okay, there's something in the lung. We need to diagnose this." But that's a few years ago. By now, we know that we need to put these immediately on very high dose, very toxic medication against fungal infection, because what happens is from one week to the next week, that lung is gone. It won't come back. The right lung of that patient- The perspective is like the feet are here. The right lung of that patient is destroyed. If the patient survives, then it will be a big bubble of air and not any functional lung tissue. It's very, very rapid. We need to be fast to understand what's happening, that we then jump in with treatment. It is, of course, intertwined with another issue that we have, and that is we don't have There's no blood test that you can take and then know, "Oh, it's mucormycosis." Unfortunately not. You have to have experience, you have to guess. We need better diagnostics and better treatments. Then comes on top another problem, and that is you now know how mucormycosis looks like. If you have another CT scan on a typical leukemic patient, this is a young 21-year-old with acute lymphoblastic leukemia, the everyday business for any hematologist on the planet. What comes here is very special because we have two fungal infections. Fumigatus, Aspergillus fumigatus, Aspergillus, you know, because Aspergillus is when you have a piece of bread at your home and you say, "Oh, that's moldy." That's usually Aspergillus fumigatus on bread, and you throw it away. You don't cut it out or something, you just dump it, right? You better do. Here's Aspergillus and Rhizopus. Rhizopus is one of the mucormycosis family, so to say, of different pathogens. You know this is rapidly, aggressively destroying the lung, and you have two different enemies there, so two different pathogens to treat. This patient was treated with isavuconazole. That's not why I show it. I show it because about a third of these patients has more than one infection, more than one fungal infection, and maybe even a bacterial infection on top, but we will hear about that later from Dr. Paterson. We were successful here, and about mixed infection is an issue. What's the problem? We have few drug classes, actually three drug classes. There it says four, but number 4 is only one representative. It's flucytosine. It's only one molecule, and nobody uses it because it's so toxic, difficult to give, to deliver. You need to measure it in the blood levels, and so usually it's not being given. There's PO only. In these fast diseases, you feel better if you treat intravenously and not by mouth. The polyenes, funny enough, it has a plural, but it's only one compound actually as well. It looks nice with four classes, but actually it's only three, and one of the three is only one single drug, and there are more drawbacks. I'll come back to that. We have late and uncertain diagnosis, I mentioned that, and that is relative to the speed of the fungal infection. We need to be even faster than the fungus, which is difficult. Now we do have, with so few drugs, we use whatever we have, and we give it. There is the discussion, shall we give? Remember that patient with the lung being destroyed, there is that discussion then, "Oh, do we give liposomal amphotericin B?" Which is the polyene. It's toxic to the kidney. We say, "Well, it's either the kidney, sacrificing the kidney function, and maybe the patient might end up on dialysis." We give a very high dose. It's not even licensed at that high dose, but we know that that is what we need to do, and we destroy the kidney while saving the lung. That is not exactly a decision you want to be forced to make with your patient. Liver toxicity and very complex drug-drug interactions. It's not that only two drugs are interacting, and then you can calculate what you expect the level will be in the blood of the one drug if you give whatever amount of the other drug. In the end, you need to measure several of these drugs. All the new cancer drugs, and David was addressing that there is so much going on in the cancer field, basically all of them have interactions with the antifungals. There is resistance. I don't want to expand too much on resistance because we all have heard about resistance a lot. Resistance is not only in the bacterial field, resistance is in the fungal field as well. It leaves not a lot of our patients with really reliable options. We are having trade-offs with each and every patient every day. Let me lead you through some global developments. This is the Candida auris story. It is auris, unfortunately, like ear, not like it is not gold, but ear. The outbreaks and pandemics, how it starts, this is special because it started everywhere in the world simultaneously, and only a few years back, 2009. Before 2009, the thing did not even have a name, and nobody had isolated it. Then it started in Japan with one single case, and there was a little delay, and then in 2016, globally, everywhere, that pandemic started. It was not starting here and then spreading, but it came like I just came back from vacation in Venice. Whether you have been there, I do not know, but if there is Acqua Alta, that is a very nice example, because if the water is rising in Venice, it is not a wave that would come from the canal and flood the St. Mark's Square. It is not, but it comes from underneath. You cannot run away because you will get wet feet regardless of where you are, because it starts everywhere simultaneously, and that is the analogy that came to my mind with Candida auris. Even worse, it is resistant. All of them have some resistance, like 96%, and 1% are pan-drug resistant. Yesterday, CDC published their new most wanted list, or the preferred pathogen list, and 1% of Candida auris untreatable because resistant against all three classes. in the U.S. alone, there is a five-digit number of cases. 1% where you do not know how to treat makes it 100 patients, and likely it is underdiagnosed and old data because it is massively increasing. It is basically exponential growth in the U.S. For many countries in the world, we do not know because they do not have the epidemiology to that detail as the United States do. The craziest thing is that Candida auris is being passed on from patient to patient or healthcare workers, so from hand to hand, which fungi usually do not do, but this one does. There is more. Candida is not only auris, there are others. Candida albicans is still sort of green light. In terms of traffic light scheme, it is still green because there is always an option to treat it, at least from the resistance standpoint. Others like glabrata, I will share an example with you that says more than these words. Parapsilosis. Parapsilosis was a no-brainer, and most people do not like fungi and do not like mycology, and they do not really know, and I am talking about physicians. They see Candida parapsilosis, "fluconazole, easy." These are over these times where that was true. 10 years ago, that was okay. The reflex was okay. Nowadays, you cannot do that because 15% or higher percentage of the patients with parapsilosis will be resistant. The pathogen will be resistant towards the standard drug. It was a no-brainer because it was the only one that we never wanted to treat with the echinocandins, which are fantastic drugs because they are not toxic, but they are very narrow in their spectrum. Parapsilosis was the only exception where echinocandins were not a good choice, and where there is sort of inborn resistance that comes with parapsilosis towards the echinocandins, one of the three drug classes that we have. Then there is auris, mentioned that one, that is clearly a red flag there. So, another case study, a patient with acute leukemia, and this is the Candida glabrata bloodstream infection, is BSI, so blood taken and it grows from the blood. Candida glabrata, and we treat with caspofungin, it is one of the echinocandins. You can take any other echinocandin, it is as good as caspo, I guess. You usually want to clear this within maximum of five days, because otherwise the risk is high that Candida will seed in the bone, which needs a year or more of treatment, or seed at the heart valve, which is, again, surgery and not devastating in the end. So, we did not succeed in this patient, so day two, four, all the way down, three weeks of candidemia. That is terrible enough because of that seeding thing, but what happened here is this is the susceptibility testing that we do with each and every of these isolates, or our colleagues in microbiology do, and S is good, S is susceptible. These are, we do not really know or we can not use them. Amphotericin, susceptible, okay. So, we do have the three echinocandins and amphotericin B. That is the first culture. Then, what happens next is the last culture where the susceptibility is gone and we are left with one class, which is the one class that only has one representative and that basically kills your kidney function. No chance we had to give this to this patient, knowing that any compromise of your renal function is an independent risk factor for death when you go for transplant, and they all need to go to transplant. So, we Scylla and Charybdis, that would be the Greek example, right? So, where you do not find a good way. If we put all the options that we have in Candida on one slide, all the available options, and it looks quite good, it is traffic light, but The Lancet has, for whatever, there is an orange in between yellow and red, okay? But you know what orange means in traffic lights, so these four. The green ones look fantastic because that is the way to go, that is the green options, but it is only one class. So, if there is resistance, then there is no green, and that means that there is no green on the whole slide. That is a situation, not for some remote place somewhere in Africa or where conditions are hard, but this is the case here in Switzerland, okay? If that is gone, susceptibility towards the green, then that is only one step and you end up with a patient like the one with the glabrata candidemia. You will find more and more of these pathogens we have never heard before of this viswanathii. It sounds Indian, maybe that is where it was first described, I do not even know, but it was a big outbreak in Italy. It was contaminated milrinone, it is a drug that is being used in cardiology, and they were infected with the milrinone, with the Candida in there. You will find more and more of these examples. These are resistant because nobody ever produced a drug against this viswanathii, so there is resistance firsthand in there. Another patient just recently came to our hospital. This is blood, and because of the stain to make them visible, the red cells, part of them are blue, but all of these are red cells. Red cells are made at the size of seven microns so that they can squeeze through the capillaries and bring the oxygen where it is needed everywhere in the human body. You already saw that there is something that does not belong there, this banana, as we call it, or Fusarium, it would be the correct term. This is Fusarium infection in the blood, not good. What happens, you see they are bigger, they do not squeeze. They reach the capillary, and that is where they end. They do not necessarily need oxygen. They just eat what is surrounding, and meanwhile, they grow these lengthy things. That is why we call them filamentous fungi, molds. Filamentous fungi, same word or the same organisms are meant with that. You do not want to have that in your blood, because if you have, then what happens is that blood vessels are clotting. This is the blood vessel, the rim. You can likely see it better than I do, so close to the screen. There is this red oval-shaped, that is the normal blood vessel, but it is filled now with Fusarium, and Fusarium is having a party because it eats everything around. What you clinically see is these necrotic areas, because if you close down a blood vessel at the capillary level, there is no other way to support the tissue, so the tissue will then die. You cannot count all these necrotic spots on a patient because it is too many. That patient had the advantage that we immediately were called in Cologne, and we said, "Okay, the patient needs immediately to be transferred and rolled into a clinical trial," which we currently have in Cologne, which is one of the fosmanogepix trials. She was saved because of that drug in that trial. That is the beauty in mycology, okay? You can really do something. You can do something and see something happens. It is almost like surgery. Treatment pathways. We have these for many, many fungi. We issue them with a large cooperative group throughout the world, and we see these green options, which is wonderful. Green is always good, as said, traffic light. The green is amphotericin, voriconazole, and then it repeats because it is always amphotericin and voriconazole. It just says give the one or the other or both together, or this or that sequence. It is not very educated, okay? 20% of the patients will survive, maybe 30% survive if you follow the green scheme, because there is no real good drug against Fusarium out there, except the one that we hopefully will have licensed when? 2029 or 2030 or so. That will really be a game changer. One more, Sporothrix brasiliensis. If you have not heard, it was only described in 2007 or 2008 or so, the first time that it was described. It was described on infected cats, and only in Rio de Janeiro, David. That is why I like your Rio photo. That pathogen was only in Rio de Janeiro, in the city and in the state of Rio de Janeiro, same name, and that was it. Nobody was interested. Then a cat escaped on the truck of a truck driver to Curitiba, another city in Brazil. That is so nicely described, that first index cat case, and then the young girl who had that cat as a pet. So these two are the index couple. We even know the name of the cat, okay? It is really very well documented. Now it