Good morning, I think we're ready to get started. We have a few announcements as all the others have had. We want to welcome you to this session called Tackling Public and Occupational Health in a Global Corporation. We appreciate you being here and we're honored to be speaking to all of you. We realize there are many interesting topics right now and thank you for being here. Next year we're going to call ours a TED Talk too and see how we do. I think that's like a real draw. Anyway, we want to welcome you here and we're glad to be talking about this topic that is important to us. So we're ExxonMobil, all of us as presenters, I'll introduce us in a minute, but to just kind of set the ground about what we're talking about today, to let you know that we present often about our programs that we've developed and initiatives that we have. Often we're asked this question, how did you do it? How did you get from an idea to something where your entire organization has embraced whatever the program, the issue is, and what's that whole cycle like? So that is what we're going to focus on today. We'll do it sort of scenario based. We'll talk about three programs that you'll see and hear about, but we're really going to try to tie it into a model that we have. And all of you have access to it because it's kind of helpful to see that model in front of you as you talk. This is not the project plan, just to be clear. This is high level, the things that we always want to think about. And we're all technical people. We go down into the weeds real easily. This brings us back up to make sure that we're doing things the right way. Now as we get started, these are the sort of flight attendant things that I need to tell you. The bathrooms are that way. Open your app. There's a button that you push and you'll get your CME, okay? And if you can, turn your phones to vibrate and anything else, there's a help desk outside and they can help you. So we will get moving. We have no disclosures. And this is who we are. To my right, I have, the far right, we have Dr. Malik Diara. He for many years was our public health advisor in ExxonMobil. He's recently moved into a more operational job supporting a new affiliate that's going to be building up in Mozambique. We have Dr. Ashik Zaman. He is our US OH manager and also oversees Mexico as well. They'll each say a little more about themselves when they get up and speak. I'm Dr. Vicky Weldon. I'm the global medical director for ExxonMobil. I've been with the company pretty much my whole career. I've had the opportunity to see all of these programs from inception to where they are today. And I am the historian in our department, officially. By the end of this session, we want you to be able to answer these three questions. How do you design, implement, scale a public and occupational health initiatives, particularly in a large organization, but we want this to be flexible and translatable for anybody. These are really fundamental things that you'll need to address. And we'll show you the model shortly. But if you're not a large company, don't get blocked by that. This should apply to you and be helpful as well. If you don't have our exact same resources, that's okay. We're going to share with you ways to do this without the resources. And we reach out to others all the time. And so we'll talk about those resources. So a little about our company. We operate in six continents in nearly every country. That makes it difficult when you're trying to expand programs across the enterprise. We have 60,000 employees, many, many, many more contractors. It's important to understand in your organization how you fit and what the organizational design is. So I'll say a little about ours. We call ourselves MOH. We're Medicine and Occupational Health. We're comprised of physicians, nurses, industrial hygienists, technicians, and many administrative staff as well who help us to run our part of the business supporting the company. We report in to what would be sort of the VP of safety, health, environmental, sustainability, security, and operations who has a direct line to the CEO. Many others of you, particularly if you're in more of a finance or tech kind of business, you may report in to HR. That matters. You need to know kind of the dynamics of your company and how things get done. If you report in through safety, more than likely you struggle a little more to implement and work with HR. If you report in to HR, more than likely it's a little bit harder for you to work with safety. So you just have to know that and you have to realize it's going to take a little more effort and energy depending on your current relationships within those parts of your organization. We are lucky to have health and safety be a core value of our corporation. So we do have that as a building block for many of the programs that we do. But that's not to say we don't have to make strong business cases. We do it every day and every day you walk in, it's a new day. So these are concepts that we're going to talk about and you'll see them sprinkled throughout the whole talk. This is the model that we're referring to. We've borrowed from ideas that others have had. We're not unique. We don't have this copyrighted or anything. But we're really kind of trying to characterize the overall cycle that we will follow as we assess a risk, we develop solutions, then we develop them to whatever scale they need to be, and then throughout their life cycle. So we may go around this circle many times and we're going to give you some examples. I'm going to give you one on wellness where it's been a slow, slow, steady buildup over time. We're going to give you an example of malaria, a very mature program where we had to stand some things down and it's been a successful program. Standing something down that's been successful is almost harder than building something up. Thirdly, we're going to talk about COVID, which was a mad race around the circle like a bajillion times. So a little detail about it. We have an assessment phase. I think some important features here are this is where we're gathering data. We certainly want to leverage all the resources we can. So we look inside and outside our corporation. Groups like this are very, very helpful for making connections for people who are in our sector, our industry sector, or have similar large-scale corporations, or just have great ideas. We certainly benefit from meeting and talking to people, and we leverage those when we're building programs or creating solutions. We then, after we do some benchmarking, et cetera, we then move into looking at gaps. Where do we have gaps? What's available to us? Where do we have to build something? But we always try to take what's available. We look at local solutions, and we start to think about scalability and where there might be differences, or is it a program? So sometimes the solution is very clear. We just do the same thing. We do it across the entire organization. You'll see with our wellness initiative, because health issues are local, health infrastructure is local, the public health issues are different, there's a very local component to our culture of health program that we launched. And then we have to have senior leadership engagement, and then we launch our program, we understand our management of change, and then we continue to review the cycle. In the middle, you see stakeholder engagement, and it is every part of this circle. It is horizontal, it is vertical, it's diagonal, and probably squiggly is how you have to approach your stakeholder engagement. I think it is probably, for most of these things, the most critical thing to do in work. So we'll talk about that. Our three examples sort of lean into different parts of this model. So what we want to do is sort of help you understand how we use it by talking through some examples. So we're going to start with our wellness initiative, and it is branded Culture of Health. And the areas we're really going to focus on here are internal and external