Good morning, good afternoon, good evening, everyone. Welcome to our ninth annual ESG event. Thanks for spending the time with us over the next 90 minutes. I'm going through the safe harbor statement now. The information presented today contains forward-looking statements that involve known and unknown risks, uncertainties, and other factors. This may cause actual results to be materially different from any future results, performance, or achievements expressed or implied by such statements. For a description of some of these factors, please refer to the company's Form 20-F and its most recent quarterly results on Form 6-K that respectively were filed with and furnished to the U.S. Securities and Exchange Commission. Today, we will have some presentations and a panel discussion.
We start with Sir Ronald Cohen, followed by a Q&A, then we have Lutz Hegemann, Steffen Lang, and Klaus Moosmayer walking us through the ESG presentation, we will do a Q&A as well to end. We start now with a video of Vas, our CEO.
Thank you for joining us for today's event, during which we'll share updates on our efforts to increase access to medicines and environmental sustainability. We've come a long way since our first ESG event in 2014. We continue to evolve our strategy, strengthen our governance, and deliver real and meaningful progress on ESG topics. Novartis has embarked on one of the most ambitious transformations of any large company in recent memory. After over $100 billion in transactions, we are emerging as a fully focused medicines company that delivers high-value medicines to address society's greatest disease burdens. In September, we unveiled our renewed strategy, underpinned by clear focus on five core therapeutic areas, key technology platforms, and priority geographies. As Novartis reimagines medicine, building trust with society remains a key foundation of our strategy.
We remain committed to making progress across the ESG spectrum and on our most material topics as a medicines company. Patient health and safety, access to healthcare, innovation, and ethical standards. Our efforts align with our purpose to improve and extend lives with stakeholder expectations and ultimately with where our company is uniquely positioned to deliver real progress for patients, health systems, and society at large. In today's event, our teams will focus on two of our most material topics, access and innovation and environmental sustainability, where we will continue to play our part in accelerating the transition to a net zero world. We will also share how we are preparing our company to respond to society's changing expectations and adapt to the regulatory landscape. I wanna share two stories that illuminate the ways we're working to translate our commitments into real progress.
First, I wanna highlight a program called Beacon of Hope. Novartis and our Novartis US Foundation launched Beacon of Hope last year, an innovative partnership with 26 historically black colleges and universities, the Thurgood Marshall College Fund, and other companies across the biopharmaceutical industry aimed at addressing the root causes of racial disparities in health. Among other efforts, the partnership focuses on validating data standards in research and diagnosis, and importantly, empowering the next generation of black leaders through educational programs related to health and equity. There's a long and complicated history when it comes to health equity in the United States, and it has resulted in systemic disparities people of color have been forced to endure for too long.
Like all systemic issues, securing real and lasting health equity will require systemic solutions that engages communities directly affected and that bring together institutions that can help shape a brighter future. Our 10-year $50 million commitment is already spurring meaningful action. Through Morehouse School of Medicine, two Novartis clinical trials are already underway and include specific research to help address inherent biases in data standards used to diagnose and treat certain diseases. Data like that could help improve the health system and health practices many lives and generations to come. I recently met with leaders from Morehouse School of Medicine to discuss the opportunities ahead, and I left our conversation with great optimism for the outcomes our broad, inclusive partnership can achieve together as we work to affect real change for communities who need it most.
The second story illuminates progress on one of our flagship programs and speaks to the broader idea that the core mission of our industry to improve human health across the long arc of history is not one that can be achieved in the short term. When it comes to a disease like malaria, which is one of the oldest known diseases plaguing humankind since biblical times, humanity is still working to eradicate it. That is where long-term efforts from companies like ours can pay off. In collaboration with many others, Novartis has been working to tackle malaria for decades. We have delivered well over 1 billion courses of antimalarial treatment, including hundreds of millions of pediatric treatments, largely at no profit since 1999. We continue innovation efforts to bring forward the next generation of malaria treatments.
Together with our partners at Medicines for Malaria Venture, we recently announced a decision to move a novel ganaplacide lumefantrine SDF combination for adults and children with malaria into phase 3 development. These are just a few of the many efforts that are ongoing at Novartis, and there is much more to share. As you've heard me say many times, we aim to deliver sustainable long-term value for our shareholders. We as a company, keep challenging ourselves to maximize the impact we have on patient lives and human health globally. Both my executive committee and I have integrated ESG-related targets into our objectives, and we are fully committed to meeting those objectives and further driving our ESG agenda. Thank you again for your continued interest in Novartis and for joining us today. I'm confident you'll find the event both informative and inspiring as we share programmatic updates.
Continuing efforts like these, I am confident Novartis will soon become the most valued and trusted medicines company in the world.
It's my pleasure to introduce you now to our speakers. Sir Ronald Cohen is a pioneering philanthropist, venture capitalist, private equity investor, and social innovator who's driving the Global Steering Group for Impact Investment and The Portland Trust. He's a co-founder for Social Finance in the U.K., U.S., and Israel, and co-founder, chair of Bridges Fund Management, and former co-founding chair of Big Society Capital. He graduated from the University of Oxford and holds an MBA from Harvard Business School. He's the author of the book Impact: Reshaping Capitalism to Drive Real Change. In the second half of the event, we will hear from Lutz Hegemann, Steffen Lang, and Klaus Moosmayer. Lutz Hegemann, a member of the executive committee, leads the global health unit at Novartis and is responsible for integrating environmental, social governance matters into the core of the company's business, with a special emphasis on innovation and access.
Steffen Lang, member of the executive committee and President, Operations, leads a team of over 35,000 associates dedicated to manufacturing and supplying high-quality medicines to patients and providing operational services and quality services to the entire Novartis enterprise. Klaus Moosmayer, member of the executive committee and Chief Ethics, Risk and Compliance at Novartis, is transforming the organization in the same way the company is reimagining medicine, by pursuing innovation, using data and digital, and unleashing the creative power of employees to embed ethics into the core of our business. With this, I'm handing over to Sir Ronald Cohen.
