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Nine for 2022: International issues that are compelling, new or changed in 2022

The year 2020 ended on a note of hope, with the 8th December vaccination of 91-year-old Margaret Keenan,
The post Nine for 2022: International issues that are compelling, new or changed in 2022 appeared first on .



The year 2020 ended on a note of hope, with the 8th December vaccination of 91-year-old Margaret Keenan, the world’s first person to receive a COVID-19 vaccine outside clinical trials.

Despite an estimated 9.25 billion doses administered globally by 4th January, with 25 different vaccines either approved for use or under emergency use authorisation, 2022 starts on a more sombre note due to the rise of the Omicron variant. Add to this the fact that the world missed the WHO targets for global vaccination by the end of 2021 and will likely continue to miss targets in 2022.

In this examination of issues that will shape the course of 2022, we’ll update the ongoing impacts of the pandemic, which have, as they did in 2021, a pervasive effect on both pharma and healthcare issues, with themes we highlighted at the beginning of 2021 continuing their impact.

Although the Pandemic is a long way from over, events and trends are starting to clarify the shape of the post-pandemic pharmaceutical and healthcare world.

The next phase of the Covid-19 – from vaccines to treatments

The rise of the Omicron variant, with its clear evidence of significantly enhanced transmissibility, intensifies pressure to roll out both initial vaccination and boosters. This will undoubtedly exacerbate tension between the advocates of global vaccination focus and the desires of wealthier countries to roll out booster programmes as rapidly as possible.

New vaccines, specifically developed for Omicron, may be required, and Moderna, BioNTech, and Johnson&Johnson have all announced they are in the process of creating these, with availability possible in the first half of 2022. This response is at a speed that would be considered unthinkable pre-pandemic, but, given a highly transmissible variant and the ever-present threat of new variants of concern, it may still not be fast enough.

“This response is at a speed that would be considered unthinkable pre-pandemic but given a highly transmissible variant and the ever-present threat of new variants of concern, it may still not be fast enough.”

New COVID-19 treatments will also be available in 2022, but they are not a panacea. New oral therapies join the existing monoclonal antibody cocktails and include molnupiravir (Lagevrio, Merck) and a combination of the new antiviral nirmatrelvir with the HIV antiviral ritonavir (Paxlovid, Pfizer).

Lagevrio was approved by the FDA, MHRA and EMA before the end of 2021. However, the final data presented to the FDA showed a 30% reduction in admissions, lower than current monoclonal antibody cocktails, and lower than Lagevrio’s own phase III data.

Pfizer reported in early December that Paxlovid, now also approved in US, Europe and UK, retained 89% efficacy in preventing hospitalisation and death from an earlier readout. These agents may not be suitable for all patients, and for molnupiravir, FDA panellists expressed concern about the possibility of resistance developing. Countries, led by the US, are pre-ordering substantial quantities of Merck’s and Pfizer’s antivirals. Both companies have signed agreements to support access to these agents in low and middle-income countries.

Oral antivirals present significant logistical challenges to realising their full potential. The window of opportunity to administer treatments is narrow – within five days of symptoms. This may pose a barrier to effective use. While commercial solutions are being created to provide a telehealth logistics solution to treatment delivery in the US, these could preserve well-organised healthcare systems and wealthy individuals.

Oral agents will be a useful adjunct, but vaccination will remain the primary lever to contain the pandemic, with innovations in COVID-19 vaccines appearing in 2022.

CNS’s moment of truth

Last year we highlighted that many CNS disease areas are ripe for a revival of value growth because of a combination of high prevalence, continued unmet need, and the promise of innovative approvals. Consequently, 2022 will be the moment of truth as to whether this promise is going to be realised commercially.

Aduhelm, an Alzheimer’s treatment with the promise of disease modification, was approved 2021 but 2022’s the year to see if anti-amyloid Alzheimer’s treatments will fly, with competitors following fast. Aduhelm’s Q3/2021 sales were $300k; investors will expect strong ramp-up in H1/2022.

A pivotal Medicare NCD decision is pending in draft in January 2022, with a final decision by Apr 2022, with significant implications for Aduhelm use. New supporting data could also appear in 2022, but potential competitors are not far behind. For example, Eli Lilly’s donanemab has a rolling FDA submission, and a 2022 phase III readout, with possible FDA approval in H2/2022.

Lilly also plans an H2H trial of donanemab vs Aduhelm to start enrolling by the end of 2021. Other competitors, including Roche’s gantenerumab, may follow. As such, 2022 will be the year when we will gain certainty as to whether we have a turning point in Alzheimer’s treatment – or still some way to go.