partnerships, scalability and optionality, got that here, sorry, scalability and optionality, and then leveraging local systems. These were the pieces. Stakeholder engagement, really critical. So these were the areas that probably we had to emphasize the most in order to develop our global culture of health. We're talking here about a 15-year journey. This isn't a short one, and I've heard other presenters talk about it. This is moving from something that was a small program and then scaling it up until ultimately, I really believe I can see that it is a part of our culture. So how did we do that? First we had to kind of assess the need. There had to be a reason to do this. And in 2008, we saw two emerging threats that really prompted us to develop what we now call our culture of health program. The two threats will be familiar to, certainly the first one is familiar to all of you. And I'm going to focus more on this right side. Medical expenses were just escalating at a pretty dramatic rate, and it really was a threat to the corporation's bottom line. And they looked to us to say, how do you sort of bend that curve? How do we get a better experience and don't have to spend so much money sort of on the reactive side and become a little more proactive? Kind of alongside that, we had some, we did see that we had rising absenteeism in a few of our locations, and it was really causing some problems with threatening their ability to staff our operations. I think initially the thought was that it was gaming the system, people were taking off and getting absent. But when we looked at it and there was a, for this, there was a two-year assessment period with HR and MOH combined to really analyze the landscape here and analyze the problem. And what we found is that our employees really did not have the proactive supports that they needed for their health. It was a reactive system that we operate in, particularly in the U.S., and that we needed to do a better job of helping people manage their health. So that is how the program came about. The business case was extraordinarily strong. It clearly crossed a lot of stakeholders, HR, MOH, safety, could see the benefit to our safety programs if we had this. And for the corporation, across, I think this will be familiar for many of you, it was becoming an expectation by many of the younger people that we were hiring that we have some programs that focused on them. So a real caring kind of environment, and this enabled us to have some programming that was very specific, it was palpable, you knew it was directed to you and it was to support you, and we found that that was beneficial. So what is it? What did we develop? We leveraged the core values, so it started at the top, really important, you have to have the engagement of your senior leaders, because you have to staff this, you have to give some money to it, it has to be important. We then looked at three specific areas. We wanted to have people be aware and give them education, but frankly that's not the real problem. The real problem is moving people to action. Our demographics are a very intelligent population, they know what they need to do, but doing it is the hard part. So we had worksite activities that helped to support them. People spent the majority of their day in the workplace, and frankly it was hard. I worked in a refinery for quite a few years. The only lettuce you could get was deep fried lettuce, I'm telling you, the salad bar, everything was fried. So we really worked hard to create some supports for people in the workplace so that they could actually have a smoother pathway to be healthy. We also did biometric screening so they would know their numbers, maybe inspire them by giving them deeper insights into their own personal risk. We used conversations about risk because that's how our company talks, and it meant something to a lot of the engineers to understand that. So those are some of the things. And then we took support services that were already existing in the company. So many of the HR programs were individually branded, whether it was financial support, whether it was EIP, babysitting services, you name it. People didn't know how to navigate that space. We were spending money on vendors and suppliers, and people weren't using them. So we put it all under this brand called Culture of Health. We made it fun. We made it vibrant. We made it something people wanted to be a part of. And then we really began to see some uptake, a lot of uptake, actually. So we started with two pilots in the U.S. We then learned from that, and we spread it across the U.S. Then we did four pilots internationally. And while we were in the middle of the four pilots, which we were funding out of our department, I got a call that said, yeah, we're in one of those downturns in the energy industry, and if you're in this business, you know it cycles. And they said, you're going to have to tell them that you can't pay for it anymore, and if they want it, they need to do it, pay for it themselves. And so I thought, well, this is the end. It's done. We're not going to be able to keep doing this. But what happened is I called each of the country managers, and what they said was, wow, like, we need this more than ever. It's hard out here, and we need people. This is fun for employees. They love it. They're learning things that's important to them. It shows we care, and we need that. So we're going to keep doing it. So I was really relieved to start having those conversations, and one after another, that's what they said. And so I felt like that was when we had kind of done what we needed to do. We turned it into more of a culture. It's an expectation of our employees, and it's not just a discretionary, defined little program. So how did we do that? We did it with people, with people who are interested in health, and you will find them everywhere in your organization. There are people who care about their health. There are people who love to talk about health. There are people who want to be champions of a program like this. We did not rely on, this is what we did not do. We did not say we need one sponsor from leadership, and, you know, they're going to champion this for us, and then they move on to another job, or they move to another company, and it's all over. We created a network of people throughout our entire organization. They all had slightly different roles. It was just bits and pieces of people. They did it in their extra time with the energy they have for health and wellness, and became well-being champions for us. They helped with the vendor supplier interface. They helped people navigate. They became go-to people for how do you navigate the health services in our large corporation, and then, lastly, we created a steering committee where we said we want senior vice presidents, people who know enough about the operations but aren't so far away from the operations that they are not in touch. We want one from every business that we have in ExxonMobil, and they're going to meet with us on a regular basis and tell us what they need, what they're seeing, what we can do, and then how we do and deliver the things that we do, so I think those things are the secret sauce to how we did this, and I put the words up there, transforming, and it really should be a program into a flexible platform into a culture, and when I say flexible platform, it's a framework for any health issue now, and it is kind of the home. When we have emerging issues, how do we roll it out? We roll it out through culture health. We have the framework, the organizational framework to do this. It can contract, and it did a little during COVID, but in the middle of COVID, we needed resilience training. We needed to show we cared about our employees, and we did it through culture health. We ramped that up really quickly, and we pushed it out through our network, so that's how we've done it, and I hope this is helpful to you to kind of get the vision and understand that our model is what we leveraged, and