What is Sustainability for Asia?

SONODA Shigeto welcomed participants to the lecture and reviewed the content of the previous week’s lecture by Dr. Saunthari Somasundaram, President of the National Cancer Society of Malaysia (NCSM), and Dr. Jason Chin Yu Aun, Medical Officer, NCSM. Students provided their views on the issues that had been covered about the medical disparity between rural and urban areas in cancer treatment in Malaysia.

KAWAHARA Norie introduced the lecturer for Lecture No. 9, Angelique LEWIS, Senior Director, Access to Health, Sustainability, Astellas Pharma Inc. It was noted that the BEAUTY and Health Project being advanced by the Asia Cancer Forum and NCSM, with the support of Astellas Pharma, emphasizes enhancing health, education, and literacy in Malaysia, aiming to boost cancer prevention and early detection. The project began in 2022 and is due to run for three years. Dr. Kawahara noted that in the lecture Ms. Lewis would be exploring the philosophy guiding the BEAUTY and Health Project, and how sustainability is positioned within a corporate context. She noted that while the lecture series to date has covered the importance of public-private partnerships, today’s lecture offers a unique opportunity to understand the corporate perspective and discover where they find value.

Ms. Lewis has been a specialist in the sustainability field for a long time. She has been an invaluable advisor and contributor to the BEAUTY and Health Project. Dr. Kawahara noted that the following pre-recorded lecture by Ms. Lewis, who is currently traveling on business matters in Africa, stated that any questions would be responded to by Ms. Lewis’ colleague at Astellas, FUJII Izumi, who was attending the lecture in person.

Ms. Lewis joined Astellas Pharma in 2018 and for nearly six years has focused her time and effort within the sustainability division. Today, she is responsible for a team of five individuals, focusing on increasing access to health in locations where the company has a presence for programs, like the BEAUTY and Health Project, where Astellas provides funding to those programs, and organizations like National Cancer Society Malaysia (NCSM) and Asia Cancer Forum (ACF) come together to create a program to increase healthcare system strengthening and health literacy. As a funder of the program, Astellas is very proud of the work that ACF and NCSM have been doing over the last two and a half years.

Astellas has supported programs like this in other geographies where it has a presence. Ms. Lewis noted that her role also focuses on the daily overview and oversight of the Astellas Global Health Foundation. The Astellas Global Health Foundation is an independent private foundation that funds programs in geographies where Astellas does not have a corporate presence.

Those programs often focus on three key areas, increasing access to help in the areas of neglected tropical diseases and communicable diseases, mental health and children's health, community resilience, and disaster support. The foundation was formed in 2018, and over the last five years has provided funding to increase access to health for more than 30 million individuals worldwide.

In terms of what sustainability at Astellas is, the company seeks to have a positive impact on our planet, our society, and our business. As a global pharmaceutical company, we recognize that the decisions we make today have an impact on lives and futures all around the world.

At Astellas, we put our philosophy into practice to strengthen the realization of a sustainable society. Our key contributions include the creation of healthcare solutions that address unmet medical needs and a commitment to delivering on our corporate and social responsibilities. We believe that earning the genuine trust of society in both our company and our products will positively influence our company's sustainability.

So, when Astellas interacts with society, we engage in the sustainability of society, as well as the sustainability of Astellas. By doing this, we earn the trust of society, which enhances our sustainability. We contribute to improving the health of people around the world through the provision of innovative and reliable pharmaceutical products.

The company’s mission is the sustainable enhancement of enterprise value.

Sustainability efforts are guided by a materiality matrix, which outlines 19 key issues for society and Astellas. Among these, Astellas has prioritized nine material issues. Additionally, two environmental issues have been identified as key issues of strong social demand.

The BEAUTY and Health project in Malaysia has been a valuable experience, as NCSM and ACF have an understanding of what the community needs. Astellas is very proud of the work that has been done to date.

Another project that Astellas funded is the City Cancer Challenge Foundation (C/Can), under which Astellas is implementing a care model in Peru.

Programs supported in FY2022 included AMPATH Mexico through the University of Texas Foundation, which is a community-based cancer prevention and early detection program. Another program was MAP International in the Dominican Republic, which aims to build awareness of prostate cancer and cancer screenings.

Astellas also has programs that are supported on a local basis, and those programs are determined by local staff. Our team is also responsible for the educational activities of medical and pharmaceutical-related organizations in Japan. There are 115 events or organizations that have been supported in fiscal year 2022, amounting to approximately 9.4 million yen in total.

In terms of the scope of Access to Health activities, Astellas looks at three main areas, as shown in the figure below.

The Astellas Global Health Foundation is a standalone legal entity formed in 2018. The foundation brought together three historic Astellas foundations and from that point forward, we have been the global foundation for the company.

The foundation focuses on increasing access to health in geographies where the corporation does not have a presence, and we focus on building “One World: A Healthier Tomorrow.” We focus on improving access to health in the categories of mental health, children’s health, neglected tropical diseases, and communicable diseases, building community resilience, and providing disaster support.

