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Welcome to the
SPHS Webinar Series
"Human Rights and Gender
Equality in Health Supply
Chains"
www.savinglivesustainably.org
October 17, 2017
Agenda
1. Welcome remarks by the moderator
2. Introduction to speakers
3. Presentations
• UNDP: Introduction to the SPHS initiative
• UNDP: Gender Equality in the Global Health
Supply Chains
• Ethical Trading Initiative: Human Rights and
Gender Equality in Health Supply Chains
• British Medical Association: The Human Cost of
Healthcare
4. Q&A
Speakers
Ms. Bharati Sadasivam
Gender Practice Team Leader
UNDP
Ms. Arthy Hartwell
Head of International & Immigration, Professionalism,
and Guidance, Policy Directorate
British Medical Association
Ms. Cindy Berman
Head of Modern Slavery Strategy
Ethical Trading Initiative
Sustainable Procurement
in the Health Sector
(SPHS)
Dr. Rosemary Kumwenda
SPHS Coordinator and Team Leader for Regional
HIV, Health and Development, UNDP Europe and
CIS
SPHS Webinar Series : Human Rights and Gender
Equality in Health Supply Chains, October 17,
2017
INTRODUCTION
Global perspectives on
health and environment
SPHS Task Team is, through a transparent and
inclusive engagement process, leveraging its
normative and market power, lowering the
environmental impact of its procurement, with a final
aim of improving human health and well-being.
Procurement Statistics
2015
Procurement Statistics
2013 - 2015
Procurement Statistics
2013 - 2015
Linking our work to the
Sustainable
Development Goals and
Key Focus Areas
More global than ever
Online Knowledge-Hub on
Good Practices in
Sustainable Health
Procurement and
Manufacturing:
www.savinglivesustainably.org
The SPHS global
network of collaborators
Communication
Statistics 2016
Looking Forward –
More Sustainable Health
Policies, Strategies and
Practices
GET IN TOUCH @ www.savinglivesustainably.org
Twitter: @UN_SPHS
We look forward to working with you on
a more sustainable global health sector.
Gender Equality in the
Global Health Supply
Chains
Ms. Bharati Sadasivam
Gender Practice Team Leader
UNDP Europe and CIS
SPHS Webinar Series : Human Rights and Gender
Equality in Health Supply Chains, October 17,
2017
PRESENTATION #1
Global template for complex world
Universal in scope
Reflects concerns of rich advanced economies and developing
world
Poverty, deprivation, inequality (including gender inequality),
and unsustainable patterns of production and consumption are
common concerns
The 2030 Agenda
for Sustainable
Development
Scope: economic, social, environmental, and political dimensions
of inequality and injustice.
Reflects concern with structural issues at a time of rising
inequality through the goals of:
Reducing inequality (Goal 10)
Strengthening full employment and decent work (Goal 8)
Supporting quality investments in infrastructure (Goal 9), health
(Goal 3), education (Goal 4)
Ensuring sustainable consumption and production patterns
(Goal 12)Broad and
ambitious
agenda
Broad scope of targets:
Discriminatory laws, harmful practices, violence against women
and girls
Sexual and reproductive health and reproductive rights
Distribution of unpaid care work
Access to productive resources
Participation in decision-makingGoal 5: Achieve
gender equality
and empower all
women and girls
Besides Goal 5, UN Country Teams identified Goal 1 (“End
poverty in all its forms”) as the SDG where gender most needs
to be mainstreamed in ECA countries.
