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1、Impact Report2023/2024Table of ContentsOverview3OurCompany4Highlights5CEOletter6Selectawardsandrecognition8OurcorporateStrategicFramework9Ourapproachtosustainability10OurpriorityUNSustainableDevelopmentGoals(SDGs)17AccesstoHealth18Discoveryandinvention22Availability28Affordabilityandsustainableacces

2、s33Strengtheninghealthsystemsandaddressinginequity40Employees45Globaltalentmanagement46Diversity,equityandinclusion55Healthandsafety62Compensationandbenefits70EnvironmentalSustainability73Climate,energyandairemissions74Water84Biodiversity89Waste92Materials96Ethics&Values101Ethicalcorporatebehavior10

3、2Customerhealthandsafety106Supplychain113Humanrights122Privacyanddatasecurity124Governmentrelations127Reportingindices130GlobalReportingInitiative(GRI)131SustainabilityAccountingStandardsBoard(SASB)140UNGlobalCompact(UNGC)143UNSustainableDevelopmentGoals(SDGs)144CultureofHealthforBusiness(COH4B)145S

4、takeholderCapitalismMetrics147About this reportThisisthe2023/2024ImpactReportofMerck&Co.,Inc.,Rahway,NJ,USA,which is known as MSD outside the United States(U.S.)andCanada.AlldataiscurrentasofDecember31,2023,unlessotherwisenoted.InformationondocumentsfiledwiththeSecurities and Exchange Commission(SEC

5、),such as our 2023 Form 10-Kand2024proxystatement,canbefoundonourcorporatewebsite,whichisintendedonlyforresidentsoftheU.S.andCanada.ToalignwithU.S.governmentreportingrequirements,thedataforgenderdiversityinthisreportusesthetermsmenandwomen.Werecognizeandembracethegenderspectrumanddiversityofouremplo

6、yees,andhaveinternallyestablishedvoluntarySelf-IDoptionsforemployeestoself-reportontheirgenderidentity.Thetotalsinthisreportmaynotequal100percentduetoroundingoremployeeswhohavenotreportedtheirgenderand/orrace/ethnicity.Forward-looking Statement of Merck&Co.,Inc.ThisreportofMerck&Co.,Inc.,Rahway,NJ,U

7、SA(the“Company”)includes“forward-lookingstatements”withinthemeaningofthesafeharborprovisionsoftheU.S.PrivateSecuritiesLitigationReformActof1995.Thesestatementsarebased upon the current beliefs and expectations of the Companys managementandaresubjecttosignificantrisksanduncertainties.There can be no

8、guarantees with respect to pipeline candidates that the candidates will receive the necessary regulatory approvals orthattheywillprovetobecommerciallysuccessful.Ifunderlyingassumptionsproveinaccurateorrisksoruncertaintiesmaterialize,actualresultsmaydiffermateriallyfromthosesetforthintheforward-looki

9、ngstatements.Risks and uncertainties include but are not limited to,general industry conditions and competition;general economic factors,includinginterestrateandcurrencyexchangeratefluctuations;the impact of pharmaceutical industry regulation and health care legislation in the United States and inte

10、rnationally;global trends toward health care cost containment;technological advances,new products and patents attained by competitors;challenges inherent in new product development,including obtaining regulatory approval;the Companys ability to accurately predict futuremarketconditions;manufacturing

11、difficultiesordelays;financialinstabilityofinternationaleconomiesandsovereignrisk;dependenceontheeffectivenessoftheCompanyspatentsandother protections for innovative products;and the exposure to litigation,includingpatentlitigation,and/orregulatoryactions.The Company undertakes no obligation to publ

12、icly update anyforward-lookingstatement,whetherasaresultofnewinformation,futureeventsorotherwise.Additionalfactorsthatcouldcauseresultstodiffermateriallyfromthosedescribedintheforward-lookingstatementscanbefoundintheCompanysAnnualReportonForm10-KfortheyearendedDecember31,2023andtheCompanysotherfilin

13、gswiththeSecuritiesandExchange Commission(SEC)available at the SECs Internet site(www.sec.gov).Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverview2Merck 2023/2024 Impact ReportOverviewIn this section:Our CompanyHighlightsCEO letterSelect awards and recognition

14、Our corporate Strategic FrameworkOur approach to sustainabilityUN Sustainable Development Goals(SDGs)Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices3Merck 2023/2024 Impact ReportOverviewWeusethepowerofleading-edgesciencetosaveandimprovelivesaroundtheworld.GlobalRe

15、portingInitiative(GRI)/SustainabilityAccountingStandardsBoard(SASB)disclosuresinthis section:GRI2-1GRI2-12GRI2-13GRI2-14GRI2-22GRI3-1GRI3-2GRI3-3 For more info on disclosures,see the Reporting indices.How we operate We are a global health care company that delivers innovative health solutions throug

16、h our medicines,includingbiologictherapies,vaccinesandAnimalHealthproducts.IntheU.S.andCanada,weareknownasMerck&Co.,Inc.,orMerck.OutsideoftheU.S.andCanada,weareknownasMSD.Wemanageourbusinessthroughtwooperatingsegments,PharmaceuticalandAnimalHealth.The Pharmaceutical segment includes human health pha

17、rmaceuticals and vaccine products.Humanhealthpharmaceuticalproductsconsistoftherapeuticandpreventiveagents,generallysoldbyprescription,forthetreatmentofhumandisordersanddiseases.We sell these products primarily to drug wholesalers and retailers,hospitals,government agenciesandmanagedhealthcareprovid

18、erssuchashealthmaintenanceorganizations,pharmacybenefitmanagersandotherinstitutions.Humanhealthvaccineproductsconsistofpreventivepediatric,adolescentandadultvaccines.Wesellthesevaccinesprimarilytophysicians,wholesalers,distributorsandgovernmententities.The Animal Health segment discovers,develops,ma

19、nufactures and markets a wide range of veterinary pharmaceutical and vaccine products,as well as health management solutions and services for the prevention,treatment and control of diseases in all major livestockandcompanionanimalspecies.Wealsoofferanextensivesuiteofdigitallyconnectedidentification

20、,traceabilityandmonitoringproducts.WesellourAnimalHealthproductstoveterinarians,distributors,animalproducers,farmersandpetowners.For more information on our business,please see our 2023 Form 10-K.Our Company Inadditiontoourscientificpriorities,wealsowork to foster a diverse and inclusive global work

21、force,to ensure a safe and sustainable future for our communities,and to operate responsiblyeveryday.This report includes our voluntary disclosures againsttheEnvironmental,Social&Governance(ESG)reportingframeworksweveprioritized,andcoversourenterprise-wideoperationsfromJanuary1,2023,toDecember31,202

22、3,withsome information on activities that took place in2024.For over a century,we have brought transformative science to society by developing anddeliveringlife-changingmedicinesandvaccinestopatientswhoneedthem.Asaleading biopharmaceutical company,we are attheforefrontofscientificresearch,workingtir

23、elessly to provide innovative health solutions to advance the prevention and treatment of diseasesinbothhumansandanimals.As of Dec.31,2023,we had approximately:72,000Employees worldwideMore than550millionPeople reached with our medicines and vaccines in 2023(p.20)Annual revenue in 2023:$60.1 billion

24、R&D spend in 2023:$30.5 billionAccess to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices4Merck 2023/2024 Impact ReportOverview550 millionPeople reached with our medicines and vaccines in 2023(p.20)240 millionPeople enabled to access our innovative medicines and vaccines thr

25、ough access solutions in 2023(p.33)54 millionPeople,underserved by health care,reached through our social investments(2021-2023)(p.40)79%Of countries reached globally with our products in 2023(p.28)83%Of the top 20 global burdens of disease addressed by our pipeline and products(p.22)99%Parity indic

26、ated in our global pay equity study for female employees compared to their male colleagues.For the third year in a row,we have maintained greater than 99%pay equity by race as well as gender in the U.S.(p.61)51%Women comprise more than half of our global workforce(p.60)21,000Employees are members of

27、 at least one of our 10 Employee Business Resource Groups,nearly 30%of our global workforce(p.57)Net zeroCommitted to a net-zero target for our greenhouse gas(GHG)emissions across our global operations(Scopes1,2,and 3)by 2045,aligned with the guidelines of the Science Based Targets initiative(SBTi)(

28、p.75)6Times since 2017 weve been honored as a winner of the Green Chemistry Challenge Awards sponsored by the Environmental Protection Agency(EPA)and/or the American Chemical Society(p.100)24/7Availability of our MSD reporting tool,which allows employees and third parties to raise concerns confident

29、ially and anonymously(where permitted by law)(p.103)99%Employees who completed our Leading With Ethics&Integrity training series in2023(p.104)$3.6 billionSpending with small and diverse Tier 1 and 2 suppliers globally in 2023(p.119)Highlights10 pointsAllocated to certain sustainability metrics tied

30、to Access to Health and Employees out of 100 points in our 2023 Company Scorecard,which is used to determine the payout of our annual incentive plan for most employees,including our executives(p.10)Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesAccess to HealthEmployeesEnvironment

31、al SustainabilityEthics&ValuesReporting indices5Merck 2023/2024 Impact ReportOverviewCEO letterDear Stakeholders,For more than a century,weve been devoted toinnovativescientificdiscovery,deliveringmedicines and vaccines to address critical health needs,optimizingtheefficiencyofoursupplychain,increas

32、ing diversity in clinical trials,evolving our Merck Manual for medical reference andsomuchmore.Importantly,everythingwe do is inspired by our purposeto save and improve the lives of people and animals around theworld.Byharnessingleading-edgescience,weve tackled some of the worlds biggest health chal

33、lenges for generations,and we remaincommittedtoexpandingaccesstolife-changing medicines,vaccines and technologies formanymoredecadestocome.Operatingourbusiness responsibly and sustainably is at the core of our values and foundational to our ways ofworkingandbusinessoperations.To help propel our purp

34、ose,we continue to prioritizeourambitioussustainabilitygoals,whichspanfourkeyfocusareas:1)Accessto Health;2)Employees;3)Environmental Sustainabilityand4)Ethics&Values.Over the last year,our concerted focus on innovation,collaboration and delivering significantandsustainedstakeholdervaluehas driven r

35、emarkable progress and impactful outcomes.Totheseends,Improudtosharethefollowingkeyaccomplishments:Expanding and enabling access to health Enabling access to health underpins every actionwetakeandeverydecisionwemake.Across our enterprise,we collaborate with global partners and stakeholders to advanc

36、e our scientificdiscoveries,expandandenableaccessto our medicines and vaccines,and implement initiativesthatdrivehealthequity.In2023,wereachedmorethan550millionpeoplewithour medicines and vaccines through commercial channels,clinical trials,voluntary licensing andproductdonations.Thesecriticaleffort

37、sinclude our MECTIZAN Donation Program,the longest-runningdisease-specificdrugdonationeffortofitskind,whichaimstocombatriverblindnessandlymphaticfilariasisandreachedapproximately385millionpeoplelastyear.In2023,wealsoexpandedonour2021accessto health ambition,and now have a new goal toenable350million

38、morepeopletoaccessourmedicinesandvaccinesby2025.In2023alone,oureffortsenabledaccessfor240millionpeople.Ourproductsweredeliveredtonearly80%ofcountriesglobally.Andthroughoursocial investments,including partnerships to advance health equity and other impact initiatives,wereachedmorethan54millionpeoplei

39、nlow-andmiddle-incomecountriesand populations underserved by health care in high-incomecountries,surpassingourgoalofreachingmorethan50millionpeopleby2025.Developing and rewarding a diverse,inclusive and healthy workforceWe believe the best path to value creation is through our talent,and the variety

40、 of backgrounds and ideas they bring are central tothesuccessofourcompany.Diversity,equityandinclusionisabusinessimperative.Itimprovesourunderstandingofourcustomers,promotes the inclusion of diverse populations in our clinical trials and inspires the innovationthatdrivesourbusiness.Weremaincommitted

41、 to actively cultivating a talented,diverse and inclusive workforce that best representsand can thus best serveour customers,healthcareprovidersandpatients.In2023,wedefinedandintroduced15newenterprise leadership skills,designed to further advanceourculture,powerorganizationalandindividual performanc

42、e,and drive value for our stakeholdersandcommunities.We continue to nurture a diverse,equitable andinclusiveworkplace.Womencomprise51%ofourglobalworkforce,50%ofourboardof directors,and in 2023,our global pay equity studyindicatedagreaterthan99%parityin compensation between female and male employees.