each time we kind of grow it a little, we go around and around, and we're currently in an evaluation process now as well. So it'll continue to morph. But the model has been helpful in particularly leveraging some of these aspects of internal external partnerships where we helped benchmark what everyone was doing, scalability, flexible options, and leveraging the path of least resistance. I didn't even talk about this. But we used safety and health committees that already existed to do a lot of the implementation. So all of these things are how we did that. So we're going to go. We have two more examples. And then we're going to get to questions and comments. Because we're happy to hear your ideas as well. I look around. I see people I know. I know you all deal with this as well. So we're happy to hear from you about what you do and what resonates with you and where you've had the big challenges. With that, these are some resources. National Business Group for Health, Global Business Group for Health, particularly if you're US-based, is very helpful. Now we're going to move on to a mature, longstanding program that we evaluated in order to kind of right-size it. So Dr. Adhira. Thank you. Good morning. Thank you, Dr. Weldon. My name is Malik Jara. I was a public health manager for ExxonMobil for 14 years. And just like Dr. Weldon mentioned, I've been assigned to support an upstream country just recently and being promoted. Before joining ExxonMobil, I've been for 20 years with nonprofit organizations and working on malaria and different maternal and child health activities. I'm really feeling honored and privileged being able to present this experience and seeing lots of friends, former colleagues, who are also familiar with what I'm going to present. Personally, growing up in West Africa, Senegal, I've been subject to some malaria episodes. But fortunately, I was able to be quickly treated and recover. But going into my internships, I've seen some kids that were really, really affected by malaria and some pregnant women who would suffer from preeclampsia just because of such episode. My presentation will be related to our malaria program for our workplace. And it's how we have modified a very successful workplace program that has been established for years and even close to two decades in a very large company, as you have seen on the slide from Dr. Weldon, and across multiple organizations and countries. You've seen that we are in maybe 40 different countries or 50 close to all continents. And this program really was successful, or is still successful. So we use the framework that you have seen just before to scale down one important component of the program and adopted the safety approach of the company to manage the malaria risk as low as reasonably practicable. In this review of the malaria program, the key sub-elements that you can see highlighted here that we have used to scale this program are, first, how to apply and monitor metrics for adjustment. So I'll show the results of what we were able to track. The second part is related to benchmarking and consultation with external experts. And the last one was conducting option analysis to determine what should we continue to implement to what level. This slide is indicating how we have been successful in the implementation of our program and the metrics we have developed and monitored to lead us to this review. And there are definitely the charts or the data that you are seeing here is definitely showing how successful was our program, or still is. The first one, no fatality for over 15 years, knowing that we got some in the early 2000. 95 decrease in the malaria cases and 98% for compliance of malaria chemoprophylaxis utilization. And I will elaborate on that. And we consistently applied that verification across all our malaria sites. And the verification of the use of malaria preventive medicines has been a key factor for the success of our program. With senior executive engagement to develop a test for it and have people visiting or assigned to malaria countries being randomly selected to verify how they are using their chemoprophylaxis. And we were collecting urine samples from across our sites and sending them for testing in the US. Subsequently, we got improvements in this program to develop a field test. So besides the success that you can see on these charts, the presented data really illustrate how we have applied the metrics, monitored trends, and looking at both the lagging indicators, cases, fatalities, and the leading indicators in terms of verification. That is really illustrative of the first element I've mentioned at the beginning, at the top of the framework, indicating how the execution of the program was done and how the sustainability of it was being prepared. And this information has been used to determine what adjustment can be done in what component of our malaria program. And on the next slide, you will see that we have displayed the safeguard of the malaria program. On your right, you have the safeguards that are minimizing the possibility of having an episode of malaria. And on your left, you have the safeguards that are preventing having severe consequences for malaria, knowing that you can easily die from malaria if you have a delayed treatment or ineffective treatment. And these are the elements that we have carefully looked at to determine what can be scaled up or what can be scaled down among these different measures, but still maintaining the effectiveness of the program. And considering the previously presented data in terms of leading lagging indicators, we conducted a review using the option analysis and scalability aspects for the planning of the components to maintain or modify. And on the next slide, we have the key decision factors that we have used to see how to have our Fit for Risk malaria program. And the elements are divided in two parts. The first two bullets are really indicating how in the communities and the general population we saw a drastic reduction of the malaria risk. Some countries have been already certified by WHO for malaria elimination. And we even have some, like in the past 20 years, the mortality really reduced by 50% if we compare how many people were dying in 2000. And now it's about half a million, while in the past it was close to a million. It is also mentioning how the medicines for prevention and for treatment have really evolved. We have much more effective medicines for that. And you look at the diagnostic and vector control methods. They have also very well evolved and are much more available across the different countries. And the second part of the analysis, where you look at the four bullets at the bottom, it's the result of the benchmarking studies that we have conducted, and really indicating that our program is really doing well comparatively to others, but well in terms of implementation. But in terms of results, we really identify that we have relatively similar results. In general, maybe some more cases in some companies, but in general they were kind of similar. And for companies who are not conducting the verification of the malaria chemoprophylaxis compliance. And the availability of a new, more effective preventive medicine with weekly dosage that can improve the compliance, Tafenocin, for those who know it, created a significant additional factor for change. Its introduction would have needed the development also of a field test. And that result was not certain because that medicine has a very low elimination in the urine, and that's the type of biological samples that we've been using to verify compliance. In addition, what we have seen is that we are, or we were the only one organization testing people for verification of malaria chemoprophylaxis compliance. And considering all these factors, we really said it is very important to carefully look at all these parameters, the malaria risk, and we conducted a review in the spirit of the safety culture of the company. And the review was done to see what safeguards