ECA Country Teams identified the following targets as priorities:
5.1: End all forms of discrimination against all women and
girls everywhere (75.8%)
5.2: Eliminate all forms of violence against all women and
girls in the public and private spheres, including trafficking and
sexual and other types of exploitation (72.7%)
5.c: Adopt and strengthen sound policies and enforceable
legislation for the promotion of gender equality and the
empowerment of all women and girls at all (75.8%)
UN Country
Team priority
targets
Need to tackle a broad set of core issues and challenges, such
as:
 Unpaid care/domestic work - gendered division of labour in non-
market based productive activities
 Labour regulation, social security
 Access to/control over assets and resources
 Gender-based violence
 Access to justice, legal protection
This can only be done through addressing structural
causes/drivers, not symptoms:
 Inequality in power relations between women and men
 Social norms, stereotypes and practices that discriminate
against women and girls in all development spheres (economic,
social, political, environmental)
SDGs and global
health supply
chains
The UNCTAD report Trade and Gender (2004: 16) summarises
the ways in which trade can affect gender equality:
 A positive or negative impact on growth and employment
opportunities;
 Competitive pressures, which may reduce or encourage gender
discrimination, in particular wage differentials;
 Facilitating or raising barriers to access by women to resources
and services; and
 Multilateral trading rules, which may facilitate or constrain
governments in applying policies or regulations that address
gender inequality
SDGs and global
health supply
chains
Drivers of gender inequality in supply chains:
Working hours, particularly involuntary overtime
Freedom of association and collective bargaining
Informal labour and forced labour: Women and girls represent
the greatest share of the 21 million people in forced labour
globally
Horizontal and vertical job segregation, gendered divisions of
labourSDGs and global
health supply
chains
SDGs and global
health supply
chains
Integrating gender equality principles into global heath supply
chains will increase:
Safety
Sustainability
Efficiency
Equity
Women’s
Empowerment
Principles
Principle 5: Implement enterprise development, supply chain
and marketing practices that empower women
Expand business relationships with women-owned enterprises,
including small businesses, and women entrepreneurs
 Support gender-sensitive solutions to credit and lending
barriers Ask business partners and peers to respect the company’s
commitment to advancing equality and inclusion
Respect the dignity of women in all marketing and other
company materials
 Ensure that company products, services and facilities are not
used for human trafficking and/or labour or sexual exploitation
Promoting
gender equality
through
procurement
The following measures should be considered while designing
procurement strategy and guidelines:
 Consider women led businesses or businesses that employ
more women for procurement contracts; consider companies
that employ 50% women or have clear gender equality policies in
place.
Target companies that implement preferential gender
responsive procurement policy for award of contracts.
Recruit, train and promote women in public procurement
 Simplify tendering processes
Include gender-responsive evaluation criteria
Encourage signing of voluntary agreement
 Disaggregate procurement data
Procurement in health sector value chains has great potential for
equal opportunities in employment.
It is important to train and equip responsible officials and
agencies with information that will help them understand how to
advance women’s employment and address gender dimensions in
procurement processes. This is not, and should not be a “gender-
neutral” sector.
 All sectors including international organizations: it is important
to invest in the health manufacturing and supply chain sector
with a gender lens because of the multiple ways in which such
investment can advance Agenda 2030 and the SDGs at national
levels.
Conclusions
Human Rights and Gender
Equality in Health Supply
Chains
Ms. Cindy Berman
Head of Modern Slavery Strategy
Ethical Trading Initiative
PRESENTATION #2
Presentation
Outline
⚫ What is ETI and how do we work?
⚫ Labour rights risks in health supply chains (Pakistan example)
⚫ Gender dimensions of health supply chains
⚫ How to tackle this
⚫ UN Guiding Principles on Business & Human Rights
⚫ Human Rights Due Diligence
⚫ Critical elements of a response
⚫ Opportunities
⚫ Further resources
Members of
What is Ethical Trading Initiative?
ETI
Employment is freely chosen
Freedom of association
& the right to collective
bargaining
Safe and hygienic working
conditions
No child labour
Living wages are paid
Working hours are not excessive
No discrimination
Regular employment
No inhumane treatment
THE ETI BASE CODE
ETI
Influencing
policy &
practice
Building
capacity
Supply chain
programmes
Sharing
knowledge &
learning
Accountability
& reporting
Enabling
collaboration
– locally &
globally
Modern Slavery Act,
Cambodia, Bangladesh Accord
TNMS, Turkey, Spain,
Rajasthan, South Africa,
Kenya, Morocco, Peru
Training on Modern Slavery
and Due Diligence;
Coaching
India, Bangladesh, China
Pakistan, Turkey etc.
Guidance, toolkits,
research, events,
sharing lessons &
resources
Company annual
reporting and review
ETHICAL TRADING INITIATIVE
Health Supply
Chains
⚫ Increasing global demand for health supplies (ageing etc.)
