© Bill & Melinda Gates Foundation |

ALL LIVES HAVE EQUAL VALUE

NY Pharma Forum

Andrin Oswald, MD

© 2014 Bill & Melinda Gates Foundation

December 1, 2017

© Bill & Melinda Gates Foundation | 3

WHAT WE DO

Areas of greatest

need

Where we can have

the greatest impact

FamilyPlanning

Polio

Maternal,Newborn &

Child Health

AgriculturalDevelopment

FinancialServices for

the PoorWater,

Sanitation& HygieneNutrition

Entericand

DiarrhealDiseases

Pneumonia

NeglectedTropicalDiseases

Malaria

Tuberculosis

HIV

AREAS

OF

FOCUS

The foundation has donated $44.1 billion since 2002

© Bill & Melinda Gates Foundation | 4

OUR CONTRIBUTIONS

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

5,500

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Mill

ion

s

Grants DCE P&A

HOW WE DO WHAT WE DO

Grantees and partners are at the

center of our work

© Bill & Melinda Gates Foundation | 5

Together, we take risks, push for

new solutions and harness the

power of science and technology

This work requires support from

governments, the private sector,

communities, nonprofits and

individuals

CEO GLOBAL HEALTH ROUNDTABLE

© Bill & Melinda Gates Foundation | 6

PARTNERSHIP IN ACTION: TB DRUG ACCELERATOR

Multiple Candidates,

Advance Regimen to

Proof of Concept

Lead

Optimization

Collaborative

Discovery Research

Hit Generation

Target Identification

Company

Compound Libraries

PHARMACEUTICAL COMPANIESRESEARCH INSTITUTIONS

© Bill & Melinda Gates Foundation | 7

An innovative approach to funding

promising global health technologies

A social impact fund open to individual

and institutional investors

Focused on development of drugs,

vaccines, diagnostics, and other

interventions for low-income countries

New technologies targeting malaria,

TB, HIV/AIDS, maternal and

infant mortality

GLOBAL HEALTH INVESTMENT FUND

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CEP

I © Bill & Melinda Gates Foundation | 9

COALITION FOR EPIDEMIC PREPAREDNESS INNOVATIONS

Click Here to

Watch Video

Live the Legacy.

Live the Legacy. Protect the Future.

Mike Nally, President, Global Vaccines

December, 2017

This presentation of Merck & Co., Inc., Kenilworth, N.J., USA (the “company”) includes “forward -looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of the company’s management and are subject to significant risks and uncertainties. There can be no guarante es with respect to pipeline products that the products will receive the necessary regulatory approvals or that they will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ mater ially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors , including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legis lation in the United States and internationally; global trends toward health care cost containment; technological advances, new products an d patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the company ’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international eco nomies and sovereign risk; dependence on the effectiveness of the company’s patents and other protections for innovative products; and the exposur e to litigation, including patent litigation, and/or regulatory actions.

The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward -looking statements can be found in the company’s 2016 Annual Report on Form 10-K and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov).

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Today, a future where HIV/AIDS can be a manageable illness is closer, in part, because of Merck’s response to the crisis

Our scientists were among the first to discover and

develop medicines for the treatment of HIV

People l iv ing wi th HIV

36.7 MillionOnly 60% of HIV infected

people know of thei r s tatus

Number of people l iv ing wi th HIV

on ant i ret rovi ra l therapy 17 Million

The surest remedy for any disease is to invent the best medicine or vaccine and ensure that the broadest number of patients have access to it

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Children under age 5 died everyday due to lack of simple interventions such as Medicines and Vaccines

Annual Deaths due to Hepatitis

Estimated 257M & 71M with chronic HBV & HCV infection.

Deaths in low-income countries caused by Non-Communicable Diseases

(NCDs) - Cardiovascular, Cancers, Diabetes or Chronic lung diseases

Or 70% of all global deaths were due to NCDs

43% of all NCD deaths occurred before the age of 70

Or 31% of all global deaths due to Ischaemic heart disease and stroke

16,00

0

1.3M

37%

40M

15M

Years increase in Global Life Expectancy between 2000 to 20155

National Health Expenditure $ 2.5

Trillion

Prescription Drug

Expense

$250 Billion

Vaccines

~$19 Billion

US National Healthcare Budget Only Allocates ~1% For Vaccination Programs But Delivers 5 Times As Much In Savings

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Expenditure, 2009 Childhood Vaccination Program Benefits1

Cases Prevented

~ 20 Million

Deaths Prevented

~ 42, 000

Direct Costs Saved

$20 Billion

Societal Costs Saved (Direct + Indirect)

$ 76 Billion

Additional $25.5 Billion In Direct Costs Can Be Saved By Improving Uptake Of Adult Vaccines2

1 Zhou, F., et al. (2014). Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009. Pediatrics, 133(4).

Diseases Evaluated: Diphtheria, Tetanus, Pertussis, Hib, Polio, Measles, Mumps, Rubella, Congenital Rubella Syndrome, Hep B, Varicella, HepA, Pneumococcus-related diseases & Rota2 Estimated Human and Economic Burden of Four Major Adult Vaccine-Preventable Diseases in the United States,

2013 McLaughlin, JM, McGinnis, JJ, Tan, L, Mercatante, A., Fortuna, J., J Primary Prevent

Diseases Evaluated: Influenza, pneumococcal disease (both invasive disease and pneumonia), Herpes zoster (shingles), and Per tussis (whooping cough)

FOR MORE THAN A CENTURY, MERCK HAS BEEN INVENTINGTO SOLVE SOME OF THEGREATEST CHALLENGESTO PEOPLE’S HEALTHAND WELL-BEINGAROUND THE WORLD.

