Leighton Jones Director, Emergency Response & New Initiatives Direct Relief

[email protected] History |

Since 1948, nonsectarian, apolitical, and privately funded Established by immigrant businessmen displaced during wartime to help people in postwar Europe living under tremendous hardship HUMANITARIAN HEALTH MISSION

...to improve the health and lives of people affected by poverty or emergencies – without regard to politics, religion, or ability to pay. | Guiding Principles GUIDING PRINCIPLES • Serve People. • Life from the Bottom, Pull from the Top. • Build Upon What Exists. • Remove Barriers. • Play to Strengths. • Ensure Value for Money. • Be a Good Partner and Advocate. • Respond Fast While Looking Ahead. • Do Not Discriminate. • Aim High.

Global Programs |

HEALTH FOCUS

In the United States & throughout the World

Community Health

Disease Prevention

Disease Treatment

Maternal and Child Health

Preparing for Disasters

Responding to Disasters Supporting 2,000 healthcare facilities in 100+ countries and all 50 U.S. states

20,000+ deliveries, $1.3 billion in medical aid delivered in 2019

Largest provider of charitable medicines in the U.S.

Largest facility of pre-positioned emergency response medical supplies globally APPROACH

1. Identify providers and analyze the health needs​ of the most vulnerable

2. Mobilize and deliver philanthropic resources​

3. Derive and amplify insights PARTNERSHIPS Partnerships |

HEALTHCARE DONORS Product contributions from 120+ global pharmaceutical and medical companies

Over $1.3 billion (wholesale) in annual product donations

Thousands of medicines provided that enable treatment of millions of patients annually

Corporate signature programs with AbbVie, Amgen, Baxter, BD, Biogen, J&J, Lilly, Pfizer, Takeda, Teva, etc. Partnerships |

Technology Donors: Partnerships |

Logistics Donor: COMPLIANCE

To ensure the integrity of the supply chain and the products in Direct Relief’s trust for the safe delivery of medicines to people in need Compliance | UNIQUE ACCREDITATION

• National Association of Boards of Pharmacy Verified-Accredited Wholesaler Distributor (VAWD).

• Licensed Rx distributor in all 50 states.

• FDA Wholesale Drug Distributor Registration.

• Compliant with FDA Supply Chain Security Act.

• ~10 audits per year by major manufacturers and regulatory agencies. Compliance | U.S. DRUG DISTRIBUTION LAWS

Federal and state statutes and regulations Code of Federal Regulations • Common aim – protect public health and • Administrative law published in safety Federal Register • 50 titles, 4 applicable: Prescription Drug Marketing Act (1987) • Title 15 Commerce & Foreign Trade • Standards for Rx drug distribution • Title 21 Food & Drugs • Licensing authority granted to states • Title 46 Shipping • Title 49 Transportation U.S. Patriot Act (2001) • Specially Designated Nationals (SDN) List CA Pharmacy Law Book • Code of Regulations Drug Supply Chain Security Act (2013) • California Business & Professions • Authorized trading partners Code • Verification of product • California Health & Safety Code • Track and trace • California Civil Code • Wholesale distributor licensing & reporting

50 State Codes of Regulation Financial Support | SOURCES OF CASH SUPPORT $29.4 MILLION Growth | EXPANDING ASSISTANCE & QUALITY HEALTH CARE

2019 1300

2018 1132.8

2017 1078.2

2016 748.4

2015 859

2014 430.3

2013 372.9

2012 286.1

2011 387.1

2010 318.4

2009 155.20

0.00 200.00 400.00 600.00 800.00 1,000.00 1,200.00 1,400.00

Wholesale Value of Goods Received (in millions) RECOGNITION #1 - Top 10 Charities Changing the World

#1 Charity Top 10 Most Everyone’s Heard Of Innovative Nonprofits

100% efficient Directors’ Award

President’s Award for Peter F. Drucker Award for Outstanding Use of GIS Nonprofit Innovation SANTA BARBARA DISTRIBUTION CENTER Facilities | U.S. DISTRIBUTION CENTER

155,000 sq. ft. facility (10K pallet spaces)

2,800 sq.ft. cold-chain room (300 pallet spaces)

20,000 shipments so far this year (62% increase from 2018)

5.5 million lbs. of product provided

Facilities | CONTRACT WAREHOUSES Netherlands & Mexico

Receive medicines from Amgen, GSK, Pfizer, Takeda, BD, etc.