43、Further,intheU.S.,forthethirdyear in a row,we have achieved greater than 99%payequityacrossraceandgender.Embodying and prioritizing environmentalstewardshipWe know the global health of people and animals isinextricablylinkedtothehealthoftheplanet.This is why we are committed to playing an active rol

44、e in mitigating the impacts of climate change.Notably,in2024,wecommittedtobenet-zeroacrossScopes1,2and3greenhousegasemissionsby2045,alignedwithguidancefromtheScienceBasedTargetsinitiative.Our environmental sustainability strategy is designed to achieve our objectives by focusing on three critical ar

45、eas:operational efficiency,designingnewproductstominimizeenvironmental impact,and reducing the impacts in our upstream and downstream valuechain.Andwehavebeenrecognizedwith six consecutive Green Chemistry Challenge Awardsnine overallas a resultofourongoingeffortstominimizethefootprintofourproducts.T

46、heawardsare sponsored by the Environmental Protection Agency and the American ChemistrySocietyandrecognizenewandinnovativeenvironmentallyconsciouschemistrytechnologies.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices6Merck 2023/2024 Impact ReportOverviewHolding our

47、selves to the highest standardsWe operate responsibly every day in every way,and we hold ourselves accountable to thehigheststandardsofethicsandvalues.Ourcodeofconductisourcompass,ensuringwe maintain our reputation as a trusted,credibleandresponsiblecompany.Italsoencourages employees to speak up and

48、 report potential concerns to ensure our ethics and valuesarereflectedinourbusinessoperations.Wemaintainfullcompliancewithallprivacyanddataregulatoryrequirementsrelatedtoactiveincidentmonitoring,risk/harmanalysisandon-timenotificationofdatabreaches.We are also a signatory to the United Nations Globa

49、l Compact(UNGC),and we align our operations with the Ten Principles of the UNGC toimprovecommunitiesaroundtheglobe.Additionally,we increased our spend with smallanddiverseTier1and2suppliersfrom$3.2billionin2022to$3.6billionin2023,fostering a healthy,equitable and diverse supplychain.In 2023,we also

50、added sustainability metrics to our Company Scorecard,which directly correlatestoourannualincentiveplan.Themetricslinkthecompensationformostemployees,including executives,to our performance in driving greater access to health care and employee engagement and inclusion.AndImpleasedtoreportthat,inour

51、inaugural year,we achieved all of our goals for these new sustainability metrics on our CompanyScorecard.Sustaining our momentumI am very proud of our collective progress and the positive impact weve made on the lives of people,animals and communities around theworld.In2023,MerckwasnamedoneoftheTop1

52、00MostSustainableU.S.Companiesby Barrons and one of Americas Most JUST CompaniesbyJUSTCapitalandCNBC.Andnotably,werankedNo.1inthehealthsectorforbothrecognitions.Thisyear,wewerealsorecognizedonTIMEsinaugurallistof the Worlds Most Sustainable Companies,rankingNo.28outof500companies.Thesehonors are a t

53、estament to our unwavering passion and commitment to saving and improvinglivesglobally.Iremainconfidentthatwecandoevenmoreto further advance global health and access,drive diversity,equity and inclusivity,protect theenvironmentandoperateresponsibly.Imexcitedandenergizedbythepossibilitiesofourscience

54、-ledstrategy,thepromisethatourshort-andlong-termeffortspresent,andthepositive,sustainable impacts that we can make todayandwellintothefuture.My sincerest thanks for your continued support as wepursueahealthierandbrighterfutureforall.Very best regards,Rob Davis Chairman&ChiefExecutiveOfficerAccess to

55、 HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices7Merck 2023/2024 Impact ReportOverviewSelect awards and recognitionBarronsTop 100 Most Sustainable U.S.Companies#38 overall and#1 in the sector(2024)NewsweekAmericas Most Responsible Companies#1 overall and#1inthe sector(2024)

56、JUST CapitalAmericas Most JUST Companies#25 overall and#1 in the sector(2024)Were proud that our longstanding commitment to drive responsible actions has received external recognition as westrivetomanagesustainability-relatedrisksandcreatevalueforourbusiness,societyandourstakeholders.Fortune#62 on t

57、he 100 Best Companies to Work For list(2024)SeramountOne of the 75 companies on theTop Companies for Executive Women list(2023)TIME#28 on the Worlds Most Sustainable Companies list(2024)Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices8Merck 2023/2024 Impact ReportO

58、verviewOur corporateStrategic FrameworkOur ValuesPatients FirstEthics and IntegrityRespect for PeopleInnovation and Scientific ExcellenceOur AspirationWe aspire to be the premier research-intensive biopharmaceutical companyOur PurposeWe use the power of leading-edge science to save and improve lives

59、 around the worldOur Ways of WorkingWin asone teamFocus onwhat mattersAct withurgencyExperiment,learnand adaptEmbrace diversityand inclusionSpeak up and beopen-mindedWe operate responsibly every day on behalf of society,shareholders and all our stakeholders to enable a safe,sustainable and healthy f

60、uture for people and communities everywhere.Invest in,augment,and accelerate our pipeline to deliver life-changing productsDemonstrate value to our stakeholders and extend access to solutions that address unmet medical needsDrive innovation,growth and productivity enabled by digital and dataInvest i

61、n the growth,success,and well-being of our peopleOur PrioritiesAccess to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices9Merck 2023/2024 Impact ReportOverviewOur strategy includes a commitment to integrating sustainability at every level of our businessoperations.Bydoingso,

62、wecreateopportunities to serve our patients,employees and society,as well as to bring value to our businessandshareholders.Building on our legacy of stewardship,we drive progress in our four longstanding focus areas:Access to HealthIn collaboration with key stakeholders,we work to ensure our science

63、 advances health care,and our products are accessibleandaffordablearoundtheworld EmployeesOur success is built on a culture thatembracesdifferentperspectivesandvaluesthecontributionsofeachindividual.Werecognizethatourcompetitivenessis strengthened by a diverse,skilled and engagedworkforce.Environmen

64、tal SustainabilityA healthy planet is essential to human and animal health and the sustainability of our business,while also providing opportunities for product innovation and reduction in costsandrisks.Wehavealonghistoryof environmental stewardship and compliance,andwecontinuouslyevolveourstrategya

65、ndeffortsinthefaceofachangingclimate.Ethics&ValuesOur ethics and values drive everything we do,creating an accountable culturethatenhancesourdecision-makingandabilitytodeliveronourpurpose.Were strategically embedding actions across our focus areas to serve our most important stakeholders:ourpatients

66、.Oursustainabilityeffortsaimtopositionusas a partner of choice within the global health ecosystem to drive environmental and social change,to build stakeholder trust,to improve ourlong-termbusinessperformance,toincreaseinvestmentflow,andtocultivateadiverseandinclusiveculturewherebest-in-classtalentc

67、hoosestowork.Thisapproachalso manages risks across our supply chain and business operations,increases patient and investorconfidence,bringsinnewopportunitieswith customers and peers and builds stronger communities through our health equity initiatives.To be successful,proactive and meaningful engage

68、ment with stakeholders is critically important to building enduring relationships andfosteringmorecollaborativepartnerships.Thisensuresthatourstrategiesareinformed,relevant and aligned,with both societal needs andbusinessobjectives.Our corporate Strategic FrameworkFor over a century,our unwavering d

69、edication to operating responsibly has been a hallmark of ouridentity.Thiscommitmentisintegraltoourcorporate Strategic Framework(see next page),and underscores our pledge to foster a safe,sustainable and healthy future for communities worldwide.In 2023,we added sustainability metrics to our Company

70、Scorecard,which directly affectsthepayoutunderourannualincentiveOur approach to sustainability Update on our sustainabilitybondThrough September 30,2023,we havefullyallocatedthe$994millionofthenetproceedsfromour2021sustainabilitybond.Weallocatedapproximately81percentoftheamount to projects that are

71、either completed or underway during the three-yearlook-backperiod,andallocatedtheremaining19percentto social and green projects in alignment with our sustainability financingframework.For more information,please see our 2023 Sustainability Bond Allocation Report on our Investor Relations page of our

72、 corporatewebsite.plan.Themetricsaccountfor10percentofthe Scorecard,and link the compensation for most employees,including executives,to our Companys performance in driving greater access to health care,employee engagement andinclusion.Notably,wemetallofthegoalsforthesenewsustainabilitymetricsinthef

73、irstyear.For more information about our Company Scorecard,please see page 55 of our 2024 proxy statement.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices10Merck 2023/2024 Impact ReportOverviewManagementThe groups below are responsible for directing theday-to-daysup

74、ervisionofoursustainabilitystrategy and driving performance:Strategic Policy&Sustainability Council(SPSC)The SPSC,under the guidance of the Executive Team,ensures we advance our Strategic Framework through public policy and sustainability effortsthatproactivelyshapeandrespondtothechangingregulatoryl

75、andscape.Thisgroupofcross-functional senior leaders makes recommendations to the Executive Team on critical public policy and sustainability issues,and monitors related performanceacrossregionsandfunctions.ESG Strategy Management Team(ESMT)With guidance from SPSC,the ESMT advises,shapesanddrivesourl

76、ong-termsustainabilitystrategy,including providing recommendations regardingbusinessrisksandopportunities.Therole of this group of functional experts is to create long-termvalue,differentiateusasaleaderinsustainability and answer to stakeholder demands about key issues across our four focus areas:Ac

77、cess to Health,Employees,Environmental Sustainability andEthics&Values.TheESMTensuresourstrategy and priorities align with and support our corporate Strategic Framework to meet our public commitmentsandstakeholderexpectations.ESG Strategy&Engagement Team This team is responsible for raising the visi

78、bility of sustainability-relatedissuesandactivities,aswellas fostering connections across business units and functional areas to assist with the integration of sustainability principles into business policies,strategiesandpractices.ThisincludesproducingourannualImpactReport.Governance of environment

79、alsustainabilityOur Environmental,Health and Safety(EHS)Councilisacross-functionalbodywith leadership representation from each area of our business and is responsible for overseeing our environmental sustainability strategy,policyandriskmitigationcontrols.It monitors performance against our targets

80、and increases transparency on environmental issues within the Company,theExecutiveTeamandtheBoard.The Global Safety and Environment(GSE)vice president communicates progress on environmental sustainability goals,objectives and other material issues to the Board,ExecutiveTeamandEHSCouncil.The GSE vice

81、 president is also a part of the Strategic Policy&Sustainability Council(SPSC).Additionally,theheadoftheEnvironmental Sustainability Center of Excellence(CoE)isamemberoftheESMT.Ourcross-functionalEnvironmentalSustainability Implementation Steering Committee was designated by the EHS Council to overs

82、ee the progress of initiatives that support the achievement of our public targets and provide guidance on resourcing of our environmental sustainabilitystrategy.For information on environmental health and safety management and governance,please visit the Sustainability Resources page on our corporat

83、e website.Sustainability governanceBoard of directorsWe are committed to governance policies and practices that serve the interests of ourbusinessandourshareholders.Ourgovernance structure is an integral part of this commitment.OurBoardofDirectorsoverseesESG matters for the Company,through its commi

