The Gauntlet: The Challenges that Lie Ahead for Big Pharma and the Industry as a Whole

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The Gauntlet: The Challenges that Lie Ahead for Big Pharma and the Industry as a Whole

14 November 2022

The pharmaceutical industry is a force for good!

Our opening remark serves as a reminder and maxim within our company’s mission statement of elevating the patient’s and consumer’s perception of the pharmaceutical industry. Now more so than ever in recent times, this maxim of ours is necessary to recalibrate the perception of our industry. For failure to do so will have far reaching consequences, not just upon the pharmaceutical industry but also on public health. As it stands, Big Pharma and the remaining stakeholders within the pharmaceutical industry must, if not currently are, run through a gauntlet consisting of disenfranchised, incredulous and angry members of the public. This brief will look at the current obstacles and challenges that await Big Pharma and other industry players, whilst proffering solutions that go some way to repairing the strained relationship between pharma and the public. The objective of this reconciliation between both pharma and public seeks to restore the lack of confidence and subsequently the trust that has been broken. The future and integrity of the pharmaceutical industry depends on the mending of this relationship.

Beginning with confidence itself, it is its latter crystalised end product of trust, that has been eroded or completely shattered resulting in the pharmaceutical industry being brought into disrepute. The leading contributing factor has been the lack of transparency in commercial activities and the decisions of Pfizer Inc. surrounding their vaccine. The earliest sense of opacity and perceived artifice involved the non-attendance of Albert Bourla pulling out of an initially scheduled European Parliament’s special committee on COVID (COVID committee). Mr. Bourla was not legally bound to attend nor was he subjected to any criminal punishment, as this was not an inquiry. Mr Bourla was intended to speak off the record. Mr. Bourla’s non-attendance proved irksome and did little to quell the committee’s frustration in the pursuit of answer. Another invitation has been extended to Mr Bourla. In Mr. Bourla’s place Janine Small, Pfizer’s Regional President of International Developed Markets stood in. The committee sought to address their concerns surrounding the heavily redacted vaccine purchase contract and the text messages between the Pfizer CEO and EU President Ursula von der Leyen. French MEP and COVI Committee member Veronique Trillet-Lenoir put these questions to Ms. Small. The purpose of Ms. Trillet-Lenoir’s line of questioning was to establish the relevant components about the operations in the manufacturing and delivery of the vaccines. ¹ To this, Small answered that the information remains confidential for “competition reasons. This answer in the eyes of the COVI Committee ran contrary to Pfizer’s initial claim of transparency.

Source: Medika.lfe. Janine Small address the COVI Committee.

societal instruments such as politics (policies), the media and science during the pandemic. Reflecting back on the pandemic through the eyes of the public, the UK government’s message over seen by the Chief Medical Officer (CMO), of “Stay at Home Saves Lives, Protect the NHS” because the mantra promulgated by 24 hours news media along with the daily statistics of those infected and killed by the coronavirus. With the machinery of politics and the media- fuelled by the science, there was indeed a great sense of fear and concern. Helpless, in the midst of the pandemic, the only light at the end of this dark tunnel was the arrival of the vaccine. It is here where the greatest scrutiny is applied. It is believed that the vaccine costs Pfizer $1.18 to make which they intended to sell to the US government for $20 and then will subsequently sell them on the consumer market at a price of $130 next year. Given the cost to end-users, the vaccine carries a 10,000% mark up heading into 2023. Pfizer yearly revenue in 2021 jumped from $41.6bn in 2020 to $81.2bn of which $36bn was attributed to vaccine sales.² IIt is the commercial practices that has not only drawn scrutiny, but indignation given that the initial research conducted by Pfizer’s German partner BioNTech, was funded by the German tax payer.³ From the public’s perception Pfizer has immensely enriched itself off the back of a devastating global tragedy. The challenge now facing Pfizer and the industry as a whole, whether they can adroitly and tactfully allay both questions and concerns around the morality and motive of the pharmaceutical industry. This challenge becomes more complicated when the commercial motive is inextricably affected by the next challenge associated with clinical evidence.