Fully licensed, bonded warehouse

Pick, pack and ship customized orders throughout the developing world

Products include of cold-chain therapies SUPPORTING COMMUNITY HEALTH Direct Relief’s provider network serves 11 million underserved patients U.S. Community Health | SAFETY NET SUPPORT Support from 120+ donors allows ongoing donations to increase access to medicines and over-the-counter items for uninsured patients: • Partners receive access to online ordering • Receive offers of medicines, supplies, over-the-counter items, personal care and hygiene items • No fees whatsoever – shipping is free. • More than a 1,000 shipments of medicine and supplies shipped monthly. Global Programs | PARTNER ENROLLMENT Humanitarian focus, in line with Direct Relief’s mission

Application, Medical Licenses, Contract required

Online ordering, order fulfillment, batch- tracking/tracing, reporting

Proven track record to distribute

Partner survey data, internal data requests/fulfillment/usage, and other third-party data sources

Associations | ASSOCIATION MEMBERSHIPS GLOBAL PROGRAMS Oncology | ONCOLOGY

Screening and treatment improves life expectancy if addressed with the right education, protocols, and medicines Network of 170+ Global Cancer Hospitals / Foundations

$400M in Cancer Medicines Provided

Member of Union for International Cancer Control (UICC)

City Cancer Challenge (C/CAN) Implementing Partner

Global HOPE Pediatric Cancer Initiative

Oncology | GLOBAL ONCOLOGY NETWORK Network of 170+ specialized cancer hospitals in 56 countries | Diabetes

DIABETES

Programs that address both Type 1 and Type 2, to help people live full, healthy lives

International Diabetes Federation

Life For A Child

U.S. Summer Camp

Awareness / Training in Mexico

U.S. Safety-Net Support

U.S. Patient Assistance Programs

Health Kits for Emergency Preparedness and Response

Disaster Response Stockpile

Rare Diseases | RARE DISEASES

Lifelong commitment to therapy for people around the globe

• Supports patients with Gaucher, Fabry, MPS II, and Spinal Muscular Atrophy

• Baseline level of medical infrastructure and medical staff to safely treat

• New patients added through application and selected by an independent Medical Expert Committee

• Cold chain products with a high degree of logistical oversight Maternal & Child Health |

PROTECTING MOTHERS & CHILDREN

Prenatal Vitamin Distribution

• 46 countries

• 1 million bottles

Midwife Kits

• Designed for 50 safe births

• Facilitated 200,000 safe births

Maternal & Child Health | POSTNATAL HEALTH

Fistula Repair Modules • FY20 Direct Relief provided 125 fistula repair modules containing all the essential surgical supplies and medication . • Enabled 6,000 surgeries. U.S. Community Health | MEDICALLY FOCUSED CAMPS Opioid Epidemic | OPIOID PROGRAM

• Surveyed more than 1,400 healthcare entities, representing more than 4,000 clinical sites.

• Pfizer and Direct Relief partner to provide Naloxone.

• 2017 launch of the program with commitment of 1 million doses. Santa Barbara Neighborhood Clinic’s Janice Shey • Requests for provider- Behavioral Healthcare Coordinator and former addict administered stock as well as kitting for patients, families, friends

Opioid Epidemic | OPIOID PROGRAM ELIGIBILITY

• 501(c)3 nonprofit health facility or public health department.

• Comply with all State Board of Pharmacy regulations in storing and dispensing medications.

• Have a Medical Director or Pharmacist with valid state license.

• Dispense donated products to patients within the United States and U.S. territories.

Opioid Epidemic | OPIOID PROGRAM TO DATE

• 442,770 doses delivered to • 526 vetted healthcare facilities • 49 states and territories

• Public Health Departments: • California • Kentucky • Maryland • Missouri • North Carolina • North Dakota • Ohio • Oregon • Pennsylvania • West Virginia Opioid Epidemic | OPIOID PROGRAM SUCCESS • 198 responses from 43 states

• 62% respondents do not purchase or receive donations of Naloxone/Narcan from any other groups

• More than 10,500 reversals (estimate, self-reported by respondents)

EMERGENCY RESPONSE Disaster Response | PREPAREDNESS & RESPONSE

Pre-Positioned Hurricane Kits

• 100 patients. • For 3-5 days. • All purpose care. • Pre-positioned at FQHCs and on-hand for immediate deployment. • Developed in collaboration with the Commission on Emergency Preparedness PREPAREDNESS & RESPONSE Pre-Positioned Preparedness Kits Recipients selected based on Disaster vulnerability, Past response experience, Patient population, Capacity to respond. Disaster Response | PREPAREDNESS & RESPONSE

Emergency Health Kits

• 100 patients. • For 3-5 days. • Designed for safety-net facilities post-disaster care. • Stored at Direct Relief for rapid deployment. • Wildfire modules.

Disaster Response | PREPAREDNESS & RESPONSE

Emergency Medical Packs

• Mobile non-Rx first aid. • Personal safety gear. • Wound & eye care. • Developed in collaboration with CalEMSA

Disaster Response | PREPAREDNESS & RESPONSE

Family Hygiene Kits

• Essential personal care items. • For families displaced during disasters. • Stored at Direct Relief for rapid deployment.

Disaster Response | PREPAREDNESS & RESPONSE

Disaster Stockpile

• Specific Disaster Needs • Insulin, • N95 masks, • Vaccines, • Etc.

DISASTER RECOVERY & RESILIENCY GRANTS Grants | INVESTING IN RECOVERY & RESILIENCY • Leverage existing clinical network. • Funds to improve resiliency. • Emergency response grants. • Improve resiliency.

NEW INITIATIVES New Initiatives | NEW INITIATIVES • Investigating Alternate Power Solutions • , California, . • Strengthening Relationships with Emergency Management & Public Health. • Assisting with Strategic National Stockpile.

Leighton Jones [email protected]