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AstraZeneca’s CEO on Covid: ‘We Just Have to Adjust to it’

AstraZeneca’s CEO on Covid: ‘We Just Have to Adjust to it’

Sunday, 27 November, 2022 - 05:45
AstraZeneca’s Chief Executive Officer, Sir Pascal Soriot

AstraZeneca’s Chief Executive Officer, Sir Pascal Soriot, told Asharq Al-Awsat in an interview that Covid-19 is not over “and we just have to adjust to it like we live with the flu.”

“Most people who get it basically get sick for a few days and do not need to be hospitalized because vaccines are providing a baseline immunity,” he said.

He stressed the importance of tackling long Covid and protecting the immune compromised people.

Asked about how he felt once he heard the good news from his company’s laboratories that he got the vaccine, he said: “I was very involved in the discussions with Oxford and the development of the vaccine. When we learned that we had a vaccine that works and our team said that we can manufacture it, I was incredibly happy because we thought we can make a difference.”

He also advised people to listen to science and not to social media.

On China’s zero-Covid policy, he said: “I understand the policy in the initial phase … I must say today they will have to transition at some point, China cannot be closed to the rest of the world for ever. They need to reopen to facilitate communication and trade with the rest of the world, people meeting each other.”

Here is the full text of the interview:

- We appreciate that AstraZeneca’s investments and interests go far beyond Covid-19, but is Covid-19 over?

I don’t think Covid-19 is over unfortunately, I think Covid will stay with us for a little while and we just have to adjust to it like we live with the flu. I think this year the biggest problem actually is flu and Respiratory Syncytial Virus Infection (RSV). Covid-19 is still there but most people who get it basically get sick for a few days and do not need to be hospitalized because vaccines are providing a baseline immunity.

With Covid, I think the two key things we now have to tackle are:

1- Long Covid, there are quite a substantial proportion of patients who get Covid and do not recover easily, long Covid can be mild or can be serious and goes all the way up to not being able to work for months.

2- Protecting the immune compromised people, for example people who underwent transplants or have blood cancer have zero immunity and do not respond to vaccine. Those who have multiple sclerosis and solid tumor cancers have some immunity and some limited response to the vaccine. Some people need a different level of different protection and we have developed a long acting antibodies combination called Evusheld to protect them for 6 months. Covid will still be there with us and we need to tackle it but it is mostly long Covid and the immune compromised that should attract our attention.

- As you mentioned, we now have to learn to live with Covid. Thanks to some pioneers, some leaders, CEOs and companies, who helped us to get some immunity and to live with Covid, and definitely AstraZeneca is one of them, as well as yourself. How did you feel when you first heard about Covid and once you heard the good news from Oxford and your laboratories that you got the vaccine? How did you feel personally and as CEO of AstraZeneca?

It was an evolution at the time because we basically heard about Covid-19 just like everybody around January 2020. We have a large presence in China, we are based in Shanghai and we have about 20,000 employees in China. So, as you can imagine, we heard about Covid and the impact on people in China very early on. We were tracking what was happening and we thought: how can we help?

Initially we helped with simply buying masks, where we could and deliver them to hospitals that did not have any. Then we thought: what else can we do? We started looking at some of our medicines and repurposing them to see whether they could be used to treat Covid. After that we started the development of our long acting antibody combination Evusheld and then sometime around April 2020 as we were looking at what more we could do, we came across the vaccine at Oxford and we agreed with Oxford that we could collaborate with them. It was a very successful collaboration and we are very happy we were able to jump in and help.

It has not been a very simple journey because as you can image we took a vaccine that had been created by a great team of scientists but in an academic lab and they had started to develop it but they were developing it doing trials the way an academic center would do it, not the way industry would do it. It was challenging at times, for instance the US asked all sorts of questions because the way the initial trials run by Oxford were not run the way industry does them so we had to catch up and do all sorts of work to bring the program to an industry standard and FDA (Food and Drug Administration) standard.

There were weeks and months of intense work, it was very challenging of course but very rewarding because we made a huge difference. As you know we delivered more than 3 billion doses of vaccine and it has been independently estimated that the vaccine saved 6.3 million lives globally.