Source: Grocer Kantar 52w/e May 2022

Source: Daily Mail. Pfizer has enjoyed record profits and is projected to enjoy more heading into 2023

Evidence based medicine (EBM) and the ethical principle of autonomy, are the cornerstones of allopathic Western Medicine and during this pandemic, the public witnessed the deviation and erosion of both. Thus, the next challenge facing Big Pharma and the pharmaceutical industry is the public’s disillusionment, specifically, their distrust of the profession’s methodology and expertise. Before a medicinal product is launched on the market and available to the public, the drug candidate (proposed medical product) prior to approval and launch) is extensively tested through a series of clinical phases (Phase I, II & III). The rationale behind the process is to test the safety and therapeutic efficacy for a claimed indication (a condition, illness or disease) as stipulated by the intended marketing authorisation (MA) holder (who tends to be the products proprietor or inventor). During the pandemic a common sound bite in the media was the importance of “flattening the curve”. This meant reducing the r-rate, known as the reproduction rate of the virus through the average number of secondary infections produced by a single infected person.⁴ The r-rate was an indication of transmission and central to the two lockdowns imposed upon the UK economy and public. A 2021 study revealed that a single dose of a coronavirus vaccine would reduce household transmission of the virus by up to a half. Those given a first dose of either Pfizer or AstraZeneca vaccine- who became infected three weeks later – were between 38% and 49% less likely to pass the virus on than unvaccinated people.⁵ Therefore, the vaccine was seen as a means to ease restrictions, lift the lockdown and ease into the new normal. However, this did not seem the case.

During the COVI Committee, Janine Small was asked by Dutch MEP Robert Roos, of the JA21 political party, whether Pfizer vaccine was tested on stopping the transmission of the virus before entering the market. Small replied, “No”. She further added:

“…We had to really move at the speed of science to really understand what is taking place with the market.”

This is harrowing. There was no data, no clinical evidence and hence no science for a pharmaceutical product making claims towards halving transmission as part of a vaccine drive. For a profession and industry that prides itself on prudence and clinical evidence, this was nothing short of opportunistic, rash and reckless. This answer was not only injurious to the sector, it brought the whole pharmaceutical industry into disrepute. On the subject of injuries, there have been reports of recipients of the Pfizer vaccine experiencing myocarditis and heart attacks despite having no history of cardiac issues.⁶ Other vaccines have caused paralysis in a 12 year old girl, concerns surrounding fertility and premature deaths amongst healthy and fit individuals.⁷ From data collated between 9/12/20 and 20/04/22 for the mRNA Pfizer/BioNTech vaccine and 29^th September and 28^th September 2022 for AstraZeneca vaccine. The rate of vaccine deaths is now higher than COVID deaths are, with the figures showing 1,227 deaths plus 149 miscarriages. ^{8 9} The sudden death of adults in the last 18 months across the globe is to be covered in an up and coming private documentary entitled “Died Suddenly” streaming 21^st November 2022.¹⁰ The industry must brace itself for the question that are sure to follow.

Aside from the untrialled claims of transmission and the climbing death tolls, as a result of the erosion of EBM, the inherent right of autonomy had been attacked. Those that expressed concern and thus, sought more information to arrive at a position of informed consent were lambasted and labelled as “antivaxxers”, “covidiots”, “flat-earthers” and conspiracy theorists. Again, the combination of the media apparatus and the experts of the pharmacy industry created a toxic and divisive environment. “The Vaccinated” and “The Unvaccinated”. The Clean” and “The Unclean.” Adding to this hostile climate came the truly chilling policy imposed, by the then government and Health Secretary Savid Javid, on NHS staff and other care workers of

“No Jab, No Job!”

This policy was a direct contradiction of the Public Health (Control of Disease) Act 1984 and the Coronavirus Act 2020 and despite the government revoking this policy in February 2022, the damage had already been done. The sweeping disregard for the importance of EBM and ethics has left confidence and trust in the pharmaceutical industry in tatters. Aside, from rebuilding this broken trust, Big Pharma has created a more hostile and premier challenge with immediate consequences.

The final challenge to the pharmaceutical industry and one with immediate consequences is the rebellious spirit and “awakening” within not only the UK, but also the global public. This rebellious stance, fuelled by skepticism, poses a real danger to non-adherence and non-compliance with prescribed medication or the refusal to seek medical treatment all together. This is a trend already visible amongst minority ethnic groups, a group most susceptible to health inequalities.^{11 12} This rebellious spirit will exacerbate the already poor uptake and falling rate of childhood vaccinations across all programs.¹³ To tackle this challenge with any means of success there must be an acknowledgment that the leverage within the power dynamic between healthcare sector (including pharmaceutical companies, health institutions and healthcare professionals) and the public is no longer tilted in favour of the healthcare sector. The information age has not only dispelled the mystique surrounding the healthcare sector, it has recalibrated it to be a more even keel. This once lopsided relationship has seen the public question the necessity of the vaccines against that of an approved and generic medicine that is clinically efficacious and cheaper medicine in the form of Ivermectin.