84、tteesandasawhole.OurExecutiveTeamand senior management are responsible for reviewing,refiningandimplementingourlong-termsustainabilitystrategy.Throughgroupssuch as the Strategic Policy&Sustainability Council,ourseniorleadersdirecttheday-to-daysupervisionofthisstrategy.Corporate governance20192020202

85、120222023Independent directors on the Board1212121211Board members who are independent92%92%86%92%92%Separate chairman of the Board and CEO1NoNoYesNoNoLead independent directorYesYesYesYesYesWomen on the Board46%46%43%46%50%Members of underrepresented ethnic groups on the Board23%31%21%15%17%Note:Ex

86、ceptasotherwisenoted,allfiguresabovearederivedfromourproxystatementfiledthefollowingyearandarerounded.1 FromJuly1,2021,toNovember30,2022,thepositionsofBoardchairmanandCEOwereseparate.AsofDecember1,2022,thepositionsofBoardchairmanandCEOarenotseparate.For information on our Boards nomination process a

87、nd the Boards roles and responsibilities for the management of and reporting on sustainability topics at the Company,please see our 2024 proxy statement(pages 20-22).For information onhow to communicate with the Board,please see page 25 of our proxy statement.Our Executive Team updates the Board on

88、ourlong-termsustainabilitystrategyandperformance through both discussions as a full Board as well as through Committee discussions onspecifictopics.Forexample,theBoardsGovernance Committee,which monitors and assists the Board in its oversight of sustainability matters,ensures relevant issues are sub

89、ject to review by Board Committees with relevantareasofcompetency.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices11Merck 2023/2024 Impact ReportOverviewESG impact materiality assessmentOur approach to ESG impact materiality assessmentTo conduct the assessment,we b

90、egan with a list of material issues for our industry,including:We conduct an ESG impact materiality assessment to focus,act and report on the mostcriticalpotentialbusinessrisksandopportunitiesthatinfluenceourabilitytocreatevalue.Weassesstheexternallandscape,ourbusinesspriorities,andtheissuesthatarec

91、riticalforourstakeholdersandtheplanet,toprioritizethemostimportanttopicsthatwillbemanagedthroughoursustainabilitystrategy.Natural capital Physical and sociopolitical risks Product and service safety and quality Product design and lifecycle management Public health risks Responsible consumption and p

92、roduction Selling practices and product labeling Sourcingefficiencyandmanagement Talent management Transition to renewables and alternative energies Transparency Wasteandhazardousmaterialsmanagement Water and wastewater managementWe then partnered with a third party to scan competitor,supplier and c

93、ustomer ESG reportsandfinancialcommunications,aswellas news sources and mandatory and voluntary regulationsfromaroundtheworld.Wecoupledthis assessment with surveys to our leaders as well as to investors we engage with regularly on sustainability-relatedtopics.We also conducted ESG impact materiality

94、 assessmentsin2015,2018and2021.Access to health care and medicine Air emissions Business model resilience Climate change risks and management Community relations Competitive behavior Customer practices Customer privacy and data security Ecological impacts Employee diversity and inclusion Employee he

95、alth and safety Energy management Equityandaffordability Ethical corporate behavior Ethics in R&D GHG emissions Governance structures and mechanisms Human rights Innovation and technology Labor practices Management of local impacts Management of the legal and regulatory environmentIn our 2023 ESG im

96、pact materiality assessment,the following topics emerged as the most critical.Theyaregroupedbelowbyourfocusareas:Access to Health Access to health care and medicine(pages 18-44)Equityandaffordability(pages33-44)Product safety and quality(pages 106-112,Clinical trials)Public health risks(pages 18-44)

97、Employees Employee diversity and inclusion(pages 55-61)Employeehealthandsafety(pages62-69)Talent management(pages 46-54)Environmental Sustainability Climate change risks and management(pages 74-83)Ethics&Values Ethical corporate behavior(pages 102-105,Code of Conduct&Compliance)Privacy and data secu

98、rity(pages 124-126,MSD Privacy)Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices12Merck 2023/2024 Impact ReportOverviewOur approach to stakeholder engagementWe engage with a diverse group of stakeholders to gain insights that caninformoureffortsandfosterourprogresst

99、owardsolutionsthatbenefitsocietyandsupportourbusiness.Wenotemanyoftheseengagementsinthisreport,and the groups of stakeholders with whom we regularly engage include:Patients and caregiversFor patient communitieswhich include individual patients,their caregivers and family members,patient advocacy lea

100、ders and patient organizationsitiscriticalthatwerespectand honor their life experiences to better understand their health care journeys,expected outcomesanddecision-makingconsiderations.For more information on our work with patient groups,please see our Patients page which includes ourCommitment to

101、Patients on our corporate website.ShareholdersThroughout the year,we regularly engage with our shareholders and seek to better understand theirperspectives.We have a proactive shareholder engagement program,in which members of Investor Relations,theOfficeoftheSecretary,HumanResources and the ESG Str

102、ategy&Engagement Team,aswellasothersubject-matterexperts,engagewithourshareholderstoremainwell-informed regarding their perspectives on current issues and to address any questions orconcerns.Theseteamsserveasliaisonsbetween shareholders,members of senior managementandourBoard.In addition,we conduct

103、an extensive shareholder outreach program twice a year focused on governance,executive compensation and ESG matters.Webelieveitismostproductivetodiscuss these matters well in advance of the AnnualMeetingofShareholders.Thisenablesmanagement and the Board to gather investor perspectives and make educa

104、ted and deliberate decisions that are balanced and appropriate for our diverse shareholder base and in the best interestsofourbusiness.For more information on our engagements with shareholders,including topics discussed,please see our 2024 proxy statement(pages 24-25).Health care professionalsWe are

105、 committed to providing appropriate and balanced information to physicians and other health care professionals about our medicines,vaccinesandongoingresearch.For more information on our work with health care professionals,please see pages18-44,and for our disclosures on payments to health care profe

106、ssionals,please visit the Transparency Disclosures page on our corporate website.EmployeesWe strive to foster a positive and inclusive working environment for our employees by providing resources to improve their health and that of their families,as well as opportunities to further their professiona

107、l development and get moreinvolvedinthecommunitieswheretheylive.Aspartofoureffortstomaintainasatisfyingand productive work environment,we routinely survey employees to learn about their perspectives on the business and on how we are responding to the needs of our globalworkforce.TheEmployeePulseSurv

108、ey,ourall-employeeengagementsurvey,isourflagshipemployeefeedbackmechanismandisconductedmultipletimesayear.To learn more about our work with employees,please see pages 45-72.PayersWe work with payers worldwide to inform their understanding of the relationship between the prices of our products and th

109、e true value they delivertopatientsandhealthcaresystems.For more information on our work with payers,please see our 2023 Pricing Action Transparency Report on the Sustainability Resources page of our corporate website.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indice

110、s13Merck 2023/2024 Impact ReportOverviewGovernments,multilateral organizationsandregulatorsWe work with policymakers,legislators,multilateralorganizationsandgovernmentsworldwide to ensure that policy and regulatory environments globally,nationally and locally foster patient access to medicines and v

111、accines,and that these environments are conducive to ethical business practices,scienceandinnovation.For more information on these engagements,please see pages 127-129.Suppliers and businesspartnersWe encourage responsible approaches on the part of suppliers regarding labor,employment,human rights,h

112、ealth and safety,ethics,diversityandprotectionoftheenvironment.Inaddition,westrivetoengagesmallanddiversesuppliers.To learn more about our work with suppliers,please see pages 113-123.Trade and industry associationsWe engage with stakeholders through our membershipinnumerousorganizations.Weareamembe

113、rofmanyindustryandtradegroups.Weworkwiththesegroupsbecausethey represent the pharmaceutical industry and business community in debates led by governments and other stakeholders,and because they help the industry reach consensus onpolicyissues.To learn more about our work with industry and trade orga

114、nizations,please see pages 127-129.Local communitiesWe work toward developing culturally appropriate mechanisms to engage and build relationships with our local community stakeholdersandnon-governmentalorganizations(NGOs).Weconductthisengagement predominantly through our philanthropicefforts,whichca

115、nbefoundonthePhilanthropy pageonourcorporatewebsite.Veterinary professionals and animal caretakers We value our partnerships with veterinary professionals and animal caretakers as a way to contribute to the health of the animals in their care with innovative products and solutions for farmandcompani

116、onanimalspecies.Weregularlycommunicate and collaborate with our customers and industry leaders in our shared pursuit of improvingthehealthofanimals.To learn more about our work with veterinarians and animal caretakers,pleasevisitthe Animal Health website.Access to HealthEmployeesEnvironmental Sustai

117、nabilityEthics&ValuesReporting indices14Merck 2023/2024 Impact ReportOverviewSustainability goals and performanceGoals(in millions)202120222023TOTALFurther advance health equity by reaching 50 million people in LMICs and people underserved by health care in high-income countries with our social inve

118、stments by 2025.1,215.018.621.254.8Reach at least 75%of countries around the world annually with our products.379%76%79%Enable 350 million more people to access our innovative medicines and vaccines globally through access solutions by 2025.466.7189.2240.0Access to HealthAsaresearch-intensivebiophar

119、maceuticalcompany,expandingaccesstohealthiscentraltoourpurposetosaveandimprovelives.Wediscover,developanddeliverinnovativemedicinesandvaccines.Incollaborationwithkeystakeholders,wehelpensureourscienceadvanceshealthcare,andourproductsareaccessibleandaffordableglobally.Wealsoapplyourexpertiseandfinanc

120、ialresources to address systemic barriers to health equity,where we believe we can make the strongest contributionstohealthsystems,communitiesandpatients.EmployeesOursuccessisbuiltonacultureofdiversityandinclusion,recognizingtheinvaluablecontributionsofeachindividual.Wearededicatedtocultivatingawork

121、forcethatisnotonlydiverseandskilledbutalsoengaged,recognizingthisasacriticaldriverofourcompetitiveness.Ourgoalsrepresentourpubliccommitmentstodeliveringvaluetosociety.Overthe past year,we challenged ourselves to continue meaningful progress towards ourambitiouscommitmentswithineachofourfocusareas.Th

122、roughcollaborativepartnerships and a holistic approach,were creating scalable solutions to major globalissues.Goals202120222023Maintain or exceed our current inclusion index score by 2025.5,6On trackOn trackOn trackMaintain or exceed our current employee engagement index score by 2025.5,6On trackOn

123、trackOn track1 SocialinvestmentsincludeourCompanysphilanthropicpartnerships,programsandimpactinvestments.Underservedpopulationsaredefinedasthosethatfacehealthdisparitiesduetodisadvantagesrelatedtoinsurancestatus,socialdeterminantsofhealth,race,ethnicity,genderidentity/sexualorientation,ageand/orlang

124、uagepreference.Thegoaliscumulativeacrossthereportingperiodof2021-2025andisindependentofabaselineperiod.Actualsforeachyeartodatearebasedonreportsreceivedbetweenthe1stofMarchandthelastdayofFebruaryofthecorrespondingperformanceyear.2 Third-partyreportingisusedtocalculatethenumberofpeoplereachedthroughs

125、ocialinvestments.Insomecases,third-partyreportsmayincludecumulativepeoplereachedforthereportingperiod,and/ordatathatisattributabletootherpartnersaswellasourCompanysphilanthropicinvestment.3 CountriesareasdefinedbytheWorldBankCountryandLendingGroups.Includesonlyhumanhealthproducts.4 Metrics contribut

126、ing to this goal are displayed on an annual basis and provide information on the number of people who we estimate nowhavetheoptiontoaccessmedicinesandvaccinesasaresultofoursustainableaccessstrategies,solutionsandpartnerships.ThesesolutionsincludeourcommitmenttoGaviandUNICEF(ratherthandosesshipped),c