is a geographic spread because it goes from cat to cat, and from cat to dog, and cat to human, because cat scratches are the way to pass it on. I mean, who owns a cat knows that that is what cats do, right? We forgive them, unless they have Sporothrix. The thing is that we now have a geographic spread, not only outside of the state of Rio, but in Brazil, in South America, and Middle and North America. So soon it will be here, right? So there is always another pathogen. That is the beauty of infectious diseases. So why do we still need differentiated options? Forgive me if that is sort of repetitive here and there, but I have to rub it in because it is what we do every day. We have groundhog day because we have every day and every bed the same problems in different variations and mixtures. So diagnosis is too slow. Toxicity is high. Renal, I mentioned. Liver is the key toxicity organ for, target organ for azoles, the one and only class out there which we have IV and oral. But if you have elevated livers over here, liver function tests, then that does not help you. We need drug levels in many of these compounds, specifically for the azoles. We need to measure to see whether we are in a toxic range or in a range that does not even work. We do need drugs that can be given by oral route and not only IV. If you happen to be so unlucky that you need six months of treatment, and you can take pills for six months, that is okay. If they work, then that is okay. But if you need IV for six months, that dramatically changes your life. So no day is like the days that you had before. Drug-drug interactions, mentioned several times. They are plenty, they are manifold, and they are with all the fantastic oncology or hematology drugs, venetoclax, BTK inhibitors, tacrolimus, immunosuppressants, you name them. Whatever is a new one, every month there is a new one that has interactions with the drugs that we need for these patients. Then there are breakthrough infections that is part of because of resistance, maybe other aspects that we might want to discuss separately. So the trade-offs with current standards of care for the polyenes, I mentioned, they have a broad spectrum, but they are very toxic, and they are not even plural. It is only one. Then azoles are broadly active, but drug-drug interactions and toxicity to the liver. Echinocandins, very small, fantastic in terms of toxicity, but there are only a few pathogens that you can treat with them, and only IV. Flucytosine, it is being used as a partner combination in cryptococcal meningitis, but that is basically the only area where it is being used, and even there, it is often not available. The paths without green options, I could not put all of them on here because it would be very small font then. Lomentospora prolificans, definitely no green options. It is just frank red because that pathogen, it is another mold, so these elongating ones, you do not want to have it in your bloodstream. Resistant to almost all drugs, basically usually to all drugs that we can test for and could use for treatment. We resort to strange things like terbinafine, which is something for skin disease, toenail infection, but we hope that it does something, but it is more sort of you add a prayer on top, so to say. Fusarium, I just told you a lot about Fusarium. We need broadly active drugs because often we do not need We know it is fast. We need to do things right immediately, but we do not know what the pathogen is. That is a catch-22, right? Pan-resistant Candida auris, mentioned that one. Azole-resistant Aspergillus fumigatus. Today, if that happens, we only have IV drugs and no oral drugs and no prophylaxis. Then the Mucorales, the pathogens, the big family that causes mucormycosis. That was the threatening, nasty images from the beginning of my talk. Current clinical practice options are limited. Even in general, Candida auris, normal Aspergillus cases where we say, "Oh, just another Aspergillus," even there, we are limited because of the toxicity interactions, et cetera. There is one way out, and that is doing smart clinical trials. Clinical trials are particularly difficult because if you need to treat empirically, so while you think, "Oh, it might be a fungal infection," or you know it is one, but you do not know what exactly is the fungus, then that is, of course, more difficult than if you have an established diagnosis the moment it happens, like a broken leg, and then you know what to do, so to say. It is more difficult here. We do have that diagnostic uncertainty. We do have confounded endpoints because mortality, they all have different reasons to die, these patients, so we need to do different things at the same time, and one of them is treat the fungal infection. If you treat the fungal infection and because of drug-drug interactions, you then cannot treat leukemia, what do you do? You lose the patient. You have crazy choices which you want to treat, so you want to do both. Upcoming developments, because I do not want to leave you in depression, okay? That would be not fair to the other speakers as well. Upcoming developments, new mechanisms of action, which is the best? In alphabetical order, fosmanogepix, new mechanism of action, IV and oral, and pretty broad. Most of the pathogens I mentioned are on there, and we do have that broad spectrum and IV and oral. That is important because if you treat successfully with an intravenous drug, but you know that your patient can go home now because you have that nice success, you want to let your patient go, but you cannot let the patient go on IV, okay? I mentioned that, and you want to have an oral option. Ibrexafungerp is another sort of new, but it is a new class, the triterpenoid class, currently being developed for vulvovaginal candidiasis, but it could be used in other infections as well. Olorofim, new class, DHODH, is a very long enzyme name behind that, inhibitor. It is oral only. I think it will make a difference in some of these fungi, certainly not in the yeasts, not in Candida, because it is inactive there, but in the molds, it will find a place. Rezafungin has been licensed two years ago or three years ago. It is a long-acting echinocandin, just for, I am mentioning it for completeness here, because it is just the fourth echinocandin, but you only give it once weekly, which is okay-ish if you do not have an oral, right? Then it is okay to give once weekly IV. Turletricin, a polyene, it is IV once weekly. Target is in the direction of Aspergillus and Candida. It might lead to earlier discharge, but then you still want to have an oral to treat with. One last final, I think I talked about that, except for the climate change and the risk that threatens all of us, but I promised to not mention it, so I skipped that one. Real-world experience, that is funny because I made this slide two weeks ago, and it is a made-up case, okay? 60-year-old with AML, acute myelogenous leukemia, on modern drugs against that leukemia, receives posaconazole prophylaxis. That is the first compromise, because if you give posa prophylaxis to the modern drugs, then goodbye to your liver function test. They will go through the roof. So, you need to reduce the dose. That is the first trade-off. I can tell you, it sounds easy, but it does not work. You can reduce the dose, but then when the period where you use prophylaxis with an antifungal is over, the standard hematologist does not remember to increase the dose of venetoclax again. So, he underdoses the AML treatment. Nobody wants that. Hematologists say, "No, I do not prophylax. Okay, I just see what happens." We will see fungal infection maybe. In that patient, then at day 20, fever and new lung nodules, bronchoscopy, a mold was found, mold or filamentous fungus, but we need a name and susceptibility testing, otherwise we do not know which drug to choose from the few choices we have, and that will take days. I am currently waiting, and that is why I said it is funny that I did this two weeks ago, because I am currently waiting for the results. What is the mold from the lung of a patient that we are currently treating back home? Knowing the mold will decide on the treatment and will decide on whether we let the patient die or not. That is as crude as it is. I clicked in the wrong direction. What I would like to leave you, take-home messages. I am not leaving, I will be around, but the take-home messages are the burden is large and growing, millions of deaths every year, and growing. The resistant and emerging fungi leave some paths, some is too positive, but leave some paths without any green options. Practice changes with the efficacy, safety, fewer drug interactions that the new and upcoming drugs will hopefully bring to all patients, and with education and guidelines, but it takes a while until then people react to it. The best thing is that new classes are coming. Remember the slide? Two new classes that are coming and useful. We only have three, so from three to five, that is like a revolution. That is so exciting to watch that change, to witness that change, and bring that to our patients. Indeed, real-world data and drug access will decide their impact, of course, and beyond the clinical trials, which we need first, of course. Well, thank you very much. That was my few cents, and I will be here. Thank you. Big thank you to Professor Kontoyiannis for setting the scene for us and for making sure that we never look at red blood cells the same way again. Thank you very much for that. I remember last time, he actually told us basically to live on top of a Swiss mountain so that we never get sick, just to get some fresh. You need to clarify there. The thing is that I would not have said Austria because they have a specific pathogen in Innsbruck, which I do not want. Ah, see? Which is, it is Aspergillus terreus. Yeah. It is Innsbruck and some other pockets, and it is their number one Aspergillus. There are regional differences, and it is fully resistant by birth, so to say, towards amphotericin, the polyenes. You need to invite him to your next dinner party. He is a lifeline. I have one quick question. Please. I mean, you have outlined some of the remaining unmet medical needs, resistance, late diagnosis, few drug classes, toxicity. Out of them, what worries you the most and why? It's always a mix. I would say toxicity is number 1, followed by drug-drug interactions. Often, as you saw, we have both in the same patient. We need broad activity because we are lacking the diagnostics. Even if we have molecular diagnostics, so the most fancy newest edition that tells us what the name of the pathogen is, we don't know whether that specific pathogen is resistant or not. We need to be broad. Okay. We have time to get into that later on in the panel session. With that, can you please put your hands together for Professor Kontoyiannis? Thank you. Now for our next keynote, it is our pleasure to welcome Professor David Paterson, Professor of Medicine over at the National University of Singapore. Thank you so much for choosing to come to beautiful Zurich and leaving the sunny weather there. He is a leading international expert on antimicrobial resistance, and today he is just going to walk us through the current trends in multi-drug resistant infections and also the new treatment options that are available on the table. With that, for your attention, please also give him a very warm welcome to the stage. Well, thank you very much, Olivia Kinghorst, for the introduction. I might just ask you a question. Have any of you had an appointment with a doctor and had to wait more than 30 minutes before you saw the doctor? Okay, even in Switzerland. All right. Because I am going to tell you first about a patient I saw for a 30-minute appointment, and I was with her for two hours. When I went out of the room and said goodbye to her, the waiting room was like this, and it was a bit embarrassing. But her story was very interesting, and in the end, she actually showed me a letter that her father had written in 1944 to the captain of a U.S. Army base in Australia. Basically, the letter said, "I am really desperate. I have had one daughter who has died from pneumonia two years ago, and my surviving daughter is in hospital now with a serious infection. I have heard that the U.S. Army has this wonder drug called penicillin, and could it be possible that the army could donate to the Australian hospital enough penicillin to save my daughter?" I guess there weren't all of the regulations that there are today, because in fact, the U.S. Army did provide the penicillin for the patient, and she is alive today. I saw her maybe about four or five years ago, and it is amazing that a person was alive in the pre-antibiotic era, and thanks for being in the cusp of coming into the antibiotic era, she is alive today. It really has been amazing the way that science has reacted to the problem of bacterial infections. You heard from David before that over 7 million people die every year from bacterial infections. Back in 1928, because it is the 100th anniversary in two years' time, Florey found a fungus, one of Oliver's friends, that actually produced a substance that killed bacteria. This is the fungus. It is called Penicillium. I am proud to say that Australia, where I come from, and also Olivia comes from Australia, I heard before, we are the only country on Earth where the development of antibiotics is celebrated on a banknote. You can actually see up there Fleming's agar plate. The white blob is the fungus. You cannot see any of the little white specks close to the fungus, and that is because the Penicillium fungus was producing an antibiotic that was killing the bacteria. This guy here, his name is Florey. He is an Australian, that is why he is on the 50-dollar note, and he actually was the one who worked out how to produce it in large quantities. Of course, penicillin was a true miracle drug, but the miracle of penicillin did not