Ivermectin is an oral anti-parasitic agent and across a meta-analyses of 18 randomised-controlled treatment trials, the administration of Ivermectin in COVID-19 patients was statistically significant in the reduction in mortality, time to clinical recovery, and time to viral clearance.¹⁴ The efficacy of

Ivermectin has been described as miraculous” by Dr. Pierre Kory at a COVID Committee in the US considering the devastation COVID-19 wreaked on the African-American and Latino community. When renowned podcaster Joe Rogan purchased Ivermectin, he was chastised for obtaining Ivermectin (most likely prescribed to him), which the media erroneously and disparagingly labelled as “horse dewormer” and not safe or approved to be used for human use. The perpetuated falsehood has served as casus belli against the perceived corruption and dishonesty of the pharma sector, a stance that in of itself will contribute to the proliferation and continued use of counterfeit medication as a means to gain one up on the “greed” of the pharmaceutical corporations. The furore that the Joe Rogan story created has further raised questions and scrutiny as to the motive and veracity of the pharmaceutical industry surrounding the vaccines and now future therapeutics.

Distrusting pharmaceutical companies, coupled with disinterest and a sense of complacency, will lead to non-adherence, non-compliance and the potential rise in counterfeit medication among members of the public. This would pose not just a public health crisis in the UK, but around the world. As a sector we must act fast to address this.

The new-wave of rebellious scrutiny has been led by the likes of Candace Owens through her “Shot in the Dark” series, available on social media platform Parler, and has further emboldened a leading vaccine researcher and campaigner in Robert F. Kennedy Jr. These voices and others will not be diminished. As it stands, they have laid down the gauntlet for us. From the pharmaceutical industry’s current position here to where we would like the pharmaceutical industry to be, the industry must pass through this difficult corridor and scrutinous passage that makes up the awaiting gauntlet. Therefore, we prose the following solutions for its successful navigation.

The first of our proposed solutions is to address the concerns around transparency. The industry must accept and address the gauntlet’s response to transparency with skepticism if Big Pharma and the pharmaceutical industry are to survive the gauntlet. To achieve successful navigation the industry must show its working and hence, must be willing to present, explain and share clinical data surrounding medicinal products in particularly vaccines. It is imperative that the public has confidence with the medicinal products, public health leaders and drafted government policies. Confidence can only be achieved through effective and correctly practiced EBM. Only through these means can trust be established.

The next solution may be far more challenging and even out of our hands. Nevertheless, it is by no means a reason not to try. The pharmaceutical industry especially Big Pharma, must do all they can to ensure responsible media coverage on matters associated with medicine and public health. For clarity, we use the term media to include not just TV coverage but print, online and social media. Continued misinformation, inaccuracy and politicised sensationalism draw scorn and calls from the public of “propaganda”, ”profiteering” and “fear-mongering”. This is not conducive to the industry and drives a wedge in between the necessary relationship between the pharmaceutical industry and the public. This could be addressed in two ways. One way would be educating the media. This could be through better briefing to any media outlets and channels. The aim would be to set the record straight factually by explaining the medicinal product’s mechanism of action, or the illness or health condition of topic. Attending non-legally binding committee hearings or panels would be a positive and welcomed step in the right direction on this front. Equally, the media too are educators (and many within the media industry would share this notion too) and thus, there indeed exists scope and necessity for sensible unified messaging against medical expertise and statistical evidence. The second option for sensible media coverage is for pharmaceutical companies and pharma stakeholders to be proactive, instead of reactive and hence, control the narrative from the outset. This needn’t be hostile or delivered in a belittling fashion, but using clinical expertise and communicating directly with the public in a manner that restores confidence and subsequently trust from the outset. In a world of decentralised media, led by social media, with many platforms for consumer engagement, a media strategy of this kind would be a welcomed remedy and most effective.

In conclusion, Big Pharma and pharmaceutical industry find themselves at a critical juncture. Given the current public sentiment, the entire pharmaceutical industry faces an existential battle for its future. There will be a need to fight. Specific battles will need to be fought to successfully navigate this gauntlet. These battles will not be fought with money, or through PR, nor l through lip service. Rather this battle will only be won through transparency. Transparency in clinical and scientific data. Transparency in commercial operations that neither obfuscates or injurious to commercial competition in a free market. And above all, transparency in veracity and motive. This battle will need to be won on the recognition and respect of bioethical principle of autonomy, for any acts that threaten the existence or acknowledgment will result in the surrendering of key battlegrounds in the fight for transparency. Adopting these approaches before engaging in these battles within the gauntlet will serve as the only remedy to soothe the current restless and rebellious spirit, whilst mending the eroded bridge of confidence between Pharma and public.

The pharmaceutical industry is a force for good and we, Nnadi’s Healthcare & Pharmaceuticals, shall help to see the industry come out of the other side of this gauntlet to prove it.