⚫ Complex and fragmented supply chains – multiple countries,
manufacturing processes
⚫ Increasingly globalised & deregulated labour markets
⚫ Procurement rules and regulations – cost drivers, speed,
volume, security of supply & product quality
⚫ Labour / human rights risks – race to the bottom
⚫ Lack of coherence – modern slavery legislation, increasing
human rights due diligence regulation vs government systems
⚫ Limited expertise, resource & capacity
⚫ Sourcing from countries with poor governance, limited space for
civil society, media, trade unions, transparency
Key Issues
Labour Rights
Risks in Health
Supply Chains
⚫ Long supply chains - rights violation risks at every stage
⚫ Lack of visibility, oversight, problems with audits
⚫ Multi-staged manufacturing processes
⚫ Authorised & unauthorised sub-contracting
⚫Unregistered, unregulated small units & businesses
⚫ Informal sector & home working (gender dimensions)
⚫ No formal contracts – workers paid piece rate no fixed wages
⚫ Poor / no oversight of health & safety, wages, hours
⚫ Lack of record-keeping, HR systems
⚫ Use of labour contractors (no employer/employee relationship)
⚫ Unscrupulous recruitment practices, debt bondage risks
⚫ Piece rates, rather than a fixed regular income.
An example: NHS
Supply Labour
Management
Assurance
System
⚫ Based on ETI Base Code
⚫ Four step assurance system – suppliers must be at Level 2 to bid
for contracts, must reach level 3 within 18 months
⚫
Gender issues in
global value
chains
⚫ Increasingly feminized wage labour
⚫ Discrimination (added to other labour rights risks )
⚫ low / unskilled work
⚫ precarious work
⚫ low status jobs, limited advancement opportunities
⚫ poorly paid
⚫ long hours, no flexible working
⚫ poor health & safety at work & to work
⚫ childcare, domestic responsibilities not recognised
⚫ subject to sexual harassment, threat & abuse
⚫ limited representation, voice, choice & negotiation power
⚫ Home working (piece rates, rights as workers not recognised, no
oversight, isolated, lack of collective organising power)
⚫ Very poor data (lack of sex-disaggregated data & monitoring)
Some of the challenges…
Gender
dimensions to
consider
⚫ Agency (trade union; other organization;
individual / collective voice & decision-making)
⚫ Aspiration (meeting goals, opportunities for
advancement)
⚫ Dignity (treatment, behavior, attitudes)
⚫ Reward (wages, other benefits – including
maternity, childcare etc.)
⚫ Safety (including sexual violence & harassment,
safety to & from work & at work)
⚫ Security (job & income security, permanent /
temporary contracts, formal/informal work)
The way forward:
Tackling human
rights & gender
equality in health
supply chains
3 Pillars of the UN Guiding Principles for Business and Human Rights
UN Guiding Principles on
Business & Human Rights
ETI human rights
due diligence
framework
Human rights due diligence is the action taken by a
company to both identify and act upon actual and
potential risks for workers in its operations, supply
chains and the services it uses
Includes:
⚫Assessment of actual and potential human rights risks
⚫Mitigation of risk and remediation for workers impacted by
human rights violations
⚫Identification of corporate leverage and responsibility, decision-
making and actions needed
⚫Monitoring, review, reporting and continuous improvement
Driving leadership and
improvements in
corporate operations
and global supply chains
CRITICAL
ELEMENTS
⚫ Recognise complexity – no quick fixes
⚫ Recognise roles and responsibilities
⚫ Diagnose the problems and design appropriate solutions
⚫ Use leverage – government’s own procurement power is huge!
⚫ Build partnerships and foster collaboration
⚫ Carrot and Stick works
⚫ incentivise change but
⚫ hold those responsible to account
⚫ Rights, dignity and agency of workers respected & advanced
⚫ Better information to drive decision-making
⚫ Transparency & public accountability is key
⚫Review, learn, monitor, evaluate, share lessons
OPPORTUNITIES
⚫ SDGs provide key opportunity for entry points
⚫ New legislation (UK MSA, EU Directives, French, Dutch law)
⚫ OSCE initiative to drive public procurement, transparency,
labour monitoring and enforcement - engage with member states,
use guidance
⚫Engage with government departments & local authorities
providing health services & supplies. Insist on ethical procurement
⚫ Identify leaders & good practice (e.g. NHS Supply – Labour
Monitoring and Assurance System)
⚫ Work with experts, engage with trade unions, civil society
organisations, representatives of vulnerable workers
THANK YOU!