Other CNS molecular innovations may also deliver in 2022, with possible approvals in major depressive disorder and insomnia, as well as important earlier stage readouts in neurogenerative disorders and the use of psilocybin for CNS conditions, but it may be digital therapeutics where the most spectacular breakthroughs are.

Digital therapeutics and telemedicine for a range of mood disorders will increasingly be reimbursed. They may start to present a line of first treatment for many patients before they receive any molecular pharmacotherapy.

Behavioural therapy is a mainstay of treatment for many common mental health conditions, including depression and anxiety, and more complex conditions such as post-traumatic stress disorder and Bipolar. A range of digital solutions, including apps and telemedicine with healthcare professionals, are now available and are starting to demonstrate significant clinical impact.

The new primary care takes shape

Digital approaches to common primary care disorders such as depression and anxiety are one of the ways that innovation is re-entering primary care. In doing so this is creating a primary care environment that is very different to the “traditional” one of first line small molecule blockbusters used for the widest possible populations.

Primary care will be at the forefront of care delivery digitisation in many countries, driven by necessity during lockdowns. Amid an explosion in digital aids, such as condition management apps, diagnostics and sensors, and lastly desirability, digital and remote primary care is now preferred by some patients and healthcare professionals. For example, in rural settings or for patients with low mobility.

Rapidly evolving care settings are just one aspect of the new primary care. Molecular innovation will revive often genericised primary care therapy areas. Small molecule migraine treatments are among the most successful new primary care launches in 2020, bucking the tendency for many non-Orphan medicines to underperform historic norms if launched in the Pandemic.

New primary care treatments are not just small molecules; Novartis launched the silencing RNA treatment Leqvio (inclisiran) as a twice-yearly subcutaneous injection for patients with mixed dyslipidaemia or primary hypercholesterolaemia, alone or in conjunction with existing therapies such as statins.

This type of therapy promises improved outcomes in a subset of the population with dyslipidaemia that are not reaching treatment goals with genericised primary care treatments. However, in conditions as prevalent as this, even a population subset is a substantial number of patients necessitating a new approach to market access that neither emulates the pricing of specialty treatments nor is forced to compete with generics.

A notable example of this is the population level agreement Novartis has forged with NHS England, which aims to see 300,000 people receive Leqvio over a three-year period.

Whether this novel arrangement works as envisaged will be apparent during 2022. If it is, other “specialty like” innovations are in the pipe for other high prevalence therapy areas such as hypertension. A new primary care will be born.


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PopPay Platform Expands To Government-Backed Digital Currency

PopPay Platform Expands To Government-Backed Digital Currency
PR Newswire
PASADENA, Calif. and NASSAU, The Bahamas, May 19, 2022

For First Time Ever, Consumers Can Use Their Face To Make Purchases With A Central Bank Digital Currency



PopPay Platform Expands To Government-Backed Digital Currency

PR Newswire

For First Time Ever, Consumers Can Use Their Face To Make Purchases With A Central Bank Digital Currency

PASADENA, Calif. and NASSAU, The Bahamas, May 19, 2022 /PRNewswire/ -- PopID and SunCash announced today that for the first time in history, consumers can now use the PopPay face verification platform to purchase goods and services with a central bank digital currency (CBDC) – digital money issued and backed by a government. Bahamian consumers can now link their SunCash account to PopPay to enable face pay transactions using their Sand Dollars. They can then spend the digital currency at a network of SunCash merchants using just their face for authentication. Various local and global brands are or will be accepting digital Sand Dollars authenticated by PopPay through the SunCash platform.  

"PopPay's cutting edge technology provides a more consumer-friendly, seamless, and secure experience for SunCash's users," said Desmond Pyfrom, CEO of SunCash.  The existing apps for transacting in digital Sand Dollar generally require consumers' use of smart phones, QR codes, or various other codes to complete a transaction at the point of sale. "With the integration of the PopPay platform into the SunCash App, Bahamian consumers can now quickly, efficiently, and safely use the digital Sand Dollar to purchase food and other products even if the consumer does not have a functional smart phone or an internet connection," said Pyfrom, as is the case for thousands of Bahamians.1

The world is quickly moving towards central bank digital currencies—accelerated by the Covid-19 pandemic and the growth of cryptocurrencies. As of 2022, fourteen countries have launched CBDCs, or are in advanced pilots, and approximately 90 countries, accounting for over ninety percent of global GDP, are considering issuing CBDCs, according to the Atlantic Council.