References:

1.  Clara Bauer-Babef. Pfizer remains discreet about COVID vaccine purchase contracts. https://www.euractiv.com/section/coronavirus/news/pfizer-remains-discreet-about-covid-vaccine-purchase-contracts/ [accessed 01 November 2022]

2. Mansur Shaheen. Pfizer cashes in on pandemic: Pharma giant plans to sell its vaccine with a 10,000% markup — despite revenues tripling and CEO pocketing $50m during Covid crisis. https://www.dailymail.co.uk/health/article-11357661/How-Pfizer-plans-sell-Covid-vaccine-10-000-markup.html [accessed 04 November 2022]

3. Ibid.

4.Gov.uk. The R-value and growth rate. https://www.gov.uk/guidance/the-r-value-and-growth-rate [accessed 05 Nov 2022]

5. BBC News. Covid: One dose of vaccine halves transmission-study. https://www.bbc.co.uk/news/health-56904993#comments [accessed 05 November 2022]

6. Tara Haelle. Why is it so hard to compensate people for serious vaccine side effects? National Geographic. https://www.nationalgeographic.com/science/article/why-is-it-so-hard-to-compensate-people-for-serious-vaccine-side-effects [accessed 05 November 2022]

7. Gillian Jamieson. Covid vaccines, treatments, mental health and the future. Supplementary Written Evidence. https://committees.parliament.uk/writtenevidence/36788/html/ [accessed 05 November 2022]

8. Ibid https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1072043/COVID-19_mRNA_Pfizer-_BioNTech_vaccine_analysis_print.pdf [accessed 05 November 2022]

9. Ibid https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1115342/COVID 19_Vaccine_AstraZeneca_analysis_print_-_26OCT22.pdf [accessed 05 November 2022]

10. Died Suddenly- The Documentary. The Stew Peters Network. https://diedsuddenly.info/ [accessed 05 November 2022]

11. Kadambari S, Vanderslott S. Lessons about COVID-19 vaccine hesitancy among minority ethnic people in the UK. The Lancet Infect Dis. 2021. 21; (9) P1204-1206.

12. Khan S. Rebuilding trust in medicine among ethnic minority communities. BMA. 2022. https://www.bma.org.uk/news-and-opinion/rebuilding-trust-in-medicine-among-ethnic-minority-communities [accessed 05 November 2022]

13. Gov.uk. Parents warned about dangers of children missing vaccines. Press release. https://www.gov.uk/government/news/parents-warned-about-dangers-of-children-missing-vaccines [accessed 05 November 2022]

14. Kory P, Meduri GU, Varon J Iglesias J , Marik PE. Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. Am J Therap. 2021. 28 (3) pe299-e318

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Our Patron: Archangel Michael

6 December 2024

Following on from our “Faith & Medicine” article and in keeping with the theme of spirituality, I’d like to announce that the Archangel Michael stands as the patron of Nnadi’s Healthcare & Pharmaceuticals Ltd. “St Michael the Archangel, defend us in battle, be our protection against the wickedness and snares of the devil. May God rebuke him we humbly pray; and do thou, O Prince of Heavenly host, by the power of God, cast into hell Satan and all evil spirits who prowl about the world seeking the ruins of souls.” Whilst Nnadi’s Healthcare & Pharmaceuticals remains a company that will always stay true to the principles of evidence-based medicine and “Good Science”, we pledge to utilise the scientific skill, talent and ambition that this company possesses to best serve patients & customers be they in the United Kingdom or abroad. Our privilege to serve those in need of our goods & services is a commitment we do not take lightly. We are most humbled and grateful to undertake this responsibility, and thus ask for the guidance & protection of St Michael the Archangel in all our endeavours henceforth. Most Sincerely, Sonny A. Ume Founder & Managing Director

Faith & Medicine: How Understanding the Relationship between Faith and Western Medicine to Better Improve Primary Care Health.