can be adjusted, among them the chemoprophylaxis compliance. In this slide, it's really presenting the safety approach we have used to see how can we manage the malaria risks for our workers that are sent to the malaria location as low as reasonably practicable. And this is definitely a safety approach to our health issues and make sure that we are all on board in terms of what would be the conclusion and the recommendation. And when you look at the histograms that are on your, on your left, on your left, you can see the most implemented measures by other companies saying that this is really in place. And those on the right are those that are less implemented by other companies, but our conclusion is that, or analysis indicated that with the combination of our program safeguards and the introduction of taphenoquine, even without testing for chemoprophylaxis compliance, we can manage the malaria risk as low as reasonably practicable. And to conclude with my last slide, it's just to say that the review of our well-established malaria program was conducted using the following elements of our model. First, we reviewed our program metrics to sustain its implementation. We assessed the malaria risk and the safeguards with consultation with external experts and did an option analysis to determine the best combination of safeguards to manage the risk as low as reasonably practicable. To further have a fit-for-risk program, while maintaining its effectiveness. And just to share with you what you can use to also implement your malaria measures for travelers, you would send to malaria locations or within your own sites. You have a guide that has been developed with the OGP-IPCAS, that's the oil and gas companies. It's published and you can access to it to see how to have, if you have a site in a malaria location, what to consider. The CDC yellow book where, if you send travelers, what to provide to them for treatment and prevention. And the WHO guidelines. So this is, in a nutshell, how we reviewed our malaria program. And I will hand it over to Dr. Ashik for him to continue on the third example. Thank you. Good morning, everybody. Thanks for being here. I want to give some reassurance. I hope this is not just the average COVID-19 talk because we've all gotten kind of maybe overwhelmed with hearing about this topic. So my name is, as Dr. Diara mentioned, is Ashik Zaman. I am the Regional Occupational Health Manager for the United States and Mexico at ExxonMobil. I had the pleasure of joining ExxonMobil in July of 2020, which is an interesting time to join a global corporation, right, in the thick of a global pandemic. I started my career at the Baton Rouge Refinery in Baton Rouge, Louisiana. It is one of the largest in the world. It's home to 3,500 workers from an employee standpoint. And then, depending on the time of year, it can be as many, if not more, contractors. Of course, the Baton Rouge Refinery is not a unique example within our corporation. We have operations across the world, as Dr. Weldon mentioned. And it is important for us to maintain operations during a pandemic, given that we're part of the critical energy infrastructure. And I'm very proud to say that, due to some of the things that we'll talk about, we were able to maintain operations throughout the pandemic, and we did not stop operations for even one day. So, the goal of this portion of the talk will be to relate that strategic model that Dr. Weldon mentioned to the COVID-19 pandemic response. And I think what you'll take away is that we basically touched on each and every piece of that pie that we have gone over. And we had to do so, as many of you did, in rapid, multiple successions, and we're still in that place now. We're not quite over the hump yet. So, just briefly, to go over the elements that I'll focus more specifically on, again, understanding that we touched on all of these, is, number one, data gathering and risk assessment. Number two, which is probably a theme you've recognized that's central to all three of these topics, is that we had to make sure that we engage stakeholders. Number three is scalability and options analysis. And then, finally, the senior business leadership engagement really was critical for us on the front end, as well as throughout our pandemic response. So, this is kind of one of those things that I'm going to tell you what I'm going to tell you. I'll tell you it, and then I'll tell you what I told you. But the themes that we'll talk about briefly are our global approach with a focus on local implementation, how we navigated rapidly evolving data and information to become the trusted source. I do want to just briefly mention this, so I prom you that there's a difference between data and information. And we'll talk about that a little more specifically later. We'll discuss our risk-based approach to safeguards and mitigations, including vaccines. And then I'll briefly talk about the future state, where we go from here. So, let's start off with what our early response was, how early we identified the pandemic threat and how we progressively mobilized our response mechanisms all the way from the local boots on the ground level or at the country level, the regional level, and then finally the corporate level. That corporate level also to show you that that engagement with senior business leadership from the model had to happen very early. I think what you'll notice on the left-hand side of the slide here is that we had established or operationalized these mechanisms almost fully by the time that COVID-19 was declared a pandemic in March of 2020. But we also had established most of them by the time that COVID was declared a public health emergency of international concern. So the question is, how did we do this so quickly? And the response is that we had these mechanisms in place. We were not, pardon my pun, we were not reinventing the wheel, but we were mobilizing teams that had longstanding experience in pandemic response and infectious disease control and prevention. These are teams that had prior experience with things like MERS coronavirus, with SARS, with Ebola, Zika, and so on. The list really goes on and on. If you look at the right-hand side of the slide, I think you see the tiered approach that we took. We've got very tactical groups, like those who might be sitting at a site like I was in Baton Rouge. We've got regional groups that integrate some of that data into information. And then we've got corporate groups that actually help us to develop, to administer policies. And I'm very proud to say that our organization, MOH, was integrated essentially at every layer of that cake. But two teams that I want to draw specific attention to are the COVID-19 operations team and the COVID-19 strategic team. So from an operations team perspective, this consisted of occupational health managers around the world, within our department, and they were able to give us the boots on the ground perspective. So what is the situation, for example, in Singapore or in China or in Russia? But the overall goal is to have a coordinated approach. So that was the purpose of the operations team. The strategic team, on the other hand, involved groups of occupational health managers, industrial hygienists, and other professionals who were subject matter experts in a variety of areas. They looked at things like disease surveillance, variant evolution, testing, treatment, vaccines, workplace data. I'm very proud to say that we are, of course, a global corporation, but we are also a global medical department. And we were able to leverage that international component and the scope of our operations to develop internal subject matter experts for all of those areas that I mentioned. So again, this kind of goes back to the model that we talked about, that that internal stakeholder engagement and those partnerships really were critically important. So let's talk a little bit about data and information. I will just give you the 50,000-foot perspective first to say that our objective