Guidance & more info:
www.ethicaltrade.org
• Human Rights Due Diligence Framework
• ETI Base Code Guidance series
• Blogs & briefings
• Research reports
• Training – through our website
The Human Cost of
Healthcare
Ms. Arthy Hartwell
Head of International
British Medical Association
PRESENTATION #3
Many suppliers to
the NHS
outsource the
manufacture of
their products to
factories around
the world
The Human Cost
of Healthcare
“Ethical procurement is
about the overall
practices of purchasing
organisations and the
steps they take to ensure
that employment
conditions and workers’
rights, in the supply
chains of the products
and services they
procure, are maintained
in line with
internationally
recognised conventions
and local laws, as a
minimum”
“The provision of
healthcare goods
and services is big
business”
Department of Health
NHS EnglandNHS Wales NHS Scotland
Commissioning
Groups
NHS providers
NHS
Supply
Chain
ServicesGoods
Scottish
Health
Supplies
Welsh
Health
Supplies
Procurement
Hubs
Healthcare Industry
Department of Health
NHS EnglandNHS Wales NHS Scotland
Commissioning
Groups
NHS providers
NHS
Supply
Chain
Service
s
Goods
Scottish
Health
Supplie
s
Welsh
Health
Supplie
s
Procuremen
t Hubs
Healthcare Industry
Assured labour standards
in contracts for surgical
instruments & some
textiles
2013
Gloves, procedure packs,
disposable curtains,
suction consumables2014
Polymer products, theatre
clothing, continence
products
2015
Wound care, office
furniture, podiatry
2016
£18m
£110m
£142m
£80m
Labour
Standards
Assurance
System
⚫Pioneering approach to
include ethical procurement
considerations into the tender
for Surgical Instruments (2012)
⚫Covers a range of policies,
procedures and practices to;
identify labour standards
issues, mitigate risks, and drive
continuous improvement.
⚫Responsibility is on the
supplier to demonstrate they
have effective systems in
place.
Level 4 – Progressive
demonstrates leadership level management of
labour standards.
Level 3 – Established Implementation
robust system for managing labour standards in
place. A more action-orientated level of
compliance.
Level 2 – Initiating Implementation
Demonstrates progression from level 1 and
started to implement processes and procedures
to manage labour standards.
Level 1 – Foundation
Sets the building blocks for labour standards
management in practice. Begun to consider
how labour standards relate to its business.
Ethical
procurement for
health workbook
Provide practical guidance for
organisations in the health and
social care sector to embed labour
standards considerations into
procurement and supplier
management activities.
Promote awareness of labour
standards risk in supply chains
serving the health and care sector.
Demonstrate that ethical trade is
compatible with public contracting
policy and regulation.
Address the misperception that
ethical trade is incompatible with
public procurement law and/or
value for money requirements.
EPH Flexible
Framework
Legislative
environment
UK Modern Slavery Act 2016
EU Non-Financial Reporting Directive
2014/95/EU
EU Public Procurement Directive
2014/36/EU
UK Public Contract Regulations 2015
UK
Sweden
Norway
Germany
Italy
Netherlands Standardise criteria and methods
Synchronised approach to effect
market forces
Engagement with European
Commission
Thank you
ahartwell@bma.org.uk
bma.org.uk/fairmedtrade
@fairmedtrade
Q & A
GET IN TOUCH @ www.savinglivesustainably.org
Twitter: @UN_SPHS
We look forward to working with you on
a more sustainable global health sector.

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SPHS Webinar Series: Human Rights and Gender Equality in the Global Health Supply Chains

  • 1. Welcome to the SPHS Webinar Series "Human Rights and Gender Equality in Health Supply Chains" www.savinglivesustainably.org October 17, 2017
  • 2. Agenda 1. Welcome remarks by the moderator 2. Introduction to speakers 3. Presentations • UNDP: Introduction to the SPHS initiative • UNDP: Gender Equality in the Global Health Supply Chains • Ethical Trading Initiative: Human Rights and Gender Equality in Health Supply Chains • British Medical Association: The Human Cost of Healthcare 4. Q&A
  • 3. Speakers Ms. Bharati Sadasivam Gender Practice Team Leader UNDP Ms. Arthy Hartwell Head of International & Immigration, Professionalism, and Guidance, Policy Directorate British Medical Association Ms. Cindy Berman Head of Modern Slavery Strategy Ethical Trading Initiative
  • 4. Sustainable Procurement in the Health Sector (SPHS) Dr. Rosemary Kumwenda SPHS Coordinator and Team Leader for Regional HIV, Health and Development, UNDP Europe and CIS SPHS Webinar Series : Human Rights and Gender Equality in Health Supply Chains, October 17, 2017 INTRODUCTION
  • 5. Global perspectives on health and environment SPHS Task Team is, through a transparent and inclusive engagement process, leveraging its normative and market power, lowering the environmental impact of its procurement, with a final aim of improving human health and well-being.