6 December 2024

In the Western world, and specifically to Western medicine (allopathic medicine), faith commonly tends to meet medicine at the intersect of “last resort”. Sporting analogies vividly depict such dire occasions, the “Hail Mary Pass” of American Football, “The bottom of the ninth” of American baseball or “90 minutes plus stoppage time” in football (soccer). Once the game plans and tactics have been tried and exhausted to no avail, the game of the respective sports take on a more urgent, opportunistic and hopeful complexion for the teams involved. This scenario is very much reminiscent of when medicine has been deployed as the opening gambit to tackle ill health only to find it is yielding little to no dividends towards improving to the patient’s health or condition. In this situation desperate times call for desperate measures and in the face of such desperation faith is sought and clung onto. Faith and medicine enjoy a polarising duality; Spirituality versus Science, “The Unseen” versus “The Proven”, subjectivity versus objectivity, belief versus evidence. Even in the face of this presented incompatibility between Faith and Medicine, there resides a common thread that unifies both. Patients. This article will look at the importance of acknowledging faith in medicine and the role faith plays in healthcare, particularly in primary care. The opening sentiment of this article on the relationship between Faith and Medicine may appear somewhat flippant and reductive. For some patients, faith does not follow a sense of hopelessness or vulnerability. Rather faith, in their respective religion, is their North Star. Their compass in navigating their day-to-day life of which, their healthcare needs are no different. Faith is central to the identity of an individual and for the collective community and demographic. An understanding of a patient’s faith in the healthcare sector is necessary in a multicultural country like the UK and more so in her multicultural major cities such as London. According to the latest data from the ONS (Office for National Statistics) 2021 Census, Christianity remains the largest religion in London with 40.66%, with Islam, Hinduism, Judaism, Sikhism and Buddhism following in sequential order at 14.99%, 5.15%, 1.65%, 1.64% and 0.99% respectively 1. When making an eyeball comparison of the religions distribution chart from the ONS 2011 Census against the ethnic group distribution chart from the 2021 Census, it provides a quantitative and qualitative insight into where specific demographics are situated across London 2. For instance you will find a majority of the Black Afro-Caribbean demographic in South East London an area with a high number of individuals identify as Christians, Asian-Indian in West London, an area where a large majority identify as Hindus and Sikhs, Asian Pakistanis far West & East London where Islam is the dominant religion and individuals who identify as Jewish are predominantly situated in the North and North West London area. A majority people who identify within an ethnic group demographic will have some connection to a religion, which plays an integral part to shaping their culture as well as their faith. This is of significance as these individuals then to be those as risk of preventative chronic disease of which the health outcome can be a poor prognosis. The data derived from the charts below will form the basis for strategies that are to be deployed in meeting the clinical needs of the multicultural demographic in London.

Investment is a Waiting Game: Mini Update from Managing Director

9 September 2024

Dear Reader, We’d like to apologise for our absence and inconsistency in our posting activities. We had planned for 2023 to be the year to springboard growth for the company. However, by August 2023 our plans were derailed by unapproved amendments to an investment deal, unforeseen operational changes by appointed service partner and the negligent damage to our current stock. Due this catalogues of disruptions, it resulted in the business having to concentrate its efforts on stabilizing and navigating through this thorny period. Sadly the decisive actions we took have impacted our agility and growth for 2023 heading into early 2024. It would be no stretch of the English language to deem 2023 as an annus horribilis for Nnadi’s Healthcare & Pharmaceuticals. Despite the hurdles of learning and operational obstacles to surmount, we persevere not out of foolishness or folly but out of a sense of duty and determination to contribute something positive to the country. Something positive for the nation’s economy and the health of the population too. Through Fergie’s Sparkling Water®, we have had the opportunity to connect and listen to people. We have come to gain an insight into people’s relationship with their nutrition, GP and the NHS as a whole. Through these conversations with the public, it is apparent there is still much work to do. Aside from these conversations, I would be remiss not to mention and acknowledge the kind words of support and gradual return business we have accrued in spite of all these difficulties since August 2023. We are grateful to these customers and supporters, we shall repay their faith by continuing to make strides towards securing investment. Our path towards securing investment now adopts a strategy of patience (as much as we can afford). The investment climate in the UK is constricted and conservative to nascent SME science ventures. According to an experienced business advisor, investments in the UK have dropped by 61%. Aside from the slow velocity of investment capital, there seems to be a shortage of courage and patience towards modest & sustainable business model. Investing in STEM ventures is not for the faint-hearted, but it is an investment that pays dividends both financially and socially. In this climate, we have to wait discerningly for the correct investing partner that will pull us out of the vicious cycle of traction against capital. I have full confidence in the company’s potential and mission. I hope this is a sentiment shared by our investors. We shall indeed wait and see. In the meantime, we shall continue with our daily operational activities and ambitions. We have come to accept that investment is very much now a waiting game. Kindest Regards, Sonny Ume Founder & Managing Director

Nnadi’s Healthcare & Pharmaceuticals Annual Report of 2022: Letter from Managing Director