The Bahamas was the first country to launch a CBDC when it deployed the Sand Dollar nationwide in October 2020. As part of that program, a limited number of supervised financial institutions were authorized to sponsor a mobile payment wallet for the digital dollar of the Bahamas. SunCash was one of the supervised financial institutions approved by the Central Bank of The Bahamas.

"The PopPay platform is designed to allow consumers to link any payment method to their face, including credit cards, debit cards, direct bank transfers, stablecoins, and CBDCs," said John Miller, CEO of PopID and Chairman of its holding company, Cali Group.  "With governments around the world increasingly implementing CBDCs to replace physical cash, PopPay serves the critical policy objective of ensuring that all people can transact with the currency."

"We applaud SunCash for its deployment of this solution that allows Bahamians to transact in Sand Dollar using only their face," said John Rolle, Governor of the Central Bank of The Bahamas. "Such security features are important to increasing personal comfort around the use of digital payments and advancing the Central Bank's goal of increasing financial inclusion among all segments of our society."

A face pay option is an important feature for any country with the goal of increasing financial inclusion with the adoption of a CBDC, as those that are unbanked, under-banked, or without smartphones or reliable internet tend to be the most vulnerable parts of society.

Keith Russell of AD+ECH GLOBAL facilitated the partnership between PopID and SunCash.

About PopID
PopID provides a comprehensive platform, PopPay, for revolutionizing digital interactions and payments using facial verification. PopPay gives consumers the option of identifying themselves in the most natural way possible – with their face – for ordering and payment – enabling more personalized, secure, and streamlined experiences. To learn more about PopPay, visit

About SunCash
SunCash is the largest digital payments, mobile money, and e-commerce service provider in The Bahamas. SunCash's proprietary technology provides financial solutions to all segments of society, including the banked, underbanked, and un-banked Bahamians, as well as non-resident populations in The Bahamas. SunCash has over 55,000 active wallet customers, accounting for approximately 1/7th of the total population of The Bahamas, and more than 1,000 merchants who accept SunCash payment solutions. Customers can also access SunCash services online, through the SunCash App, at local stores, or from more than 100 kiosk locations throughout The Bahamas. SunCash is licensed by both the Central Bank and Securities Commission of The Bahamas. To learn more about SunCash, visit

Diane Zuniga 
Golin (for PopID); (909) 510-0433 

1 Simon Kemp, "Digital 2022: The Bahamas" (Kepios 2022),


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The retailers that should weather the coming economic storm

Conditions are about to get tougher for retailers as they face a perfect storm of falling incomes, galloping inflation, and rising interest rates.  These…



Conditions are about to get tougher for retailers as they face a perfect storm of falling incomes, galloping inflation, and rising interest rates.  These impacts will crimp the discretionary spending power of many people. The one exception could be the under 25-year-old Gen Z demographic, who have fewer non-discretionary costs than other age groups. The retailers who sell to them could fare better than most.

Over the last six months, discretionary retail stocks have been among the worst performers on the ASX, with the S&P/ASX 300 Retailers Accumulation Index underperforming the broader market index by 13 per cent over that period. Admittedly, this recent under performance merely unwinds the 20 per cent out performance of this index in the preceding 18 month period which coincided with the recovery in the market from the pandemic lows.

Over the last six months, only 1 of the 17 stocks in this index has managed to perform better than the broader market, JB HiFi, while four generated losses of over 50 per cent. Notably these stocks, Red Bubble, Kogan, City Chic and Temple & Webster, are all online retailers, and performed very strongly over the first year of the pandemic as they were perceived to be COVID winners.

Figure 1: Total return of retailing stocks between 16 Nov 2021 and 16 May 2022

Source: Bloomberg

The market is concerned that the combination of falling incomes – as households face rising inflation on a broad basis eating into real spending power, and rising interest rates – will reduce discretionary spending power. However, it is not as simple as this. 

While these factors are likely to lead to pressure on overall discretionary consumption, these factors do not affect all segments of the economy equally.

CBA’s economic team has released data for household income and spending growth for the March quarter of 2022. This data is broken down by age demographic.

In looking at the potential impact of spending from cycling the impact of large stimulus payments that were received by households in the prior year, CBA’s data suggests that the percentage of Millennials receiving some sort of government payment has fallen the most relative to the December quarter of 2021 followed by Generation X. Gen Z and Baby Boomers have experienced less of a reduction.

Offsetting the reduction in government benefits is an increase in the percentage of people receiving a salary. This is likely as a result of people returning to work post the pandemic and the current strong labour market.