127、ollaborationstooptimizeresourcesinhealthsystems,expandedfinancialcoveragethroughinsurance,andnewcommunity-basedchannelpartnerships.“Innovativemedicinesandvaccines”referstoourCompanyson-patentproducts.Enable“morepeople”isdefinedaspopulationssupportedbyinitiativesimplementedandlaunchedinmarketandwillb

128、eincomparisontothebaseline(2020)asof2025.Evidenceformetricsissourcedfrompubliclyavailabledataandproxysourcesbymarket.Whileproxiesdifferbymarket,allmethodologiesareevaluatedandrepresentourbestestimateofpeopleenabledtoaccessinnovativemedicinesandvaccines.Peoplewhowereenabledtoaccessinnovativemedicines

129、andvaccinesdidnotnecessarilyreceivesuchinnovativemedicinesandvaccines.5 In2022,werevisedemployeesurveymeasurementstoalignwithevolvingbestpractices.Inthisreport,2022dataareusedasthebaselineforfuturecomparison.6ThePulsesurveyisopentoemployeesglobally.Access to HealthEmployeesEnvironmental Sustainabili

130、tyEthics&ValuesReporting indices15Merck 2023/2024 Impact ReportOverviewEnvironmental SustainabilityWerecognizethevitalconnectionbetweenthehealthofourplanetandthewell-beingofpeopleandanimals.Wehaveadoptedasetofclimategoalstohelpussucceedinanincreasinglyresource-constrainedworld.Goals202120222023Reduc

131、e our operational GHG emissions(i.e.,Scopes 1&2)46%by 2030,from a 2019 baseline.110%below baseline8%below baseline212%below baselineReduce our value chain(Scope 3)GHG emissions by 30%by 2030,from a 2019 baseline.39%above baseline6%above baseline4%above baselineSource 100%of our purchased electricity

132、 from renewable sources by 2025.441%45%57%Achieve net-zero greenhouse gas(GHG)emissions(Scopes 1,2&3)by 2045.In 2024,we committed to a net-zero target for our greenhouse gas(GHG)emissions across our global operations(Scopes 1,2,and 3)by 2045,aligned with the guidelines of the Science Based Targets i

133、nitiative(SBTi).Ethics&ValuesWearecommittedtoupholdingintegrityandthehighestethicalstandardsineverythingwedo.Wefosteraworkplaceenvironmentwhereemployeescanvoicetheiropinionssafelyandfreely.Bygrounding our operations in our core ethics and values,we cultivate accountability that enhances our decision

134、making,adaptabilityandreliability.Ethics&Values202120222023Foster a“Speak Up”culture by maintaining or exceeding our current percentage of global employees responding favorably to the“Willingness to report”question in an internal survey as an annual average,by 2025.5,6On trackOn trackMaintain 100%co

135、mpliance to privacy and data protection regulatory requirements for active incident monitoring,risk/harm analysis and on-time notification of data breaches.7100%compliance maintained100%compliance maintained100%compliance maintainedScope1GHGemissionsaredirectemissionsfromownedorcontrolledsourcessuch

136、ason-sitefuelcombustionandfleetvehicles.Scope2GHGemissionsareindirectemissionsfromthegenerationofpurchasedenergyconsumedbythereportingcompany.InaccordancewiththeWorldResourceInstitutesGHGProtocol,prior-yeardatahavebeenadjustedtoaddorremovefacilitiesthathavebeenacquired,soldorspun-off.Adjustmentsalso

137、reflectchangesinmethodologytoensureconsistencyfromyeartoyear,includingScope2emissionfactorupdatesE-GRID(2023),IEA(2023),EUResidual(2023),UKDefra(2023)&InventariosCorporativos(2023)andScope1&3emissionfactorupdatesEPAClimateLeaders(2023).Scope3GHGemissionsincludeallotherindirectemissionsinacompanysval

138、uechain.4Wehavedefined“purchasedelectricity”aselectricitysourcedfromexternalsuppliersaswellasrenewableelectricitythatwasgeneratedandutilizedonsitewhereweretainedtherenewableattributesorwherewehaveobtainedrenewableattributesthroughcontract.5 Favorable response indicates the percentage of respondents

139、who respond“yes”to the question stating,“I am willing to report employee misconductandpotentialethicsorcomplianceissues.”6In2021,wedevelopedthe“WillingnesstoReport”questionreferencedinfootnote4toalignwithevolvingbestpractices.ThisquestionwasfirstincludedinourPulsesurveyinMarch2022,and2022dataareused

140、asthebaselineagainstwhich2023dataarecompared.7 Regulatoryrequirementsdifferbyregion.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices16Merck 2023/2024 Impact ReportOverviewOur priority United Nations(UN)Sustainable Development Goals(SDGs)The SDGs represent the inter

141、national communitys plan of action for“people,planetandprosperity.”The2030AgendaforSustainable Development,adopted by all United NationsMemberStatesin2015,providesashared blueprint for peace and prosperity for theplanetanditspeople.Atitscorearethe17SDGs.We believe we have an important role and a res

142、ponsibility to help reduce the burden of disease and improve access to medicines and vaccinesaroundtheworld.ThatiswhySDG3(GoodHealthandWell-being)isattheheartofourbusiness.Italsoalignswithourpurposetosaveandimprovelives.While every SDG is essential to fostering sustainabledevelopment,wehaveprioritiz

143、edeight(listed above the photo)where we believe wecanhavethebiggestimpact.Access to HealthEmployeesEnvironmental SustainabilityEthics&ValuesReporting indices17Merck 2023/2024 Impact ReportOverviewAccess to HealthExpanding access to health is at the core of our purpose to use the powerofleading-edges

144、ciencetosaveandimprovelives.Ourfocusis on discovering,developing,and delivering innovative products and services that address medical needs and improve health in a responsibleandsustainablemanner.Ourcommitmenttoimprovingaccess is embedded in our business strategies and across functions andgeographie

145、s.Topics covered in this section:Discovery and inventionAvailabilityAffordability and sustainable accessStrengthening health systems and addressing inequityGoals(in millions)2023TOTALFurther advance health equity by reaching 50 million people in low-income and middle-income countries(LMICs)and peopl

146、e underserved by health care in high-income countries with our social investments by 2025.1,221.254.8Reach at least 75%of countries around the world annually with our products.379%Enable 350 million more people to access our innovative medicines and vaccines globally,through access solutions by 2025

147、.4240.01 SocialinvestmentsincludeourCompanysphilanthropicpartnerships,programsandimpactinvestments.Underservedpopulationsaredefinedasthosethatfacehealthdisparitiesduetodisadvantagesrelatedtoinsurancestatus,socialdeterminantsofhealth,race,ethnicity,genderidentity/sexualorientation,ageand/orlanguagepr

148、eference.Thegoaliscumulativeacrossthereportingperiodof2021-2025andisindependentofabaselineperiod.Actualsforeachyeartodatearebasedonreportsreceivedbetweenthe1stofMarchandthelastdayofFebruaryofthecorrespondingperformanceyear.2 Third-partyreportingisusedtocalculatethenumberofpeoplereachedthroughsociali

149、nvestments.Insomecases,third-partyreportsmayincludecumulativepeoplereachedforthereportingperiod,and/ordatathatisattributabletootherpartnersaswellasourCompanysphilanthropicinvestment.3 CountriesareasdefinedbytheWorldBankCountryandLendingGroups.Includesonlyhumanhealthproducts.4 Metrics contributing to

150、 this goal are displayed on an annual basis and provide information on the number of people who we estimate now have the option to access medicines and vaccines as a result of oursustainableaccessstrategies,solutionsandpartnerships.ThesesolutionsincludeourcommitmenttoGaviandUNICEF(ratherthandosesshi

151、pped),collaborationstooptimizeresourcesinhealthsystems,expandedfinancialcoveragethroughinsurance,andnewcommunity-basedchannelpartnerships.“Innovativemedicinesandvaccines”referstoourCompanyson-patentproducts.Enable“morepeople”isdefinedaspopulationssupportedbyinitiativesimplementedandlaunchedinmarketa

152、ndwillbeincomparisontothebaseline(2020)asof2025.Evidenceformetricsissourcedfrompubliclyavailabledataandproxysourcesbymarket.Whileproxiesdifferbymarket,allmethodologiesareevaluatedandrepresentourbestestimateofpeopleenabledtoaccessinnovativemedicinesandvaccines.Peoplewhowereenabledtoaccessinnovativeme

153、dicinesandvaccinesdidnotnecessarilyreceivesuchinnovativemedicinesandvaccines.18Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthOur approach to access to healthWe developed our Statement of Guiding Principlestosteerouraccessappro

154、ach.Thebelowgoalsdemonstrateourambition:Discovering and inventing medicines and vaccines that address global health needs where we can have the greatest impact(for more information,please see pages 22-27)Making available a reliable,safe global supply of quality medicines and vaccines,and investing i

155、n solutions to enable timely access to our products in a responsible and sustainable manner(for more information,please see pages 28-32)Developing,testing and implementing solutionsthataddressbarrierstoaffordabilityand sustainable access of our medicines and vaccines(for more information,please see

156、pages 33-39)Through collaborations,investment and innovation,applying our expertise and investing resources to address systemic barriers to access and health equity(for moreinformation,pleaseseepages40-44)These principles align to our goals and demonstrate our measurable and meaningful actionstoadva

157、nceaccesstohealth.We strive to make our products accessible andaffordabletothosewhocanbenefitfromthem.Forexample,weworkwithcustomerstoenhancetheflowofpatientcareprocesses,andwithgovernmentsandnon-governmentalorganizations(NGOs)toexpandhealthcarefinancingandopennewdeliverychannelsforinnovativemedicin

158、es.Wealsoworkwithmultilateralandnon-profitorganizationsonaccesssolutionsforLMICs.Strengtheninghealthsystems through collaboration is a crucial part of oureffortstoenableaccesstohealthcarethatisaffordable,efficient,equitableandsustainableonaglobalscale.Additionally,werecognizetherisingimpactofclimate

159、changeonhealth.Wecollaboratetomitigate that impact through our environmental stewardship and compliance,and by advancing novel medicine and vaccine candidates to address diseases with an increasing prevalence due to changingclimatepatterns.Ourcollaborationsextendtohumanitariandisasterresponseefforts

160、andstrengtheningresilienceinhealthsystems.Itisessentialtobalanceaffordabilitywhileappropriatelyincentivizingthediscoveryanddevelopmentofnewmedicinesandvaccines.We believe it is possible to have a pricing system that allows patients to access the latest products whilesustainingleading-edgescientificr

161、esearchforfuturemedicalinnovations.Suchinventionsareoftenkeytoexpandingaccess.Forexample,the development of new formulations can broaden distribution of medicines and vaccines,includinginresource-constrainedhealthsystems,ortheycanhelptreatearlier-stagediseases where health and economic impacts maybe

162、improved.19Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequity550 M Commercial channels Clinical trials We r

163、eached 79%of countries with our products in 2023.To understand the reach and impact of our products,we track and report the number of people reached with our medicines and vaccines.people reached with our medicines and vaccines(2023)1 Commitment to UNICEF/GAVI Customer collaborations Merck for Mothe

164、rs Charitable contributionspeople enabled to access our innovative medicines and vaccines(2023)2We also develop,test and implement market-based solutions that address barriers to access,enabling more people to access our medicines and vaccines.In addition,our social investments help to reduce barrie

165、rs for populations underserved by health care globally.people reached with our social investments to address health equity(2021-2023)3,4240 M54 M Voluntary licensing Product donations External financing solutions New access channels Impact investments Health equity initiativesReaching people with ou

166、r medicines and vaccinesEnabling sustainable access and strengthening health systems1 This people reached metric estimates the number of people who have received a Merck&Co.,Inc.productthroughcommercialchannels,clinicaltrials,voluntarylicensingandproductdonations.Productdonationsincludepeoplereached