23 December 2022

Dear Reader, This year has been a year of marked progess and incremental growth in comparison to the previous year. Early into Q1, we began officially trading with Fergie’s Sparkling Water ® and have been garnering sales throughout the year. Between late Q2 and mid Q3 , we encountered challenges and hinderances in involving our marketing campaign impeding us from fully capitalising upon the double heatwave that swept through the UK in the Summer. Due to thte unwelcomed impact, we have parted ways from the responsible marketing firm that oversaw our campaign during the periods of the aforementioned quarters. New marketing partners have been identified for 2023. Despites seeing sales and an increase in social media follwers across all platforms, we have had to contend with difficult macroeconomic factors. The leading macroeconomic factor has indeed been the steep rise in inflation, exacerbated by the Russia-Ukraine conflict in March of this year leading to soaring commodity prices affecting businesses, families and individuals alike. As a result of this, the UK, amongst other countries in Europe, are enduring a cost of living crisis. In relevance to our sector, for Fergie’s Sparkling Water ® , grocery shopping (food) inflation currently stands at 14.6% (down 0.1%, 6 Dec 2022), significantly higher than this time last year’s recorded at 4.2%. To combat this inflationary environment we have decided on two courses of action. Firstly, we have opted not to engage in cost-push inflatuion from our end, which would see us pass the additional cost onto the consumer. This is clearly demonstrated by us not levying a delivery charge on the customer’s orders. Secondly, we have offered small sample packs and have revised and reduced our prices across our current SKU (flavours/lines) which now includes multiflavour packs. These practices have created new customers, returning customers and prospective customers. Regarding the later, we have seen an increase in orders left at the basket checkout (a common practice observed by e-commerce merchants and retailers). We would prefer to convert these incompleted orders to sales. We shall indeed concentrate attention and focus on this practice and these prospective customers in the coming year. Aside from opening achievements and current challenges, we have achieved milestones on a marketing and parternship front this year. In mid Q2 we were part sponsors of a well known health conference with leading dietician and nutritionist . We will explore the possibility of sponsoring this event again. In addition to this come Q1 of 2023 we will be sponsoring a University Netball Team Club for the second half of their season. We intend for this to be a promising promotional endeavour. Whilst forming sponsorship links we enagegd in our first out-of-home (OOH) marketing campaign in a thriving and bustling area within the city of London. This achievement and opportunity allowed us for to showcase our distinctive golden cans and unique and delicious flavours to passers-by in the capital. Again, we aim to incorporate this form of marketing into future marketing campaigns. Rounding up on positive fronts, the final preparations are being made towards the end of Q4 following the better articulation of our product portfolio and strategy heading into 2023. On behalf of the company I am filled with much confidence and optimism as to what lies ahead for 2023. Overall, 2022 has provided an additional 12 months that have served as an invaluable learning curve. Both in evaluation and identification and better yet, realization. And come the end of this year we realize the necessity and central importance of securing funding in 2023. I believe my confidence and optimism are not misplaced surrounding the current potential and awaiting achievements of this company. For, if we can successfully complete our next round of funding and secure sufficient capital investment, it would serve as both fuel and vehicle to propel our commercial ambitions and endeavours. Nnadi’s Healthcare & Pharmaceuticals aspires to make its contribution to the gauntlet and satellite challenges that have arisen following the aftermath of the COVID-19 pandemic and subsequent scrutiny of the pharmaceutical industry. Given our stance towards the current perception of the pharmaceutical industry and our intended efforts to a propose remedy to the heightened scrutiny through Nnadi’s Healthcare & Pharmaceuticals’ operating model, hence there has not been a more enticing time to be involved in this sector. Nnadi’s Healthcare & Pharmaceuticals will strive to be among those enterprises, big and small, who wish to use all their efforts in tackling the challenges and seizing the opportunities that lie ahead in this field. Again, our ambition can only be realized with the necessary capital to fortify and grow based on what we have achieved so far. In closing, and returning to current matters, I would like to take this time to thank you for reading this and subsequent articles we have posted this year. I would like to thank all those who have supported and offered advice to bring us this for. And finally, above all else I would like to thank our customers who have invaluable not just in support through purchase, but in patience too. I would like to wish you and you a very Merry Christmas and a happy and prosperous New Year. May 2023 be a year of achivements and delivery for you as I hope it will be for Nnadi’s Healthcare & Pharmaceuticals. Kind Regards, Sonny Ume Founder & Managing Director Nnadi’s Healthcare & Pharmaceuticals Ltd.

Sponsorship Announcement: Unversity of Strathclyde Netball Club x Fergie’s Sparkling Water®

23 December 2022

Fergie’s Sparkling Water ® is delighted to announce it will be a sponsor for the second half of the University of Strathclyde Female Netball Club (USFNC). Fergie’s Sparkling Water ® can be enjoyed as part of a healthy diet, but as a thirst-quenching healthier alternative after physical activity such as sports. Increasing and encourage physical activity, through the medium of sports, is something we wish to do now and in the future. A club officer and player of the USNC, Oriana Smith said; “We have chosen Fergie's Sparkling water as one of our sponsors this year because we really believe in their product of a healthy alternative to sugary soft drinks. As a netball team who take our sport seriously, we can't wait to enjoy Fergie's drinks after our games and around Strathclyde Campus. Thanks so much Fergie's for being one of our sponsors this year!” We will certainly cheering the team on!