Figure 2: Share of households receiving government benefits or salaries
(change between 4Q21 and 1Q22)
Source: CBA

This then feeds into the impact on each demographic’s growth in overall income over the last 12 months. This shows that Gen Z has benefited the most from the current strong employment market with increased employment and strong wage growth while the percentage receiving government benefits remains higher than other demographics and above pre-pandemic levels. 

Figure 3: Household income and spending – annual average % change in 1Q22
Source: CBA

Not surprisingly, it is also Gen Z that has shown the strongest spending growth in the March quarter. For the other generations, spending growth has exceeded income growth, implying that their savings rates have declined to fund that growth in spending.

But savings are still well above 2019 levels for all generations and still rising. This will provide a buffer against cost increases and slowing growth in the medium term as inflation and higher interest rates bite. Gen Z has the biggest savings buffer.

Figure 4: Household savings – average deposit and offset balancesSource: CBA

Not surprisingly, overall household wealth is considerably higher than at the end of 2019, primarily as a result of rocketing residential property prices on the back of emergency monetary policy settings. The wealth effect of housing prices is an important driver of discretionary spending in Australia and has benefited retailers over the last two years.

Figure 5: Household wealth – average per household

Source: CBA

Of course, what interest rates can give, they can also take away. With variable mortgage rates likely to increase 1-2 percentage points over the next year, residential property prices are expected to fall, reversing some of this wealth effect.

There is no doubt that conditions are set to tighten for retailers over the coming year. However, reversing wealth effects from falling property prices and falling discretionary income levels will primarily impact those generations that own most of the housing stock, namely the Baby Boomers, Gen X and to a lesser extent the Millennials. Baby Boomers are more likely to be impacted by falls in house prices while Millennials will be more impacted by the need to allocate more of their income toward mortgage repayments.

For those that rent rather than own their home, rents are also likely to rise, as property owners try to pass on rising mortgage, utility and maintenance costs to tenants.

Those with families will be more impacted by rising prices of non-discretionary goods and services like food and utilities. This impact will be concentrated on Millennials and Gen X.

While not immune, the younger Gen Z demographic is likely to fare better than other generations given it faces fewer non-discretionary costs, and is not as exposed to property and wealth effects. At the same time, it is experiencing the strongest income growth and has had the most significant increase in its savings over the last two years.

Hence, we prefer retailers that cater to this younger demographic in the discretionary segment such and Universal Store and Accent Group.

The Montgomery Funds owns shares in City Chic, Universal Store and Accent Group. This article was prepared 18 May 2022 with the information we have today, and our view may change. It does not constitute formal advice or professional investment advice. If you wish to trade Goodman Group you should seek financial advice.

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Diesel Costs Deliver Body Blow To Trucking Industry, Impacting Broader Economy

Diesel Costs Deliver Body Blow To Trucking Industry, Impacting Broader Economy

By Noi Mahoney of Freightwaves

With diesel prices remaining…



Diesel Costs Deliver Body Blow To Trucking Industry, Impacting Broader Economy

By Noi Mahoney of Freightwaves

With diesel prices remaining elevated — forcing significant costs onto shippers and trucking companies — the impact of fuel costs on inflation could put a dent in consumer spending, according to experts.

Diesel pump prices averaged $5.61 a gallon nationwide, 51% higher than diesel prices across the country in January

Economist Anirban Basu said the elevated price of diesel fuel damages the near-term U.S. economic outlook and “renders the chance of recession in 2023 much greater.”

“These high diesel prices mean that despite the Federal Reserve’s early stage efforts to curb inflationary pressures, for now, inflationary pressures will run rampant through the economy,” Basu, CEO of Baltimore-based Sage Policy Group, told FreightWaves. 

Earlier this month, the Federal Reserve announced a half-percentage-point increase in interest rates, the largest hike in over two decades. The U.S. inflation rate is at 8.3%, near 40-year highs.

Basu said consumer spending remains strong, even with elevated diesel prices, but that could change as shippers and trucking companies eventually must pass higher fuel costs on to the public. 

“One of the things we’ve been seeing in the U.S., particularly on the East Coast, is that diesel fuel inventories have been shrinking, which suggests that despite all this inflationary pressure, there’s still a lot of consumer activity, still lots of trucks on the road and the supply is unable to keep up with demand,” Basu said. “The higher price of diesel fuel will become embedded in the cost of everything consumers purchase.” 

Prices of fresh produce rising

Jordan DeWart, a managing director at RedWood Mexico, based in Laredo, Texas, said the types of consumer goods that could be immediately affected by higher diesel prices include fresh produce. Redwood Mexico is part of Chicago-based Redwood Logistics.