- On a personal level, how did you feel when you heard the news from your team that AstraZeneca developed the vaccine and it was approved?

I was very involved in the discussions with Oxford and the development of the vaccine. When we learned that we had a vaccine that works and our team said that we can manufacture it, I was incredibly happy because we thought we can make a difference.

We had set up supply chains around the world to supply different geographies through different supply chains so we can supply everybody. One problem we faced was that we had agreed to partner with the Serum Institute of India (SII) who have a large capacity to manufacture extensively and we had agreed with SII and the Indian government that half of the production of SII would be kept in India and the other half would be exported to a number of countries around the world. But when Covid cases exploded in India, the government had to prioritize their population and decided to keep everything for India. This created a supply issue in many countries.

We faced many challenges no doubt, but everybody at AZ was very happy to deliver this vaccine.

- You succeeded in this while working with scientists and different people. What lessons were learned through that process? Are we more ready now to face any potential pandemic in the future?

As a society, probably we are more ready, it is not perfect but we are more ready mainly because people have the challenge created by pandemics in mind. But the question is: What about in 10 years time if there are no other pandemics, which I hope there would not be, then people might focus on other priorities and reduce their attention to pandemic preparedness.

Today two things exist:

1- There are centers around the world monitoring the emergence of new viruses and working together

2- With Covid, initially people thought it was only a Chinese issue. I can tell you I was in Europe at the time and it came to Italy and many people and many countries around Europe thought it was only an Italian issue, as if there was a border between Italy and the rest of Europe that can stop Covid. There was denial at the time in many places. I don’t think there will be a denial again.

Now there are centers monitoring the emergence of new viruses. Governments are more likely to potentially even overreact to some new viruses instead of ignoring them. We will have new technologies that can bring new vaccines to patients much faster. The world has learned that for vaccines on that scale you need collaborations between the private and public sectors, we have to have governments working with private industry and with academics to bring vaccines to the world much faster.

It is worth mentioning that without the US government investment, I do not think we would have had those vaccines at that scale so fast. The US government funded the development of several vaccines because it is a risky proposition. You have a new virus, a new vaccine and you do not know if it is going to work. It cost hundreds of millions of dollars to develop, you have to set up a manufacturing network which cost a lot of money and you need to have all this money spent in advance of knowing if the vaccine works. The US government placed advanced orders and put money at risk in those developments. Without the U.S. I do not think the world would have reacted as well as we did.

- Different people have different views on how they deal with vaccine, how they deal with Covid and how they deal with the pandemic. As CEO of one of the largest companies what is your advice to the public?

I am leading a scientific organization so of course I believe in science and believe in looking at data. My advice is for people to look at data. Society reacted incredibly fast to this virus and there was a lot we did not know about the virus and a lot that we did not know about the vaccines. Some people said that the vaccines were not made available fast enough, that poor countries did not get the vaccines fast enough. If we look back, the response was incredibly fast, not fast enough for some countries of course but overall very fast. There were a lot of unknowns, we did not know how to use the vaccines, we did not know the consequences of vaccinations, we were not so sure who to vaccinate. When you have this, different people come up with their own ‘realities’ and own ‘truths’.

Today a lot more data is available and people can look at the data, it is clear now from the data that the vaccination for Covid is really very useful for people over 50-55 years old and those who suffer from severe chronic diseases. For younger people, vaccination is probably less critical and two doses might be sufficient and we might not need so many boosters because they have baseline immunity provided by the vaccine and which probably lasts a long time.

There is a lot more data that has emerged and everybody has to make their own decision for themselves. It is a personal healthcare issue and you have to decide how to treat yourself and everybody has to make their own choice. Fundamentally people should look at the data and not look at social media. They should ask scientists and not look at the media.

A problem is that, because there were many unknowns and we were moving so fast, some experts said things that proved to be wrong and this created an environment where some people could say: look at that expert, he said a,b,c and it was totally wrong so why should we listen to experts? But today we have a large amount of data and the scientific view is becoming more coherent.

My advice is for people to listen to science and to not listen to social media.

- One reason that people like you helped us to face this pandemic was working together: the private sectors, governments, scientists and companies as it was cross border crisis which is very similar to the climate change. What lessons to bring from tackling the pandemic to tackle the climate? You with other companies made this great initiative on the eve of COP27 in Sharm El Sheikh, Egypt? How to copy the success in facing climate change?