Crying over spilt milk: Are the marketing practices to promote infant baby formula jeopardising breastfeeding?

7 September 2022

The role of a mother in the development of an infant is invaluable. Whether it be supporting intellectual development or social development at an early age, there remains and even more crucial form of development. Nutritional development. To mark the significance of nutritional development in the early weeks and months of a babies’ life, the first week of August (1st-7th) is considered World Breastfeeding Week by the World Alliance for Breastfeeding Action (WABA). WABA is a global network of individuals and organisations dedicated to the protection, promotion and support of breastfeeding worldwide. However, it would seem that the message and rationale promulgated by WABA faces much challenge whilst heading towards a collision course with the proprietors of instant baby formula milk (IBFM) a form of breast milk substitute (BMS) and their proliferation over the previous decades. This article will explore how and whether the marketing practices deployed to promote BMS affects and hence jeopardises breastfeeding. We shall look at the importance and significance of breastfeeding, the current challenges and barriers to breastfeeding. We’ll review the marketing practices used by brand labels of IBFM and rebuttals they propose to these claims. Finally, we shall conclude on the repercussions of these claims on the marketing practices and their impact on breastfeeding and IBFM, before providing a conclusion. Breastfeeding is one of the earliest and vital acts a mother engages in to support the physiological and nutritional development of her baby. It is for this reason why the World Health Organisation (WHO) recommends solely breastfeeding babies for the first six months of their life. 1 The WHO’s recommendation stems from the constituents of human breast milk, all of which contain basic essential nutrients such as carbohydrates, protein and fats too. Apart from breast milk being tailor made for a mother’s baby, breast milk is rich in million of live cells (white blood cells and stem cells etc.) that are immune-boosting and help organs develop and heal. Breast milk contains enzymes, growth factors, antibodies known as immunoglobulins (key in protecting the baby from illness and infections) by neutralising bacteria and viruses. In addition to this breast milk includes long-chain fatty acids, which play a pivotal part in the development of a babies nervous system, brain and eye development. Finally, breast milk contains 1,400 microRNAs which are thought to regulate gene expression crucial in preventing or halting disease development, whilst supporting the babies immune system and remodeling of the mother’s breast. 2 The development and properties of breast milk occur over three stages; colostrum, transitional milk and mature milk (foremilk & hindmilk).

Inflation: The Biggest Threat to Diabetes?

8 June 2022

Inflation, defined in simple economic terms, is when prices of goods and services generally increase (along with a rise in demand) whilst reducing the purchasing power of money as each unit of currency buys fewer goods and services. The 40th President of the United States, Ronald Reagan, once quipped, “Inflation was violent as a mugger, frightening as an armed robber and as deadly as a hit man.” And as this perpetrator is very much on the loose and as of the time of writing, poses a clear and present danger to family and households in the West. The global economy, in particularly those of the West, is emerging from the embers and effects of the COVID-19 pandemic and whilst still undergoing a jittery and steady recovery, inflation seems to have stalled and in some cases reverse growth in the West. In the United States inflation has hit an annual rate of 8.3% down from 8.5% in March, but still an inflation rate that remains close to a 40-year high.1 Across the pond, Western European nations are grappling, with inflation across the Eurozone reaching 7.5%.2 In addition to this, the raging conflict between Russia and Ukraine has exacerbated the inflationary pressures on the continent. This article will look at how inflation is impacting the UK population and the dangers towards diabetes prevention and what attainable steps or measures can be taken to tackle this. Despite the backdrop of the COVID-19 pandemic, the escalation of geopolitical tension between the US, Russia and Ukraine has now regrettably broken out into military conflict as of Thursday 24th February 2022 and has sent commodity prices soaring. As of 2019, Russia and Ukraine exported more than 25% of the World’s wheat.3 Ukraine is considered the breadbasket of Europe, as 71% of Ukraine land is agricultural. Ukraine is also home to a quarter of the World’s “black soil” or “Chernozem”, which is highly fertile.