really last that long. This is data from London, looking at staph infections, and you can see that really, in less than 10 years, 80% of staph was resistant to penicillin in this particular hospital. Of course, the pharmaceutical industry responded and developed new classes of antibiotics, but by the late 1950s, 1960s, MRSA came along. This has been our battle ever since penicillin has been discovered. We have developed new antibiotics, we have introduced them, but the bacteria have responded by coming up with new mechanisms of resistance. I do like history, and I will just tell you another little history lesson. This was an Italian microbiologist called Giuseppe Brotzu. I do not know if any of you have been to Sardinia, and the beautiful coastline. This is the status quo in Sardinia. In 1946, unfortunately, because of there had been destruction during World War II and rampant sort of redevelopment, raw sewage was being pumped into that beautiful water. Brotzu looked out, and he saw that the water was brown, and he hypothesized that it was full of E. coli. He took a sample, and yes, it grew E. coli. There were also patches of clear water, and he hypothesized that there was something in the clear water that was killing the E. coli. He sampled the clear water. There was no E. coli, but there was a fungus, one of Oliver's friends. This fungus was called Cephalosporium. As a result of Brotzu's discovery, this whole class of antibiotics called the cephalosporins were developed. I am sure all of you know Roche. For at least a decade, a Roche cephalosporin called Rocephin, ceftriaxone, was the world's biggest-selling injectable antibiotic. These have been phenomenally hardy classes of antibiotics. We have had to go up in different generations of cephalosporins, but they really have been a wonderful innovation, thanks to Giuseppe Brotzu's discovery of that clear water. Just like Oliver said, in Brazil, they even know the name of the cat that escaped. I want to tell you the story of Mrs. Temoniera. She had a urinary tract infection due to E. coli in Athens in June 1965. Obviously, the privacy laws in Greece in the 1960s were not, what's that, GDPR or whatever? Non-existent. Interestingly, amoxicillin, which was a penicillin derivative, was introduced into Greece in 1964. Mrs. Temoniera came to her doctor with a UTI, and it was found that her E. coli was resistant to amoxicillin. Very strange. Luckily, it was found as to why Mrs. Temoniera's E. coli was resistant. I often ask the medical students, "How clever are bacteria? What's their IQ?" They scratch their head. Of course, they don't have an IQ, but I think it's probably about 500. It's not artificial intelligence, it's super intelligence. Because within months of amoxicillin being introduced into Greece, we now had an E. coli resistant to amoxicillin. We did have a response. The industry did develop new cephalosporins that were not destroyed by this thing called TEM-1. TEM stands for Mrs. Temoniera. This is an enzyme produced by the E. coli that could destroy the amoxicillin. That's really quite amazing, that the bacteria, in response to this new threat, could develop an enzyme that would destroy the antibiotic. So, we had now this response by industry, by Roche, for example, with the ceftriaxone, Rocephin. What happened next? There was subsequently the discovery of these enzymes, these beta-lactamases, that could destroy Rocephin, destroy ceftriaxone. It's an interesting story again. It occurred first in Germany, but just as with Mrs. Temoniera, it was about six months after the third-generation cephalosporins were introduced into Germany, they found a number of patients in Frankfurt who had a Klebsiella germ that was resistant to the Roche antibiotic. It spread into Europe, not that quickly, but eventually got a wriggle on, and by the mid to late 1980s, hundreds of isolates were found. So this problem of ESBLs has been a significant one. You can imagine now we've had, my maths is not very good, over 40 years of these ESBLs. They're in things like E. coli. They're very, very widespread. It was quite a while before anyone had done a trial, what is the best antibiotic to treat these? Some colleagues and I did this. We published it, maybe 2019. You'll see one of the antibiotics here is called meropenem. Meropenem is what we sort of have called an end-of-the-line antibiotic. It's a type of antibiotic called a carbapenem, and I'll get to the C of carbapenem in a minute. We did this study really to see, well, what is the preferred antibiotic to treat serious infections? In other words, people like Oliver's patients who've got leukemia or they're in ICU, who've got this germ in their blood. It's interesting, if you think about E. coli, who are the people in the world who get E. coli? Women who get urinary tract infections, over 90% of the time it's due to E. coli. These enzymes, these ESBLs, are now widespread in E. coli that causes urinary tract infection in women. It was great timing that just recently I saw a paper that looked at, well, if you've got an ESBL-producing E. coli that is causing a urinary tract infection. What is the current status, and this is from the U.S., for other oral options for that infection? They looked at more than 7,000 patients in the U.S. As I mentioned, most of them were E. coli. Basically, the two tablet antibiotic options, one is a class called quinolones. You might have heard of ciprofloxacin, for example. 81% were resistant. Trimethoprim-sulfamethoxazole, a thing called Bactrim, this has been a combination available for years. Over two-thirds were resistant. Here we have a situation, an incredibly common infection. What woman, and in fact, many men, has not had a urinary tract infection? It is going to be due to E. coli, and now one of the most dominant strains, we have resistance to lots of antibiotics, but particularly the antibiotics that are going to be available to be given as tablets. I have had patients who have had a urinary tract infection who I have had to admit for intravenous therapy because there were no tablet options available. You can see in this particular study, 28% of the women had a recurrence of their urinary tract infection, almost certainly because it was not adequately treated because of resistance. Now, you might have seen in small print down the bottom of that paper, GSK. GSK do have a new oral option which they are developing for urinary tract infection. Interestingly, it is a class of antibiotics called the carbapenems, which I mentioned before, which we use in seriously ill patients. I do want to talk for a second about the consequences of overuse of carbapenem antibiotics. This is a road in Bolivia called the Road of Death. It is not surprising. It is a one-way street, and you can imagine if there is someone big coming one way, you cannot overtake, or you can have a go, but I think 300 people have a go and fall off the edge each year, or you can reverse back, which is not easy. If you are in an intensive care unit or if you are in a hematology unit, you are sick, and now you have a carbapenem-resistant organism, you have, in many places around the world, a more than 50% chance of dying. If I said to a cancer specialist, "Tell me a cancer where you diagnose the person today and four weeks later they have got a more than 50% chance of dying," I do not think there is such a thing. If I fell over and had a cardiac arrest here now, I think I would have more than a 50. Hopefully someone would resuscitate me. I think I would have a more than 50% chance of surviving in a month. This is a massive issue, and when you look at the deaths, and unfortunately there is a body count, over 4 million people die each year. Now, these, you, yes, many of them are sick, many of them are in intensive care units or have got cancer, but many of these patients would live to fight another day if it had not have been for their carbapenem-resistant organism. When we look at the organisms that cause death, I am going to talk for the rest of the day exclusively about a type called gram negatives, and the ones in bold are what we call gram negatives. Staph is a gram positive, E. coli is a gram negative, Acinetobacter is a gram negative. Now, when I talked about those enzymes that destroy antibiotics before, when you are talking about those able to destroy carbapenem antibiotics, they are crocodiles. They are big and they are nasty. Unfortunately, what makes life tricky is that there is not just one type of crocodile. There are a variety of different ones. Some destroy some antibiotics and leave others alone. Some are actually inhibited. We can inactivate some of these beta-lactamases, but some that we cannot. I would like you to imagine we wanted to get into this fort, and we are actually an antibiotic. In fact, the entry point into the fort I have marked here by PBP. What an antibiotic has to do first is, there is actually an outer wall here, which I have not even included. It has got to get over the outer wall. It has got to get across this moat, and in this moat is a nasty type of crocodile. In this situation, there is one called NDM. I will not go into details about it, but it is actually now the most common carbapenemase in the world. Then you have got to scale this wall and attach to the PBPs. This is the target for many of our antibiotics. The reality in many parts of the world are that these NDMs are highly prevalent, and now what has made life even more difficult is the target, the PBPs, have actually mutated, and therefore antibiotics cannot bind to the PBPs and destroy the bacteria. When I am talking here, I am talking specifically about penicillins and cephalosporins and carbapenems, antibiotics which we call the beta-lactam antibiotics. We have relied almost exclusively on those for treatment of serious infections. There are a couple of other classes, but they are like Oliver's ones. They bung up your kidneys and have a lot of other toxicity. What we need in our pipelines are alternatives to beta-lactams, because if you are not a beta-lactam, you are immune to these crocodiles. You also could not care about the PBPs because that is your target. If you are a beta-lactam, the PBPs are your target. If you are a novel class, a new class, you have got a different target. I think maybe later we can talk about the Basilea pipeline in that they are looking at some antibiotics that are not beta-lactams, which is an interesting concept. All right. Well, I know afternoon tea is beckoning, so I just want to give you some state-of-the-art and my predictions for 2030. These names we do not really care about specifically. However, I have, these are the different types of crocodiles, CRAB, OXA-48, NDM, et cetera. All of the antibiotics that are listed here are beta-lactam antibiotics. The type that has to bind to that PBP and has to evade the crocodiles. This is our current state-of-the-art. My predictions in 2030 is that we will have some new options. For the ESBL producers, these are the ones that are going to cause the urinary tract infections, yes, we will have the carbapenems. There may be some other intravenous options, but hopefully we will have some good non-carbapenem oral options that we can prescribe to our patients. You can see, interestingly, that we don't have many oral options for some of the carbapenem-resistant organisms, and increasingly there's a trend, certainly in U.S. hospitals, in European hospitals, start someone on intravenous therapy, but if they're well enough, get them out on oral options as quickly as possible, and we need those for the carbapenem-resistant organisms. You can see some of the other things we won't get into. CRAB, it's interesting here in Switzerland, Roche and BioVersys both have options that are being developed for that particular one. Unfortunately, I suspect we're going to have patients in the future who will be in the post-antibiotic era. My patient was on the cusp of the pre-antibiotic and the antibiotic era. If you're on that road of death, there are now completely untreatable infections. The implication is that antimicrobial resistance in these Gram-negatives, just like fungal infections, they are a big threat to cancer care, to transplantation, to ICU care. There are predictions that by 2050, more people will die from infections due to antibiotic-resistant bacteria and fungi than will die from cancer. I'll just say that again. By 2050, more people around the world will die due to infections, about fungal infections, antibiotic-resistant bacteria, than will die from cancer. You know in the oncology space how much activity there's been every day. There's some news about a cancer vaccine, et cetera. I think this prediction is going to come true. What do we need? Well, there are still bread-and-butter infections, things that are common that are going to need treatment out of hospital. Oral non-carbapenem options for those ESBL-producing organisms causing UTIs, particularly if it could cover some of the smaller Klebsiella, that would be great. And potentially non-beta-lactam options for the serious infections, so we don't have to worry about Klebsiella, we don't have to worry about targets being mutated, would also be a major advance. I think, Olivia, it's almost coffee time. Yes. We'll keep this short and sweet. Thank you so much once again. Just a quick question from my side. We've touched on the benefits of new oral options that are on the table, but how can we ensure that they're not contributing to further antibiotic resistance? I think that's a big question. Yeah. No, it really is. Even yesterday, I heard a colleague from Thailand who their Thai FDA actually rejected an application for an oral carbapenem antibiotic for UTIs because they said, "We can't guarantee appropriate stewardship or appropriate use of this antibiotic in the broader community. We want to keep this class of antibiotics for seriously ill patients in the hospital." It is a big concern. Typically, out of