Thank you. Thank you very much, Nicole, and it's a great pleasure to be here with you, the Novartis team, and Novartis shareholders. We're living at a time when the world of investment and business is going through a massive transformation. I lived through a similar transformation 50 years ago when I entered the venture capital and private equity industries and built up Apax Partners into a leading firm. 50 years ago, entrepreneurship came together with the technology and the professional venture capital industry to bring about a revolution in the way we invest and do business. No investor, no business was left untouched by this revolution. I believe we are in the first stage of an equally massive revolution.
This time it's coming from three forces coming together, and I would like to spend a couple of minutes on this as a background to the presentations that you're going to hear from Novartis executives and the discussion in which you're all going to engage. Few people can refute the fact that we're going through a massive change in values in our societies. It started with young people 10 or 15 years ago refusing to buy the products of companies that are doing harm, refusing to work for them, and investors becoming aware of the implications for the returns on their portfolios. It's led to a change in financial markets that we have never seen before.
$40 trillion of ESG funding are addressing impact as well as profit. Three and a half trillion dollars of impact investment, where the intention to create impact is like the intention of ESG, but where the impact created is measured. These flows are transforming capital markets in unexpected ways. Novartis in 2018 or 2019 launched the first sustainability-linked bond, where its cost of capital basically falls if it achieves certain preset targets about social impact. In the case of Novartis, access of vulnerable groups to its drugs. We see today no less than $2.5 trillion of sustainability-linked bonds and loans. Financial markets have absorbed the message of impact, which is basically that we can no longer just maximize profit and seek to optimize risk and return.
We're in a world now where we have to optimize risk, return, and impact. The second major force transforming our world, for the better I might say, is the force of technology. We see huge leaps of technology with artificial intelligence, machine learning, augmented reality, the genome, and powerful computing, ever more powerful computing coming together. These new technologies enable us to deliver impact globally in ways that humanity could never previously contemplate. Once again, just like the arrival of the microchip and computing and the cell phone and the internet transformed business models right across our world, we're going to see the transformation of business models now that incorporate technology and impact. Tesla is the first example of this, and for all the idiosyncrasies of Elon Musk, it is obvious that Tesla could not have succeeded if it had not had an impact dimension.
Had it tried to just enter the automobile industry with another combustion engine, it would have failed. Because it optimized risk, return, and impact, it was able to attract first consumers, talent, and investors to build what became a trillion-dollar company and disrupted the whole of the automobile industry. We're going to see this disruption occur in every sector. Impact and technology coming together are already transforming the health industry. We begin to see telehealth platforms that are providing diagnosis to very remote places in the world. We see new education platforms where the student pay for their education once they've got into a job. We're beginning to see fintech platforms that are reducing the cost of overdrafts for poor families and transforming the banking system. We see it, of course, in clean energy. We see it in every area.
We are going to be living through a second wave of disruption, this time coming from impact and technology converging. They are converging with the third major force, and that is the force of transparency. For the first time in history, computing power, artificial intelligence, machine learning, and big data are enabling us to measure the impacts of companies in a granular way and to translate them into monetary terms that make them comparable between impacts and with profits. An effort that I have been involved with, chairing the Impact-Weighted Accounts Initiative at Harvard Business School, has published, in monetary terms, thousands of companies' impacts. Their impact on the environment from their operations, their impact on people through their employment practices, their impact on people and planet from their product and their supply chains.
We see the SEC putting on the table transparency on all the environmental impacts that companies create. We see the IFRS Foundation, which is responsible for financial accounting, as all of you probably know, across the world, except the U.S., establishing an International Sustainability Standards Board to standardize the physical impact created by companies. We see the EU mandating transparency on investment vehicles, we see the efforts in standardizing the valuation of impact, which started at Harvard, spinning now into the International Foundation for Valuing Impact. The message, Nicole, is that we are shifting to a world of optimizing risk return and impact, and measuring that impact transparently and in a verified way, in the same way that we do profit. Now, that has major implications for businesses. Healthcare businesses have a major advantage. The inherent nature of their activities is to do good.
If you go beyond that general objective to the things that we have already heard said in this meeting, to the issue of accessibility by vulnerable groups in developed countries, as we've heard about the Black population in the United States, but also in emerging countries, that is going to become one of the factors that pharmaceutical companies are going to fight over. Who is delivering the greatest impact? Accessibility means price. It means making important drugs available at affordable levels throughout the world. As this transparency comes to pharmaceutical companies, their sales and their investments are going to be analyzed by investors and compared. In this regard, Novartis has been a leader in many ways, again, as we heard its CEO say.
I hope that these comments help to frame the rest of our discussion today. We're lucky to be living at a time when financial markets and business are beginning to accommodate improvements to the lives of people and planet, so that we can meet the great challenges we face.
Thank you very much, Sir Ronald Cohen, for those very interesting insights. That obviously triggers now some questions that I may ask you. Maybe just very simple first, what is the difference between ESG investing versus impact investing?
The difference, Nicole, is measurement. Both share the same intention. You can argue that ESG's intention has been so far mainly to reduce harm, and impact investment is mainly seeking solutions to the challenges we face, but both intentions are valid and worthwhile. The big difference is measurement. Impact investment measures rigorously, and ESG will become impact investment as the transparency I've been describing that is coming to us through impact accounting becomes mandatory everywhere. It won't take more, in my view, than three to five years, because we can already see in the work at Harvard that there is a correlation between companies' pollution level and the lower stock market valuation. The higher the pollution level, the lower the stock market valuation. Regulators have to standardize and verify the information that investors get and ensure that they get it at the same time.
We are going through an explosion of impact data today. As measurement comes in the same way that it came to profit in 1933 and 1934, we're going to be transforming ESG into impact investment.
Thank you. You mentioned that impact measurement is the key of the impact revolution. How do you see this from an investor perspective, and how does it work, like, right with the short-term targets when we look, like, from a public company on the quarterly results that we publish? It would be interesting to hear your thoughts on this.
I'll give you an example. If you look at the data sets at the IWA at Harvard, you can see that ExxonMobil creates $39 billion of damage annually on the environment from its operations. It compares with Shell at about $23 billion and BP at $15 billion. If investors look at these three companies and decide that they want to engage with fossil fuel companies, are they going to engage with those that have the worst environmental performance? They will fear that a carbon tax will be introduced and that ExxonMobil will be taxed on $39 billion of damage. They will fear that talent and customers and investors will leave ExxonMobil for the same reason.