fundamentally was to enable real-time, fit-for-risk decision support. And we found out, actually, that in doing so, we had to first become the trusted information source. So again, I've alluded to this a couple times. Why am I saying trusted information source and not trusted data source? So to sidestep briefly, let's talk about the difference between data and information. So data by itself lacks context. It lacks narrative. It lacks meaning. It's only when you impart that meaning to data that you contextualize it, that it turns into information that we can action. So again, this is a key point, so I'll mention it one more time. It's only when you add meaning to data that you get information that you can act on. So that's kind of how this slide is organized. On the left-hand column, you have our data sources. On the middle, you've got the tools and resources that we use to transform that data into information. And on the right-hand side, you've got the objective, which is to achieve real-time, fit-for-risk decision support. We'll start off on the top in the yellow boxes. These are probably the sources of data that we're more familiar with when we think about COVID. What are the cases? What are the case rates? How severe is the disease? How full are our hospitals and our ICU beds? So we took that data and we integrated it with tools and resources such as dashboards that allowed us to keep a real-time pulse check on COVID-19 at any given point in time, at any given location. And then we also leveraged our scope fundamentally as a global engineering company to have access to data scientists who allowed us to do things like modeling and analytics. And it's through those tools that we were able to actually answer questions that we may not have been able to answer otherwise. I'll give you one example. So pretty early on, we looked at the marginal risk that we undertake if we return folks from quarantine after five days versus seven days, 10, or 14 days. How much is that risk changing depending on when folks return from quarantine? That was not information that was available at the time. So it really was our ability to leverage those other resources outside of our medical department, those other internal or external stakeholders, depending on your perspective, to find out answers to those key questions. When we start on, if you look at the blue boxes here, these are also data sources technically, but probably not as easy to relate to from calling them data sources. But these are things like the emerging scientific evidence, which I think everybody here probably remembers early on. That evidence was changing on a daily basis, or sometimes multiple times a day. And of course, things like news and media reports, I think that we all probably, in a retrospective manner, can agree that the news cycle, so to speak, really affected the work that we did. The sources like Twitter, social media, it really influenced and informed our workers. So it was important for us to consider those things as well. And then even agency or public health guidance was changing pretty frequently early on. So how did we transform that data, so to speak, into information? We applied internal and external subject matter expertise. I'd already mentioned from an internal perspective, the COVID-19 strategic team, where we developed that expertise at a grassroots level across the world. And from an external perspective, one example I'll give you is that we had leveraged relationships with folks like Dr. Peter Hotez, who you might remember from being on CNN pretty frequently. He was able to give multiple talks to our workforce, numbering in the thousands, that helped educate them on vaccines, for example. What are the risks, the benefits, what's the safety, what's the effectiveness, and so on. So the goal of that was to distill and really evaluate the strength of evidence. So what is the information that we have based on the data, the data sources that we've evaluated, and how strong is that evidence? And that's fundamentally what allowed us to make real-time, fit-for-risk decisions. So one other example, just talking a little bit about analytics, once we had a little bit of runtime, it was important for us to consider the situation from a rate-of-change perspective. So what you see on the screen is, of course, a map of the world that's color-coded, and the colors correspond to the seven-day rolling averages of the rate of change for cases. So we looked at places where case rates were pretty low, but they were getting worse. Other places where case rates were really high, but they were getting better. And it's only when we started to stitch that information together that we transformed, again, what was fundamentally data about cases into information that allowed us to make decisions based on risk. So here you can see that the situation in the United States was really bad in January of 2021, and then over the course of the next few months, really improved. And it was ultimately that ability for us to assess the risk or gather the data that allowed us to make decisions about scalability and options analysis. And that's particularly true with respect to safeguards. So here's another example of a health and safety bow tie that is similar to the one Dr. Diarra presented. I did want to mention one thing, again, being part of a global engineering company, that it was important for us to speak the same language as our stakeholders. So the safety bow tie diagram is a common tool that's used by safety professionals and engineers, and so we try to leverage those tools when we can to really relate to them and talk to them, communicate on their level. So just to orient you briefly, on the left-hand side, you've got the hazard, which is COVID-19. On the right-hand side is the consequence of that hazard if it's unmitigated. So of course, here we'd have significant effects to safety, health, operations, to reputation fundamentally. And in the middle, you've got the hazard event, which is transmission. So of course, we've got some preventive safeguards. We've got things like hazard identification, surveillance of the disease, things like personal protective measures, masking, social distancing, vaccines. Then we've got site preparedness and screening, and I did want to bring some light to this example just by showing that we, like many of you, early on during the pandemic utilized temperature screening as a way for us to check folks before they entered our sites. And the evolution of data regarded to temperature screening, it led us down the pathway that there's probably limited utility to doing that. And again, fundamentally, that change in risk or that risk assessment allowed us to scale back that particular safeguard. On the right-hand side, you've got the mitigative safeguards. So these are things after transmissions already occurred that we can use to prevent the consequence, things like early diagnosis and treatment, contact tracing, which I'm sure everyone is sick of hearing about at this point, and then, of course, some other measures. I did briefly just want to mention the vaccine part, the vaccination strategy, again, tying back to the model by understanding that we knew that if we were able to encourage vaccination among our workers, that it would change the risk profile for those folks, and it would change the risk profile fundamentally for our worker population. And that would lead us down the pathway of being able to do an options analysis and to scale back as we needed with respect to safeguards. So from a 50,000-foot perspective, we looked at the safety and effectiveness of vaccine products. We looked at access from a supply chain perspective, again, talking about optionality. We may not have access to the same vaccines that we do in Angola as we do in the United States or in Papua New Guinea. So that understanding of access was really important. We had to prioritize who should receive vaccines at what time, and again, this was based on risk. The fourth step here is really critical, communication. And