hospital, there aren't the sort of stewardship teams that we have in hospital, but we've got to educate people, how do we preserve very finite resources, which is what antibiotics are, so that they're not going to run out in six months like they have in the past. I think we need another session dedicated specifically to stewardship. I sense you're a man of many stories, so if you are, happy to catch him at the coffee break. I'm sure you're happy to answer any questions. Excellent. With that, thank you so much once again. My pleasure, Olivia Kinghorst. We have heard from the CEO, we have set the stage, and of course, there is quite a lot of content that we have had to take through. With that, we are going to give you a moment to digest everything with a quick coffee break. That will be about 30 minutes. Of course, we welcome all of you to get in touch with any of the Basilea representatives. They are the ones who are looking extra friendly with big smiles on their faces. With that, thank you very much. We will see you in half an hour here. Ladies and gentlemen, welcome back. I hope that you enjoyed the coffee break. You have one or two coffees in your system, or macarons, to carry us for the final stretch of this afternoon. I just want to give you a quick overview of still what to expect. We have a couple of sessions left. We will be hearing from the Chief Medical Officer as well as the Chief Financial Officer of Basilea before we come together and hearing from all of the C-suite. We have got CMO, CFO, as well as the CEO. A reminder to everyone in the audience, make sure to submit your questions. They are open to any burning questions you might have, so make sure to take this opportunity to put any of them in the hot seat if you like. We are now going to dive deeper into Basilea's pipeline as well as the latest updates. With that, I would love to, of course, welcome a familiar face, Marc Engelhardt, Chief Medical Officer of Basilea, to the stage. Please give him a very warm welcome. Thank you very much. Welcome from my side as well. We have heard prior to the coffee break that there are significant unmet medical needs that remain in the treatment of antifungal and antibacterial infections, and our task is to develop solutions to address these medical needs. When we look for new agents and new compounds that we can develop, we look at a few things, actually many things. The ones that stand out or that we really try to achieve is, in the first line, efficacy. Here, we are looking at novel mechanisms of actions for most of the compounds we want to develop, and this is to address the emergence and the issues around resistance that David and Oliver talked about in more detail. We also carefully look at the spectrum of coverage of the new anti-infectives, and usually a broad spectrum enables more empiric treatment. If it takes time to diagnose what is causing the infection, then a broad spectrum provides the possibility to treat a patient empirically and provides time to then get to a final diagnosis. What is also important is really tissue distribution, so we need to look for agents that have a wide tissue distribution or reach the compartments that are relevant for the infection, and I will discuss this a little bit in more detail later. Then, the compounds need to maintain the activity when resistance continues to emerge. The second point is safety. Oliver especially had this as one of his top criteria for novel agents. Novel agents need to be safe and well-tolerated by the patients. They also need to be suitable for long-term treatment, particularly in fungal infections. As these patients are often very complex, take chemotherapies, immunotherapy, many other concomitant medication, drug-drug interactions are becoming increasingly important. We need a favorable drug-drug interaction profile to be able to combine these medications with what else the patients need to be treated with. The third point is practicality. For patients, it is really important to have drugs that they can take, that they can adhere to, and this includes having oral options and having easy administration schemes. The opportunity really in developing new drugs is not develop just a new anti-infective, but focus on those compounds that can address these needs and these can fulfill these profiles. We have selected two late-stage assets, fosmanogepix, a broad-spectrum novel antifungal, and ceftibuten-ledaborbactam, an oral antibiotic, and these address significant unmet medical needs and meet our criteria of commercially viable pipeline opportunities, although they do this in very different ways, as I will describe in the next 10 minutes. Adesh will then elucidate in more detail our approach to portfolio prioritization. Fosmanogepix is a first-in-class broad-spectrum antifungal. It has a completely novel mechanism of action, and as Oliver Cornely pointed out, fungal infections can be rapidly life-threatening. A broad coverage is important to enable early treatment, and a novel mechanism of action helps in addressing the increasing challenges of antifungal resistance. Fosmanogepix already has large clinical evidence generated through a comprehensive phase I program, three phase II studies in Candida and mold infections, as well as the ongoing two phase III studies in invasive candidiasis and invasive mold infections. In addition, there is a very busy expanded access program that is designed for patients who have no other treatment options. I will point details to this expanded access program, I will explain later. Fosmanogepix also, as it addresses high unmet medical needs, has acquired several regulatory benefits such as QIDP designation, fast track designation, and very importantly, it is supported by BARDA, not only financially, but also this expresses really the urgent need of developing new anti-infectives. The key attributes of fosmanogepix is really the very broad spectrum. Fosmanogepix covers almost all fungal infections or fungal pathogens that are relevant for disease in humans. It also covers Sporothrix, so the cats would be covered too. It has a very wide tissue distribution, unlike other agents, easily penetrates the central nervous system and the eye, and it is available IV and oral, and that is really important because many of these patients are critically ill, so IV treatment can be initiated, and then upon improvement of the clinical situation, they can be switched down to oral. I think also the reverse direction is really important because these patients continue to undergo chemotherapies, and they will enter phases where oral intake gets very difficult, so being able to switch back and forth from IV to oral is really crucial in the hematologic malignancy patients. Then the novel mechanism of action we already discussed, it is important for resistant pathogens, but also whenever new therapeutic approaches are required. This displays now the mechanism of action of fosmanogepix. Fosmanogepix is a small molecule that passively enters the fungal cell. So this, all you see here is a fungal cell, and you see the outer cell wall which limits the fungal cell, and then manogepix, which is the active component, acts inside the cell in the endoplasmic reticulum, and here it inhibits an enzyme that is called the GPI-anchored wall transfer protein one, or GWT1, and this enzyme is responsible for synthesizing anchoring molecules that transport proteins from the endoplasmic reticulum to the cell wall, and these proteins then protect the fungal cell wall. When this enzyme is inhibited, the production of these anchoring elements and the transport of the protein stops, and you get in the cell an accumulation of these immature mannoproteins, so the cell is stressed from the inside because of this accumulation. At the same time, these proteins that cover the fungal cell wall, they are missing, so the cell is kind of attacked from two sides, from the inside with the intracellular stress and from the outside with the lack of these covering proteins, and this makes the cell unstable and also recognizable for the human immune system, and that ultimately all these mechanisms then lead to cell death. It is a very novel mechanism of action. Nothing that is currently on the market or in development has any similarity to this mechanism, and that also avoids any cross-resistance to existing or agents that are in development. I mentioned before that there is an increase in real-world experience with fosmanogepix. There is a global expanded access program ongoing, and to date, there are over 600 patients treated in this program in more than 20 countries. This program provides this real-world experience that you cannot get really in a regular clinical trial setting. What we are seeing is a broad spectrum of very diverse fungi that usually do not go into a registration program. In addition, there is an opportunity to explore the efficacy and safety in other populations, such as children or severely hepatically or renally impaired patients. Long-term treatment, some of these patients are going on for up to four years. Also, the use of fosmanogepix in combination with other antifungals. So there is a rich experience coming out of this program. Apart from that, these compassionate use programs are, of course, primarily designed to help these patients who have no other treatment options. We have published a whole series of experience from the expanded access program and will continue to publish this experience with fosmanogepix, and it will also help us when we prepare the regulatory filing for fosmanogepix. So we have seen the medical need, and one question, of course, that we are asking ourselves too is, what is the commercial potential? Here, we can look at precedents. Cresemba, isavuconazole, that we have developed together with Astellas, has currently global sales of $870 million and is still growing. VFEND, or voriconazole, has reached global sales of $825 million. So this is a benchmark. With fosmanogepix and its profile, so the very broad spectrum, the wide tissue distribution, IV and oral bioavailability, our peak sales estimate for this compound is about $1 billion, based on a superior profile compared to what is on the market. I think overall, we look at the fungal space in a way that there is a persistent burden of invasive fungal infections with limited treatment options and limited innovation. This continues to create opportunities as long as the compound that we develop is differentiated. Let me now turn to the second late-stage asset, which is ceftibuten-ledaborbactam. This is a completely different compound. While fosmanogepix addresses major medical needs in invasive fungal infections, ceftibuten-ledaborbactam addresses a different but equally important need by providing an oral option for resistant Gram-negative infections and is being developed for complicated urinary tract infections. So ceftibuten-ledaborbactam is a combination product of ceftibuten, which is a well-known and approved cephalosporin, that David pointed out how the cephalosporins were developed in Sardinia. It is combined with ledaborbactam, which is a novel beta-lactamase inhibitor. What ledaborbactam does is it protects ceftibuten from cleavage by the crocodiles and restores the activity of ceftibuten against resistant Gram-negative pathogens. Ceftibuten-ledaborbactam then develops a spectrum which is quite desirable for urinary tract infection. It covers most of the relevant Gram-negative pathogens in this space. Ceftibuten-ledaborbactam has robust phase I clinical trial data and is supported by non-clinical data that supports the registration program in complicated urinary tract infections. While the registration program in complicated urinary tract infections is now being prepared, we have one phase I study currently ongoing that evaluates the fixed-dose combination of the ceftibuten and the ledaborbactam, which will then be used in the registration of phase II, phase III program, and which is designed to delineate the optimal dosing regimen along with pharmacokinetics, food effect, safety, and tolerability. As said, the start of the registration program is planned for mid-2027. Complicated urinary tract infections are urinary tract infections that extend beyond the bladder, and usually they are associated with more severe local or systemic signs of infection. They are very frequent in the hospital as well as in the community, and about 75% of complicated urinary tract infections are caused by Enterobacterales, including E. coli and Klebsiella, and these are often multi-resistant. We have seen in David's presentation that ESBL-carrying Enterobacterales are often resistant against other oral agents such as quinolones or trimethoprim-sulfamethoxazole. So there is really very limited oral options for these resistant infections, and that results that patients who have a urinary tract infection, a complicated urinary tract infections with ESBL or quinolone-resistant pathogens, they often end up in the hospital just for getting IV treatment. Here is really the medical need that is being addressed by ceftibuten-ledaborbactam. It is an oral therapy in this space, has the potential to improve patient convenience. It more or less leads to a care setting shift to a lower-cost setting, so from the hospital to an ambulatory home setting, or also to reduce emergency room visits that often these patients then have to, especially in the U.S., where there is more than 2 million of these episodes every year. Many of them end up in the emergency room. They may get an IV treatment, then be either admitted or go to infusion center. So an oral option would really remove this very complicated setup for these patients that could go home if there was an oral option available. So clearly, that is really the value of ceftibuten-ledaborbactam and the unmet medical needed addresses. The space in general is a validated market because there are a number of IV-only available antibiotics or