If ExxonMobil decides that it wants to remedy its environmental damage, how much is it going to represent in investment and how is that going to affect its bottom line? Investors, Nicole, are going to be analyzing the impact I mentioned in the same way that they have been analyzing the profit dimension. The companies that are able to optimize risk, return, and impact are the ones that are going to enjoy the greatest growth, profitability, and valuation premium.
Thank you. Maybe a follow-up on the measurement, right? It's still very early how we measure, so we are still, like, in a nascent phase. Why should a company make an impact or a focus to actually measure impact if it's so difficult to do so? Would be interesting to hear your thoughts on this.
Well, you don't have to measure every single impact to start with. In many places, we see companies that are already measuring and valuing their impacts. At Harvard, we counted about 100 companies across the world, valuing their impacts, not just measuring it in quantity terms. Why are these companies doing it? Because they realize that the goalposts have moved for business, and that as transparency comes, those who are doing badly in terms of impact performance will see their valuations punished. They are engaging in impact measurement in order to manage and improve their impacts. Take a food company, a company like Danone. Danone, in the Harvard data, creates $8.5 billion of damage a year because of the sugar in its products. You compare it with General Mills.
General Mills creates $2.5 billion of positive impact because it's selling fiber. What are the implications for Danone's product portfolio? How much money is it going to have to spend in updating its product portfolio to deliver positive health benefits? As the transparency comes, its competitors are going to be going in that direction. You can see that the transparency is going to create a race to the top. Those companies that don't embrace impact today are going to be like those that didn't embrace technology when it started to come on the scene four or five decades ago. They will be overtaken by new and existing competitors, very often by new ones.
Thank you. You talked about the challenge of risk, return, and impact. If I may ask you, for a multinational company, when they shift, what do you see as the biggest challenge for them to implement?
I think different companies, if they have transparency on their impact, will begin to address the various dimensions of their impact creation. For some companies, it may be their product portfolio that requires heavy investment. For others, it may be their environmental emissions and the damage that they cause. For others, it may be their labor practices. For yet others, it may be their supply chains. It will vary from sector to sector. What we can already see happening is companies focusing on all their impacts, as Novartis is trying to do, and to improve the impact performance on these four dimensions of impact creation.
You're mentioning that there are differences, right? Depending from company to company. Are there some practical must-dos to prepare a company to do this shift that you could share with us?
I think it is crucial today for companies to introduce to their finance departments an entity that measures and values the impacts that they create. Boardrooms, before the end of this decade, will not just be looking at the profit and loss statement or profit budgets. They're going to be looking at P&Ls and impact performance, because that's what investors are demanding and that's what talent is demanding. The key today is to manage your impacts. If you want to manage your impacts, you self-evidently have to measure them first. That is what every company should be doing now. Investors are going to be looking for these impacts in order to assess the likely upside or downside in terms of both earnings per share and valuation multiples, PE ratios.
Okay. Maybe, right, in your book you write a lot about the strategy and impact. What is your thinking? Like, what needs to be done to really make the impact part of decision-making and part of a living strategy, and not that it's just like a talking and a story and not, nothing tangible?
I think competition is doing that. You can see what happened in the automobile industry, when electric cars were brought by Tesla. The whole of the industry had to go in that direction. Now, many people in the automobile industry up until then believed that electric vehicles would come, but they had no pressure to do anything about it. Now, with transparency coming, we're going to see pressure on companies to update their product portfolios, and it's going to disrupt the way in which they're carrying out their business. We're going to see investors working out the correlation between better impact performance and future growth and profits. Let me give you an example. I invest in early stage tech impact companies. One of these companies is a company which has AI-based software to manage public transport.
In the old days, such a company, and many of the original competitors in that field still today, only measure their growth and profit. If you look at this company, it tracks the carbon emissions from its vehicles. It tries to reduce the carbon emissions by better plotting of routes, better sizing of vehicles at different times of day according to the demand. It measures commuting times for more vulnerable populations. It measures working hours for the drivers, so they don't work overlong hours, and it measures reduction in number of accidents. Every company, in my view, by the end of this decade, is going to have to start to measure its impact and to manage them as well as its profits.
The issue around transparency, Nicole, is no different than what happened after the Wall Street crash of 29 when investors sat up and said, "My God, we don't know what profits businesses are making. Every company can pick its own accounting principles. There are no auditors to verify them, and companies can even put part of their profit into a hidden reserve without telling shareholders." Four years later, we had the introduction of GAAP accounting and auditing, and then the creation of the SEC. We have $40 trillion of money today seeking to achieve impact with no visibility on the impact being created, and greenwashing is rife. It's taken us a couple of years since the crash of 2019 to get to the moves that I've described by the SEC, and by the ISSB and by the EU.
It will not take us a lot longer than it took us in the early 30s to react to this situation. The catalyst for these changes in strategy at every aspect of a company's impact creation are going to come much sooner than most people expect.
Thank you. No, it's a very nice example, and obviously, right, transparency is very key because you can only measure what you see. Maybe a very simple question. How do you define impact exactly?
For me, impact is the positive effect that you have on lives and/or planet. That is something that has been missing from our capitalist system up until now. Of course, impact has always been in the background for some business leaders. They've tried to do good and to do well at the same time. The system has focused on optimizing risk and return only. It's created almost insurmountable challenges climatically and socially. We see the gap between rich and poor, and Vas was giving the figures for Black populations in the United States in terms of health, getting wider and wider. They're as wide as they've ever been since 1929. Our system is having to change to enable us to cope with these challenges, and it is bringing impact to overthrow the tyranny of profit.
Putting impact performance alongside profit performance to keep profit in its place. The beauty of this transformation is that those who know how to optimize risk return and impact may be even more profitable, probably will be more profitable than those who simply ignore what's happening in terms of values today and technology, and continue to think of profit alone.
All right. We have a couple of questions on the web. Jo Walton from Credit Suisse is asking, you have a EUR 2 billion sustainability bond with excess elements linked to Sandoz. How will you handle this as you split Sandoz? What element of overall access to medicine product delivery score do you think comes from Sandoz operations? I think this is one that we will pause and take in the next Q&A when we talk with our Novartis executives. Here I have one for you, Sir Ronald. For an industry that does so much good for the broader world, the public image of the big pharmaceutical industry, as measured by polls such as the Gallup surveys, et cetera, is pretty poor. What do you think the industry could do differently to address this?