it speaks to that stakeholder engagement piece. We had to communicate with folks on their level and to, again, be the trusted information source to dispel rumors or myths and really to get across the key points. And then finally, from an administration and tracking perspective, ultimately, our goal was to understand population immunity and to improve the immunity of our population, again, so we could use that optionality and scale back safeguards. And I will just tell one personal story from an administration perspective. We of course had some large-scale clinics that we set up to administer vaccines, but we also leveraged local resources as the path of least resistance to hook our individuals, our employees up with resources in the community. So the personal story is that in Baton Rouge in February of 2021, right when vaccines became available, we leveraged our partnerships with the local health authorities and administer hundreds of vaccines in Baton Rouge to a population, honestly, that was pretty hesitant from a vaccine perspective. So we took that as a huge win. And then very briefly to talk about the future state, where do we go from here? I think fundamentally, we've got to understand variant evolution. So as we look over time, what is the transmissibility of variants that are coming out? What is the severity of disease associated with those variants? What is the immune evasiveness of the variants? We've also got to understand population immunity. So how immune is our population, both from the perspective of either having received a vaccine or from having had a previous infection? So what's that immune status? We've got to anticipate, and we're even seeing this now, that the data is becoming less and less reliable. Data sources that we'd relied on like Johns Hopkins or the WHO, they're either no longer publishing data about cases or their publishing is becoming less frequent over time. And I think that will be a trend that we continue to see. But there is some hope. We, of course, hope that there are new developments in vaccines, other treatment options. And then from an adaptation perspective, I think we're at a really critical point here in the U.S. that next month, we will scale back from classifying COVID-19 as a public health emergency. So what does normal look like? That's an important question for us to answer. And fundamentally, we, again, want to understand risk as it evolves so that we can escalate and de-escalate safeguards as we need to. It's important for us as a group, I think, to continue going around that circle. Although the scope may be slightly different, we don't want to go into a new normal and then potentially the next time something like this happens to reinvent the wheel. That's what we don't want. So I'll close just with some resources as we've done in the prior two sections. On the top left is neck strain. Sounds like neck strain, doesn't it? But no neck strain. It's probably the most reliable resource in terms of variant evolution. It gives you a really nice map of circulating variants. You can split it up by region that you're looking at or globally. On the bottom right is the WHO weekly epidemiological update. I think that's probably the best integrated document that's published on a weekly basis that helps you understand the current state. And then on the flanks, you've also got two documents from OGP IPICA. One is on pandemic management and the other on infectious disease outbreak management. And also very proud to say that our organization, Dr. Diarra and others, had participated in making these documents with those groups. And then a little bit of a shameless brag in the middle that we, of course, have really robust internal resources at ExxonMobil. We have an employee resource center. And then as I mentioned a couple times before, we were able to leverage our external stakeholders like Dr. Peter Hotez and others to educate our workforce and educate our medical staff. With that, I will hand it back to Dr. Walden to bring us full circle. Thank you. All right. Sort of makes my heart rate go up a little bit when we talk about COVID, thinking back to how crazy that was. Anyway, okay, so we've come full circle. We've given you three examples. Hopefully this is helpful. Hopefully it brings it a little bit to life to kind of show you the things that we think about, the way that we think about, what we think are the critical enablers to kind of grow these programs or scale them down either way across our organization. So we only have a few minutes, but we are happy to have questions, comments, if anyone is inspired to tell us more about their journey or ask a question. Yeah. Go ahead. Thank you. Thank you. And thank you, all of you, for a very interesting presentation. My name is Brian Davey. I'm from the World Bank Group, and we have employees in over 100 locations, so I identify 100% with your issues. Two questions with a common theme of both different levels of resource available in different places and cultural and regional attitudes in your employees to having interest in available resources. So specifically on vaccines for COVID, we tried our best to have equity of distribution, but simply were not able to procure as an organization and distribute the same vaccine to all our staff. So ultimately, had no choice but to combine strength with all the other UN organizations, and through that joint negotiating power, eventually did manage to procure vaccines, send them out, and administer them, but that willingness to undertake such a huge program is now starting to fall away, and we're confronting the problem of going forward and having to distribute boosters and bivalent vaccines and see a lot of problems ahead in doing that. So question, did you actually procure, distribute, and administer vaccines so that there was equity of access to the same vaccines, and how are you thinking about that going forward? Yeah, so I would say COVID and vaccination was clearly a different issue for us because it interfaced with things we had no control over. Often our corporation can manage the supply chain, we can manage the external. There's not as much external factor that we have to take into account, but as you said, with the issue of vaccines and COVID, there wasn't equity. There were different vaccines available in different countries. Some were more effective than others. Some had nothing. We certainly recognized that as an issue, as probably everybody did, and we did our best to help address that. Where we could, we procured, but primarily we tried to partner with using our local resources. We tried to help whatever local government resources were there. There were many times where we had existing relationships, where we were able to say, we can help you. How can we help you? If you are having difficulty with, say you have the vaccine, but you just don't have the resources to administer them, we can help you. We can administer to our own group. We tried to be creative and find ways. Did we do it perfectly? No. Was there complete equity? No. We managed the best we could with the circumstances that were there. Thank you. The second question had to do with your wellness programs and vendors. You suggested that you had tailored multiple vendors, could you expand on that and also if you did find any vendors that themselves had a global capability to deliver tailored solutions for different regional attitudes and needs? Yeah. So I think it's very difficult to find one vendor that can do things at scale of a large international company. So you end up having to piece it together and find the best vendors because there's a trade-off. The broader they are, they may not be as good or whatever, but we didn't find anybody that really fit that. So we had a few more local solutions, but what we did do is we centrally did a lot of the planning through a company that we were using. So we would create toolkits centrally. There was basically a menu of toolkits that any location could use and then implement it there and they could adapt