combinations of beta-lactamase inhibitors. One example is AVYCAZ, which has currently peak sales of about $750 million and is still growing. We believe with a profile that ceftibuten-ledaborbactam provides, especially the oral availability and the associated benefits for patients of being able to be discharged, and for the health system with less hospital admissions, less emergency room visits, that that potential is at about $500 million in peak sales. In summary, fosmanogepix and ceftibuten-ledaborbactam address distinct needs for new therapies in the antifungal and antibacterial space, and they meet our criteria for efficacy, safety, practicability, and also commercial potential. They deliver meaningful differentiation, which is really important. When we develop drugs, we first look at really how can they be differentiated, and they offer viable development pathways. It is quite clear how to perform the studies and how to bring them to regulatory submissions. We are actively advancing both late-stage assets. As said, fosmanogepix is currently in two phase III studies. It is supported by the real-world experience from the expanded access program, and we expect data readouts for the fosmanogepix phase III program around mid-2028. Ceftibuten-ledaborbactam, we are preparing the start of the registration program, which is phase II, phase III study, which will start mid-2027. Here, we have a very clear development pathway for complicated urinary tract infection. There is a dedicated FDA guidance for this indication, so it is very clear how to move these assets forward. Finally, I would like to briefly touch on the earlier stage clinical pipeline, starting with BAL2062. This is another novel antifungal. It is an IV drug which we would position as a first-line treatment for invasive aspergillosis, completely novel mechanism of action. It has been through phase I and has shown to be well tolerated. We do not expect any drug-drug interactions, which we have heard is really a key consideration. The two points for this drug is really safety and drug-drug interactions, and we have seen in the phase I that it has a favorable renal safety profile. This would tick a number of boxes that are of increasing concerns. We currently are in exchange with the regulators to define the best way forward in terms of phase II, phase III program, and also will evaluate this compound from a commercial perspective. This BAL2062 is also supported by BARDA. It is in the same bucket as fosmanogepix. The other compound is BAL2420. It is an antibiotic, and it addresses the need that David pointed out as a non-beta-lactam agent that is directed against Gram-negative bacteria, especially Enterobacteriaceae. Here, this compound will address carbapenem-resistant pathogens with a novel mechanism action, so that is not affected by carbapenemase or all these sorts of crocodiles that are around. We have started a first-in-human phase I clinical study with this compound in beginning of this year, and we expect to complete the phase I study, this first-in-human study, in the first half of 2027. This development is supported by CARB-X because it is an earlier stage compound, and BARDA also only would support this as a later stage. Over the last 20 minutes or so, I have shown you our industry-leading pipeline, and we intend to keeping one step ahead and bringing this to patients and expanding further through our expertise in the infectious diseases field, especially bacterial and antifungals, and through our worldwide collaboration partnerships. Thank you very much, and I will hand it back to Olivia to move us on in the program. Thank you. Thank you so much. We have obviously covered a lot of territory, and I think it is time now for us to digest everything. If I could just welcome back our experts once again to the stage, Professor Cornely and Professor Paterson. Please make yourselves at home, and we will reserve this time now for about 15 minutes. We can hear for some questions from the audience when it comes to some of these unmet medical needs. Please. Marc, I want to kick things along because you have obviously been working with both these experts for a while now. Just as context for the audience and some background, can you just talk to us about how that started, what you have all been through, and why we are here on the stage today? I think, I mean, these are the key experts in the respective field of antibacterials and antifungal development, and that is what we do. I think we have a lot of interaction since 15 years when I joined Basilea, and it starts really in talking about the medical needs, but then also reviewing compounds who may address these medical needs, and then it goes on to how could a clinical program be structured. It goes so far then that when we have established protocols, that we send it to David or Oliver and have them and their teams take a look at it to tell us, can they do the study or what are really the pain points for them from a feasibility perspective. It is really strategic, but also operational, and it is not the As David said, you have an oncology community that may be a bit bigger, but having this little smaller community enables a really close collaboration over many years. It really seems like they are both a great sounding board for Basilea. Did you want to jump in, Dr. Paterson? Yeah. I think it is always important to look at the clinical perspective, and when, for example, when I am visiting hospitals in China or different parts of the world, what are the pain points for clinicians? What are the needs that they need? I think sometimes from a development company, it is always, I think, important to have that external view from what are the issues for patients and their doctors. It is key to the feasibility of the study because there are many studies out there, but the patients do not exist. The inclusion and exclusion criteria result into a tiny number of patients, and that is not what we need. We need studies that can be accomplished because then it tells us that these are studies for the patients that will be there after the study is completed as well. Professor Cornely, I want to stick with you because we are talking about the pain points here. Can you give us an example of a patient with a very serious fungal infection that is incredibly hard to treat, and where do today's treatments really let you down, do you think? Well, the prime example is mucormycosis. It is in frequency, the one that is next to Aspergillus, and mucor is the next in line. Mucormycosis affects either patients who are having an uncontrolled diabetes, that is on a global scale, the majority of patients, or the higher number than the deeply immunosuppressed hematology patients. That's the other group, so to say. Then there are multiple others, but that's the key ones. If you have diabetes, then it means that your renal function is already compromised. It may not show in a standard lab, but with the first dose of liposomal amphotericin B, it shows in the lab, and it shows the real kidney damage that was already there. For leukemic patients, they're usually in their 60s, maybe 50s, maybe 60s, so renal function, just as a natural phenomenon, is decreased already, just proportional to years lived, yeah, to age. Again, liposomal amphotericin B, which is, I mean, I can name the drug because we all know that there are only three classes anyway, so for mucor, it's only two drugs actually that we can use, and only two classes. So we have the toxicity on top of the underlying preexisting conditions of the patient. That's the key concern, and followed by drug-drug interactions. That's the two that keep us awake, so to say. I know you've touched on toxicity, but let's move on to resistance now, because we are seeing more fungal infections that are resistant to existing medicines. In this case, how is this changing the way that doctors are now treating really critically ill patients? Dr. Paterson. We often get it wrong, and I think because of resistance. If we choose the wrong antibiotic, because remember, the results of antibiotic susceptibility typically take two or three days after the specimen is collected before they come back. Because of that, we've got two or three days of potentially choosing the wrong antibiotic. If you're in intensive care, that could be a life or death situation. If you're a woman with a urinary tract infection, it might mean you've been stuck on the wrong antibiotic and you're not going to get back to work, you're not going to get better quicker, or you might even have a higher chance of relapse. You might sort of get better, but then it comes back. Resistance, people used to say, "Oh, it's the silent pandemic." It's not silent. People are dying from it, and people are suffering from it. In your presentation, you talked about some of the unmet medical needs. We did receive a question from the audience right now when it comes to delayed diagnosis. I am just going to read this out for you. What are the main reasons for that? Is it the late onset of symptoms? Is it the cost of advanced diagnosis testing? How can it be addressed? It is just that there are no diagnostic tests that would catch it. With the example of mucormycosis, to stay with that, you have the first symptom, which might be a fever. It is not very dramatic. It is just something that could have other causes as well. If you do not react to that fever immediately with the treatment of mucormycosis, which you do not do because of the toxicity, you want to try to find out what it is it a bacterial or a fungal infection? If you miss six days before you and that is easy to do because you wait for results, as David just pointed out. If there are six days over until you start treatment, that doubles the death rate for that patient, for that population. Doubling means from basically 45% to 90+%. Six days. We need rapid diagnostics, to allow us to treat earlier. I guess if we would treat early, we would have much better results. By the way, we are opening the questions also to the audience, so if you do have one, feel free to raise your hand already. We can bring a microphone over. Let us take the question from the gentleman over here in the second row, and also to stand up and introduce yourself for us. Thanks for taking the questions. Ram Selvaraju, H.C. Wainwright. I think for Dr. Cornely, it would be helpful if you could sort of characterize, A, among the key fungal infections that you highlighted in your presentation as being of greatest concern, relatively, if we look ahead to the next, let's call it, three to five years, which of these would you say constitute the most serious public health threat and why? Across, for example, mucormycosis, Fusarium, and Candida auris. Then just a quick one for Dr. Paterson. When you think about the potential opportunity, for example, in the U.S. for a drug like Zevtera, just from your assessment of the level of receptivity among prescribing physicians, what do you think is likely to be the kind of key resistance factor that needs to be overcome in order to ensure maximal commercial utilization, maximum benefit to the healthcare system of the availability of a drug like Zevtera, especially in the context of the broad label and the unmet need? Thank you. By the sheer numbers, Candida is the most frequent. You cannot prophylax because you cannot identify the patient that has the highest risk, so to say. So it's reactive to its actual real treatment. So Candida is by far the largest problem. You can nicely see that in that CDC report that was published yesterday. So it's massively frequent. I would say for Candida auris, that's the one that is always resistant to at least one class, often to two classes. It is out of control, okay? So nobody is going to stop this. So it will be a lot of patients. You cannot do infection control and say, "Oh, I can reverse that development." It's not going to happen. So Candida is the number 1, followed by Aspergillus, with all the different issues that are, all the different trade-offs, et cetera, followed by mucormycosis. That's a European, or it would be a U.S. perspective. If you would ask Latin America, they would not say mucor, they would say Fusarium. So there are regional differences, but Fusarium and mucor, maybe they are roughly same level on a global perspective. So that's the ones. Then it trails off, and there are many others. We don't really have. For some, we don't even have ICD codes, so we don't have the statistics for, not the ones that are mentioned, but for some others. So we don't know how frequent they are. The crazy thing is, the moment there is a drug that holds promise, then all of a sudden, they pop up everywhere. Everybody has seen one, and ideally, they refer them to a center. So they are underestimated. But number 1 is Candida and Aspergillus, and then followed by the others. Perhaps, for the next one, we keep it short and sweet. It is about maximizing commercial success in the U.S. Yes. In 2001, I set up the antibiotic stewardship program at the University of Pittsburgh Medical Center. Sitting next to me was a consultant from McKinsey. The purpose of the antibiotic stewardship program was to reduce costs for the pharmacy, and that continues today. Every hospital in the U.S. has antibiotic stewardship programs, which are dampening the upside for intravenous antibiotics. The exception is if you can get an antibiotic that does truly meet an unmet need. So there is a resistance mechanism that is quite widespread that is not adequately being met. That is when there can be substantial upside. So ceftazidime-avibactam, which sold $500 million a year in the U.S., has that. It hits KPC and OXA-48 producers, so two types of crocodiles. The alternative was something very nephrotoxic, toxic to the kidneys. Just as a quick pointer, out of hospital, there is not antibiotic stewardship. To some extent, of course, there are insurance companies which are trying to reduce