I think the pharmaceutical industry has to recognize that access to its drugs is a key aspect of its impact. To innovate in a cancer treatment that costs $300,000 a shot is not an innovation that provides huge impact in the world. If you could come up with a treatment that cost $10,000 a shot, then you would see much greater impact. I'm making these comments with specific companies in mind, which it wouldn't be appropriate to name. The pharmaceutical industry is going to be measured in the future on who benefits from the drugs that are produced. Is it only the middle class and the wealthy? Is it the vulnerable as well in developed countries? Is it emerging country customers as well? What efforts are pharmaceutical companies making to deliver the maximum impact?
Pharma has to get its head around optimizing risk return and impact, and companies are going to be competing with one another in achieving the best performance on these three dimensions. Those companies that are able to show great impact performance, great accessibility for their drugs, will do better in terms of growth and valuation than those that stubbornly try to maximize profit only and ignore the populations that they are serving.
Yes. Thank you very much. We have one last question on the web. Right. You mentioned before when you talked about impact, the positive impact. When we look at the other side, how do you measure in dollars negative impact on society, for example, the weapon industry?
The which industry?
The weapon industry.
Weapon industry. There are some major difficulties in measuring every impact. In a similar way, we have judgments in financial analysis that determine the profit and the value of companies. We've recently seen a change in the treatment of leases which transformed some companies' balance sheets. We make constant assumptions about revenue recognition for different types of companies that also affect their bottom line. I think we're going to start off by measuring the large number of simple things to measure before we get to really tough questions like the weapons industry. Clearly within the weapons industry, there are some companies that are producing primarily defensive weapon, radar would be an example, and there are others that are working on offensive weapons.
We're living through a period when offensive weapons have become an important part of defending democracy and the right of a nation to survive. We're going to have to improve our ability to measure these types of impacts. It may be that there will be a distinction between defense companies. I haven't thought about it in detail, Nicole. Just as happened with financial accounting, where we started in the thirties with a system which has taken nine decades to refine, we will be constantly refining the way in which we measure impact. Investors will contribute to that thinking, and at the end of the day, will lead to the establishment of standards that they feel should apply to different categories of companies, including those in defense.
Thank you very, very much for your insights and the time that you spent with us. I think we all got a good sense of right what is still ahead of us. Thanks a lot again for joining us. With this, I'm handing over now to Lutz Hegemann.
Thank you very much, Nicole. Good afternoon, ladies and gentlemen. In the next 10 minutes, I'll take you a little deeper into the topic of innovation and access to medicines, as it was already outlined by Vas Narasimhan in his opening comments. Now, I'd like to start by reminding us that at Novartis we have been engaged in the question around access and how we can make our innovation accessible as broadly as possible for more than 20 years. Initially, like many private sector players, we started with a donation model. As of today, we are still the sole donor of multi-drug therapy for leprosy to the WHO.
I was personally very touched just a few weeks ago at the 21st International Leprosy Congress when the leprosy community thanked us at Novartis for this continued support of the efforts to eliminate this terrible disease. In 2001, Vas had briefly mentioned that, we developed our new antimalarial, which is currently still the standard of care, Coartem, and we developed a no-loss strategy, which was already a bit more business oriented than the initial start with the donation program.
Over the years, we've been piloting new approaches, whether that was our Healthy Family community health care model, which I had the pleasure, you will see the picture below was together with my leadership team visiting in India just last month, or the introduction of emerging market brands in low and middle income countries, which allow us to demand a lower price point for our innovation. Novartis Access was another step on the road. As of 2017 onwards, we are, based on our materiality assessment, now integrating access into the business, doing it in a sustainable way, but considering it throughout the entire value chain. Examples here are the Novartis Access Principles that many of you are familiar with, which we launched in 2017. The new strategy for Sub-Saharan Africa, which I'll be speaking to in a minute.
The sustainability-linked bonds that was being mentioned by Sir Ronald, or the collaboration in the U.S. to address health inequity also in high-income countries, is an example that Vas had mentioned, and I'll elaborate on that a little further in a minute. Why does access matter still today and probably today even more than it did in the past? We have, according to WHO estimations, 2 billion people worldwide who do not get the medicines that they truly need. It's becoming increasingly obvious, and the COVID pandemic exacerbated this, that this is not just the low and middle-income country issue, but also a challenge in high-income countries. In low and middle-income countries, we still have a dual burden of disease where we have an unfinished agenda in communicable diseases like malaria, leprosy, Chagas, dengue, many other diseases.
We see also tremendous rise of non-communicable diseases that now the deaths related to non-communicable diseases from low and middle-income countries has long surpassed the death rate in high-income countries. Underlying our structural challenges, we have weak and fragile health systems. We have systems that are under-resourced, lack of investment, but also geopolitical and economic challenges. I travel to Africa quite frequently, and it's heartbreaking to see the current implications that the geopolitical and economic uncertainty has on those communities specifically. Also in high-income countries, we see challenges with the sustainability of health systems, largely linked to demographic and economic challenges as well. The aging population puts an ever more strong demand on health systems. Of course, it is difficult to continue with the current financing mechanisms to enable this.
We do see health disparity as been mentioned before. The Novartis Access Principles that we introduced in 2017 commit us to systematically integrate access strategy across the entire value chain, from research and development through affordability and access, and health system strengthening is a very important component here as well. Our aim is that 100% of our launches have a global access strategy. Now for research and development, essentially what we need to ensure is that the innovations are fit for purpose in resource-rich and resource-poor settings. Affordability and availability is often singled out as the biggest barrier to access. While it is important, we have proven through the different approaches that we have taken over the years that by just reducing the price of a medicine or even giving it for free, we do not necessarily generate broader access.
What is becoming increasingly obvious is that a main barrier is the absorptive capacity of a healthcare or the lack thereof, and that we need to work together with partners to strengthen the health system to derive the maximum benefit from our innovations. Now, what does that mean in practice? Allow me to share a few real-life examples, starting with malaria, which as you heard in Va's video, remains one of the world's biggest killer and has a particular damaging effect on small children. Over the years, we have been dedicated to the cause of malaria elimination. You see a few milestones here, particularly on the research and development side outlined, given the fact that there is not many private sector players engaged in the fight against malaria.