  • 9. Linking our work to the Sustainable Development Goals and Key Focus Areas
  • 11. Online Knowledge-Hub on Good Practices in Sustainable Health Procurement and Manufacturing: www.savinglivesustainably.org
  • 12. The SPHS global network of collaborators
  • 14. Looking Forward – More Sustainable Health Policies, Strategies and Practices
  • 15. GET IN TOUCH @ www.savinglivesustainably.org Twitter: @UN_SPHS We look forward to working with you on a more sustainable global health sector.
  • 16. Gender Equality in the Global Health Supply Chains Ms. Bharati Sadasivam Gender Practice Team Leader UNDP Europe and CIS SPHS Webinar Series : Human Rights and Gender Equality in Health Supply Chains, October 17, 2017 PRESENTATION #1
  • 17. Global template for complex world Universal in scope Reflects concerns of rich advanced economies and developing world Poverty, deprivation, inequality (including gender inequality), and unsustainable patterns of production and consumption are common concerns The 2030 Agenda for Sustainable Development
  • 18. Scope: economic, social, environmental, and political dimensions of inequality and injustice. Reflects concern with structural issues at a time of rising inequality through the goals of: Reducing inequality (Goal 10) Strengthening full employment and decent work (Goal 8) Supporting quality investments in infrastructure (Goal 9), health (Goal 3), education (Goal 4) Ensuring sustainable consumption and production patterns (Goal 12)Broad and ambitious agenda
  • 19. Broad scope of targets: Discriminatory laws, harmful practices, violence against women and girls Sexual and reproductive health and reproductive rights Distribution of unpaid care work Access to productive resources Participation in decision-makingGoal 5: Achieve gender equality and empower all women and girls
  • 20. Besides Goal 5, UN Country Teams identified Goal 1 (“End poverty in all its forms”) as the SDG where gender most needs to be mainstreamed in ECA countries. ECA Country Teams identified the following targets as priorities: 5.1: End all forms of discrimination against all women and girls everywhere (75.8%) 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation (72.7%) 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all (75.8%) UN Country Team priority targets
  • 21. Need to tackle a broad set of core issues and challenges, such as:  Unpaid care/domestic work - gendered division of labour in non- market based productive activities  Labour regulation, social security  Access to/control over assets and resources  Gender-based violence  Access to justice, legal protection This can only be done through addressing structural causes/drivers, not symptoms:  Inequality in power relations between women and men  Social norms, stereotypes and practices that discriminate against women and girls in all development spheres (economic, social, political, environmental) SDGs and global health supply chains
  • 22. The UNCTAD report Trade and Gender (2004: 16) summarises the ways in which trade can affect gender equality:  A positive or negative impact on growth and employment opportunities;  Competitive pressures, which may reduce or encourage gender discrimination, in particular wage differentials;  Facilitating or raising barriers to access by women to resources and services; and  Multilateral trading rules, which may facilitate or constrain governments in applying policies or regulations that address gender inequality SDGs and global health supply chains
  • 23. Drivers of gender inequality in supply chains: Working hours, particularly involuntary overtime Freedom of association and collective bargaining Informal labour and forced labour: Women and girls represent the greatest share of the 21 million people in forced labour globally Horizontal and vertical job segregation, gendered divisions of labourSDGs and global health supply chains
  • 24. SDGs and global health supply chains Integrating gender equality principles into global heath supply chains will increase: Safety Sustainability Efficiency Equity
  • 25. Women’s Empowerment Principles Principle 5: Implement enterprise development, supply chain and marketing practices that empower women Expand business relationships with women-owned enterprises, including small businesses, and women entrepreneurs  Support gender-sensitive solutions to credit and lending barriers Ask business partners and peers to respect the company’s commitment to advancing equality and inclusion Respect the dignity of women in all marketing and other company materials  Ensure that company products, services and facilities are not used for human trafficking and/or labour or sexual exploitation
  • 26. Promoting gender equality through procurement The following measures should be considered while designing procurement strategy and guidelines:  Consider women led businesses or businesses that employ more women for procurement contracts; consider companies that employ 50% women or have clear gender equality policies in place. Target companies that implement preferential gender responsive procurement policy for award of contracts. Recruit, train and promote women in public procurement  Simplify tendering processes Include gender-responsive evaluation criteria Encourage signing of voluntary agreement  Disaggregate procurement data
  • 27. Procurement in health sector value chains has great potential for equal opportunities in employment. It is important to train and equip responsible officials and agencies with information that will help them understand how to advance women’s employment and address gender dimensions in procurement processes. This is not, and should not be a “gender- neutral” sector.  All sectors including international organizations: it is important to invest in the health manufacturing and supply chain sector with a gender lens because of the multiple ways in which such investment can advance Agenda 2030 and the SDGs at national levels. Conclusions
  • 28. Human Rights and Gender Equality in Health Supply Chains Ms. Cindy Berman Head of Modern Slavery Strategy Ethical Trading Initiative PRESENTATION #2
  • 29. Presentation Outline ⚫ What is ETI and how do we work? ⚫ Labour rights risks in health supply chains (Pakistan example) ⚫ Gender dimensions of health supply chains ⚫ How to tackle this ⚫ UN Guiding Principles on Business & Human Rights ⚫ Human Rights Due Diligence ⚫ Critical elements of a response ⚫ Opportunities ⚫ Further resources
  • 30.