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BUSINESSESVaccines, Prescription medicines, Biologic therapies, Animal Health products

HEADQUARTERSKenilworth, NJ,

U.S.A. operating in more than 140

countries

Merck & Co., Inc.is our legal name and is listed

on the New York Stock Exchangeunder the symbol "MRK.“

EMPLOYEESapproximately 69,000

20 Years of commitment to ongoing HPV clinical development

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PROOF OF CONCEPT STUDIES

(MONOVALENT VACCINES)

WOMEN, 16-26 YEARS

1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017

9-VALENT HPV VACCINE

GIRLS /BOYS, 9-14 YEARS (2-

DOSE SCHEDULE)

QUADRIVALENT HPV VACCINE

WOMEN, 16-26 YEARS

GIRLS/BOYS, 9-15 YEARS

QUADRIVALENT HPV VACCINE

WOMEN, 24-45 YEARS

MEN, 16-26 YEARS

9-VALENT HPV VACCINE

WOMEN/MEN, 16-26 YEARS

GIRLS /BOYS, 9-15 YEARS

8/9-VALENT

CANDIDATES

SELECT DOSE

By expanding the scope

of HPV prevention,

GARDASIL 9 makes HPV

cancer elimination a

realistic

Public Health Goal

Gardasil & Gardasil 9 were developed

over two decades

Gardasil was licensed in females in

2006, and in males in 2009

Gardasil 9 was licensed in 2014, & as a

2-dose schedule in 2016

The New Health Economy is challenging pharma companies to better manage data, place a value on medical treatments, and deal with empowered patients

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We believe we have an important roleand responsibility in improving accessto medicines and vaccines and improvingquality health care worldwide.

Our key initiatives reflect that belief.

M E R C K F O R M O T H E R S

M E C T I Z A N D O N AT I O N P R O G R A M

U . S . PAT I E N TA S S I S TA N C E P R O G R A M

M E R C K F E L L O W S H I P F O R G L O B A L H E A LT H

M S D - W E L L C O ME T R U S T H I L L E M A N L A B O R ATO R I E S

A F YA R A B I E S I N I T I AT I V E

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KEY INIT IATIVES

MSD-WELLCOME TRUST HILLEMAN LABORATORIES

This first-of-its-kind, nonprofit, R&D joint venture is focused on creating new vaccines, and adapting existing vaccines for low-income countries.

LAUNCHED IN

2009focused on low-cost vaccines treating a number of diseases

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CREATING NEW PARADIGMS OF PARTNERSHIPS & DRUG DEVELOPMENT

OUR CONTRIBUTIONS IN FIGHTING EBOLA

During the 2014 Ebola outbreak, we worked in an unprecedented partnership with the international health community and committed to advancing a vaccine candidate to fight a global health emergency

JULY 2016

FDA granted the Ebola vaccine candidate,

rVSV-ZEBOV-GP (V920) Breakthrough

Therapy Designation, and the EMA

granted it PRIME (PRIority MEdicines)

status, enabling the company to continue

to accelerate development of the vaccine

candidate.

DECEMBER 2016

The Lancet published final results of the

2015 Guinea Ebola clinical study, showing

promising efficacy of Merck’s

investigational vaccine against Ebola Zaire

in a ring vaccination trial.

MAY 2017

The WHO declared another Ebola

outbreak in the Democratic Republic of the

Congo (DRC). 300,000 emergency doses

of Merck’s investigational vaccine could

be available in case of a large-scale

outbreak. The story continues to develop.

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Commitment to supply GARDASIL® & Rotateq® to Gavi markets to help our common goal to save lives

Vaccine implementation support to Gavicountries

Upon licensure, MSD has pledged to make the Ebola vaccine available to the world’s poorest countries (Gavi-eligible) at the lowest possible access price

Over 30 Million Doses of Gardasil® and Rotateq® Have Been Distributed In Gavi-eligible Countries Through 2016Over 10 Million Lives Touched

THANK YOU

Japan’s Initiative for Global Health R&D

BT Slingsby, GHIT Fund CEO

Ozawa et al. Estimated economic impact of vaccinations in 73 low- and middleincomecountries, 2001–2020. Bull World Health Organ 2017;95:629–638 | doi:http://dx.doi.org/10.2471/BLT.16.178475