Whether it is the introduction of new technology or the commitment, as recently reemphasized at the Kigali summit, to continue researching and developing new medicines, our commitment remains very firm. Most recently, we have now transitioned our frontrunner molecule combination, ganaplacide and lumefantrine, into phase 3 development, which also has the ability to address emerging resistance, of which we see early signs. We have paired this with a business model that is largely a no-loss strategy and will continue to do that for future malaria innovations as well. As you see, the impact has been very significant. We have delivered well over 1 billion treatments to patients in need, and according to WHO estimations, roughly saved about 7.5 million lives or even more.
We remain committed to this cause and have a fairly substantial pipeline for malaria, but also for other neglected diseases like leishmaniasis, Chagas disease, dengue, cryptosporidiosis, and other diseases at our dedicated research facility, the Novartis Institute for Tropical Diseases in Emeryville. I'm very encouraged personally by this broad and deep pipeline that we will now gradually take forward into development and then into programmatic implementation. Another example that required us to take a holistic approach is sickle cell disease, which is a hereditary disease, and it disproportionately affects people in sub-Saharan Africa, where the life expectancy is much, much lower than in other parts of the world.
While in Africa, patients, 50%-90% of infants die before they even reach the age of five years. People in the United States or the United Kingdom with the same condition can reach a productive adulthood and can live in a fairly healthy way due to some relatively simple interventions. The first intervention is the early detection of the disease through newborns screening. The second intervention is first-line treatment like hydroxyurea. The third then becomes disease-modifying treatments like our own crizanlizumab, which we launched a few years ago in the United States.
Now bringing this to the largest patient population worldwide in sub-Saharan Africa required us to strengthen the entire ecosystem, working with partners to build up diagnostic capabilities, working with partners to bring hydroxyurea into the country at an affordable level, but also working with governments on national treatment guidelines, building up treatment centers of excellence in countries and/or leveraging data and digital like a digital application for newborn screening to strengthen those resource-constrained settings. We are committed to take a model that we have initially piloted in Ghana, where we now have been able to essentially hand over this model to the Ghanaian government at their expenses. We are now replicating this in countries across sub-Saharan Africa.
Ultimately, our goal, here we have been partnering with the Bill & Melinda Gates Foundation, is to develop a curative treatment for this genetic disease, which would, of course, require to reimagine how we are applying gene therapy relative to how we do it today. The idea is to do this in a very frugal way, in a way where it can be injected into patients and deliver its benefit. Oncology, another health priority, which requires a very different approach just given the complexity of this disease area. Here we have taken from the very get-go, a very strong partnership approach, working with The Max Foundation. We have been working with the foundation for over 20 years and constantly expanding the countries that we serve, as well as the conditions in which we operate.
Also more recently, being a founding member of the Access to Oncology Medicines Coalition, ATOM, where we have been partnering the first voluntary license with the Medicines Patent Pool for a non-communicable disease. Our approach in Sub-Saharan Africa, where we have pivoted from a classical, financially driven approach to an impact-driven approach, trying to reach as many patients as possible across three core therapeutic areas and different specialty and programs, has proven to achieve its goal to reach patients more and more and also to the financials follow through, which to me is a proof of concept that you can do the right thing for impact and that your financials essentially follow in parallel, and it can be sustainable.
While we still need to further optimize this model, it is a model that we are very committed to and convinced that it can be continued and will be continued in the future. Lastly, coming to the Beacon of Hope project that Vas had briefly mentioned, which is a unique program that looks at health disparity in the United States, especially as it's being linked to race, but it also shows that work needs to be done in high-income countries. As you see on the left panel of this slide, and I've just selected two metrics here, the impact of a pandemic, where you see a disproportionate effect on the Black population. You had 40% higher death rates in Black Americans than in white Americans, which speaks to that health disparity.
If you look at cancer survival on the lower left panel, where you see just the curves separating from each other in a very alarming way. The idea here of the Beacon of Hope project is first that we want to make a long-term commitment because this is not a quick fix, and we are committing to work together with the communities for more than 10 years. Secondly, it is this co-creation with the affected communities. We cannot come in and say, "Here, we have the solution for your problem," but we first need to listen, and that is exactly what the team did by first listening to the concerns and barriers for a period of more than six months.
What we saw was that the problem lies very, very deeply, and we need to also address it from the ground up. If we want more patients of color in clinical trials, we first need to train investigators of colors. We need to build up trial centers where those patients go to seek care. All of that is being entailed in the Beacon of Hope project with the impact that we hope to see then, of course, that we will have a greater level of acceptance in underserved populations of science and innovation, but also higher level of trial participation as it is becoming increasingly mandated in addition to this being the right thing to do. This brings me to the end, and I'll be back to join the question and answers later.
At this point, I'd like to hand it over to my colleague, Steffen Lang, who is the President of Operations, to give us an update on the environmental sustainability. Steffen.
Thank you very much, Lutz, good morning, good afternoon to all of you. It's my pleasure to be here with you today. Sustainability is a key component of our strategy, we aim to drive sustainability across the entire value chain. Today, I would like to focus on three key aspects: our environmental sustainability targets, our progress until now, and the actions we are taking to build and maintain a resilient supply chain. Our environmental and sustainability ambition is focused around three dimensions: climate, waste, and water. Across all these dimensions, we have three major milestones: 2025, 2030, and 2040. For climate, we aim to be carbon neutral in our own operations by 2025 and become fully carbon neutral across the value chain by 2030. Last year, we further strengthened our climate ambition to net zero by 2040.
This year, we have committed to the SBTI, the Science Based Targets initiative, to develop our targets in line with the 1.5 degree pathways. For waste, we had set a target to reduce our waste by 50% by 2025. We have achieved this target already last year. By 2030, we strive to become plastic neutral in that area. For water, we aim to reduce consumption by 50% by 2025 and ensure no water quality impact from our own manufacturing effluents, both at our own sites and suppliers manufacturing product for us. We aim to be water sustainable as well as a company by 2030. We have defined a very systematic approach across all those areas to meet our sustainability targets. These sustainability targets are well embedded in the objectives of our leaders.
