The Board of Directors of Joincare, as the highest organ represent for Access to Healthcare issues, is responsible for understanding and monitoring the management of the Group's Access to Healthcare issues through the Sustainable Development Committee. The Sustainable Development Committee is responsible for regularly reviewing the Group's strategies, policies and performance on Access to Healthcare issues overseeing and reporting the progress to the Board of Directors, and urging the Group to improve access to healthcare.

To improve our product availability and make more safe and effective products available to global patients, Joincare expands the productionand marketing of vaccines, patent medicines, generics, APls, and IVD (In-Vitro Diagnostics) reagents and devices overseas mainly via direcoperation and authorising local distributors. So far, our products have been approved for registration in major pharmaceutical markets andemerging markets in multiple countries and areas across Asia, Europe. North America and Africa.

Internationalization is a long-term strategic priority for Joincare. The Group advances its globalization strategy through multiple dimensions, including licensing-in, outbound technology and intellectual property transfer, and engagement with overseas capital markets. We have formulated overseas business expansion plans that include low- and middle-income countries, aiming to enhance our global market presence.

In the licensing-in process, we actively seek high-quality overseas pharmaceutical assets and pipeline products to strengthen our portfolio in key therapeutic areas such as respiratory, gastrointestinal, psychiatry, and assisted reproduction. At the same time, we are committed to promoting technology licensing of high-end, complex formulations in emerging markets, enabling patients in low- and middle-income countries to access high-quality medicines.

In terms of industry chain integration, the Group fully leverages its strategic advantage of “API–formulation integration”, using its strengths as a springboard to expand its business footprint while reinforcing global supply chain deployment and integration capabilities. The Group has entered into a strategic partnership with PT Kalbe Farma Tbk., a leading pharmaceutical company in Southeast Asia, to jointly establish an API manufacturing facility in Indonesia. The facility is expected to supply products to markets in Europe and the United States while also meeting the healthcare needs of Southeast Asia, further enhancing the global accessibility of the Group’s high-quality products.

In January 2024, Joincare obtained the registration approval for Compound Ipratropium Bromide Solution for Inhalation in the Philippines, which set a good beginning for other products to enter the global market. The Philippine FDA plans to conduct GMP certification on-site inspection on the Company's inhalation formulation workshops. In the same year, Malaysia officially scheduled for PIC/S GMP certification on-site inspection for Compound Ipratropium Bromide Solution for Inhalation. Passing the high-standard PIC/S inspection will push the Group's production quality management to a new level.

In 2024, to further explore the global market, we fully completed stability studies for several inhaled liquid preparations to test their stability in overseas climate zones. The preparations involved include the Tobramycin Inhalation Solution, the Ipratropium Bromide Solution for Inhalation, the Budesonide Suspension for Inhalation and the Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation. The studies were steadily advanced according to different standards and guidelines in overseas countries. In 2024, we set up subsidiaries in the Philippines and the Netherlands to secure business development in key regional markets. The Philippine subsidiary obtained the drug business license and submitted GMP on-site inspection applications for multiple inhalation preparation workshops to the Philippine FDA. The Dutch subsidiary completed the quality system construction, submitted the application for production permit and import permit to the Medicines Evaluation Board (MEB) of the Netherlands, and obtained MEB-granted EU registration declaration schedule for target types.

The cost of medicines accounts for the majority of the medication-related financial burden. Joincare is committed to alleviating the financial burden on patients by adopting inter-country and intra-country tiered pricing based on affordability, aiming to provide high-quality medicines to more patients at affordable prices.

Joincare actively responds to the national volume-based procurement policy by leveraging its strong R&D and manufacturing capabilities to include a wide range of products in centralized procurement applications. Through participation in these programs, we have expanded market coverage and served a broader patient population.

We also actively engage in the national reimbursement drug list (NRDL) inclusion process. For products listed in the NRDL, we strictly comply with regulations by publishing the reimbursement pricing standards on the official drug price inquiry platforms of local healthcare authorities, ensuring that pricing remains fair and transparent.