I think the recipe is very similar in many ways:

1- We have to look at science and technology to help us find solutions because there are many solutions to climate change.

2- Partnerships between public and private sectors are critical.

During Covid vaccine, we had great partnerships with the Saudi government and talked with Saudi officials many times via video, we also worked with the Moroccan government, and I was very impressed by how very organized they were early on. We also partnered with Egypt. Those collaborations were very successful and we even shipped the vaccine to Palestine. There were so many countries that we did not necessarily think about but during the course of various discussions we were asked if we can ship vaccines to Palestine because they did not have vaccines, so we did that.

Collaboration across public and private was very successful and the same can apply to the COP27.

While attending COP27 I met with the Egyptian prime minister and the health minister and we have a program in Egypt called ‘Green Hospitals’. This initiative is a partnership between the private and public sectors as well as with academic organizations like hospitals. Collaboration is really a key solution.

- Do you sense that the same urgency in dealing with climate change?

It is human nature to react to a big threat very fast with great intensity but with climate change some people realize it is urgent and some other people do not realize it is urgent. The reality is right now people across geographies and countries are still arguing with one another about various other issues. If tomorrow we are threatened as a human species by a massive natural catastrophe then everybody will quickly realize we are all in the same boat. We are all sharing the same planet and we all have to work together. But today the urgency is not as high as it should be unfortunately. However, the realization that something has to be done is growing. When you see what happened in Pakistan and the floods that affected more than 10 million children. I am French and also Australian and I lived through the great fires in Australia and then the floods, you see the impact of climate change. More and more people are realizing that something needs to be done.

- There is another element I think may link the Covid 19 and climate change which is justice. AstraZeneca actually played a big role in establishing justice by providing the vaccine to poor people almost free of charge without any profit. But there is this feeling that poor countries and poor people are paying a higher price for the pandemic and for climate change.

Absolutely, and that is true. I met with the Secretary General of the Commonwealth. The Commonwealth is made of 56 countries with the biggest one is India which has 1.4 billion people and the smallest is an island with a population of 11,000. Within the Commonwealth you see countries that are starting to suffer. Some islands are saying soon enough there will be no country for us, we will be submerged. When you realize that a big part of the Antarctic is starting to break off and if it melts, that may lead to an increase of 63cm in the water level everywhere round the world. Some parts of the world will disappear under water. Typically, the poorest parts of the world will suffer first, as always unfortunately.

If you look at climate change, people are talking about an average of 1.5 degrees or 2 degrees in the increase of temperature, but some parts of the world will suffer a lot more than this. In the northern part of Africa the increase in temperature will be much more, and they will suffer draughts and it will be terrible for people there and we will witness mass migration.

At COP27 it was agreed to create a fund to help poor countries and I think this is a good thing but it is not sufficient. The answer is to really stop carbon emissions. Otherwise, we are on a road to massive catastrophe for everybody.

- Are you more optimistic now than you were few years ago in terms of tackling the climate change?

I am, because the realization is growing, private industries and private organizations are jumping in and the US government now is also taking the lead. Many governments have that in their agendas. I realize that some companies and some governments are talking green but don’t take much action but there are more and more countries and companies that are taking real measures.

There is a growing trend for industries to disclose what they are doing about climate change and people can monitor, track and criticize what the companies are doing. I believe we are moving in the right direction but the problem is are we going to be moving fast enough? Actually the scientists tell you that their predictions of 10-15 years ago are happening much faster than they thought and we are in this vicious circle where things are getting worse than expected and accelerating even more.

- Living in Europe, we noticed the past few months did not bring good news because once again because of the war in Ukraine, we heard that some European countries and some European entities are talking about using the old sources of energy, like coal and oil. There was this perception that there is a bit of retraction from the policies of giving more priority for green energy?