costs, but in a way, there is bigger upside for orally administered antibiotics, for example, for urinary tract infection in the U.S., because there is not that hospital-controlled program to reduce use of antibiotics. Wonderful. Now, I am aware that because we are in Switzerland, we love keeping to time, but we have received quite a number of questions. There was also a question coming from the audience. Was it? Yes? Can we just squeeze that in, and we can keep it short and sweet, right? I try. Thanks. Thank you. Thanks for the presentation so far. Very interesting, educational, and I have to admit, also a bit frightening. My question to you, there seems to be this perception gap in the public, but also from an industry perspective. What would need to happen to change that so that companies in the infectious disease space would get more attention? The drug development would probably see a big push. I think that the tricky thing is that many of the people who are dying are dying with their cancer, or they've had a transplant, or they're in ICU for a different reason. People historically expect that bad things happen if you've got cancer, if you've had a transplant, if you're in the ICU. Whereas the reality today with cancer care, transplantation medicine, critical care, many of those people would be survivors, but for the infections that they're getting. It's not like you expect someone healthy comes in, gets a resistant organism, "Oh, they died from a resistant organism." People do have complicated backstories when we're talking about fungal infections and some of these resistant bacterial infections. What is always very helpful if there is a patient advocacy group. For fungal infections, there is none, because they are rapid, fatal, so you either die or you survive. If you survive, then you, yes, you know you had a fungal infection, but the underlying problem, leukemia, for example, if you will become active in the future as an advocate, then that will be in the leukemia field, not in the fungal field. Yeah, because you are asking, "What is the solution?" So we need more noise. If the noise comes from the patients, wonderful, but there's a certain difficulty here. I don't know about Gram-negatives. Is there advocacy? We need some famous people to die from resistant infections. They have so many optimistic words for us today. With that, we're going to have to leave it there, but don't worry, we will have another panel coming up, and we've reserved some of those questions, especially when it comes to the assets and pipeline for that from Marc as well. With that, thank you so much for sharing your thoughts on the stage. Thank you. So far, we've set the scene when it comes to the medical side, but let's turn to something now that is equally important, and I'm talking, of course, about the business model and financial. Here to break down all the numbers for us, as well as the growth opportunities, we have Adesh Kaul, CFO of Basilea. So please give him a warm welcome to the stage, and he's also happy to take questions as well. Thank you very much. Thank you. Thank you, and I hope it's going to be a little bit more uplifting than the last thought that we had just before. Let me just figure out first the technical challenges here. Good. This afternoon, we've heard about the unmet medical need in the treatment of bacterial and fungal infections, but also about the real options to improve how we are treating these infections. Still, it takes more than just great science to do that. It takes financial strength, financial flexibility, and discipline in capital allocation. David said, oh, sorry for that. Warming up and keeping you on your toes. David started off with Agenda 2030 and the strategic priorities that will take us forward. Marc talked about progressing our pipeline and importantly, broadening our commercial portfolio with bringing our two late-stage assets to the market. So let me pick up here and basically turn to the financial side of the story. Financial strength and flexibility, and how we are trying to put this to use in order to keep building an industry-leading pipeline. I will talk in the next few minutes about what is behind our financial strength, and there are, in essence, three key drivers. On the one hand, our strong and durable cash generation from Cresemba and Zevtera. Second, the substantial non-dilutive funding that helps us to offset a significant part of the investments that we have to do into our clinical portfolio. And third, our balance sheet, the strong cash position that we have. Let me take these one by one, starting on the commercial side. Starting with Cresemba, the key driver of our cash generation. What is remarkable about Cresemba is its continued strong momentum. 11 years after the first commercial launch in the U.S., the drug is still growing in market sales 25% year on year. It has reached now $817 million in annual sales on a rolling basis as of the end of June 2026. That combination of scale, growth, and longevity demonstrates the durability of the Cresemba franchise. Importantly, we believe there is still more to come. Cresemba is already today the leading branded antifungal in the world, and it is on track to become the biggest-selling antifungal in the world ever. We expect generic entries in the U.S. in Q4 2027 and generic entries in Europe in H2 2028. But the Cresemba story does not end there. We continue to see meaningful opportunities for growth beyond 2028 in markets like Japan and, again, outside of those key markets. From a financial perspective, that matters. We expect Cresemba to remain a strong, durable contributor to our cash generation over the entire period of Agenda 2030. Cresemba clearly is driving our cash generation today, but as we look more towards 2030, we want to broaden our revenue base. We want to have more growth drivers and reduce our dependency on a single asset. Zevtera is an important part on that journey. As David mentioned, U.S. approval for the drug was one of the important milestones that we had set for ourselves back in 2022. The U.S. remains the most important market for branded hospital antibiotics with MRSA activity. That is why we are particularly pleased that the drug was launched in the U.S. by our partner, Innoviva Specialty Therapeutics, in July 2025. Initial activities with regard to market access and coverage have been very successful, so a strong foundation has been set. From that perspective, we, as well as our partner, are expecting that Zevtera revenues will gain momentum in the quarters and years to come. To put that into perspective, Zevtera is unlikely to materially contribute to our cash contribution in the cash generation in the coming years relative to what Cresemba is going to do. But as we move closer and closer to 2030 and beyond that, Zevtera is going to contribute more meaningfully. With market exclusivity until 2034, we are convinced that it will support our long-term growth with the contributions that Zevtera is going to make in the future. The bottom line is clear. We have a strong and durable commercial business. In February this year, we announced that in the period 2026 to 2030, we are aiming to generate CHF 600 million in cumulative sales, cumulative cash flows from Cresemba and Zevtera. So where do we stand? I would say so far, so good. As of August, we indicated that based on the strong sales momentum that we are seeing in Cresemba, we can increase our revenue guidance for our commercial business from CHF 180 million to CHF 210 million. This is, of course, not all, even with our business model, transferred into cash. So what you have to hold against it is cost of products sold of about CHF 30 million. This is actually how far I will go with math tonight. That basically means that the number that really matters is CHF 180 million, so CHF 210 million minus CHF 30 million, in cash flows that we expect to be generating from Cresemba and Zevtera in 2026 alone, which is already about 30% of our target, which we had set ourselves under Agenda 2030. We have a strong starting point with significant further growth potential ahead of us. Coming to the second driver of our financial strength, non-dilutive funding. Under our existing agreements with BARDA and CARB-X, we are basically eligible for potentially up to CHF 440 million in non-dilutive funding, of which CHF 350 million are expected to be available in the period 2026 to 2030 if we deliver according to plan. Non-dilutive funding is particularly interesting and attractive for our shareholders. It reduces our own level of investment that we have to do into our R&D pipeline without diluting our shareholders, without having debt on our balance sheet, or any obligations with regard to paying back basically the support that we have so generously been receiving from BARDA and CARB-X. It allows us to advance an ambitious clinical portfolio while preserving financial flexibility. Coming to the third driver, basically the balance sheet. As of mid this year, we had CHF 176 million in cash and cash equivalents. Since 2022, we have been consistently and significantly reducing our debt level and are expecting to become debt-free in the course of 2027. Importantly, looking ahead, we expect to be able to fully fund Agenda 2030 from our own cash generation and from our own financial means without the need to raise any further capital. This again, increases our strategic flexibility for future decisions. So far, I have talked a lot about financials and commercial success of our portfolio, but ultimately, that success starts with something much more fundamental. Our products address a relevant medical need, and they reach patients on a global basis. That is what creates the foundation for the long-term commercial and financial success. Our global commercial reach is built on a strong and established network of partners. These partnerships allow us to access markets, to reach patients all over the world without the need to have our own infrastructure and build our own infrastructure in all these countries. Many of these relationships that you are seeing there on the right-hand side have been established a decade ago and have grown over that decade. That combination of global reach, longstanding partnership, and durable franchises is an important strength of our business model. To make this whole a little bit more tangible, through our 11 commercial partnerships that you have seen on the previous slide, we have actually made Cresemba and Zevtera available in more than 70, almost 80 countries around the world. In the meantime, more than 600,000 patients with severe infections have been treated with our products in all different age groups. Ultimately, that patient impact is what sits behind the commercial and financial success of our brands. This track record is also important from another perspective. Cresemba and Zevtera provide the tangible evidence, the tangible support for our ability to bring differentiated products to the market, to patients around the world. That gives us a strong foundation in our discussions with potential partners when it comes to acquiring or in-licensing novel assets. But having the financial capacity to invest and being an attractive partner is only part of the equation. We also need to be disciplined about where we put our money. There are plenty of assets in our core area of anti-infectives for severe infections. For us, it is not only about adding more assets to our pipeline, it is about adding the right assets to our pipeline. That means to be selective and to apply consistently the same criteria, which are well-defined for us, to the opportunities that we see before we act on them. Everything starts actually with the question, we need to be convinced that we are a good owner of an asset. That means there must be a clear strategic fit with where our expertise lies and with our capabilities to allow us to add meaningfully value over the life of the asset. If we cannot see how our ownership creates additional value, the asset is not right for us. The second question is equally important, and that is, does the asset address a relevant and meaningful unmet medical need? For us, innovation for the sake of innovation is not sufficient. We need to be convinced that an asset has the potential to address, to make a difference to either patients, healthcare systems, and/or society, ideally to all of them at the same time. That combination of innovation, of meaningful impact, is what matters to us. Then comes the question of positioning. Can we generate the clinical evidence that allows us to clearly differentiate the asset and to demonstrate where its use in clinical practice should be? For us, simply running a phase III study that meets its endpoints is not enough. We need to see evidence that supports why a product can make a difference. That is ultimately what gives us confidence that we can build a differentiated, commercially attractive product. We heard before, just in the panel, about feasibility. The plan needs to be executable at the end of the day. We need to have some visibility that there is actually a path forward, and therefore, we are putting actually quite a keen eye on timelines, on risk, and then also, of course, on the level of investment that is required in our view before we commit any capital. The ultimate step is basically to look at the economics. We need to see a path to viable and attractive commercial partnering. Again, very much in line with our model. This is where all the pieces come together. The unmet medical need, the positioning, the development path, ultimately the commercial opportunity. It is the final pressure test for the business case before we decide whether an opportunity is right for us or not. Now, it is time probably to wrap up, so let me bring all these things a little bit together. In essence, we are in a very strong position to be able to execute on Agenda 2030 and the three priorities that David