“With produce, that’s typically more in the spot rate business, and any of those smaller trucking companies are going to be heavily impacted by fuel costs,” DeWart said.

The U.S. imported more than $15 billion in fresh produce from Mexico in 2021, including avocados, tomatoes, grapes, bell peppers and strawberries, according to the U.S. Department of Agriculture.

“Everything coming northbound from Mexico through Laredo, the rates have been very sustained, but fuel prices keep going up, presumably with any differences being absorbed by the trucking companies in the spot market,” DeWart said. “When we talk to asset-based truckers, especially the smaller companies, they’re really feeling the pinch.”

It’s not only cross-border operators feeling the pinch. Growers and shippers in Texas’ Rio Grande Valley are also suffering because of increased fuel costs, said Dante Galeazzi, president of the Texas International Produce Association (TIPA).

“Our growers, shippers, importers, distributors … basically our entire supply chain has been and continues to be impacted by rising fuel costs,” Galeazzi told FreightWaves. “Between one-third to one-half of the costs for fresh produce is the logistics; you can see how quickly increases in that expense category can impact the base price.”

The Rio Grande Valley is the epicenter of the Lone Star State’s fresh produce industry, stretching across the southeastern tip of Texas along the U.S.-Mexico border. More than 35 types of fruits and vegetables are grown in the valley, which contributes more than $1 billion to the state economy annually.

“More concerning is that this wave of fuel increases is in line with the statistic that our industry is paying anywhere from 70% to 150% more year-over-year for OTR shipping,” Galeazzi said. 

TIPA, which is based in Mission, Texas, represents growers, domestic shippers, import shippers, specialty shippers, distributors and material and service providers. 

Right now, Rio Grande Valley growers and shippers are absorbing higher input costs instead of passing them on to consumers, but that could soon change, Galeazzi said.

“While the fresh fruit and vegetable industry continues to experience rising input costs across the board (seed, agrochemicals, labor, fuel, packaging, etc.), we have yet to experience sufficient upstream returns associated with those expense increases,” Galeazzi said. “Our industry is citing an 18% to 22% anecdotal increase to overhead costs. Meanwhile food inflation for fresh produce is hovering around 7%. That means the costs are slowly being felt by consumers, but it’s not yet at a commensurate level with input expenses.”

Diesel fuel prices at all time highs

The cost of diesel continues to soar across the country. Diesel pump prices averaged $5.61 a gallon nationwide, according to weekly data from the Energy Information Administration (EIA). That’s 51% higher than diesel prices nationwide in January. 

California averaged the highest fuel prices across the U.S., at $6 per gallon of gas and $6.56 per gallon for diesel, according to AAA. Diesel prices are also at an all-time high of $6.41 in New York.

The higher prices of diesel fuel and gasoline are being caused by a combination of factors, including surging demand and reduced refining capacity, along with the disruption to global markets caused by COVID-19, the current lockdown in China and the ongoing Russia-Ukraine conflict, said Rory Johnston, a managing director at Toronto-based research firm Price Street.

“The overarching oil market is feeling much tighter because of the Russian-Ukraine situation,” Johnston, also writer of the newsletter Commodity Context, told FreightWaves. “What we’ve seen is a larger immediate impact from the loss of Russian refined products; in addition to exporting millions and millions of barrels a day of crude oil, Russia also exported a lot of refined products, most notably middle distillates, like gasoline or diesel.”

Several refineries on the East Coast — including facilities in Newfoundland and Labrador, Canada — scaled back during the early days of the pandemic, which has hurt diesel capacity, Johnston said.

“There was also a refinery in Philadelphia that exploded just prior to the COVID-19 period starting,” Johnston said. “There’s not enough refining capacity on the global level, and particularly in the West right now and particularly in the northeastern U.S.”

He said he doesn’t foresee any relief from increasing diesel prices over the next few months or more.

“Things are going to be really tight for at least the next year, barring any kind of economic recession and some kind of demand slowdown materially,” Johnston said. 

DeWart said trucking companies that don’t have a fuel surcharge component or contract in place and are depending on spot rates could be in big trouble over the next several months as diesel prices either keep rising or stay higher than average. 

“Their fuel costs keep going up, but they’re really not able to negotiate higher rates right now with a really tight spot market,” DeWart said. “It’s really impacting small trucking companies, anyone that decided to kind of play the spot market, rather than being locked in contracted rates. They’re really feeling the pain right now.”

DeWart said for trucking companies, it’s critical to get some type of fuel reimbursement program in place “just to protect themselves in case the cost of fuel goes even higher.”

Tyler Durden Wed, 05/18/2022 - 19:25

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