For example, a site head in one of our manufacturing operations has this in his personal scorecard, and we follow this on a quarterly base, the progress we are making against those targets. Here's our performance depicted against our 2025 targets. Overall, we are on track to meet our targets, as outlined here, which we have laid out for 2025. We have clear approaches in place to reduce our environmental footprint, and we build our approach around two key principles. The first priority is always to reduce consumption of natural resources. We typically do this by implementing appropriate innovative technology in manufacturing, so to conserve energy like use of electricity, steam, material usage, or water and cleaning. Nice examples are also upgrading our utilities, like boilers, pumps and motors.
Second priority is to switch to clean utilities and renewable solutions. We are implementing various on-site renewable energy solutions, for example, based on wind and solar across our entire network. This year onwards, we are using 100% renewable electricity in our entire operations in the US and in Europe. Similar initiatives we are also deploying in the area of waste and water. Like most companies, Scope 3 emissions, that means the emissions associated with the external supply chain, are very significant for us, as you can see also depicted here. More than 90% of our emissions are associated with the value chain from outside. Our suppliers, therefore, play a key role in our sustainability journey. To address the Scope 3 emission, we are working on several key aspects. First, we have identified hotspots.
This means where in our supply chain do we really have the big consumers of energy, for example, and causing emissions. We realized that about 60% of our Scope 3 is related to activities where external parties produce for us chemicals, pharmaceutical active ingredients, or drug products. Very similar activities we do ourselves in our Scope 1 and 2. Here the approach is that we share our learnings with our suppliers to make sure that they apply similar principles, and so that we are also very confident that they will follow the trajectory which we have laid down already in Scope 1 and 2. Secondly, it's very important to have a manageable number of suppliers. We're working constantly to reduce the supplier number we have. We have a very large number, more than 40,000 suppliers.
A nice example of the progress we are making is we started several years ago in manufacturing with more than 12,000 suppliers. as of today, we have reduced this number to 8,000, and we have plans by 2025 to reduce this number further to lower than 5,000 suppliers. Through that, we believe we also have a bit larger impact by working with fewer suppliers. We have, for this, activity as well launched the environmental sustainability criteria, to ensure that we have a consistent approach focused also on the outcome with our suppliers. We will embed this. We are in the process of embedding this into the contract so that there is also a firm commitment written down. Of course, this is a journey.
There's not an easy and a one-size-fits-all solution. We work closely with our external parties on this journey together. We are making the environmental sustainability criteria as part of our business discussions with our supplier. Equally, as we are used to talk about quality and reliability of delivery of supplies, we also augment these discussions through the commitments we have laid down on the environmental sustainability. As I mentioned, Scope 3 is very important as a topic for us. Many suppliers we are talking to are on the same page. They are engaged. They want to do it. We also use the opportunity, of course, over the coming years to reassess. If we see that our suppliers are not following our ambition, then we will also deselect those suppliers from our supply chain.
I want to close by sharing with you what actions we are taking to maintain a resilient supply chain in these challenging times. We have a supply chain, this is proven, which is very resilient through the pandemic, which, of course, it was big challenge for all of us. We have shown that we can really react in a responsive and agile way to maintain supply. One key aspect for this is that we maintain a very diverse supply network of over 50 manufacturing sites, and we have built in a dual supply chain of more than 85% of our key products to ensure that if in one part of our supply chain there is an issue, we can always continue to supply.
We also have in our organization implemented since many years dedicated product management teams who manage our supply chain end-to-end by product from sourcing to manufacturing and distribution to our customers. These dedicated product setup covers products contributing to more than 90% of our value chain. We have a big coverage here. We also maintain adequate stock levels of inventory for our key products more than 6 months, which gives us also additional reassurance. We also have established a very strong demand and supply planning process to ensure high customer service levels. Throughout the pandemic, this was also proven to be very successful. The values we see here for innovative medicines, close to 100% service levels. These are year-to-date numbers, but these were the same levels we also delivered throughout the pandemic.
These are only a few examples, and we will continue, of course, to focus on activities that help maintain and even improve our supply chain resilience to ensure that patients have access to their medicines. With that, I would like to close my part and hand over to my colleague, Klaus Moosmayer. Over to you, Klaus, please.
Yeah. Thank you very much, Steffen and Lutz and Sir Ronald. I think we all are absolutely well aware, we can go to the next slide, how important it is for the reputation of a company to have a strong ethical culture in the corporation. This is basically a cross-cutting theme for all pillars of ESG and for building trust with society. In our journey of our holistic ethics, risk management, and compliance approach as Novartis, we are doing both. We are looking, of course, as the external developments, the laws, the regulations, the standards, best practices to build a holistic ethics system, compliance management system. We're also listening very carefully to all our stakeholders. Of course, also to our associates. I want to give you a practical example.
We have now concluded two global surveys, the last years, and a third one to come next year, on the ethical culture in our organization, which is especially important to do this in times of transformation, as Vas had said in the beginning of this session. It was very encouraging to see that in each of these surveys, between 30,000 and 40,000 of the associated participated. We got very valuable insight for our ethics risk and compliance program system. Based on the feedback, we just recently announced a standalone non-retaliation policy, because the fear of retaliation, of not being able to speak up, is a very important topic to foster ethical culture in the company.
Also when we look at our compliance system, when we look at the stakeholder feedback and the collective action we do on our third-party risk management, which is closely linked to the operational topic Steffen raised in the session before on our supply chain. We take all this input and continuously evolve and enhance our ethics risk and compliance system. We will, in a couple of days, announce our new human rights commitments, which is updated, and also issue a new third-party code binding for all of our suppliers and third parties, which also has now a very strong focus on the topic of environmental footprint reduction, as Steffen has just mentioned in this part. If you go to the next slide.
If you look at the focus of society of regulation, it's clear that the theme of third-party risk management, closely linked to human rights, is a very, very important factor on ESG, on the G pillar, also on the S pillar, I would say, to build trust with society. Due diligence is definitely the basis what we do, but not enough. We would say to have a holistic picture, especially on the third-party risk management and the human rights aspects. Next to due diligence, we also, of course, offer the grievance and remediation, we offer trainings, and we engage in collective action and on-the-side activities with our suppliers based on a proper risk management, especially where we see vulnerable communities in labor rights or in the environmental side.