In expanding into overseas markets, Joincare takes into account local economic development, healthcare standards, and the pricing of comparable products to set reasonable prices that align with regional conditions and avoid increasing the financial burden on patients. We carefully assess per capita income levels in each region and analyze patients’ actual affordability, based on which we implement differentiated, tiered pricing strategies tailored to each market.

In developing countries abroad, we actively participate in government tenders as part of our product promotion efforts, striving to provide affordable medicines and services to local populations. As of the end of 2024, the Group and its subsidiaries had applied income-adjusted equitable pricing policies to 28 products sold across South Asia, Southeast Asia, Eastern Europe, Central Asia, South America, and Africa.

In response to the national strategy of rural revitalization and common prosperity, Joincare, joined hands with the Group’s holding subsidiary Livzon Group to carry on the long-term drug donation program – “Access to Public Welfare for Chronic Diseases Prevention and Treatment Programme”. We provided long-term assistance to patients with financial difficulties in remote areas who suffer from chronic diseases, such as hypertension, hyperlipidemia, cardiocerebral diseases and gastric diseases. We donated five drugs for treating chronic diseases, including Pravastatin Capsules (普伐他汀钠胶囊), Amlodipine Besylate Capsules (苯磺酸氨氯地平胶囊), Valsartan Capsules (缬沙坦胶囊), Isosorbide Mononitrate Tablets (单硝酸异山梨酯片) and Bismuth Potassium Citrate Tablets (枸橼酸铋钾片), to reduce the medical burden of chronic diseases on poor families and prevent patients from sinking back into poverty due to illness.

Since late 2018 onwards, we have carried out the “Access to Public Welfare for Chronic Diseases Prevention and Treatment Programme” successively in areas including Chaotian District, Guangyuan City; Songpan County, Aba Zang Qiang Autonomous Prefecture; Jinkouhe District, Jiange and Pingwu Counties, Leshan City, Sichuan Province; Hunyuan, Guangling and Lingqiu Counties, Datong City, Shanxi Province; Dongxiang, Tianzhu, Linze, Shandan, Huining and Su’nan Counties, Gansu Province; Xianghai National Nature Reserve, Jilin Province; Macun District, Jiaozuo City, Henan Province; Huangshan District, Huangshan City, Anhui Province; Suining County, Hunan Province; Fenyi County, Jiangxi Province; Jiangshan City, Zhejiang Province; Chayu, Bomi, and Gerze Counties, Tibet Autonomous Region; Kashgar, Xinjiang Uygur Autonomous Region Baarin Left Banner and Togtoh County, Inner Mongolia Autonomous Region; and Ziyuan County, Guangxi Zhuang Autonomous Region. These are part of our efforts to benefit the public, protect the health of rural residents, revitalize rural areas, and build a beautiful and healthy China.

Respiratory diseases rank as the third most prevalent chronic condition in China, following cardiovascular diseases and diabetes. In recent years, the incidence of respiratory illnesses such as asthma and chronic obstructive pulmonary disease (COPD) has been steadily rising. Epidemiological studies show that China has approximately 45.7 million adult asthma patients, 15 million children with asthma, and over 100 million COPD patients.

To strengthen the prevention and control system for chronic respiratory diseases, China’s National Health Commission officially included COPD in the Basic Public Health Service Program in 2024, marking a new phase in the country’s efforts to combat respiratory conditions.

In response to national strategies, Joincare actively promotes respiratory health through an integrated “online + offline” public education network. Initiatives include health livestreams via new media platforms, publication of authoritative academic research, support for cutting-edge clinical studies, and academic promotion activities. These diversified efforts aim to systematically raise public awareness of asthma and COPD, encourage at-risk populations to undergo regular lung function tests, and contribute meaningfully to the “Healthy China 2030” respiratory health goals.

During the “World Asthma Day” activities in 2024, the “Respiratory Experts’ Views” platform joined hands with 18 core hospitals across the country to live stream on asthma in 13 sessions. Professor Chen Yuzhi from the Children's Hospital affiliated to the Capital Institute of Pediatrics worked with 27 first-line experts across the country answered questions for the public from the perspectives of asthma medication, asthma management, and asthma misunderstandings, thereby strengthening asthma education.