laid out. We have the late-stage pipeline that is on track and moving towards meaningful readouts and milestones over the next years, I would say, which should eventually allow us to broaden the commercial portfolio from currently two assets to four assets by 2030. We are progressing our early-stage clinical pipeline, which we already have, and we keep on adding and looking for new opportunities through business development activities. They are leveraging our strong anti-infectives track record and also our financial strength and flexibility. There is one final last-minute update that I basically have to do with regard to our financial targets. So far, I have been talking about the CHF 600 million in cumulative cash flows from Cresemba and Zevtera that we aim to generate under Agenda 2030, the CHF 300 million in non-dilutive funding, and the CHF 160 million in cash that we had as of the end of 2025. As of yesterday, we have raised the bar. We are now expecting to generate CHF 650 million in cumulative cash flows over the same period, but at the same time, we also expect to generate CHF 215 million already by the end of 2026, which in essence means that we are still on track to have about a third, in essence, of the target realized by the end of the year. This extends to our complete guidance for 2026. In essence, what you are seeing here is that the strong commercial performance, which has allowed us to increase our revenue guidance, leads to a significant increase in operating profit as well, underscoring, in essence, the strength of our business model, which allows us to turn revenue growth quite directly into operating profit and cash flow. Bearing that in mind, that gives us the financial strength and the flexibility to invest in our existing pipeline, into future growth opportunities, and to stay, in essence, one step ahead. With that, I think I will hand over again to Olivia Kinghorst for the next part of the program. Wonderful. Thank you so much. A lot of numbers and figures for us to process, so I think it is a good chance for us now to try and summarize and bring everything back home. With that, let us call upon Marc Engelhardt, let us call on David Veitch back to the stage. We are going to hear from CEO, CMO, and CFO. We are already getting quite a number of questions from the audience. Why do not we actually start there? Who wants to take the first one? Okay. Let us go to the gentleman behind you, and can we bring a microphone there as well? Thank you. Yeah. Yeah. Take center stage. Yes, in the third row. Thank you for sharing the numbers. I am Debo. I am a PhD student at the University of Basel, and I have a question for Adesh. You spoke about the numbers and two key factors were the market need and also when the drug goes generic. I was wondering how you calculate the risk that resistance develops in this period and how it affects the sales? Over the lifetime, you mean? Yeah. I think, again, maybe I am not the right person to ask this, but in essence, part of the profiling is, in essence, of course, to also check or profile what is the frequency of resistance occurrence that happens. There are sort of standard procedures where you can say, how much liability have you for the buildup of resistance? That is an intrinsic part of what we consider before we actually move forward at all. Then comes into play, of course, looking at the biology, the mode of action, which also gives you some indication about how essential is basically a target, how easily would it be evaded. I guess finally, that is more or less the positive flip side of what we have heard before, resistance is quite frequently driven by the volumes, volume of use. As long as there is some level of antimicrobial stewardship that is around, that actually plays against sort of the pressure of resistance buildup. I would not say that the buildup of resistance over the commercial life of the product, so far at least, has been demonstrated in our case to be limiting for optimizing or maximizing the value. Thank you so much. Did we have another question? Yes. Thank you so much. Staying with you, sorry, we will come to the others. Eric working at Guard P, and I found your criteria for acquisitions or licensing of new assets both surprising and inspiring, especially if they are in that order. You presented strategic fit as the first one. Could you comment on that? I think this is important. We are operating in a therapeutic area that is not very forgiving, I would say, from a financial perspective. You have to be efficient. You heard that the returns, to some degree, are limited. You are not suddenly having a drug that is probably going to make $5 billion in sales. That is extremely unlikely to happen. How can you manage that your return on investment still works out? It is by being very, very disciplined about your level of investment. That is not by cutting corners. It is, in essence, to really leverage economies of scale and scope. Where can you efficiently leverage where you have your strength? That is, I think, probably reflected in that abbreviated sort of, there needs to be a strategic fit. Now, Adesh, I am well aware that you are the numbers guy, and we know that everyone loves to put that under the microscope. But I want to turn over to actually the company as well, because last year or two years ago when we gathered here, you had about 160 employees over at Basilea. Now that is about 200. Just curious to know, David, from your point of view, where have you added, in fact, the most competencies? Which area has grown in the company, and where is still maybe lacking where you need more expertise? Yeah. Good question. So, yeah, we probably put, I think I have got my head of HR who would give me the absolute number, but 40 to 50 extra people in the last sort of, whatever, year, 18 months. Those people naturally, when you bring in a new We brought in ceftobiprole medocaril in August of 2025. You cannot have a program that is getting ready for phase II, III development and just say to the existing team who are doing fosmanogepix, "Oh, also do this." It just does not work. I think my medical team would all leave. Marc would leave. So actually, if you have got programs and they are serious programs, you have to resource them appropriately. So, not surprisingly, therefore, to answer your question, most of the increases come in, like, for example, clinical development. But also, I mentioned earlier that manufacturing, when you submit an FDA package for a drug registrational package, you have to have a supply chain. You have to have manufacturing sorted out. API, drug product, finished product, all has to be done. So, we've got a competent technical operations team working closely with the quality team. So I've had to increase my positions in technical operations, in quality, in clinical operations, all the resources, all the departments that you would assume you need to develop a drug through to wherever it is in its development. So yeah, they're mostly the areas. Marc, turning over to you. I mean, a lot of the attention has been on Cresemba so far. Is there any assurance that you can give to the audience that we will continue to see this growth trajectory of double-digit growth? Or what confidence could you give to the audience there? From our development pipeline, I think fosmanogepix, you can see the take-up in the expanded access program. We can even look at this compared to a promoted isavuconazole launch, compare this in certain countries, what we have in terms of demand of fosmanogepix. So absolutely, this and the profile of fosmanogepix leads us to a $1 billion peak sales estimate. It's not a number we've just invented. So we look at where do we see indicators of the need for this program, and this expanded access program, I think, is unprecedented. Probably hasn't been seen since the cures for hepatitis C or HIV. I think we've been probably consuming about 15%-20% of every emergency access request the FDA receives every year. I think that shows you the unmet medical need and the pull for this drug. Ceftibuten-ledaborbactam as an oral option in a validated market, when you look at the IV drugs, so especially AVYCAZ, but also cefiderocol, I think you can make an assumption, and we've also done, of course, market research of what will be the share of patients that can be transferred on oral treatment. I think from a market access perspective, making an argument that you save emergency day visits or hospital stay visit, that should be a fairly straightforward argument. So let's turn back to the audience. Yes, we've got a question over here in the third row. Joris Zimmermann from Octavian again. I would like to follow up actually on that fosmanogepix comment you just made, Marc. On the EAP, you mentioned the 600 patients, which from my perspective is quite exceptional, regarding a pre-commercial asset. To what extent do you think that does de-risk the phase III trials and the potential commercial launch? Then coming back to the resistance, also in considering the new mode of action, can you comment on any potential risk or the likelihood of resistance development with fosmanogepix? Yeah. To the first question, how much the expanded access program is de-risking the regulatory, I think, let's say the limitation of the expanded access is it's very difficult to put response rates into context. We are seeing, let's say, 70%-75% response rate in patients that have failed prior treatment, but it's difficult to really put this into context. What you see is the drug works, but predicting the study result is still difficult. It certainly de-risks it. It gives you proof of concept for sure, but it does not really predict your randomized study result. But certainly, it will help us also in the filing in terms of pediatric experience. We've just presented about almost 30 smaller children experience in this expanded access program. This will be useful for an NDA or MAA submission in addition to long-term safety. There's multiple aspects that can go into the NDA. We can see the drug works, but we will still have to wait for the result of the randomized controlled studies. Resistance development for fosmanogepix, what's been seen in vitro is really a modification in the gene of the target, so GWT1, but that's really infrequent. We currently roughly estimate the risk of resistance for fosmanogepix is similar to echinocandins, so really low digit, and it will need a lot of exposure to get there. As said, experience will tell us, but if you wanted a ballpark, that's what we currently project. Thank you. Yes, at the back there, then we can turn to the front. Maurizio Bernasconi. Two questions from my side. One on the business model. Of course, it was very wise back then in 2021 to opt out from oncology. You were kind of balance sheet constrained, therefore you had to partner out your best assets. Now, of course, fast-forward 2030, you are in a different cash position, finance position. Is there any change to the business model in the sense that if you would be commercializing your drug your own, you would definitely have different multiples on these peak sales, at least in some geographies? That would be the first question. The second one on your BD efforts, of course, it is normal to look where the unmet medical need is, where the commercial appealiness is. I was wondering whether you are very much still sticking to your anti-infective core, because if you look that on the novelty side, there are relatively few assets available, so I guess you would be pretty much done very quickly to look at them. So where is the next therapeutic area, if at all, looking forward 10 years from now? Thank you. So, maybe I will start with the first one, then maybe you talk about the second one. I think, yeah, biotech is a rollercoaster ride, and back at a point in time, you make a decision that you make. The reason we think this is the right model even now and going forward is that when we do the sums, it is a financial decision, actually, our business model, even with fosmanogepix, ceftobiprole. I mean, you never say never about doing it yourself, but if you think about Cresemba, really biggest sort of cash product ever in this market. In the U.S., it is going to peak at about $400 million, yeah? That is the biggest market. So if it peaks at $400 million, that means for sort of and we know how much it would cost to commercialize it, have our own structure in the U.S. For four or five years, we would be losing money, yeah? That is for the most successful product ever, yeah? I would never say never. Your question is a good question because we ask ourselves that a lot. If we had absolutely at the same time launched ceftobiprole, nedapiprim, and fosmanogepix, and something else, it might make sense to do it ourself in selected markets, like the U.S., for example. Strictly speaking, for us at the moment, this model, our model makes sense because we are cash flow positive. I know we do not get the whole margin, but from a sort of cash perspective, it makes sense, we think, yeah? But actually, if the world was to change, if the PASTEUR Act in the U.S. was to become law, and actually suddenly the world changed for antibacterials and antifungals, and we got a guaranteed return in the U.S., then obviously I have a different answer, yeah? As of today, with the world that we live in today, we think it has worked well for us for the last years, and we think it is still the right model for us. But like I said, the caveat is I would never say we would never do it ourself in selected markets. But at the moment, it is the right model. Maybe you could comment on how do we build out. Are we just staying in the bacterials and fungals? Oh, there is an Agenda 2035 and 2040. No, to be serious. You heard about the unmet medical needs. Already in the 30s or 40s, basically people felt like, "Okay, we have solved the problems of bacterial infections." This therapeutic area is not going to