OVERVIEW 2019

1. OVERVIEW 2019

2. Since 1948, nonsectarian, apolitical, and privately funded

3. Established by war immigrant businessmen to help people in postwar Europe living under tremendous hardship Humanitarian health mission—to help people in need and at risk access care and realize their inherent potential Identify and support locally-run healthcare facilities by providing essential medications and supplies

4. Humanitarian supply chain function—only nonprofit accredited as a wholesale drug distributor in all 50 U.S. states

5. Compliance is Critical for our Work Verified-Accredited Wholesaler Distributor (VAWD) from National Association of Boards of Pharmacy—highest commercial standard in U.S. for drug distribution 50 state licensing for Rx distribution FDA Wholesale Drug Distributor Registration Compliant with Federal Drug Supply Chain Security Act (50 audits by major manufacturers and regulatory agencies in 7 years)

6. PARTNERSHIPS

7. Healthcare Industry: Product contributions from 150+ pharma and medical supply companies $1.1 billion (wholesale) contributions FY18 “Signature” corporate programs of AbbVie, Abbott, Baxter, BD, Pfizer, Shire, et al.

8. Technology:

9. Logistics:

10. Nonprofit & Government: National Association of Community Health Centers National Association of Free and Charitable Clinics State Primary Care Associations HHS (Strategic National Stockpile, CDC) Association of Southeast Asian Nations Ministries of Health Worldwide

11. COMMUNITY HEALTH IN U.S.

12. 2018 Recap New facility and team members ________________ Supporting 1,356 facilities in 54 states and territories ________________ 11K deliveries, $231.5 million (wholesale) in medical products delivered in 2018 ________________ 140,000 doses of Naloxone, IUD donation program, Hep C ________________ $20.7 million in emergency grants were provided

14. Free Clinics in Wisconsin In the past 10 years: Donations includes ongoing support and emergency prep and response 7 free clinics have been partners for 10 years New Replenishment partner

15. Support of the Safety Net Through 150+ company donors, Direct Relief offers an ongoing donations program: Ordering contacts receive access to online portal every two weeks Receive offers of medicines, supplies, over-the-counter items, personal care and hygiene items for low-income, uninsured patients No fees whatsoever – shipping is free of charge Returns to Direct Relief are free for any Rx products

16. ReplenishmentProgram A model to help patients that allows providers to receive drugs for multiple manufacturers in one shipment through: A single process for enrollment, verification, ordering (across all 50 states and regardless of product) Shipments based on prior month’s dispensing data Formulary now includes insulin Medicine is dispensed at the time of visit Single third-party independent audit

17. Naloxone Program Working with Pfizer to make up to 1 million doses of overdose-reversing naloxone available at no cost to free and charitable clinics, public health departments, and other nonprofit providers nationwide Needles, syringes, and alcohol swabs donated by BD are available for kits • Since March 2017: • 381 safety-net facilities • 48 states and territories • 180,140 doses

18. EMERGENCY PREP & RESPONSE

19. SPECIFIC-PURPOSE MODULES Designed through partner input/analysis, approved by standard-setting bodies UN/WHO prenatal vitamins FIGO-approved standard surgical module for obstetric fistula repair International Confederation of Midwives global standard midwife kit Medical Reserve Corps official standard medical pack Pre-positioned emergency medical supply module

20. Emergency Preparedness and Response • Preparedness before an emergency • Pre-positioned Hurricane Preparedness Packs containing medicines and supplies to treat 100 patients for three to five days • Emergency medical backpacks • Immediate and short-term response • Emergency Health Kits • Shipments of specifically requested medical aid to support relief efforts • Disaster-related inventory includes insulin, tetanus vaccines, hygiene kits, N-95 masks, inhalers, and diabetes supplies • Emergency operating funding ($25k) to cover initial recovery and outreach expenses • Clean-up costs • Overtime costs for staff • Unbudgeted capital costs • Operation of mobile medical units

21. Emergency Preparedness and Response • Long-term recovery and resiliency funding often available • Loss of revenue or capital due to facility closure and/or repairs • Insurance deductibles • Expenses incurred due to extended hours of operation • Mobile medical unit support (e.g. staffing, outfitting, maintenance, or fuel costs) • Expenses related to disaster preparedness (e.g. generator, training, or planning resources) • Workshops and trainings • Any money Direct Relief receives is spent onlyon that emergency – a major majority of funds received are regranted to partners

22. Funding Opportunities • Innovation and Continuity in Care Program with NAFC and BD • $300,000 commitment • Multi-year program for free and charitable clinics • Allows member organizations to continue or expand their ability to provide needed health care for the medically underserved in their communities • Hurricane Community Health Fund • Created with input from NAFC • Over $1.8 million distributed to 20 free and charitable clinics affected by Hurricanes Harvey and Irma • Funds covered, mobile units, staffing, emergency communications, infrastructure, etc.

23. How can we help you? • Direct Relief learns from its partners – we need your input! • How can we improve? • What are the things you need most? • What type of kits would help your efforts? • Who else can Direct Relief support in your community?

24. Questions? Ruth Smarinsky, PharmD Director of Pharmacy (310) 749-8250 RSmarinsky@DirectRelief.org Annie Vu Program Coordinator (805) 879-4949 AVu@DirectRelief.org