INNOVATION IN THE DEVELOPMENT OF NEW DRUGS AND CREATIVE SOLUTIONS TO ENSURING EARLY AND ENHANCED ACCESS Paul Stoffels, M.D. Chief Scientific Officer, Johnson & Johnson

HIV LIFE EXPECTANCY

HIV TODAY The Opportunity: The Challenges: More than 20 Antiretroviral Drugs and Combinations Diagnostics : CD4, Viral Load, Resistance Testing The Challenges: Life Long Therapy (30-50 years) Highly mutable virus leading to resistance Supply Chain Logistics Funding

WHAT IS NEEDED: INNOVATION Innovation in Therapy Innovation in Prevention Innovation in Implementation

HIV protease gene diversity matrix Viral isolates SQV 27973 viruses 1 10 20 30 40 50 60 70 80 90 Amino-acid position

INNOVATION IN THERAPY New Drug Targets – Existing Drug Targets Combinations Single pill New Regimens Strategically Designed Regimens Efficacy Prevent resistance Implementation and cost Long Acting Formulations Treatment Strategies Treat to prevent Combating resistance

INNOVATION IN PREVENTION Barrier Prevention Chemical Prevention PrEP Vaginal Ring Long-Acting Injectables Biological Prevention Antibodies HIV Vaccine—The Holy Grail

90-90-90 – FOR 50 YEARS Strategically deploy the drugs we have for maximal life expectancy and optimal access Green Pill First—Red Pill Next Universal Viral Load Testing Avoid MDR HIV

INNOVATION IN ACCESS Stratification and Simplification of Drug Regimens Supply Logistics Deployment Cost

ACCELERATING INNOVATION FOR IMPACT Transfer Best Practices Drug development focused on 90-90-90 Accelerate drug / vaccine developments: Oncology : 24 months Vaccines : Ebola vaccine – 18 months Every day counts

30 Million people X 50 years = 1.5 billion years of life.