go away. The problem of treating bacterial and fungal infections, again, is my hypothesis, is not going to go away. That is maybe one point to say. That sets really this therapeutic area apart from many others. But then also, I think we still see mortality rates, you heard about 45% that can go up to 90%, which simply cannot be yet the end of what is achievable based on all the technology and all the progress that we are making. So there also, I think when we are looking at opportunities currently, we should not limit ourselves to the tools that we have available today. That is the second thing I would say. If we are sort of a leader in this space, we will certainly keep an eye on what may be coming next and could transform. But also beyond that, infectious diseases is also broader than just the treatment of severe bacterial and fungal infections. We have been talking so far about this very narrowly defined focus of severe bacterial and fungal infections. As we were asked before about synergies, we are certainly aware of that our strength, also our business model, but also our capabilities may have utility in other areas of infectious diseases beyond just narrowly severe bacterial and fungal infections. We see growth opportunities beyond 2035 or 2040. Wonderful. I am conscious that we have time for maybe perhaps one or two questions left. Yes, from the gentleman in front. Adesh, I wanted to circle back to one of the aspects that you addressed in your prepared remarks, which is the well-established partner network that Basilea has, and what implications this may have for fosmanogepix as and when it ultimately is in position to be commercially introduced. At this juncture, would you say that it is reasonable to expect that you would use a very similar partner network to the one you already have in place for Cresemba? Because obviously, those partners you already have would perhaps have the greatest interest in a drug like fosmanogepix because they are already antifungal experienced. They would be probably just as concerned as you are about the potential eventual end of market exclusivity for Cresemba and would be looking to replace it. Or would you look at potential other ways of establishing a partner network to optimize the value of fosmanogepix? Very briefly, if you could touch on what aspects of pricing dynamics might be different for fosmanogepix versus Cresemba, mainly because, unlike Cresemba, fosmanogepix is a first-in-class antifungal. Thank you. Okay. A very broad question, in essence. Maybe to make it a little bit shorter. For Cresemba, I think we are very happy with the partner network that we have. However, we ended up with this network because of some decisions, as David also said. You make decisions based on where you are at some point in time. Probably having the number of partners that we have for Cresemba is not the optimum. I would not just take the blueprint and say like, "Okay, that is exactly what should happen." However, two caveats. One is, of course, yes, it makes absolute sense for our current Cresemba partners to look carefully at fosmanogepix. They have significant synergies, and they should be able to value it to a different degree than maybe somebody who is newly entering the space. We will certainly be talking to our partners as well, our existing partners. Then we will, as in the past, also run processes just to make sure that at that point in time, we have the optimal decision that we take. Probably having just one partner is also not the right choice from a risk perspective, also capabilities perspective. No company is equally strong in all the relevant geographic areas. Unlike what we were talking about, Zevtera, where the opportunity is largely in the U.S., for fosmanogepix, also for Cresemba, the opportunity is global, in essence. We really want to make sure that we can globally make the drug as effectively available to patients. Then your second question was about- Perhaps I can just quickly jump in. Will you be around, sticking around with us in the apéro? Okay. I am sure Adesh will be happy to take this over a drink because I sense you have many more questions. I think maybe just to- Olivia, sorry to interrupt, but just one thing, though, just to finish on what Adesh was saying. There is one other point, which is the timing of this partnership discussion, because fosmanogepix, do not forget, I think you know this is different than ceftibuten-ledaborbactam. We have a contract. When we in-license the product from Pfizer, fosmanogepix, Pfizer have the right of first commercial negotiation. Yeah. Actually, that is after the phase III study results come out. Yeah. Actually, everything Adesh said is right, but the timing of when we could talk to people is determined by the agreement we currently have with Pfizer, whereas with ceftibuten-ledaborbactam, we have not got such an agreement, so we could talk anytime. I would just add that on top of what Adesh said. Sorry, Olivia. No, no problem at all. Do we have any other question in the audience before we turn to those coming from online? Okay. Adesh, you are being put in the hot seat today. Totally. So, under today's U.S. government, how likely is it that BARDA will continue funding of new anti-infectives abroad also in the future? Would you like to take that? Oh, that's- He's getting all the easy ones. It's getting progressively more challenging. So, it's even more of a crystal ball that I would need for that. I can just say that I think the mandate of BARDA is to protect the U.S. population, in essence, from biothreats, from other kind of threats that they are out there. And this is not hugely, I think, controversial and is also not inconsistent with the priorities that the current administration has and the past administration had. And also history shows to some degree that since 2012, we have been working with BARDA, actually, across a number of projects. If the past, and I know in the financial industry, you always say the past is no indicator for the future, but if the past is some level of an indicator how it may continue, I would say I would remain at least optimistic that they will keep on supporting the development of novel antibiotics and antifungals as long as it meets their goal of protecting the U.S. population. Now, to tie everything all together, I am going to hand the last question over to you, David. You talk a lot about Basilea being a big fish in a small pond. Do you see any major competition on the horizon? No. Yes. Sorry. That was too easy. No, actually, the good thing about being a big fish in a small pond is that you are a big player. I am not saying we are the only player. But it means that, as Adesh said, opportunities tend to come to us from other companies, from physicians. We hear of opportunities. We go and look for opportunities. We are a serious player in this area. So, whilst we are trying to make, and the question at the back that Adesh answered about, we are looking outside of our serious bacterial and fungal infection area, just can we make the pond bigger? Because we think we have got a good model, good strategy. We want to play to our strengths and get more products around our business model cycle, and that means we might have to look outside of bacterial and fungal infections, our strict definition. But no, and there is always competition, yeah? But, I suppose it is quite sad for physicians that there are not enough companies- actually working in this area. In a way, you need competition. The competition we have, we value. It was mentioned that there is another oral alternative for resistant UTI pathogens, from GSK and Spero. That is good because they can help us create the market for an oral drug to treat resistant pathogens. Competition is not always bad, but it is good being a big fish. Now, maybe just a final point to wrap up and asking on behalf of all the investors and analysts in the room, if there is one metric or one milestone that we should be looking at to judge the progress of Basilea, what should that be? Yeah, it is a bit like Oliver's answer to the question, which factor? Is there one factor? Because I think for us, it is two things. Adesh would say the finances keep on going in the right direction. But I would add to that clearly, I think we will be set if we have four commercial products by 2030. And in particular, with the profile of fosmanogepix and the potential we think we have, I think the progress of fosmanogepix, the completion of the phase III studies and the approval of fosmanogepix. That is obviously pivotal for the company. Okay, plenty of food for thought there to prepare for the next Capital Markets Day. Now, we can save some questions, of course, for afterwards, but with that, I think it is fitting to end the discussion here, and we will hand the floor over back to David to deliver some closing remarks before we get into the networking. With that, thank you so much to all of our speakers. Thanks, Val. Thank you very much. Thank you for staying for the whole afternoon. Hopefully, you found it interesting. I would just say, before I wrap up, I would just say Actually, no, I will say a few slides, then I will actually wrap up with a few other comments. I just want to say, let me summarize. At the beginning, I said we are in a good place, but I think the future is even better. Why do I think Basilea will succeed? I think the important thing is we have a plan. You know by now we have this Agenda 2030 plan. I think in life, it is good to have a plan. We have a clear plan, and I think I will not go through it all again, because then I really will bore you. We have a plan, yeah? Which is important. 2030 is a major milestone. It is not the end game. It is something we think is an important milestone on our journey. We are in an exciting moment for Basilea, and we have got an exciting, I think, time to 2030. We have gone through the key milestones. We are well set. I think we have got the right team to deliver on it. Like I said, it is an exciting moment for the company. To go back to the title of the meeting, "One Step Ahead, The Next Chapter," our chapter should be an exciting one, and we are trying to make it an exciting one, yeah? Why do I feel so excited? Just a few summarizing comments. I think our focus, discipline, our business model, our products, our people, we have created a sustainable, profitable company. Coming back to the question about, you could do things yourself, go and commercialize yourself, I think at this point in time, that would be the wrong thing to do. I think our model is the right model. We are projecting a period, and Adesh went through this, and as of yesterday, you heard the update on the financials. We are projecting a period of strong financial strength over the next five years. We will build on our leadership position, this big fish, that we will build on our leadership position in the way we have described during the course of this meeting. The future pipeline in late-stage clinical development that Marc went through, we think this creates significant opportunities for the company. Those two compounds alone, if they became what we are thinking they could become, a $1.5 billion peak year sales between them, ceftobiprole and fosmanogepix, that is double the size of the company we are today with Cresemba and Zevtera in terms of in-market sales. Our business model in this therapy area, to come back to the question, we think makes sense and allows for us to be successful going forwards. Coming back to the theme of the meeting, we have tried to communicate today that as a company, we have this mentality of being one step ahead. I think, coming back to the video at the beginning, in terms of the video montage messages, in summary, we want to launch better products than currently exist. Marc explained why we think they are better products. We want to continue to partner, as Adesh explained, across the value chain with partners such as BARDA and CARB-X, where our skills are complementary to each other. We want to keep the patient need at the forefront of everything we do. We want to continue to lead in this therapy area. We will continue to look for additional assets to build on our pipeline, because there always will be attrition in pipelines, so we need more products. Then if you put all this together, as I said earlier, we think we're set for a chapter of growth for the company. With that said, now I am wrapping up. I wanted to thank you for being here, of your interest, and for sharing this meeting with us. I wanted to particularly thank our external experts, Professor Passam, Professor Cornely. Thank you for making medicine understandable for us non-medics. So thank you very much. Thank you for my other co-presenters and to Olivia. So thank you very much. Basically, networking reception follows. I think Olivia might say a word about that. Actually, we are all the Basilea people you should know, because the Basilea people have a lanyard with white on it. If you see a white lanyard ribbon, it means we're Basilea, and we're happy to answer any of your questions after the meeting. Actually, I understand the external experts will also stay around, so if you want to ask them questions, please do feel free to do so. So thank you very much. Actually, it's just going to be very short and sweet from my side. I just want to say thank you so much for taking the time to come today. I actually hope that all of you have appreciated this opportunity that Basilea has created, like an open forum, an intimate discussion where they've been happy to take any of your questions, concerns, or issues at the top of your mind. So once again, thank you so much. We've heard so much about one step ahead, so now I invite all of you guys to take one step ahead closer to the drinks. With that, thank you so much. We appreciate it. Thank you. Thanks, Olivia.

Data Source: Quartr Last updated: Oct 28, 2026

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