Again, just to reflect on this, we see our comprehensive holistic three-pillar approach on ethics, enterprise risk management, and crisis management and compliance as a good answer for the emerging and developing regulation. Please, the next slide. We will not go into the details, you're all aware of this, we see that the expectation of society, but also of the regulators, and you see this here, is continuously evolving, and we are already there. ESG clearly has developed from a topic for conferences, for discussions, for TED Talk, to a regulated landscape. Novartis has taken quite early already steps to address these regulations and reporting challenges. We have already published our integrated report, which includes Novartis and society aspects. We have brought ESG also as a topic to the risk committee.
We also have a proper setup in our board of directors with a specific focus on ESG. We have also tasked our financial organization to include non-financial reporting into their scope. Maybe in closing, coming to the last slide before we go back to Nicole for the Q&A. Next slide, please. Reporting, of course, is important, and the compliance with all these standards is relevant. At the end, and this should close the cycle back to Vas and Sir Ronald, at the end, it's not about only reporting numbers and figures. It's about impact we have as a pharmaceutical company, which is rightfully so in a very specific position, given the purpose for our patients, and therefore, the impact on ESG is a topic which we all will have in front of our minds. Thank you very much. Getting back to Nicole for the Q&A.
Thank you, Klaus, Steffen, and Lutz. Now I can welcome you to the stage for the Q&A. Maybe, what I suggest we start with the question that we had from the web on Sandoz, maybe for Lutz, right? We have a sustainability bond. What is the impact with a potential Sandoz spin on that? Then what elements of your overall access to medicines effective product delivery score do you think comes from Sandoz operations?
Yeah. Thank you very much for the question. Let me start by reminding us the parameters of the sustainability-linked bonds. If you all recall, there is two elements to it. One is linked to the global health programs, malaria, Chagas disease, sickle cell disease, and leprosy. Here, the medicines that we need in order to make progress are already Novartis medicines or will become Novartis medicines in the future. The medicine that has the largest impact on the world currently is Coartem, and it was a medicine that was developed in our own laboratories. Second to that, I would say, is the leprosy medicine, which is part of our heritage. This element is in good shape. The second part of the sustainability-linked bond was from the get-go linked to strategic innovative medicines.
Those are recently launched innovations as being de-decided by the executive committee and the innovation management board. By definition, also, those are not touching upon Sandoz medicines. I feel very confident that the sustainability-linked bond goals are being unaffected by the planned spin of Sandoz. When it comes to the question of access at large, and it may sound a bit counterintuitive, then, you would argue that generics have to play a role, and I would argue that that indeed is the case. The main benefit of generics is not so much to drive access, but to lower healthcare expenditures. That, of course, in itself is a very important goal as we are seeing health systems becoming less and less affordable. Of course, the generics provide a basic on which we can then bring innovation into communities.
Those generics do not necessarily have to be Sandoz generics or do not have to be necessarily under the umbrella of Novartis. I think it is important that basic care is available and affordable in a country, but it is only indirectly linked to our access considerations with aim at bringing innovative medicines into the countries. It's often an enabler, but it is not a goal in itself. Furthermore, of course, we are also considering how we can continue the collaboration that we had had in the past with Sandoz in the future. I'm very encouraged that we will find a good way that continues to allow us to deliver the impact to the societies and patients.
Thank you. A question for Steffen. Novartis has committed to net zero by 2040. Question number 1 we get from investors is how you plan to get there? There is also a question on the web, which is a bit linked to this. What is the difference between net zero and carbon neutral across the value chain, Scope 1, 2, and 3? Maybe you can address both of them.
Yes. Sure. I think it's correct. The net zero objective which we have is an ambitious objective. We believe it's the right thing to do. That's why we are focusing on it. I think we are on a journey, and we're making a good progress. I think we approach it in steps to get carbon neutral, first in our own operations and in a second step, then extending this same principle to our suppliers or external suppliers. I think we do this by reviewing and improving our process technology, which allow us to produce medicines in a more effective way using less resources and less energy, for example.
The same we also then, of course, export to our suppliers who, in large part do the same efforts as we do with regard to producing, but also with regard to becoming more, more efficient. The other part, of course, is then the energy we use. We switch more and more to renewable clean energy. It's very clear when we think about moving to net zero, that it's a very ambitious objective, and this will require much more collaboration so we can do our part. I think there are a lot of initiatives underway, cross-industry initiatives. A good example is the Energize initiative, where we are founding members.
This is under the leadership of Schneider Electric, where several other pharma companies are also joining in. The effort here is to increase access of renewable energy for pharma suppliers. More than 300 pharma suppliers are part of that effort, more to join. Through this we also believe we can do a step change here. I think with that, as well as embedding it, of course, also in the objectives of our leaders, it starts at the top, as Lars mentioned. It's part of the CEO scorecard. It's part of the executive committee scorecard, but also our site manufacturing leaders have this embedded in their objectives. It's part of our way of doing business. It's a long journey. We are taking it stepwise, and we are confident that we are making progress.
Thank you, Steffen. I have now a question for Klaus from the web. Accepting that the company's key human rights issues are likely to be with third parties and suppliers, however, does human rights due diligence also extend to the direct operations, given that human rights risks are likely to occur in the direct workforce also?
It's a great question. Indeed, from our risk assessment, not a surprise, we see the bigger risk in the third parties. Absolutely. I mean, the whole topic of the cultural journey of being in a dialogue with our associates. We have a specifically targeted ethics system compliance program communication stream into the manufacturing sites to see are there any concerns. Now to make this very practical, I'm also together with Steffen, responsible for health, safety environment, which is also a basic human right topic. We have the highest health safety environment standards in our own operations. Last point as a practical example, because I believe practical examples matter.
We just concluded with Lutz and his global health organization a joint screening of human rights topics, especially in our global health activities inside the company towards our partners in global health, because we believe we have to go broader than just supply chain human rights and look basically at the full scale of our operations.
Thank you, Klaus. I have another question on the web, for Lutz from Stephen Scala from Cowen. In order to facilitate the goal of access to medications, then why wouldn't it make sense for Novartis to re-enter vaccines in a big way, since vaccines are one of the most effective and accessible modalities for improving health?