Estimated economic impact of vaccinations

【Japan’s Motivation for Engaging in Global Health 1】

New Drug Development World Ranking: No.3

▶ Japan, with its unique chemical compounds, technologies, and knowhow, is an innovation leader in infectious disease drug creation

Source: JPMA Guide 2010

日本は世界第三位の新薬創出国JAPAN: New Drug Development World Ranking: No.3

One important reason I support GHIT is its effective

engagement of Japanese pharmaceutical companies…

Product development is very difficult, and some important

and potentially game-changing contributions from the

companies that participate in GHIT…

Bill Gates

Co-chair, Bill & Melinda Gates Foundation

GHIT Funding PartnersJune 2017

GHIT’s Product Development Partners

41 Japanese Organizations 53 Non-Japanese Organizations

GHIT Invested Clinical Trials

7Clinical trials

2POC achieved

5FIH conducted

2Clinical trials

0POC achieved

1FIH conducted

April, 2013 December, 2017

26Funding Partners

USD 145MInvestment Capital

９Funding Partners

USD 100MInvestment Capital

April, 2013 December, 2017

R&D Delivery

Governance Finance

GHIT 2.0 Strategic PlanFY2018 - 2022

Pfizer’s Commitment to

Global Health

Darren Back

Senior Director, Social Investments

Pfizer Corporate Responsibility

42

Trends Impacting the

Global Health Ecosystem

Evolution from

Philanthropy to

Commercial

Models

Non-Traditional

Players

Changing

Donor

Landscape

Shift to

Integrated or

Horizontal

Programs

Large Multi-

Company

Programs and

Commitments

Healthcare

Information

Technology

and Data

• Healthcare Inequality

• Urbanization & Population Shifts

• Stress to Healthcare Systems

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PEOPLE PRODUCTS

Making the Best use of Pfizer’s Resources

FUNDING

Innovation and Alliances

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Global Health Fellows

Pfizer’s signature international corporate volunteer program

pairing colleagues with international development organizations

to strengthen health services for people in need

Combines our colleagues’ entrepreneurial skills with our

partners’ efforts to address complex public health challenges

Harnessing Colleagues’ Skills

450+

Colleagues

40+

Countries

350,000+

Hours

40+

Non-profit

Partners

14 Years

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Global Health Innovation Grants

*The Pfizer Foundation is a charitable organization established by Pfizer Inc. It is a separate legal entity from Pfizer Inc with distinct legal restrictions.

Eva Mwai

Regional Director – East Africa

North Star Alliance

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Oncology Access Program:

• American Cancer Society and Clinton Health Access Initiative collaborations with

Pfizer and Cipla to increase access to cancer treatment in Africa

• Market access agreement to expand access to 11 Pfizer manufactured essential cancer

treatment medications and set competitive prices

• Expanding access in Ethiopia, Nigeria, Kenya, Uganda, Rwanda and Tanzania

Oncology Access Program

CANCER IS ONE OF THE LEADING CAUSES OF MORBIDITY AND MORTALITY, PARTICULARLY IN SUB-SAHARAN AFRICA1

CONTRIBUTING FACTORS

Lack of infrastructure, facilities and medicines

Many governments traditionally focused on treatment of communicable diseases

OVERCOMING BARRIERS TREATMENT

3

1ACCESS: Ensure affordable access to essential medicines, technology & infrastructure

QUALITY: Ensure high quality, essential medicines and a secure supply chain

AVAILABILITY: Improve procurement planning and forecasting by leveraging innovative technology

2

Do not distribute. │ 46

1 6 Countries involved in collaboration Data from GloboCan 2012 by IARC. http://globocan.iarc.fr/Default.aspx

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Trachoma Partnership

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• Seek ongoing input from stakeholders

• Think ‘outside of the box’ for creative partnerships

• Focus on sustainable solutions

• Define and agree upfront what success looks like

• Be nimble and willing to quickly course correct

• Share best practices and engage along the way

• Work within the UN Global Goals framework

Leveraging the Ecosystem

for Sustained Impact

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Thank You

The Global Cancer BurdenAmbassador Sal ly G. Cowal

Senior Vice President, Global Cancer Control

14.1 million

American Cancer Society. Global Cancer Facts & Figures 3rd Edition. Atlanta: American Cancer Society; 2015.

New Cases

Deaths

2012 2030

21.7 million

8.2 million 13 million

THE GLOBAL CANCER BURDEN

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American Cancer Society and LIVESTRONG. The Global Economic Cost of Cancer Atlanta: American Cancer Society;2010.

$895 billion

ECONOMIC IMPACT OF CANCER

total economic impact of premature death and

disability from cancer worldwide in 2008.

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The advances we’ve made in the US haven’t

made their way outside our borders to low-

and middle-income countries.

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People are

more empowered

than ever before.

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Tobacco control

Treatment access

HPV vaccination

Lodging and navigation

COLLABORATING TO MAKE A DIFFERENCE

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Where you live shouldn’t

determine if you live.

THANK YOU

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