During the “World Bronchiectasis Day” activities in 2024, the “Respiratory Experts' Views” platform collaborated with the China Bronchiectasis Registry and Research Collaboration (BE-China) to launch a series of public welfare and educational campaigns themed of “Understand Bronchiectasis, Enjoy A Healthy and Happy Life”. Meanwhile, the special bronchiectasis-themed live streaming month activity was launched. Professor Guan Weijie from the First Affiliated Hospital of Guangzhou Medical University led 57 experts from 32 core and tertiary hospitals across the country to carry out knowledge popularisation on diseases, providing detailed explanations on the pathogenesis, diagnosis methods and the latest treatment progress of bronchiectasis.

During the “World COPD Day” activities in 2024, the “Respiratory Experts’ Views” platform live streamed on COPD in 35 sessions with the theme of “Understanding Your Lung Function”. Meanwhile, Professor Wang Wei from the Respiratory Doctors Association of the Chinese Medical Doctor Association launched a COPD live-streaming month activity. A total of 70 front-line experts from 62 tertiary hospitals participated in the live streaming, calling for public attention to lung health.

Voluntary medical services and education activities for respiratory diseases

Joincare continued to join hands with major hospitals across the country to provide offline voluntary medical services and conduct patient education activities on respiratory diseases. By doing so, Joincare provided patients with free medical consultation and health education, thus raising public health awareness and popularizing disease prevention and treatment knowledge. At the event, a team of experts patiently offered free medical services to patients, carefully inquired about their medical histories and symptoms, thoroughly provided detailed physical checkups, and expertly gave professional diagnosis and treatment advice. Meanwhile, Joincare carried out diversified diagnostic and therapeutic activities on site, including pulmonary function tests, CT report interpretation, effective sputum evacuation, and respiratory rehabilitation training. In 2024, a total of 275 hospitals participated in World Asthma Day, more than 300 hospitals participated in World Bronchiectasis Day, and 328 hospitals participated in World COPD Day events, respectively, altogether serving 18,060 patients.

The Group acknowledges that antibiotic resistance has become a global public health risk theme, threatening human health. We take measures to address antibiotic resistance mainly from the following three aspects:

Responsible production: During the production of antibiotics, we strictly control the discharge of wastewater, waste gas and waste residue to prevent antibiotics from entering the natural environment. We also refine the production process to improve the production efficiency of antibiotics and reduce waste generation.

Responsible use: In strict accordance with the Management Policy for Clinical Use of Antimicrobial Medicines, Joincare strictly regulates the clinical use of antibiotics and strengthens the management of its anti-infection product portfolio. Based on the classification of antibiotics for clinical use, we actively cooperate with medical institutions to handle antibiotic abuse, enforce the principles of “non-limited use”, “limited use”, and “special use”, and promote the management of physicians’ prescription rights and control of medicine-resistance bacteria. Training lessons and lectures on optimizing medicine-resistance bacteria treatment schemes are given to improve the clinical efficacy of antibiotics and effectively prevent misuse.

Responsible R&D: We continue to carry out R&D to limit or prevent antibiotic resistance, explore the mechanism of resistance through cooperation with third parties, and study new ways of drug administration by taking the advantage of fewer dosage of inhalation formulations to ensure reasonable drug administration.

Bronchiectasis, one of common chronic respiratory diseases in China, can be aggravated by pseudomonas aeruginosa. The frequent and acute attack of bronchiectasis due to the bacterium will increase the risk of hospitalisation. Studies have shown that pseudomonas aeruginosa is generally resistant to existing antibiotics. Though the bacterium is less resistant to Tobramycin, the systemic administration will exert greater side effects. Compared with the systemic administration, inhaled antibiotics, due to rapid topical aggregation, can avoid the first-pass effect, and reduce systemic adverse reactions and the medicine-resistance risk resulted from prolonged antibiotics therapy. During the R&D of Tobramycin Inhalation Solution, Joincare carried out the first phase III clinical study on the treatment of bronchiectasis accompanied with pseudomonas aeruginosa infection in China. Moreover, we are the first in the world to set the dual study endpoint of bacterial load and patient life quality, in which major study endpoint received double positive and significant curative effect summary. In addition to the obvious clinical efficacy, the blood concentration following nebulised inhalation of Tobramycin was at an absolutely safe level without ototoxicity, nephrotoxicity, or increasing medicine-resistance risk. The successful marketing of the product has provided a better option for China’s patients with bronchiectasis.