167、throughtheMECTIZANDonationProgram,U.S.PatientAssistancePrograms,andtheMerckMedicalOutreachProgram.SourcesofdataareMerck&Co.,Inc.andthird-partydatasetsthataretrackedwithinanenterprise-wideinternaldatabase.Thepeoplereachedmetricforallsourcesiscalculatedasdosessolddividedbytheaveragedosescheduleforagiv

168、enmarketinagivenyear.Peopletaking multiple products may be counted as multiple people toward the total estimate.Insomeinstances,thisestimatemayincludepeopleenabledtoaccessour products through access solutions,which are calculated as part of our goal to enable access to our innovative medicines and v

169、accines(page 33).Thepeoplereached metric does not include people reached through social investments,which are calculated as part of our goal to further advance health equity for populations inLMICsandunderservedbyhealthcareinhigh-incomecountries(page 40).2 Metrics contributing to this goal are displ

170、ayed on an annual basis and provide information on the number of people who now have the option to access medicines and vaccines as a result of our sustainable access strategies,solutions and partnerships,including our commitment to Gavi and UNICEF(rather than doses shipped),collaborationstooptimize

171、resourcesinhealthsystems,expandedfinancialcoveragethroughinsurance,andnewcommunity-basedchannelpartnerships.“Innovativemedicinesandvaccines”referstoourCompanyson-patentproducts.Enable“morepeople”isdefinedaspopulationsininitiativeslaunchedinmarketsasof2025,incomparisontoa2020baseline.Evidenceformetri

172、csissourcedfromthebestpubliclyavailabledataandproxysourcesbymarket.Whileproxiesdifferbymarket,allmethodologiesareevaluatedandrepresentthebestestimateofpeopleenabledtoaccessinnovativemedicinesandvaccines.Peoplewhowereenabledtoaccessinnovativemedicinesandvaccinesdidnotnecessarilyreceivesuchinnovativem

173、edicinesandvaccines.3 SocialinvestmentsincludeourCompanysphilanthropicpartnerships,programsandimpactinvestments.“Underservedpopulations”aredefinedasthosethatfacehealthdisparitiesduetodisadvantagesrelatedtoinsurancestatus,socialdeterminantsofhealth,race,ethnicity,genderidentity/sexualorientation,agea

174、nd/orlanguagepreference.Thegoaliscumulativeacrossthereportingperiodof2021-2025,andisindependentofabaselineperiod.Actualsforeachyeartodatearebasedonreportsreceivedbetweenthe1stofMarchandthelastdayofFebruaryofthecorrespondingperformanceyear.4 Third-partyreportingisusedtocalculatethenumberofpeoplereach

175、edthroughsocialinvestments.Insomecases,third-partyreportsmayincludecumulativepeoplereachedforthereportingperiod,and/ordatathatareattributabletootherpartnersaswellasourCompanysphilanthropicinvestment.20Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOve

176、rviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityWe build accountability for access improvements intoourgovernance.OurExecutiveTeamandseniormanagementreview,refine,andimplementourlong-termsustainabilitystr

177、ategy,whichincludesourapproachtoglobalaccess.Our Strategic Policy&Sustainability Council(SPSC)provides oversight and guidance to ensurealignmentwithourstrategicobjectives.Policies:Access to Health Statement of Guiding PrinciplesAntimicrobial resistance global Action PlanAccess to our vaccinesAccess

178、to investigational medicinesCharitable product donationsEuropean Union health technology assessment regulationHealth technology assessmentIntellectual propertyReal-world evidenceForthefirsttime,in2023,ourcommitmenttoaccess is also part of our Company Scorecard and approved by the Board of Directors

179、Compensation and Management Development Committee.Inadditiontoothermetrics,theCompany Scorecard incorporates sustainability metrics,including access to health metrics,which directly impact annual incentive pay forexecutivesandmostemployees.External charters,principles and initiatives that guide our

180、work in our Access to Health focus area:AMR Industry Alliance:Common Antibiotic Manufacturing Framework AMR Industry Alliance:Industry Roadmap for Progress on Combating AMR Health for Animals:Antibiotics Commitment Declaration of Helsinki InternationalCouncilforHarmonisation:GoodClinicalPractice(ICH

181、-GCP)International Federation of Pharmaceutical Manufacturers&Associations(IFPMA)Code of Practice TheKigaliDeclarationonNeglectedTropicalDiseases U.S.NationalAcademyofSciences:GuidelinesforHumanEmbryonicStemCellResearch21Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&Values

182、Reporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityDiscovery and inventionWe discover and invent medicines and vaccines to address vital global healthneedswherewecanhavethegreatestimpact,

183、nowandinthefuture.In2023,ourresearchanddevelopment(R&D)expenseswere$30.5billion,including$17.1billioninchargesforseveralsignificantbusinessdevelopmenttransactions,aswellasclinicaldevelopmentanddiscoveryresearchspending.AspartofourR&Defforts,wecollaboratewithacademicinstitutions,non-profitorganizatio

184、ns,governmententitiesandotherbiopharmaceutical/biotechnology companies to help us advance the latest science and ultimately bringmedicinesandvaccinestopatients.Clinicaltrialsareacriticalpartofhowweadvancescientificinnovations.Wearecommittedtothestudyofappropriatelydiversepatientpopulations,including

185、 groups who have been previously underrepresented in clinical trials:women and children,people of varying ages,sexual orientation and gender identities,various socioeconomic,ethnic and demographic backgrounds,andothercharacteristics.During development,we evaluate the potential of our pipeline candid

186、ates toaddressmedicalneedsandsignificantpublichealthchallenges.Whenacandidatehaspotentialforsignificantpublichealthimpact,ourproductdevelopmentteamsplanwaystoprovideaccessforthefuture.Finally,once approved,we endeavor to ensure our products are available ineverycountrywhereweconductedclinicaltrials.

187、$30.5 billionIn total R&D expenses83%Of the top 20 global burdens of disease(GBD)addressed by our pipeline and products76Significant external R&D licenses and collaborations100,000People reached through clinical trials in 50 countriesGRI/SASBdisclosuresinthissection:GRI 203SASB240a.1 For more info o

188、n disclosures,see the Reporting indices.For more information on our R&D efforts,please visit the Research&Products page on our corporate website.22Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availabil

189、ity|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityReflecting global health care needs inR&DAsdefinedbytheglobalburdenofdisease(GBD)visualizationtoolsdevelopedbytheInstitute for Health Metrics and Evaluation(IHME),our products address diseases that rank high on

190、 the list of worldwide causes of illness,disabilitiesanddeath.Inaddition,ourvaccine and infectious disease research targets major burdens of disease,including in LMICs,where health care infrastructure may be resource-constrained.Considering our pipeline,the products we market,and our external collab

191、orations,weestimatethatourCompanyisseekingtoaddress 83 percent of the top 20 GBD(this figureexcludesroadinjuriesandage-relatedhearingloss)asdefinedbytheIHME,thesamepercentagein2023asin2022.Ofnote,themost recent version of the GBD by the IHME isfrom2019.We strive to discover treatments for diseases t

192、hataffectpeopleacrossabreadthofcountries,such as cardiovascular disease,which the WorldHealthOrganization(WHO)identifiesastheworldsleadingcauseofdeath.Wehavea long history of developing treatments for cardiovasculardisease.Morethan60yearsago,weintroducedourfirstcardiovasculartherapyandoureffortstoun

193、derstandandtreatcardiovascular-relateddisordershavecontinued,includingwithourinvestigational,once-dailyoralproproteinconvertasesubtilisin/kexintype9(PCSK9)inhibitor,currentlybeingevaluatedinadultswithhypercholesterolemia.Despitetheinventionofseveralwell-establishedlipid-lowering therapies,millions o

194、f people globally do notachievetheirdesiredlow-densitylipoprotein(LDL)cholesterol treatment goals,leaving them atriskforcardiacevents.In2023,webeganthreePhase3studiesevaluatingourPCSK9inhibitor,including for its potential to reduce cholesterolandimprovecardiovascularoutcomes.“The initiation of a com

195、prehensive Phase 3 program is an important milestone in our goal toofferahighlyeffectiveoralmedicationwiththepotentialtoprovideaccesstoabroadpopulationandpotentiallyallowsubstantiallymorepeopletoreachtheirLDLtreatmentgoals.Inacknowledgmentofthesignificantracial,ethnicandgenderdisparitiesincardiovasc

196、ularcare,we are taking proactive measures to engage potential participants from populations thathavehistoricallybeenunderrepresentedinclinicaltrialsofthistype.”Dr.Joerg Koglin,Senior Vice President,Merck Research Laboratories23Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&

197、ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityResearch and development20192020202120222023R&D expenses(in billions)1,2$9.7$13.4$12.2$13.5$30.5Top 20 global burdens of disease a

198、ddressed by our products and pipeline3100%88%71%83%83%Establishedsignificantexternallicensesandcollaborations478123929776 R&Dexpensesincludea$2.7billionchargein2020relatedtotheacquisitionofVelosBio,Inc.,a$1.7billionchargein2021relatedtotheacquisitionofPandionTherapeutics,Inc.,$1.7billionofintangible

199、assetimpairmentchargesin2022,andchargesof$17.1billionin2023fortheacquisitionsofPrometheusBiosciences,Inc.,andImagoBioSciences,Inc.,andtheformationofcollaborationswithDaiichiSankyoandKelunBiotech.2 ThehistoricalresultsofthebusinessesthatcontributedtoOrganon&Co.inthe2021spin-offhavebeenreflectedasdisc

200、ontinuedoperationsintheCompanysconsolidatedfinancialstatementsthroughthedateofthespin-offandthereforeareexcludedfromthe2019,2020and2021figurespresented.3 AllcalculationsforourCompanysGBDimpactarebasedonthelatestIHMEreportavailable,from2019.Assuch,impactfrommorerecentdiseaseslikeCOVID-19isnotaccounte

201、dfor.Wealsodonotincluderoadinjuriesorage-relatedhearinglossinourGBDaccountingsincetheyarenotsubjecttopharmaceuticalintervention.4 Thesepartnershipsaredeemed“significant”becausetheyinvolveanassetortechnologywiththepotentialtomakeanimportantenhancementtoourR&Dcapabilities.R&D investments and collabora

202、tions for LMICsWe have a strong legacy of infectious disease research,including for diseases that greatly impact people in LMICs like respiratory syncytial virus(RSV),tuberculosis(TB),humanimmunodeficiencyvirus(HIV),malariaanddengue.RSV is a contagious,widespread seasonal infection.Thoughalmostallch

203、ildrencontractit at least once before they are two years old,forsome,itcanbecomplicated.Anestimated95percentofRSVinfectionsandmorethan97percentofRSV-relateddeathsgloballyoccurinresource-limitedcountries,makingRSV a substantial burden of disease in these settings.Weareevaluatingamonoclonalantibody fo

204、r the prevention of RSV in infants andcertainchildrenoverageone.In 2022,we entered into a licensing agreement with the Gates Medical Research Institute(Gates MRI)for two preclinical candidates discovered at our Company with potential in combination regimens for treating TB,oneofthetop10causesofdeath

205、inLMICs.Inearly2023,oneofthesecompoundsenteredaPhase1clinicaltrial.Ourscientistsdiscovered the compounds as part of the TBDrugAccelerator(TBDA),acollaborationamong biopharmaceutical companies,researchorganizationsanduniversitiestoaccelerate new TB therapies,supported by theGatesMRI.Thelicensingagree

206、mentwithGates MRI,facilitated through the TBDA,and covering preclinical candidates,is an example of a collaboration that can help advance drug candidates toward becoming potential novel combinationTBtreatments.R&D collaborations In2023,weenteredinto76significantexternal licenses,collaborations and a

207、cquisitions with a broad range of partners,fromearly-stagesciencetoclinical-stageprograms.Thesecollaborationsaredeemed“significant”becausetheyinvolveanassetortechnology with the potential to enhance our R&Dcapabilitiesorportfolio.Hilleman Laboratories:A first-of-its-kind R&D joint ventureIn collabor