We look to support the most underserved individuals in low and middle-income countries where the company does not have a business presence. Since our formation in 2018, the foundation has provided approximately 10 million USD in grants, bringing the total worldwide funding of the three former foundations to more than 35 million USD over the last 12 years combined.

FUJII Izumi provided a brief self-introduction to her work at Astellas Pharma Inc. (“Astellas”) . Ms. Fujii works as a member of the Access to Health team in the Sustainability Division of Astellas. She has a total of 12 years of experience in the pharmaceutical industry within various divisions at Astellas, mainly focusing on oncology products across multiple phases. Her current role is to engage in project management over health system strengthening programs, such as the BEAUTY and Health Project, in collaboration with external partners. She also is a member of the Japanese Pharmaceutical Manufacturing Association (JPMA) and is involved in work relating to communicable diseases and neglected tropical diseases(NTD).

Dr. Sonoda asked about Ms. Fujii’s motivations in selecting Astellas. Ms. Fujii noted that there are two main reasons for choosing Astellas, one of which is the company’s transparency and efforts to provide new and innovative products. Another reason is that Astellas has recently tried to expand its products, including oncology and also cutting-edge products like cell gene therapy. Working at Astellas also provides an opportunity to work on both non communicable diseases and communicable diseases to serve for low and middle-income countries where a double burden of disease is also expected to face in the future.

  In addition to the information provided by Ms. Lewis, Ms. Fujii noted that Astellas has made significant contributions in the field of neglected tropical diseases (NTDs), such as schistosomiasis as a member of Consortium. 

Dr. Sonoda noted that he works as the chair of the international program for the Toyota Foundation and sometimes it can be difficult to find the most appropriate NGOs and NPOs to work with. He asked how Astellas goes about finding the most appropriate partners to work with.

Ms. Fujii responded that in the case of the BEAUTY and Health Project and also with other applications, there is a strict evaluation process that was implemented, including various criteria for identifying the best partner. Astellas also does a deep dive into the proposal and its feasibility. In the case of the BEAUTY and Health Project, the details were well-reasoned and provided in great detail. After assessing the proposal, it is then proposed to the Board of Directors for approval. Astellas is also always looking for new partnerships with whom to engage in novel programs worldwide.

Dr. Sonoda asked whether Astellas also looks at potential business opportunities in the countries where it is implementing sustainability-related projects and programs. Ms. Fujii responded that as a for-profit organization, Astellas has a responsibility to create innovative new medicines in its core business and invest profits in further research and development. In countries where we have a business presence, we would like to promote activities like BEAUTY that have a positive impact on society and people's health through projects that support and collaborate with NGOs from a medium- to long-term perspective. We are not pursuing short-term profits.

Dr. Sonoda asked by which criteria Astellas evaluates the programs it supports and what particular aspects are focused on in the process of evaluation. Ms. Fujii responded that the program provider is required to submit KPIs and achievements are evaluated against such KPIs. In addition, Astellas expects partners to have transparent communication and manage their own issues as they emerge in timely manner. 

Dr. Sonoda asked about the most attractive and interesting aspects of the BEAUTY and Health Project from the perspective of Astellas. Ms. Fujii responded that the BEAUTY project includes treatment and educational elements. In particular, not only improving screening rates for early detection and appropriate early treatment but also seeking to encourage people to promote health literacy and cancer awareness in the community. Another key point of the project is that it is a cross-border collaboration, which is unusual and it is therefore hoped that the project will make new achievements. She added that the BEAUTY project has the potential to be expanded and adapted to other countries and the outcomes are therefore eagerly awaited.

A student noted that Astellas has a focus on oncology products and asked whether medicine support is also being provided in cooperation with the BEAUTY and Health Project. Ms. Fujii responded that there are some countries where Astellas does not yet sell products, and these are disclosed on the corporate website. Upon receiving a request from a healthcare organization or government, Astellas tries to expand access to its medicines through various initiatives and strategies to enhance access to medicines, as had been introduced by Ms. Lewis in her presentation.  

  A student noted that pharmaceutical companies spend billions of dollars developing new drugs and many new drugs are beyond the reach of people in the developing world. Reverse-engineered drugs can be produced at low cost, but this is not a good practice from a business angle. 

  Ms. Fujii noted that with regards to affordability or sustainability, Astellas need to provide qualified products by prioritizing safety element. Also seeks to integrate multiple strategies under Access to Astellas product, such as by providing products at a cost basis, but also remembering the need to make profit that can be directed into future research and development projects. These considerations are always taken carefully in a way that seeks to strike a balance and ensure access to medicines in low-middle income countries. In the Access to Medicines strategy one of the key initiatives is to provide drugs at a price point that is affordable for the country in question.

 Dr. Sonoda asked if there are any democratic discussions on pricing, or whether top-tier decisions are made on such issues. Ms. Fujii responded that pricing decisions are typically made by a committee.

Dr. Kawahara thanked Ms. Lewis and Ms. Fujii for their lecture and discussion. In Asian countries, tax rates are low, and there is less funding for public healthcare. Moving forward, collaboration with corporations remains crucial. However, for such diverse entities to collaborate effectively, each sector needs to understand each other’s fundamental philosophy. In this sense, the information in the lecture was invaluable for students.