Joincare is deeply committed to the development of healthcare in low- and middile-income countries. In line with our international strategies, we are actively involved in capacity advancement initiatives for healthcare in low- and middile-income countries and work closely with local partners to collectively improving the quality and capacity of health services in those regions.

We place strong emphasis on local healthcare capacity and actively engage with medical professionals based on regional needs. Joincare’s holding subsidiary, Livzon Group, has invited Chinese medical experts to visit several cities in Pakistan—including Islamabad, Peshawar, Karachi, Lahore, and Faisalabad—to provide medical and product training for Pakistani healthcare professionals. These initiatives introduced Chinese research advancements in reproductive health to local obstetricians and gynecologists, shared successful experiences in clinical applications, and showcased cutting-edge technological innovations. The exchanges aimed to promote new concepts and technologies in the field of reproductive health, ultimately enhancing local medical expertise and the standard of medication use.

Training local healthcare workers

While expanding our formulation business in developing countries, the Group actively provides training for local healthcare workers to improve local medical service standards. While we exported Meropenem for Injection to developing countries such as the Philippines, Ukraine, Vietnam, Pakistan, Peru, and Chile, we provided registration and promotion training for local contacts and assisted our partners in conducting product usage and related training for local healthcare workers. Also, Joincare’s holding subsidiary Livzon Group is actively engaged in overseas academic promotion and training activities. Livzon Group provides detailed product usage instructions and shares clinical experience with healthcare workers in developing countries, so as to ensure the safe and effective use of our products for local patients.

Assistance to local manufacturers to improve manufacturing quality

As an APIs supplier, Joincare, together with its holding subsidiary Livzon Pharmaceutical Group, shares its research results with less developed countries and regions overseas and proceeds technology transfer. We improve the capability of local manufacturers to ensure that they can achieve international drug manufacturing quality standards. By building API plants in Indonesia and introducing advanced production equipment and processes, we encourage local manufacturers to upgrade their production processes and technology applications. High-quality API production also helps local pharmaceutical companies produce more competitive drugs, improve drug accessibility, and meet the medical needs of local residents.

Supporting local pharmacovigilance

Pharmacovigilance work in developing countries started relatively late and progress has been slow, leaving a number of problems to be solved. We have distributors in Macao and the Philippines for drugs including the Compound Ipratropium Bromide Solution for Inhalation, Levosalbutamol Hydrochloride Nebuliser Solution, and Budesonide Suspension for Inhalation. To ensure the safe use of drugs in local areas, we have signed pharmacovigilance work agreements with overseas distributors and partners, and established the communication mechanism and work process for the pharmacovigilance teams of both sides. Our Pharmacovigilance Department is responsible for processing individual safety reports from local sites, conducting data evaluation, and reporting to domestic and foreign regulatory authorities. At the same time, through our agents, we investigate and monitor the use of our drugs overseas, conduct business training for local staff, receive regular adverse event reports, and help to improve the local pharmacovigilance system for these drugs.

Rare diseases, also known as “orphan diseases”, are featured by unknown causes and extremely low incidence rates. High treatment costs for rare diseases result from their low market demand, difficulties in R&D and lack of experience in clinical medication, and even there is high cost and no medicine for some rare diseases. Under the guidance of relevant policies such as the “Healthy China 2030” Planning Outline and the Guidelines for Diagnosis and Treatment of Rare Diseases, we, based on our own scientific platform and capabilities, undertake corporate social responsibility actively by continuously investing in research on rare diseases, and focusing on improving the current situation of diagnosis and treatment of rare diseases, thus making contributions to building a Healthy China.