Absolutely. The reality is that we have to be pragmatic and practical about it. The reality of life is that governments are elected, at least in democracies, and they are going to focus on their own countries and are going to think about what they need to do for their own electorate, for their own people. Covid 19 is a good example again of what happens in these situations. Some countries were producing lots of vaccines and the world was saying you need to share. They did not share. They started sharing when they had enough for themselves. As soon as they had enough to cover their own population, they started sharing but before that they never shared much. You may criticize this but at the end of the day that is a reality of life. Elected people will look after their own people, it is a bit unfortunate and you would hope they would share more and faster but they really cannot. It is indeed the same in this energy situation, countries say they have to make sure that people have electricity and heating for the winter, otherwise as politicians they will be removed at the next elections. We have to consider this in how we plan for the climate change.

On the other hand, the silver lining in this war and the sanctions is that people realize that we need to move to renewable sources of energy to become independent. Scotland aims to become totally self-sufficient with renewable energy. I met the prime minister of Ireland recently and they have the same goal. You see countries really progressively setting up an agenda that will give them energy independence through green sources.

- On November 10 AstraZeneca announced its third quarter financial results with revenues higher than forecasted, noting that those profits were not a result of the Covid vaccine, but rather from other sources. How were these revenues achieved?

Our focus as a company is on medications for cancer, cardiovascular diseases, kidney diseases, diabetes, diseases related to metabolism, as well as respiratory diseases, asthma and rare diseases. We have a very strong portfolio of new products which we are launching everywhere. Our growth is driven by all those new products. During the 3rd quarter we obtained 19 approvals for new products and new indications. We are growing because our core business is growing. Covid vaccines did not make any profit. Still this year we are still delivering but the vaccine sales do not generate much profit as we sell more or less at cost.

- There was an 11-12% growth?

Actually a bit more than 11% for the quarter, coming from all sorts of products, we have an expensive product for kidney disease, heart disease, diabetes, several products for cancer are also growing a lot, we invest in R&D, year-to-date for end of September revenue grew by 36% driven by R&D and delivering new products.

The 3rd quarter saw an increase of 19% with the 11% you referred to was for core business, excluding all the additions. If we include the additions like rare diseases business that we acquired and all the new products launches, the year-to-date is 37% and 19% in the quarter.

- You are not producing much of the Covid vaccine. Is that right?

We are producing Covid vaccine through our network. Some was manufactured by our partner in India. We have manufactured vaccine in Thailand for South Asia, in Brazil for Brazil and in Mexico for Latin America. We have a whole network of manufacturers in many geographies around the world. Also we manufactured in Europe, UK, in Japan and in China. We have a partnership in China but the Chinese government decided to focus on their locally developed vaccines which they supplied to some countries and I know the United Arab Emirates also sourced a lot of Chinese vaccines.

- What do you think of Chinese policy of zero-Covid from science point of view?

From a science point of view, I understand the policy in the initial phase because in the initial period they really protected their population very well. I must say today they will have to transition at some point, China cannot be closed to the rest of the world for ever. They need to reopen to facilitate communication and trade with the rest of the world, people meeting each other.

When you go back to this carbon threat and climate change threat I really think collaboration around the world is key and also people realizing that we are all the same and share the same planet. At the end of the day, we all have the same hopes, same concerns and same fears. We are the same people wherever we are in the world. You only realize this if you meet people. If you live in a country and you never leave your country, and you never meet people from another country, it is very easy to think that these people are different. Then you meet them and you realize that they are like you, with the same hopes and concerns. I hope China will re-open fully very soon so people can meet and collaborate again.

I am really delighted because next week in Dubai we will meet our Chinese team who will be joining us, Middle East and the rest of the international region. Our team is coming together again and this is very exciting.

- What is AstraZeneca's future outlook globally and in the MENA region?

Our outlook is very strong. We told the market that we expect to grow by low double digit which is 10-12% year-on-year up to 2025. Post 2025 we typically do not give guidance but we told the market we expect to grow at industry leading growth, which many analysts have translated into high single digit figure and we expect to achieve this by launching new products.

In the Middle East and Africa region, in the whole international region, in Latin America and South Asia, China, we will grow because this is where the large number of people is and we have a portfolio of products that cover diseases that are common that may be treated with low cost products all the way to expensive products to treat cancer and rare diseases.

In Middle East and Africa, diabetes, kidney diseases and heart diseases are very common, asthma diseases are common and we have products that are not so expensive that address those diseases and we expect to grow a lot in all those regions.

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