Cardiovascular disease: Beat the Heart Disease and feel a Healthy Beat Therapeutic capacity presentation series V1.0.

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1 Cardiovascular disease: Beat the Heart Disease and feel a Healthy Beat Therapeutic capacity presentation series V1.0.

2 Country Overview Size: 65,610 sq km Population: 21,324,791 Population growth rate: 0.904% Population: Not genetically homogeneous and stable in terms of internal migration Life Expectancy: Male 75 Female 77 Literacy rate: 92.38% (M: 94.5%, F: 90.6%) Business Language: English Per Capita Income: USD 2053 Per Capita GDP (PPP): USD 4,500 Growth Rate: 6.4% Inflation Rate: 2.4% Form of government: Executive Presidency / Parliament Administrative Units: Nine provinces

3 Coronary heart disease burden globally CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause. An estimated 17.7 million people died from CVDs in 2015, representing 31% of all global deaths million were due to coronary heart disease million were due to stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies. People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.

4 Coronary heart disease burden globally Adult risk factors Males Females Total Current tobacco smoking (2011) 31% <1% 15% Total alcohol per capita consumption, in litres of pure alcohol (2010) High blood pressure (2008) 30.5% 26.2% 28.2% Obesity (2008) 2.6% 7.4% 5.1%

5 Coronary heart disease burden Sri Lanka

6 Coronary heart disease burden Sri Lanka Total population: 21,098,000 Income group: Lower middle class Percentage of population living in urban areas: 15.1% Population proportion between ages 30 and 70 years: 46.7% [Source: World Health Organization Non-communicable Diseases (NCD) Country Profiles (2014)]

7 Coronary heart disease burden globally: National systems response to NCDs Has an operational NCD unit/branch or department within the Ministry if Health, or equivalent Has an operational multi-sectorial national policy, strategy or action plan that integrates several NCDs and shared risk factors Has an operational policy, strategy or action plan to reduce the harmful use of alcohol Has an operational policy, strategy or action plan to reduced physical inactivity and/or promote physical activity Has an operational policy, strategy or action plan to reduce the burden of tobacco use Has an operational policy, strategy or action plan to reduce unhealthy diet and/or promote healthy diet Has evidence-based national guidelines/protocols/standards for the management of major NCDs through a primary care approach Has an NCD surveillance and monitoring system in place to enable reporting against the nine global NCD targets Has a national, population-based cancer registry

8 Coronary heart disease burden globally: National systems response to NCDs Has an operational NCD unit/branch or department within the Ministry if Health, or equivalent Has an operational multi-sectorial national policy, strategy or action plan that integrates several NCDs and shared risk factors Has an operational policy, strategy or action plan to reduce the harmful use of alcohol Has an operational policy, strategy or action plan to reduced physical inactivity and/or promote physical activity Has an operational policy, strategy or action plan to reduce the burden of tobacco use Has an operational policy, strategy or action plan to reduce unhealthy diet and/or promote healthy diet Has evidence-based national guidelines/protocols/standards for the management of major NCDs through a primary care approach Has an NCD surveillance and monitoring system in place to enable reporting against the nine global NCD targets Has a national, population-based cancer registry

9 Medical training - investigators First degree MBBS is a 5-year course (8 medical schools) Post-MBBS specialization PGIM, University of Colombo Local training 4-5 years with award of degree (e.g.md, MS) Mandatory overseas training at centres of excellence usually in the UK or Australia for 2 years Board-certification as specialist only after completion of above Undergraduate / postgraduate education & training provided free with State funding includes overseas living allowances

10

11 RemediumOne: Oncology Trial Successful managing a multicenter study in Sri Lanka Experienced investigators Efficient and clearly defined regulatory review process Experienced coordinators Experienced allied health staff High rate of protocol compliance Robust project delivery system and quality assurance

12 RemediumOne: Delivery System Project Management Recruitment & Retention Performance Management Data Management Administration Safety & Compliance

13 Our Hands-On Clinical trial experience different therapeutic area RemediumOne: Growth underpinned by robust quality and safety focus Clinical trials hands-on experience Completed and On Going Trials Vaccine trial Respiratory trial Nephrology trial Pediatric trial Opthalmology trial Autoimmune trial Cardiovascular trial Oncology trial Diabetes trial Rheumatology trial Gastroenterology trial Years

14 Access to potential investigator centers Jaffna Teaching Hospital Anuradhapura General Hospital Kurunegala Teaching Hospital Batticaloa Teaching Hospital Kandy Teaching Hospital Provincial General Hospital, Badulla National Cancer Institute National Hospital of Sri Lanka Provincial General Hospital, Ratnapura KarapitiyaTeaching Hospital

15 Study Status VISION (Our aspiration) To become the most valued partner to our Clinical Development and Life Sciences clients and a role model to our industry. VALUES (what we believe) CLIENT FOCUS ACCOUNTABLE RESPECT ENDURE Responsible, responsive attitude to our clients Ownership, honesty and integrity Honest, transparent, fair in our actions and communication Perseverance and belief in enduring partnerships inquiries@remediumone.com

16 PARTNER FOR LIFE THANK YOU

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