Tipping Point: Body Positivity vs. Weight Management

27 May 2022

“Be yourself” , “Love who you are” and “Never apologise for being you” are common self affirmations associated with wellbeing but can extend to body positivity. The fashion, beauty and sporting industry are leading the vanguard on the encouragement of body positivity in the name of representation and diversity of body types. This is indeed a good thing and very much welcomed. However, there must be a sense of awareness and caution to the indirect promotion of any health implications, in particularly prediabetes. This article will explore the dichotomy between social norms of body positivity versus clinical (health) concerns surrounding body positivity. This article will cover, to an extent, the relationship and impact of body positivity and body image may have upon mental health, healthy weight management and how best to beat prediabetes and Type-2 diabetes. Finally, we shall cover how a healthy weight is calculated, its significance and metabolic difference between individuals. This article will not cover nor engage in any post-discussion or debate on the topic of body positivity in relation to attraction. From a medical viewpoint, attraction is a subjective, fickle and not germane to this article. Given the sensitivity of the subject it would be appropriate to cover the impact on mental health and psychological well-being. Body positivity is inextricably linked to our self-image, which is key to our sense of identity. Simply put, how we look equates to how we feel. The perpetuation and desirability in the pursuit of the “perfect body” arises primarily from various forms of consumption. Common sources and outlets of this category include; Hollywood, Reality TV, ITV’s mega-successful Love Island franchise and Meta’s Instagram, all offering a window into innocuous entertainment, whilst showcasing the latest beauty trends that go on to become the societal standard. However, this harmless form of entertainment ceases to be so when the perpetuated trends by A-listers, well-known celebrities or recognised public figures (devoid of malice or agenda on their part), are, perceived as unattainable. It is this realisation that is impactful and leaves a detrimental effect on the most vulnerable members of the public on the uses of body image- teens and adolescents. The data to support this is worrying. According to UK survey of 11-16 years olds conducted by Be Real found that 79% said how they look is important to them. Over half (52%) often worried about how they looked. 1 In a survey of young people aged 13-19, 35% said their body images cause them to ‘often’ or ‘always’ worry. Research has shown that girls are more likely to be dissatisfied with their appearance an their weight than boys.2 3 In a survey by Mental Health Foundation, 46% of girls reported that their body image caused them to worry ‘often’ or ‘always’ compared to 25% of boys.4 In addition to this UK survey by Be Real, targeted at UK adolescents, it was revealed that 36% agreed they would do whatever it took to look good with 57% saying they had considered going on a diet and 10% saying they had considered cosmetic surgery.5 Disturbingly among secondary school boys, 10% said they would consider taking steroids to achieve their goals.6 Through these surveys, young people have expressed that body image is a substantial concern. Body satisfaction and a pressure to be thin is linked to depressive symptoms such as anxiety disorders (social anxiety or panic disorder) particularly in those children who do not match societal views of the ideal body.7 8 9 Possessing a poor body image may also prevent young people from engaging in healthy behaviours, as studies have found that children with poor body image are less likely to take part in physical activity. Survey data has shown that 36% of girls and 24% of boys avoided taking part in activities like physical exercise/physical education (P.E.) due to worries about their appearance. Body image is a substantial concern identified by 16-25 year olds and is the third biggest challenge currently causing harm to young people behind a lack of employment opportunities and failure to succeed within the education system being the first two.10

What is Prediabetes?

27 May 2022

To mark the Diabetes (Type-2) Prevention Week, we shall provide you with a brief overview of what prediabetes is, why it is significant, who is most at risk and what can be done to tackle it. What is prediabetes? Prediabetes, also known as non-diabetic hyperglycaemia, is a serious health condition that sees a person’s blood glucose level reside above the healthy range, but reside just below the range required for the person to be diagnosed with Type-2 Diabetes (T2D). An individual is deemed prediabetic if they have an HbA1c reading of between 42mmol/mol (6%) to 47.9mmol/mol (6.4%) or a fasting plasma glucose (FPG) of 5.5mmol/l to 6.9 mmol/l. In the UK, statistics suggest that there are 13.6 million people at risk of developing Type-2 diabetes.

Diabetes (Type-2) Prevention Week

25 May 2022

This week, 23 rd May-28 th May, marks Diabetes (Type-2) Prevention Week 2022. Type-2 diabetes is seems somewhat manageable and at times treated with a “matter of fact” attitude or simple as inevitable. This is far from the case. Type-2 diabetes is indeed a very serious and chronic disease that requires the appropriate amount of respect and discipline in controlling their blood glucose and blood pressure. If not, Type-2 Diabetes can be fatal. The one positive or optimistic angle one can adopt with Type-2 Diabetes is that it can be arrested and reversed if caught early at the prediabetic stage. This week we shall be posting articles covering: Prediabetes: What is it? Tipping Point: Body Positivity vs Prediabetes Is inflation influential in causing Type-2 Diabetes? In addition to these articles, we are also running a campaign throughout this week with a discount on Fergie’s Sparkling Water ® . Use the promo code: DPW10 for “ 10% OFF ” your total order. We shall also be providing appropriate signposting to direct or support you to the most relevant and sufficient services. We would love for you to be a part of this week!