Open Orphan : Annual Report 2021

Strategic delivery 2021

Below is an outline of the Group's achievements in 2021 across key business revenue streams and market trends.

Human challenge / clinical services

2021 was a record year for hVIVO's core human challenge trial business, with the Company delivering a strong and growing pipeline of challenge study contract wins across our world leading portfolio of human challenge models. The Company is benefitting from a significantly expanded market for infectious and respiratory disease products, with four of the top 10 global biopharma companies working with us in 2021.

In 2021 we successfully collaborated with a client who funded the rapid and cost­efficient conversion of the unoccupied Whitechapel Hotel located

immediately beside our existing QMB facility, into the Whitechapel Clinic, a 19­bedroom quarantine clinic. Following the successful delivery of this trial to the client, we continue to operate the Whitechapel Clinic for challenge trials. This expanded our existing quarantine bedroom capacity to 43 (which was subsequently increased post­period end, providing us with access to 62 beds).

We also converted a vacant lot adjacent to the existing QMB facility into a new FluCamp volunteer recruitment screening centre. Similarly, we expanded our FluCamp screening facilities with the opening of new facilities in Manchester. These projects were completed at minimal cost and the expansion enabled us to screen 84,000 volunteers for human challenge studies in 2021.

COVID­19

2021 was a pivotal year for the UK and its attempt to emerge from the COVID­ 19 pandemic, and I was proud of the significant contribution that our team made to this. As a commitment to help the UK government to fight the pandemic, the team at hVIVO worked tirelessly under difficult conditions in the midst of a pandemic, to deliver a COVID­19 characterisation study to provide unique insights into COVID­19. The results of the study were published in the peer reviewed scientific journal 'Nature Medicine' in February 2022. It is a testament to the hVIVO team and their knowledge and commitment that this study was completed safely and in a timely manner. The study was conducted in partnership with the UK Government's Vaccine Taskforce and Department of Health and Social Care (DHSC), Imperial College London and the Royal Free London NHS Foundation

Trust. Additionally, we were contracted to manufacture a SARS­CoV­2 Delta variant challenge agent with Imperial College London, as part of a Wellcome Trust­funded initiative.

The extensive worldwide coverage we received as part of this work raised Open Orphan's profile as the world leader in conducting human challenge trials and highlighted the significant benefit of these studies to deliver critical human efficacy data.

While effective vaccines and antiviral treatments have lessened the impact of COVID­19 infection in human populations, the lasting legacy of the pandemic is a significantly enlarged infectious and respiratory disease market, which is expected to grow to in excess of $250bn by 2025. The Group is leveraging this significant market growth. With extensive relationships across the industry, a world class reputation, and an ability to continue enhancing and diversifying its offering, the Group is well placed to secure further work as a result of this renewed investment and focus on respiratory diseases.

Board changes

We strengthened our Board with the appointment of Yamin 'Mo' Khan, initially as Non­Executive Director on 13 October 2021 before he was subsequently appointed CEO, post­ period end, on 24 February 2022. Mo brings 25 years of CRO experience to his role, and I have thoroughly enjoyed working with him since he joined the Group. Mo has had a significant impact on the business, and we were delighted that he since accepted the position of CEO. Mo brings extensive industry specific insights that we will leverage to deliver on our expanding pipeline of opportunities, and I am confident Mo

will continue to drive the Group's upward trajectory.

In July 2021, Professor Brendan Buckley, Non­Executive Director, and myself collectively purchased a further 1,320,754 ordinary shares at 26.5 pence per ordinary share, which increased my shareholding to 7.0% and Brendan's shareholding to 1.2% of the Company's issued ordinary share capital. I hope this demonstrates to our shareholders the Board's commitment to the business and our desire to drive shareholder value to match our considerable financial and operational growth and momentum.

In April 2022, we appointed Liberum Capital Limited as our Nominated Adviser and Joint Broker. We are delighted to be working with Liberum which is ideally placed to introduce Open Orphan's fast growing, profitable and sustainable business to new investors.

Summary

In a pandemic­hit 2021, the Group achieved record revenues, transitioned to making an EBITDA profit, and made significant operational progress. The business conducted a record number of human challenge trials, and has established itself as the world­leading provider of human challenge trials in the rapidly expanding infectious and respiratory disease market. Our work in COVID­19 enabled us to demonstrate our unparalleled expertise to a wider audience, and the market is now clearly recognising the value that human challenge trials can offer.

The business is firmly profitable and remains well capitalised with a cash balance of £15.7m to help drive the business forward and to realise further value for our shareholders. I would like to thank all of our employees for their

incredible efforts this year, and our shareholders for their continued support.

Cathal Friel

Executive Chairman

6 June 2022