208、ation with the Wellcome Trust,we founded Hilleman Laboratoriesover10yearsago,afirst-of-its-kindR&Djointventuretofacilitatewider,affordableaccesstolife-savingvaccinesandbiologicsinLMICs.Ourlongstandingsupportfor Hilleman Laboratories is part of oureffortstoexploreacontinuumofapproaches and partnershi

209、p models to better enable supply stability and facilitate more equitable access to innovativehealthproductsinlow-resourcesettings.24Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabili

210、tyandsustainableaccess|Strengthening health systems and addressing inequityDengueAccordingtotheWHO,climatechangeisasignificantcontributingfactortotheincreaseintheincidenceandspreadofdengue.Changesinclimatepatterns,includingtemperatureandrainfall,caninfluencethebreeding,survival,andbehaviorofmosquito

211、esthattransmitthedenguevirus.Abouthalfoftheworldspopulation,or4billionpeople,isatriskfordengue,primarilyintropicalandsub-tropicalregions.Wearecommittedto addressing dengue through development of our investigational vaccine,currently inlate-stagedevelopment.Since 2018,wehavecollaboratedwithInstitutoB

212、utantan,anon-profitproducerofimmunobiologicproductsforBrazil,tosharedataandlearningsfromourrespectivedenguevaccineprograms.InstitutoButantanisalsodevelopinganinvestigationalvaccineforwhichitwillseekregulatoryapprovalinBrazil;weplantoseekregulatoryapprovalinmanycountriesoutsideofBrazil.New formulatio

213、ns Innovation goes beyond new treatments.Withafocusonreducing pill burden by investigating thepotentialtoprovidelong-actingoptions to enhance the patient experience,we strive to provide options that increase the ease of administeringtreatments.Forexample,in HIV,we are researching long-actingmedicati

214、onsdesignedto reduce the frequency of administration,whichmaybenefitpatientsandresource-constrainedhealthsystems.HIV is a global epidemic that disproportionately affectspeopleinsub-SaharanAfrica.Infact,accordingtoIHME,two-thirdsofthemorethan 38 million people with HIV reside in theregion,accountingf

215、orabout75percentofHIV-relateddeathsglobally.Formorethan35years,wehaveresearchedwaystoaddresstheHIVepidemic.WehaveabroadR&D program for HIV,including a Phase 3 developmentprogramforanewonce-daily,two-drugregimen.Aspartofanagreementwith Gilead Sciences,we also have a program evaluating an investigatio

216、nal,weekly oral combinationtreatmentconsistingofourantiviralislatravirandGileadslenacapavir.Recent Phase 2 data for this investigational oralcombinationregimenshowitmaintainedviralsuppressionat24weeks,supportingits continued development as a potential long-actingoralcombinationtreatmentoptioninvirol

217、ogicallysuppressedpeoplewithHIV,withthepotentialtobethefirstoralweeklyHIVtreatment.In addition,we are collaborating on a potential new treatment option for malaria,an infection that the 2023 World Malaria Report notes is one of the largest causes of death in pregnant womenandchildrenunderage5inmostr

218、esource-poorcountries.Importantly,thereisrisingresistancetoexistingmalariatreatments.A new antimalarial drug candidate,discovered through our longstanding collaboration with theWalterandElizaHallInstituteofMedicalResearch in Australia and with funding from theWellcomeTrust,recentlyenteredintoclinica

219、ldevelopment.25Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequitySystematic evaluation to inform product ac

220、cess strategiesWe are implementing a new collaborative enterprisego-to-marketmodelthatfacilitatesaccess to health considerations early in a productsdevelopment.This framework helps us evaluate our pipeline candidates and identify their potential in addressingsignificantpublichealthburdensand unmet m

221、edical needs,particularly in underserved health care settings,including LMICs.Theinsightsfromthisevaluationprocessinform our product development and access strategies,with the overarching objective of expanding availability of our medicines and vaccinestoasmanyindividualsaspossibleinaneconomicallysu

222、stainablemanner.Starting early in development,we conduct acomprehensiveevaluationofourcandidatespotential to address unmet medical needs,particularlyinLMICs.Thisearlyandsystematicevaluation encompasses multiple factors,including the understanding of barriers to access,medical needs and economic cons

223、iderations.Candidateshavingsignificantpotentialtobenefitpopulationsinunderservedsettings are assessed for investment in access solutions,with the intent of enabling widerpatientreachglobally.Furthermore,werecognizetheimportanceofunderstandingthe existing health system infrastructure and funding mech

224、anisms,as they play a crucial roleinfacilitatingthesafeandeffectiveuseof our products and ultimately enhancing patientaccess.OurR&Dandenterprise-levelgovernancecommittees are accountable for evaluating our candidates as a part of the standard developmentprocess.Theirrecommendationsarereviewedatinter

225、nal,cross-divisionalforumsofseniorleaders.Toaccountforchangesintheexternal environment,products continue to be evaluated for their potential to address disease burdensthroughouttheirlifecycle.Sometimes the evaluation of a candidate reveals barriers to access in LMICs or underservedsettings.Inthesesi

226、tuations,the evaluation can inform how we might strengthen health systems and improve healthequity.Werecognizethataddressingthecomplexandmulti-facetedchallengestoaccess in LMICs requires collaborating with multiple stakeholders and seeking partnerships thatenablehealthcareaccess.26Merck 2023/2024 Im

227、pact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityIncreasing diversity of patients in clinical trialsIn2023:337late-stagestud

228、ies,across 21,000sitesin50countries,and 100,000peoplereachedinclinicaltrialsClinicaltrialsarecriticaltoadvancingscientificinnovations and we are determined to expand access to themincluding through increased racial and ethnic diversity among trial participants.In2023,wereachedmorethan100,000peopleth

229、roughourclinicaltrialsinmorethan50countriesworldwide.Increasing the diversity of participants inclinicaltrialsrequiresacomprehensiveapproach,which is why we are addressing avarietyofassociatedfactors.Forlate-stagetrials,werequireplanstorecruitpatientswhoreflectthediversityofthepeoplewhowilluseourpro

230、ducts.Inaddition,weprioritizeplacementofU.S.studysites in communities with higher populations of individuals who have historically been underrepresentedinclinicaltrials.And,weprovide resources and training to improve diversityinclinicalresearch.Forexample,weestablished a community advisory board to

231、gain firsthandinsightsandincorporatethevoiceofthe patient in our site and patient engagement methods.Wevealsoestablishedanewroleresearchnavigatorat12keyU.S.partnersitestoaiddiverseenrollment.Collaborations are a vital part of increasing participantdiversity.In2022,wejoinedtheNovartis-ledcollaboratio

232、n,BeaconofHope,a10-yearprogramthatestablishesclinicaltrialcenters of excellence at four historically Black medical schools,to increase diversity among clinicaltrialinvestigatorsandparticipants.Wealsocontributetosponsorshipstoconnectwith,support and train clinicians from underrepresentedgroups.Toease

233、logisticalbarriersthatmakeitdifficultfor some patients to visit clinical trial sites,were working with Greenphire,a provider of globalfinanciallifecyclemanagementsolutionsforclinicaltrials.TheorganizationsClinCarddebit card provides direct stipends and travel reimbursementforclinicaltrialparticipant

234、s.In addition,we have developed tools to reach study participants within their communities,suchasourpartnershipswithBlackDoctor.organdAcclinate,leadingorganizationsfocusedon increasing awareness of clinical trials among diverseparticipants.Wealsoco-sponsortheImproving Patient Access to Cancer Clinic

235、al Trials(IMPACT)studyattheLazarexCancerFoundation.IMPACTisathree-yearpilotprogram that strives to increase the diversity of people enrolled in clinical trials,as well as to improve retention and equitable access inoncologytrials.Wealsoimplementnoveltools and approaches to build relationships and re

236、ach potential study participants within theircommunities.Consistent with the International Conference on Harmonisation:Good Clinical Practice(ICH-GCP)requirements,aspartoftheinformed consent process,we make clinical trial participants aware of the compensation or treatment available to them and whom

237、 to contactintheeventofatreatment-relatedinjury.Inaddition,wemaintainproceduresthataddressthecostsoftreatmentintheeventoftrial-relatedinjuries,inaccordancewithapplicableregulatoryrequirements.27Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAc

238、cess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityGoal2023Reach at least 75%of countries around the world annually with our products.179%1“Countries”areasdefinedbytheWorldBankCountryandLendingGroups.Includesonlyhu

239、manhealthproducts.Availability Our Company is committed to a comprehensive global supply chain management strategy that addresses accessibility,agility,resilience,capabilityandsustainabilityonaglobalscale.Ourcommitmenttoglobalproductavailabilityisreflectedinourgoaltoreachatleast75percentofcountriesw

240、orldwideannuallywithourhumanhealthmedicinesandvaccines.In2023,weexceededexpectationsbyreaching79percentofcountries,surpassingourgoalforthethirdconsecutiveyearandshowcasingourdedicationtoextendingtheaccessibilityofourlife-savingproductsacrosstheglobe.GRI/SASBdisclosuresinthissection:GRI 203SASB240a.1

241、SASB240a.2 For more info on disclosures,see the Reporting indices.28Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressi

242、ng inequityCommercialization and supply chain planningOurapproachtocommercialization,manufacturing,and supply chain planning focuses on extending access to our products,driving innovation through digital tools,and demonstratingvaluetoourstakeholders.We are using a collaborative enterprise go-to-mark

243、etmodeltoallowearlierplanningforallmarkets,includinghigh-,middle-andlow-incomecountries.Theaimistoenableaccess to our medicines and vaccines globally,including the areas of the world where they areneededmost.Our supply chain operations are integrated across the enterprise,playing a crucial role Avai

244、lability2020202120222023Countriesaroundtheworldreachedwithourproducts(Target:75%)78%79%76%79%Ordersshippedontimeandinfull(Target:95%)98%98%98%98%Logisticspartnerswithsecurity-riskassessmentcompleted,annually(Target:100%)100%100%100%100%Reportingonthesemetricsbeganin2020.CountriesasdefinedbytheWorldB

245、ankCountryandLendingGroups.Includesonlyhumanhealthproducts.Maintainingproductqualityisparamount.Toprovidehigh-qualitymedicinesandvaccinesto people who need them,when and where theyneedthem.Wemanageoursupplychainthrough policies and procedures designed to keep the distribution system secure,agile and

246、efficient.We strategically design our supply chain networks while monitoring evolving pipeline,globalandmarketdynamics.Theintegrationof new partners and novel modalities further diversifiesthesupplychainlandscape(e.g.,small molecules,macrocyclic peptides,biologics,antibody-drugconjugates,andvaccines

247、),and helps to enable a secure and continuous distributionofmedicinesandvaccinesglobally.Oursupplychainstrategyisbuiltonresilience.Initialandperiodicsecurity-riskassessmentsforlogistic partners and contract manufacturers align with our unwavering commitment to robustsafetymeasures.Wearecommittedtoac

248、hievinga100percentsecurity-riskcompletion rate for all new logistics partners during the logistics procurement process,as wedidin2023.Theseassessmentssetacriticalbaseline to measure security risk at the onset of the business relationships and ensure alignment with our supply chain security standards

249、 to protectourproductsandpatients.Thisplanningenables us to continue to surpass our target of95percentofordersshippedontimeandinfull,withanachievementof98percentin2023(seeAvailabilitytabletotheleft).Maintaining and sustaining a global supply network alongproductlifecycles.Wedesignsupplychains compri

250、sed of internal sites and external partners that enable resiliency while improving accessinasustainableway.Our Digital Logistics Program helps build the supply chain of the future and ensure continuous supply of critical medicines and vaccines to patients worldwide through efficient,tech-enabledoper