it to language, to other cultural differences and because we have boots on the ground people pretty broadly, they were able to make those sort of adaptations, but it was tweaking, right? So they already had, we gave them, this is the concept, let's say it's a walking program. There's a walking program. These are kind of the emails you would have. This is the communication. Here's how it works. It's eight weeks long. It's whatever. So all the details were there and then they would deliver it. So some of it was internally sourced through some partnerships with a vendor centrally and that was important to do. We had to do it that way. Okay. Hi. Oh, maybe I need... Oh, hey Faisal. Hi. So, you know, first of all, I'd say an excellent and a balanced presentation, underscore balanced. So as rich as ExxonMobil is, and both fiscally and human resource wise, what internal challenges you face as a health organization, are you immune to energy cycle fluctuations and impacts on that? And the other thing part is, you know, what is the role of partnerships in this global thing? Because, you know, nobody can do it by themselves in an ExxonMobil, right? So can you give us a couple of good examples of partnerships? And the last bit, I think my colleague just asked is around, you know, how do you think of, and I say think, not maybe implement, of equity across health, healthcare, and health resources across your global population? Thank you so much. Thank you, Faisal. That was a lot. Yes, we make a lot of money, but as one of my former colleagues said, we act like we have no money. So we are very tight as an organization, and we are very, I would say, fiscally responsible. And it can be difficult to get the funding that we need, so we have to have a very strong business case. I do think just sort of, given I've been with the company for a long time, and I can look a bit in the rear view mirror and kind of say, where have we been and where are we now? The thing I would say is years back, we used to say, oh, it's safety, health, and environmental, and there's just this little tiny H in the SHE. And I think today, and we were certainly turbocharged by the pandemic to make that H bigger. There's a true understanding that we have programs that are helpful. People need support managing and navigating health. We need to protect their health. They're important assets. People live these things that we always knew. Now I have senior business leaders telling me, like, I've never known this before. Hey, did you know these things are really important? So it's a good place to be. I'm happy for that. But I kind of said in the beginning and alluded to this, every day is a new day. And every day, you wake up, and what they're facing is different. Their priorities are changing, and these things can, their core business is not health. So we're always a bit ancillary. So it's just something. We become really good communicators. We learn the story that we need to tell, and we have to be responsible and give them things that add value. So that's why these kind of relationships, speaking their language, kind of comes up over and over as each one of us talked, because that's just critical to making those things happen. And I think you had a third thing, and I forgot what it was. Partnerships. Oh, partnerships. I'm going to hand that to Malik, who is the king of partnerships. So very briefly. I'll be very quick. Thank you, Fayez, for your question. And definitely, no one can do it all, and it's very important to establish partnerships. And the key is to really combine strengths from different entities and have a common goal. And it's a relation that can be developed over time. And that's, I would say, how I can really summarize it quickly. Thank you. I don't know if people kick us out or what. I haven't done this before. We're going to run over time, but go ahead. Yeah. Just a quick question. Listening to you talk about pulling together all the data, all the information, analyzing it, a company the size of ExxonMobil, have you begun to process of integrating AI? Oh, AI. Okay. Yeah. So it's certainly a technology we're interested in. We've done that, whatever it is, the chat thing, the GP chat thing, to see what it says. And that's kind of exciting. I don't know if it's ready for prime time for us yet, but it certainly is something that we look at. Do you all have another answer that you would expand on? Maybe the one thing I'll say. I mean, that's got to be like a million-dollar question at this point in this field. But I'll say that we are maybe taking an if-you-build-it-they-will-come approach. So we've got really robust data sets, and I think, like many of you, we're beginning to wonder, how do we integrate those data sets into being meaningful? And then, of course, the application of AI, I think, may be another transformer level of our game. Yeah. Thank you. Hi. Hi. My name's Linda Forst. I'm from the University of Illinois, Chicago, and work in research, academic training, and clinical care as well in occupational health. This is a more micro question, actually. And I compliment you for the fabulous slides and really clear presentation. I have so many questions based on that. So this is one of them. How do you operationalize your framework for, or I should say, inculcate your culture of health into your providers, like your health care providers, people who work in employee health or people that are doing injury care, and also in your hygiene and safety people? What kind of training or work do you do in that? Yeah. So, yeah, it's a good question. There's probably a lot of different ways that we do that, but we certainly leverage our own staff, and we've done a lot of discussion about culture of health, kind of the things that we do. And it's this whole concept of the bow tie that we've talked about. We have things that are proactive and protective that we do, and we have things that are reactive, and we kind of speak that same language across our organization so people understand where these things fit in. And then with our safety professionals, we are often using some of our, for instance, we have wellness minutes. Well, they always had safety minutes, and frankly, after years of doing a safety minute all day, we're running out of ideas for things to say. So we said, hey, let's add some wellness things. Health is important. We're going to give you this whole set of health minutes that you can add in and do at your tool talks or whatever. So we have just found ways, and I think the thing is, everyone's at work and they're busy, so you've got to find how I can help you do your job. They don't really, you know, I mean, I'm going to give this to you, and it's going to help you do your job is a lot more effective than I need you to do something for me. So we try to use that bit of psychology and give them something that's useful, and it helps disseminate the message throughout. But like I said, I actually think it's not a hard sell. People innately want to be helpful, and they want the workplace to be healthy, so once you give them the things and the permission to do it, they'll do it, at least in our organization. That's how I've seen it. Thank you. Yes? Hi. Rick Almuden, Mozilla. A fantastic example of how great health leadership and senior management engagement enhances worker protection. So the question on senior leadership engagement, what did you find were the most useful metrics for success when you were talking to the board to say, to show this is working, keep funding it? And then the killer question, how do you, as a result of that, calculate an ROI on the culture of health? Yes. Yeah, that's a... Thank you, Ricard. I knew you would do a good question. Yeah, so interestingly, we funded, in the U.S., we funded part of our wellness program through the medical plan, which was a great idea initially because it gave us instant funding that was there, but the challenge is it put the information back behind a data privacy wall for where HR really doesn't share a lot of that. And so it's