I can only agree that vaccines, of course, are of tremendous benefit to global public health. But of course, we have seen this, I believe, in the COVID-19 pandemic, is that it is not either/or, but it ultimately is and you need both parts. You need the vaccines in order to reduce the disease burden at population level, you also need very effective medicines in order to treat those patients who, despite vaccines, are still falling sick. Of course, there is many diseases that are not susceptible to vaccination, where vaccines cannot help. I believe and I have great respect for the companies that work in the vaccine space and that innovate here and supply vaccines to the people in need. I believe it is not just vaccines.
The impact that we are aspiring to drive comes from the innovation and comes from the competencies that we have. I always look from a global health perspective into where do I have a need, but also where do I have internal competencies that give us the right to address this need? Based on a strategic decision many years ago, which I firmly believe was the right one, we have exited the vaccine space, but there's still enough to do for us. I believe that with what we are doing, we can still generate significant impact on global health.
Another question for Steffen, maybe a follow-up on the carbon emissions. Right, 80% of 80%-90% of Novartis carbon emissions are coming from Scope 3, and you mentioned that we have more than 40,000 suppliers. Do you have some concrete examples what we are doing to reduce them? Can you also share with us some reactions from the suppliers?
Yeah, for sure. Certainly it's a big number, 40,000 suppliers. We also realize when we start the discussion about our ambition that many suppliers have the same ambition, and this is also coming that it's a public interest overall. Not only from us, society, but also people joining companies, they make a selection as well, which companies has what values and environmental sustainability plays more and more target. I think there is a community being built up of companies like us, but also some of our suppliers, others not yet. There we of course, want to help, we want to support.
Sometimes it's also a bit uncertain because there is not the right level of understanding there, what can be done. As I described before, we have progressed this journey for our internal activities to reduce the consumption of resources through technology. At the same time as well then to focus more and more on clean energy, clean utilities. When we have these discussions with our suppliers, they realize that this can be done. Of course, it's about sharing best practices and so on. We see several very, very good examples of collaborations. At the same time, we also see suppliers who are not interested.
Here, as this is a multiyear program, we set ourselves up that we really partner with those suppliers, where we see they have the same values also in that direction, to become our long-term partners. Others we deselect. Of course, for us it's also good to have fewer suppliers because then we have fewer discussions, fewer interfaces. We can rely of the quality and, as I said before, we are in the process of embedding now the requirements we have on environmental sustainability side by side to our requirements we have in other important areas like product quality, like reliability and so on. This is then becoming part of our norm. This we can achieve both.
We have fewer suppliers, and those suppliers are then the one really who share our values. That's the journey we are taking.
Thank you. I have one more for Klaus. Right, reflecting on various events over the last year with COVID, the war that we have, inflation, et cetera, what do you see as the biggest risk coming to us for 2023?
Yeah. I think we all get humbled in risk management, looking back what happened the last couple of years. What is our guiding principle is that we look holistically on risks. We look at strategic risks, and there definitely we see the topics of market access, of launches, of pricing and reimbursement as top risk. Also we mentioned this, how will ESG develop? How will the expectation of society and the regulation increase? Are we able, what we firmly believe, are able to keep the pace here? Another point on, for Novartis specifically as we are moving to a stand, fully focused innovative medicines company, the importance of risk, of research and development is becoming, of course, even bigger from a risk perspective for our company.
On the operational risks, definitely the topics what we have seen, like cybersecurity, like the relevance of a stable and reliable IT infrastructure. Those, of course, the ethical and compliance challenges we are seeing are there. On the emerging risks, we try to figure in all these developments like COVID, which is not gone. Look at China at the moment. Like the war in Ukraine, into our risk assessment and in concrete risk preventive actions and mitigation, more mitigation activities like to secure energy supply, to secure buy from regions where we may have supply problems in the next years. These are definitely risk areas we have a specific focus on.
Thank you, Klaus. I have two more questions, one for Lutz and one for Steffen. Let's go first with the ones for Steffen from Richard Vosser from J.P. Morgan. We saw you take proactive steps on identifying nitrosamine impurities and Sandoz recalling valsartan, irbesartan, and olmesartan. Can you provide us with an update on where you are in terms of testing of other products for nitrosamine impurities and control strategies you have put in place to mitigate the risk?
Yeah. Thank you very much. A very good question. Of course, the nitrosamine topic is a cross-industry topic which emerged several years ago. In line with the regulations which were laid out by key regulators, we are going through our portfolio with regard to assessing the risk and identifying where necessary to introduce additional testing. We are very well advanced by now. We are roughly 70% through our portfolio. There are a number of products where we, as a consequence, have implemented end product testing. I expect this to continue this the remainder of the portfolio over the coming quarters. We are well in time also, which was set by the regulators. All in all, big effort across industry.
We work also closely with our peers and with many regulators, but we are progressing very well to conclude this, somewhere towards the end of next year.
Thanks, Steffen. Last question is from Keyur Parekh from Goldman Sachs for Lutz. How would positive impact for an innovative pharma company be measured? Reduction in disability? Reduction in mortality? Improvement in productive life?
It's a great question, but also a very complex one. If you find someone who has the answer, please send him or her my way, because we are struggling, of course, like many others, to really find the best way of quantifying the impact and describing this impact. At the current point in time, we are counting patients in terms of patient reach, which makes sense if you do a longitudinal assessment. Of course, it falls short when you are comparing different disease areas or different types of intervention. Disability-adjusted life years could be another next step that sort of takes it closer to the true impact at population level or individual level. I see this as a journey, and it's still somewhat nascent when it comes to the methodology.
You may be aware that we are very much engaged in helping advance and mature this methodology, whether it's the Weighted Account Initiative at Harvard or the Value Balancing Alliance. We'd love to find more precise measures of impact. For the time being, we are counting patients. That is a validated and audited methodology as we need it for the sustainability-linked bond. I do hope that we will have better metrics in the future. Thank you.
Thank you, Lutz. I think that's a nice way to end, right? Still a lot to do, but I think we made a lot of progress. With this, I would like to end the event and thank you all for your participation and interest in the company. Thank you very much.