251、ations.Thecloud-based data integration service gives insights intothephysicalflowofourproducts,minimizingdisruptionsandimprovingserviceandsecuritywhilereducingcosts.This commitment to resilience is evident in our proactive risk preparation,including assessment and mitigation of risk related to geopo

252、litical events,natural disasters andpandemics.Oursupplychainsabilitytopromptlyre-routeshipments,useagilecold-chaintechnologies,andproactivelyaddressdisruptions demonstrates the strength of its framework,and our commitment to sustain aglobalsupplyofproductsforpatients.For more information on our supp

253、ly chain operations see the Supply Chain section on page 113,Serialization and product security section on page 111,and the Climate risk assessment section on page 75.29Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery a

254、nd invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityRegistering medicines and vaccines where there is need Product registration and prequalificationWe seek to ensure global access to our medicinesandvaccinesbymaintainingup-to-dateproductreg

255、istrationsaroundtheglobe.In2023,weregistered159productsanddevices,withmostoftheseinLMICsintheAsiaPacific,Central and Eastern Europe,Middle East and Africa,andAmericasregions.In addition to having our medicines and vaccines approved by regulatory authorities and enhancing access to LMICs,we also purs

256、ue WHOprequalificationforcertainmedicinesandvaccines so they can be more easily procured byanddistributedtoLMICs.ThetabletotherightsummarizestheregistrationandWHOprequalificationstatusofaselectlistofourmedicinesandvaccines.WHOprequalificationfacilitatesproductprocurement by United Nations agencies i

257、nmanyLMICs.Intheabsenceofstringentnationalmedicineauthorities,itcertifiesthatproducts meet required quality,safety and efficacystandards.WHOsprequalificationprogram covers routine vaccines and medicines forHIV/AIDS,malaria,TB,hepatitis,diarrhealdiseasesandselectneglectedtropicaldiseases.We work to a

258、ddress the unique needs of LMICs where the infrastructure and personnel to deliverimmunizationservicescanbeseverelylimited.Specifically,wehavefocusedonproduct improvements such as the introduction of vaccine vial monitors(VVMs)to assess controlled-temperature-chainconditions.Products prequalified by

259、 WHOInternational nonproprietary name(INN)Date of prequalificationNumber of countries prequalified in 2023VaccinesM-M-RIIMeasles,Mumps,Rubella Virus Vaccine LiveJanuary200976ROTATEQRotavirus Vaccine,Live,Oral,PentavalentOctober 2008121GARDASILHumanpapillomavirusvaccinetypes6,11,16,18(recombinant,ads

260、orbed)”May2009129GARDASIL9Humanpapillomavirus9-valentvaccine(recombinant,adsorbed)February201890VARIVAXVaricellaVirusVaccineLive(firstvaricellavaccinetoreceiveWHOprequalification)February201886ERVEBOEbola Zaire Vaccine,LiveNovember201945HIV/AIDS treatmentsSTOCRINEfavirenz(600mgtablet,OralSolution30m

261、g)Efavirenz(50mgtablet,200mgtablet)May2006,May 200846 NotcurrentlyavailablethroughUNICEFprocurement;awaitingVVM.Product registration20192020202120222023New product registration(annual)9779141156159ProductssubmittedthathaveachievedWHOprequalification(cumulative)2,31313777Numberofpatentapplicationsfil

262、edinlow-incomecountries400000 Dataincludenewproductsandnewindications.2 ThreeproductspreviouslyreportedarenolongerpartoftheCompanysproductportfolioduetotheOrganon&Co.spin-offin2021.3 Three GARDASILproductsthathadbeenpreviouslyreportedseparatelyarereportedasoneproductstartingin2021.4 Countriesclassif

263、iedaslow-incomecountriesinthe2023WorldBankCountryandLendingGroupclassifications.30Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health system

264、s and addressing inequityManufacturing and supplying vaccinesIn the last few years,various countries have introduced new or expanded routine vaccination programs,creating unprecedented increases in globalvaccinedemand.Tomeetthis,wecontinuetoincreaseourcapacityandsupplycapabilities.Weplantoinvestappr

265、oximately$18billioninsupply-relatedcapitalprojectsfrom2023-2027,withaportiondedicatedtovaccines.Wealsocontinuetoinvestinmanufacturingandend-to-end supply improvements in both capability and capacity to help ensure a sustainable,reliable supplyofqualityandaffordablevaccines.Wearecommittedtovaccineacc

266、essibilityandhavespecificstrategiesinplacetoenhancetheavailabilityofvaccines.Partnering to fortify vaccine supplyIn Canada,we partnered with the Ministry of Health,a pharmacy chain,and a distributor in agroundbreakingsupplychaininitiativethatintroducesablockchain-basedsecurenetworkforreal-timetracki

267、ngofvaccinedoses.Thetechnologyallowsforseamlessvaccinetransferandenhancesend-to-endvisibilityacrossthesupplychain.Italsorevolutionizesinventorymanagement,creatingacollaborativenetworkwherestakeholdersshareandvisualizeinventory,improvingdistributionandpreventingsupplyissues.Partnering to reduce cervi

268、cal cancer in IndonesiaIn alignment with the HPV NationalImmunizationProgramin Indonesia,our Company forged a pivotal partnership with a local manufacturing company(Bio Farma)in late 2022 through the signing of a technology transfer agreement.Thisstrategiccollaboration facilitated the transferoftech

269、nologyandlocalizedproductionofour4-valentHPVvaccinewithinIndonesiasborders.By establishing local manufacturing capabilities,this agreement facilitates enhanced accessibility and distribution of this vaccine in Indonesia.Distributioncommencedin August 2023,with the goal of vaccinating up to three mil

270、lion age-appropriategirlsinIndonesia.Given the high prevalence of HPV-relatedcervicalcancerinIndonesia,our partnership holds promise in helping expedite the countrys journey towards reducing cervicalcancer.31Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting ind

271、icesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityEnhancing data and decision making for access planningWerecognizetheimportanceofintegratedaccess planning,data,and decision making throughoutthesuppl

272、ychain.Acoordinatedapproach ensures the availability of products through streamlined processes,which in turn fostersefficiencyandresponsivenesstoglobalhealthchallenges.Toimproveefficiencyandresponsiveness,wehavedevelopednewmethodologiesthatmodeldemandandcapacity.Thesemethodologies help us meet incre

273、ased patient demandsmoreefficientlyandnavigatesupplychain complexities with strategic foresight and strategic acumen,setting the stage for further advancementsinsupplychainstrategies.Empowering health care:using supply chain capabilities to enhance aPatient Access ProgramThroughinnovativedigitalcapa

274、bilities,suchasblockchainandserialization,weareleveraging a supply chain initiative to enhance our Patient Access Programs in the Asia PacificRegion.Thisinitiativeaimstoenhancepatientaccesstoouroncologyportfoliobyensuringproductsecurityandcompliancewithhealthauthoritiesrequirements.Throughtheimpleme

275、ntationofend-to-endtraceabilityandpackageverification,weprioritizepatientsafetyandensuretheintegrityofourproducts.For more information on serialization and product security,see page 111.New supply strategies to expand accessOur commitment to expanding access is not justanaspirationbutacontinuouseffo

276、rtmarked by tangible actions and impactful outcomes.In2023,ourCompanydevelopedstrategic partnerships to enable expansion of product reach to markets that were previously inaccessible.OurSupplyChainManagementteam is actively engaged in breaking down accessibility barriers by engaging in capability bu

277、ilding,forging strategic partnerships,and building a global internal and external supply network.OurCompanyistransformingitsmanufacturing approaches to deliver on itspromiseofmakinglife-savingproductsaccessibletopatientsworldwide.Innovations in supply chain technologies:Driving resilience and agilit

278、yOur commitment to advancing health careextendsbeyonddevelopinginnovativebiopharmaceuticals.Weunderstandtheimportanceofarobustandefficientsupplychain to ensure timely and broad access tolife-savingproducts.Asthehealthcareecosystem and global supply chain dynamics continue to evolve rapidly,we have b

279、een leveraging our digital capabilities to be more resilient,enhancingsupplychainagility.With manufacturing operations across the globe,supply chain resilience becomes paramount.Withthecomplexityinherentin biopharma supply chains,proactive identificationandmitigationofrisksiscrucial.One of the ways

280、we are addressing this is by leveragingartificialintelligence(AI)toenhanceourabilitytoidentify,monitor,analyze,andrespondtosupplychainrisksglobally.OurAI-poweredriskorchestrationplatformand continuous event monitoring provide real-timevisibilityandenabledata-drivendecisionmaking.Strongsupplychainsys

281、tems,made more robust with these innovations for efficiencyanddistributiontounder-resourcedand remote locations,will be the engine that helpsusnavigatethesechallenges.For more information on our supply chain operations see the Supply Chain section on page 113,and the Climate risk assessment section

282、on page 75.32Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordabilityandsustainableaccess|Strengthening health systems and addressing inequityAffordability and sustainable access Inspire

283、dbyourformerCEOGeorgeW.Merck,whooncesaid,“Wecanneverrestuntilawayhasbeenfoundtobringourfinestachievementstoeveryone,”we are working toward a world where everyone,everywhere,can receive the medicinesorvaccinestheyneed,whentheyneedthem.Westrivetodothisin a way that creates sustainable access to our in

284、novative products,creating long-termvalueforourstakeholders,includingshareholders,patients,andhealthsystems.Grounded in a deliberate systematic approach,our Company develops,tests andimplementsmarket-basedsolutionsthataddressbarrierstoaccessandaffordabilityofourmedicinesandvaccines.Thisallowsustoser

285、vethegreatest number of patients today,while meeting the needs of patients in thefuture.Whereappropriate,wepursuethesesolutionsinpartnershipwithprivateenterprises,governmentagencies,multilateralandnon-governmentalorganizations.Whenmarket-basedsolutionsareinadequateorunavailable,we pursue programs to

286、 provide direct access to our medicines and vaccines,includingproductdonationsandpatientassistanceprograms.Havingexceededourinitialgoalin2023,wehavenowsetanewgoaltoenable350millionmorepeoplegloballytoaccessourinnovativemedicinesandvaccinesby2025andwearewellonourway.Toreachthisgoal,wearebuildinghealt

287、hcarecapacity,strengtheningchannelsforcaredeliveryandfosteringsustainablefinancing.For more information on how these solutions are working to improve affordability and sustainable access,please see“How we enable affordability and sustainable access to ourinnovative medicines and vaccines”on page 34.