been challenging to... So for instance, I don't have outcome data that I could share. They share it, though. They share it with the CEO and the board. They show that we've bent the curve on the medical plan and what the ROI is there. We're probably more on the arm of, in the businesses, are we creating a healthy environment in the workplace? So we have scorecards for sites. They can say they have all the different elements and check it off. They can tell their boss, we've embraced culture health, here's the scorecard, we've checked all these things off. And we're more at the level of individual workers in those sorts of things as well. So we get more operational, whereas HR is more on the plan side. But it's hard. It's hard to show what you prevented. We all struggle with that always, and it's no different with us. But like I gave that example, people innately know this is doing some good, and there's so many soft benefits from having a program. Let's face it, ExxonMobil is not known for being a fun company. We introduced some fun into the workplace. We introduced a caring environment and a way for people to show they care. And that was important. And they know that. So yeah, they're numbers people, so they like the numbers. But I let HR go give them the numbers, and I talk more in sort of qualitative things. And a question from Malik, so he doesn't feel out of place. Maybe I will add on this, just to say that we have also the privilege to get very committed executives that are championing these initiatives. They communicate. Vicky mentioned the steering committee, where you have representatives of the different company organizations that are part of this group, and really walking the talk, talking the talk, and really being leaders to help have that in place. And that was the driver behind my question, because without that, I mean, the Exxon Malaria Program is the world-leading malaria treatment program in the corporate world. Absolutely. End of discussion. But two bits you didn't mention, which I thought were great parts of the Malaria Program, is your Malaria Survival Kit, and also the work you did outside the fence in reducing the burden and the community stuff that you did, are the two bits that you didn't mention, which I think you should. Thank you. Thank you. These are additional areas. We told him he couldn't talk for two hours about the Malaria Program. Thank you. Thank you. Maria Bradshaw. Hi, Maria. How are you? I'm with the Air Force. Great. My question is, as Exxon dealt with endemics or pandemics, how it evolved from SARS-1 to H1N1 to the current SARS-2. What major changes did you make in your response? Yeah. Okay. I can get a start on it, because I was kind of early in the forming and storming of this. Just the main thing. I can hear you from the previous response. Yeah. So all of the previous ones were really local responses. So we had local emergency support groups. They kind of got contained pretty rapidly. Ebola was a little bigger and more serious in terms of the fatalities, but again, a little more just of a regional response. This hands down was the most massive emergency response our corporation has ever had. Things don't typically get up to an entire enterprise wide. If you have a spill somewhere, if you have an outbreak, they're typically regional or local and not something that impacts the entire corporation. So we were ready. We just definitely had to scale up to a scale we had never done before, but the infrastructure was there. I would say on our side, the two components where we had like the global OH managers team, that one was more operational and one was strategic, that was an add on. That was not a preexisting idea, but we saw the need and we did it. We were appointing subject experts on every aspect of COVID. So we had, we appointed someone, you're going to be the expert in the vaccine. You're going to be the expert in, you know, transmission and treatment. We had people who were monitoring the news and all of that as she talked about. And so we had to set up an infrastructure that was even bigger than we ever imagined. And it had to deal with things. One problem with that is that we were not as agile and fast as we sometimes needed to be. And that created a little bit of stress. But once we kind of got past that, I'd say that was the biggest thing, just scaling up. Okay. Thank you. Yeah. Thanks. Hi. Yeah. Hi, Dr. Weldon. My name is Enyi. I work with IBM. A couple of questions. When you moved from the single source of funding to sort of having to go to each country manager to ask for funding, how did that affect your programs as a whole? Did you get any refusals? Do you have to justify that cost on an annual basis? How does it work? So we actually kind of took an interesting approach. We told, and this was sort of a corporate thing, but they said each affiliate, they can manage their own business. They can figure out how they want to fund it. Is it through a safety? Is it through the business? How will they do it? They can manage that themselves. And they did. And so we actually, the model for funding it, and that sort of thing, is different from affiliate to affiliate. But what did happen was we had a lot of pull. We had people who said, we absolutely want to do this. Sign us up, too. I remember being in meetings saying, how are we going to push this out to everybody? And we decided, there are only a couple of us working on this. So let's just say whoever is most ready and wants it, and if they have the resources and the money, we'll work with them to make it happen. And they just kept lining up. And it worked for us. It was kind of surprising, really. But I think it spoke to how much need there is to have some sort of a structure that helps people manage some of these sort of softer issues, like wellness, like resilience, et cetera. So does that answer your question? Kind of. And the reason I ask is because we're kind of having the same struggle right now. We've been kind of trying to justify having a single source of funding because it makes everything easier. And right now, we're having to kind of justify the cost of going to each different country every year to sort of look at metrics, look at need, and balance it with budget. And I mean, IBM is an IT company, so everyone knows the IT world has been having struggles in the past God knows how long. So it's been a struggle for us. So I think what we did is we said, you know, this program, you know, we want to manage the cost. We don't want to be outrageous. We'll make it as cost-efficient as it can be, but you're paying for it. So if you want it, you're going to pay for it, each country, each operation. And that way, we weren't explaining to them the cost. They were just telling us what they wanted. So usually, we want consistency everywhere. And it's one place where we said, we're going to tolerate some inconsistency in that because the programming needs to be different anyway. It is going to be customized. We're going to centrally plan things and make it cost as streamlined as it can be. But there will be nuances and differences. So that's just how we were able to do it. If I may add, it's important to have a very strong rational and a business perspective. So what's in for the business if you come with such initiative? You can highlight the mental health aspects. In times of downturns, you really have a mental, I would say, tension all across. So you can help develop the productivity even if the situation is difficult. And having the funding done by the affiliates, it's their responsibility to take care of the individuals in their direct responsibility and keep the business going. So I'm going to have to say we're done before the guy with the cane comes and pulls me off of the stage. So thank you for being here. We appreciate it. Thank you.

ExxonMobil

public health initiatives

occupational health initiatives

culture of health

malaria prevention

COVID-19 response

stakeholder engagement

data gathering

risk assessments

employee wellness

partnerships