288、Enabling access to our medicines and vaccines20192020202120222023Total number of people enabled to access our innovative medicines and vaccines through access solutions(estimate in millions)NRNR66.7189.2240.0People reached globally through product donation and patient assistance programs and partner

289、ships(estimate in millions)403.7268.3197.3359.2385.2NR:notreported.1 Metrics contributing to this goal are displayed on an annual basis and provide information on the number of people who we estimate now have the option to access medicines and vaccines as a result of our sustainable access strategie

290、s,solutionsandpartnerships.ThesesolutionsincludeourcommitmenttoGaviandUNICEF(ratherthandosesshipped),collaborationstooptimizeresourcesinhealthsystems,expandedfinancialcoveragethroughinsurance,andnewcommunity-basedchannelpartnerships.“Innovativemedicinesandvaccines”referstoourCompanyson-patentproduct

291、s.Enable“morepeople”isdefinedaspopulationssupportedbyinitiativesimplementedandlaunchedinmarketandwillbeincomparisontothebaseline(2020)asof2025.Evidenceformetricsissourcedfrompubliclyavailabledataandproxysourcesbymarket.Whileproxiesdifferbymarket,allmethodologiesareevaluatedandrepresentourbestestimat

292、eofpeopleenabledtoaccessinnovativemedicinesandvaccines.Peoplewhowereenabledtoaccessinnovativemedicinesandvaccinesdidnotnecessarilyreceivesuchinnovativemedicinesandvaccines.IncludespeoplereachedthroughtheMECTIZANDonationProgram,theMMOP,andtheU.S.PatientAssistanceProgram.TotalpeoplereachedwiththeMECTI

293、ZANDonationProgramincreasedin2023aspartnercountriescontinuedtoresumeadditionalMECTIZANdistributionfollowingdisruptionsduetothepandemic.Formoreinformation on the details related to the people reached through donations,please see page 38.GRI/SASBdisclosuresinthissection:GRI 203SASB240a.1 For more info

294、 on disclosures,see the Reporting indices.33Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordability and sustainable access|Strengthening health systems and addressing inequityHow we ena

295、ble sustainable access to our innovative medicines and vaccinesWe strivealong with many in the health care sectortofindsustainablewaystoexpandaccesstoourinnovativeproducts.Wehaveestablished a globally available framework for diagnosing barriers to access and for designing and delivering practical so

296、lutions tohelpaddressthem.Wealsohaveadedicatedinternal unit tasked with accelerating access by evolving our capabilities and capturing learnings across countries,including by helping health care systems better serve those in need through customer collaborations,health care financing,employerbenefitd

297、esignandnewdeliverychannels.Throughthisapproach,wehave accelerated the development of patient access models and solutions that expand the populationswecanreach.We remain committed to our goal to enable 350millionmorepeopletoaccessourinnovative medicines and vaccines through accesssolutionsby2025.In2

298、023,wemadesteadyprogress,enablingaccessfor240millionpeople(see page 33).CustomercollaborationsSome health care systems are challenged with long wait times and capacity constraints relatedtodiagnosisandtreatment.Thatiswhywe collaborate with more than 80 health care and service providers across Europe

299、 and Latin America to understand hurdles and advance solutionsthatstrengthenhealthcaresystems.Using our expertise,particularly in oncology,and our deep understanding of the health care ecosystem,we partner with health systems to better understand cancer patient pathway constraints and to identify so

300、lutions that enable accessandoptimalresourceuse.One such approach is in the United Kingdom.Throughout2023,wecompleted16collaborativeprojects,andinitiatedanother32,to support the National Health Services(NHS)inoptimizingcancertreatmentpathwaysandexpandingcapacity.WeworkedwithLloydsPharmacy Clinical H

301、omecare to deliver infusion services that sit outside of a university teaching hospital in Newcastle,an area with high cancerprevalence.Theoutpatientsitebringscareclosertopatients,reducingtraveltothecity center for treatment and improving the patientexperience.In Colombia,we work with multiple healt

302、h maintenanceorganizationsandoncologyhealthcareprofessionalstoidentifyinefficienciesandpain points,helping reduce the time to lung and breastcancerdiagnosis.In collaboration with Financial Times Longitude,we launched the Sustainable Access website to advocate for greater stakeholder collaborations t

303、o develop,test and scalesustainableaccesssolutions.Financing health careA recurring access challenge in LMICs is the potentiallyhighout-of-pocketcostsforcriticalillnesstreatments.Recognizingthisissue,wework with reinsurers and insurance companies todevelopaffordablehealthinsuranceproductsthatcoverin

304、novativecancertherapies.For example,in China we are collaborating with public health authorities to provide accesstoimmunotherapyfinancingthroughsupplemental medical insurance,driving greaterhealthcareinclusion.We believe that expanding the reach of insurance products will help solve major access hu

305、rdles and,in turn,increase patient accesstoinnovativecancertherapies.Thiscollaborative approach to addressing access challenges reinforces our commitment to being part of a wider ecosystem,working with those with complementary capabilities to tackle accesschallenges.34Merck 2023/2024 Impact ReportEm

306、ployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordability and sustainable access|Strengthening health systems and addressing inequityEmployers role inbenefitdesignIntheU.S.,employersplayanimportantrole in the health ca

307、re system through their employeehealthplans.Theprinciplesofvalue-basedinsurancedesign(V-BID)focusonstructuringhealthplanstoincentivizehigh-valueinterventionsanddisincentivizelow-valuecare.V-BIDaimstoimprovepatientoutcomes and manage costs,allowing funding tobereallocatedforinnovativenewtreatments.We

308、haveevaluatedaV-BIDOncologyPilotthatpioneeredtheuseofV-BIDprinciplesincorporate cancer coverage for our employees intheU.S.Wearealsousingdatatobetterunderstand our employees health risks and ourcancercareexpenditureto:Identify opportunities to move from low-valuetohigh-valuecare Continuouslyrefinean

309、devolvetheplanWe have been sharing lessons from this pilot with stakeholders and other employers in hopes itwillwidenaccesstoqualitycare.Additional information on sustainable access strategies,solutions and partnerships can be found on the Sustainable Access website.Newcommunity-levelaccess channels

310、We seek strategic partnerships with health care professionals who have the potential to enhance awareness,availability,accessibility andaffordabilityofourproducts.Thesepartnerships enable access for populations who traditionally have been unable to access innovativemedicinesandvaccines.For example,w

311、e collaborate with a health care provider who operates across nine African countries to reimagine the prevention,screeningandtreatmentofcervicalcancer.Our commitment to Gavi andUNICEFWe are deeply committed to Gavi,the Vaccine Alliance(Gavi),andUNICEFintheireffortstoexpand access to vaccines and pro

312、tect global health.Gaviisapublic-privatepartnershipthathasmadesignificantstridesinimmunizingchildren and reducing child mortality in lower-incomecountries.Gavialsoprovidesfunding support for health systems and global stockpiles of crucial vaccines for Ebola,cholera,meningitisandyellowfever.As a memb

313、er of Gavis board,and the worlds largest buyer of vaccines for developing countries,UNICEF has a pivotal role in immunizationprogramsinGavi-supportedcountries.UNICEFsSupplyDivisionprocuresmostGavi-fundedvaccines,ensuringtheiravailabilityanddistribution.Our commitment to helping protect global health

314、 by broadening access to our vaccines is fundamentaltoourmission.Toenablefurtheraccess to our HPV vaccine,to help prevent HPV-relatedcancersanddiseases,weprovidethe vaccine to Gavi at an access price for use inGavi-supportedcountries.Throughalong-term agreement with UNICEF,we committed toprovideover

315、115milliondosesofourHPVvaccineforuseinGavi-supportedcountriesfrom2021-2025.Inaddition,for2021-2025,wecommittedtoextend our current Gavi prices for our HPV vaccinetoGavi-transitionedcountrieswithaper-capitagrossnationalincomenotexceeding$3,200.Thisgreatlyassistsinexpandingand sustaining access in cou

316、ntries that have transitionedoutofGavisupport.WebelieveourpricingapproachforGavi-supportedand-transitionedcountriesinconjunctionwithour commitment to partner with stakeholders tostrengthenresilienceofimmunizationprogramscontributes to broader access toourvaccinesworldwide.ERVEBO(Ebola Zaire Vaccine,

317、Live)is the worldsfirstU.S.FoodandDrugAdministration(FDA)-approved,WHO-prequalifiedvaccineforthepreventionofEbolavirusdisease.Throughour agreement with UNICEF,we have built a500,000-doseERVEBO stockpile,and we continue delivering licensed doses to maintain it.AsofMarch2024,thevaccineisapprovedin11Af

318、ricancountries.We are a sponsor of Investing in Innovation(i3),apan-Africaninitiativetosupportthecommercializationandimpactof60promisingearly-andgrowth-stageAfricanhealthinnovatorcompanieswithgrantsandaccesssupports.Aglobalnetworkofindustryplayers,donorsandinternationalorganizationssponsorstheinitia

319、tivetosupporthigh-potentialstartupswhoaspiretotransformtheavailability,accessibility,affordability,qualityandvisibilityofhealthproductsatscaleacrossAfrica.i3seekstoadvancemarketaccessforstartupstraditionallyexcludedfromfundingandsupport.35Merck 2023/2024 Impact ReportEmployeesEnvironmental Sustainab

320、ilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability|Affordability and sustainable access|Strengthening health systems and addressing inequityOur pricing approachWe believe it is possible to have a pricing system that allows patients to access the latestpro

321、ductswhilesustainingleading-edgescientificresearchforfuturemedicalinnovations.Wehavealonghistoryofmakingour medicines and vaccines accessible and affordablethroughresponsiblepricingpracticesandindustry-leadingpatientaccessprograms.We are working to bring our products to more people globally in ways

322、that are as accessible andaffordableaspossible.Whileeachsituationvaries based on unique circumstances and market dynamics,generally we consider:Value to patients Value to health care systems Unmet need Access R&D sustainability Competition U.S.productpricingIn2017,webegandisclosinginformationaboutth

323、epriceofourmedicinesintheU.S.Our2023U.S.Pricing Action Transparency Report shows an average annual net price increaseof4.4percentin2023.Theaverageannual list price across our portfolio increased by4.5percentin2023andourgrossU.S.saleswere reduced by 37 percent in 2023 because of rebates,discountsandr

324、eturns.For more information on our approach to pricing,please see our U.S.Pricing Action Transparency Report,available on the Transparency Disclosures page of our corporate website.Additional information on our efforts and suggestions to address patient access challenges in the U.S.is available in o

325、ur CEOs testimony to the United States Senate Committee on Health,Education,Labor&Pensions in February 2024.Voluntary licensing We have experience working with generic manufacturersonglobalhealthconcerns.Overthelastseveralyears,weputthisexperiencetoworkaddressingCOVID-19globally.FromtheearlydaysofCO

326、VID-19,andcontinuingthrough2024,wehavehelpedmeetthesignificantunmetmedicalneedgloballythroughamulti-facetedstrategytoenhanceaccesstoourinvestigationalCOVID-19oraltreatmentfollowingregulatoryauthorization:We entered into advance purchase and supply agreements with the governments ofmorethan40countrie

327、stosupplyourinvestigationalCOVID-19oraltreatmentthroughatiered-pricingapproachbasedonWorldBankcriteriatoreflectcountriesrelativeabilitytofinancetheirhealthresponsetoCOVID-19.We signed voluntary license agreements during the clinical development process with multiple Indian generic manufacturers and

328、the Medicines Patent Pool,to facilitate availability of generic versions ofourmedicinetomorethan100LMICs.These licenses and local manufacturing partnerships provide supply coverage for approximately90percentofthepopulationinLMICs.We allocated up to three million courses of our supply of medicine to

329、UNICEF for LMICs as a“bridge strategy”until the voluntary licenseeswereabletoprovidesupply.Thisstrategyhasminimizedthegapbetweensupplytohigh-incomecountriesandtoLMICs.ThesupplyagreementinplacewithUNICEF has been extended until the end of2024.WewelcomedtheGatesFoundations2021commitment of$120 million

330、 to accelerate accesstogenericversionsofourmedicine.This commitment complemented our voluntary license agreements and highlights the importance of actions from multiple stakeholderstoeffectivelyincreasetimelyaccessforpatientsglobally.Throughour licensing agreements with generics manufacturers and th

331、e Medicines Patent Pool,as of the end of 2023,close to six million courses of generic therapy have been shipped to28LMICscoveredbythelicenses.36Merck 2023/2024 Impact ReportEmployeesEnvironmental SustainabilityEthics&ValuesReporting indicesOverviewAccess to HealthDiscovery and invention|Availability

332、|Affordability and sustainable access|Strengthening health systems and addressing inequityPublic policies that improve access and affordabilityPublic policies,including laws and regulations,directlyandindirectlyaffectaccessandaffordability.Wearecommittedtopromotingsound policies that drive sustainab

333、ility of healthcaresystems.Wecollaboratewithgovernments,industry associations,trade and economic forums,think tanks,academia and advocacyorganizationstoanalyzetheimpactof current and proposed policies,formulate new proposals,disseminate best practices and promoteevidence-basedpolicysolutionsattheglobal,regionalandlocallevels.We use global and regional platforms such astheG7,G20,theAsia-PacificEcon