  • 31. Members of What is Ethical Trading Initiative? ETI
  • 32. Employment is freely chosen Freedom of association & the right to collective bargaining Safe and hygienic working conditions No child labour Living wages are paid Working hours are not excessive No discrimination Regular employment No inhumane treatment THE ETI BASE CODE
  • 33. ETI Influencing policy & practice Building capacity Supply chain programmes Sharing knowledge & learning Accountability & reporting Enabling collaboration – locally & globally Modern Slavery Act, Cambodia, Bangladesh Accord TNMS, Turkey, Spain, Rajasthan, South Africa, Kenya, Morocco, Peru Training on Modern Slavery and Due Diligence; Coaching India, Bangladesh, China Pakistan, Turkey etc. Guidance, toolkits, research, events, sharing lessons & resources Company annual reporting and review ETHICAL TRADING INITIATIVE
  • 34. Health Supply Chains ⚫ Increasing global demand for health supplies (ageing etc.) ⚫ Complex and fragmented supply chains – multiple countries, manufacturing processes ⚫ Increasingly globalised & deregulated labour markets ⚫ Procurement rules and regulations – cost drivers, speed, volume, security of supply & product quality ⚫ Labour / human rights risks – race to the bottom ⚫ Lack of coherence – modern slavery legislation, increasing human rights due diligence regulation vs government systems ⚫ Limited expertise, resource & capacity ⚫ Sourcing from countries with poor governance, limited space for civil society, media, trade unions, transparency Key Issues
  • 35. Labour Rights Risks in Health Supply Chains ⚫ Long supply chains - rights violation risks at every stage ⚫ Lack of visibility, oversight, problems with audits ⚫ Multi-staged manufacturing processes ⚫ Authorised & unauthorised sub-contracting ⚫Unregistered, unregulated small units & businesses ⚫ Informal sector & home working (gender dimensions) ⚫ No formal contracts – workers paid piece rate no fixed wages ⚫ Poor / no oversight of health & safety, wages, hours ⚫ Lack of record-keeping, HR systems ⚫ Use of labour contractors (no employer/employee relationship) ⚫ Unscrupulous recruitment practices, debt bondage risks ⚫ Piece rates, rather than a fixed regular income.
  • 36. An example: NHS Supply Labour Management Assurance System ⚫ Based on ETI Base Code ⚫ Four step assurance system – suppliers must be at Level 2 to bid for contracts, must reach level 3 within 18 months ⚫
  • 37. Gender issues in global value chains ⚫ Increasingly feminized wage labour ⚫ Discrimination (added to other labour rights risks ) ⚫ low / unskilled work ⚫ precarious work ⚫ low status jobs, limited advancement opportunities ⚫ poorly paid ⚫ long hours, no flexible working ⚫ poor health & safety at work & to work ⚫ childcare, domestic responsibilities not recognised ⚫ subject to sexual harassment, threat & abuse ⚫ limited representation, voice, choice & negotiation power ⚫ Home working (piece rates, rights as workers not recognised, no oversight, isolated, lack of collective organising power) ⚫ Very poor data (lack of sex-disaggregated data & monitoring) Some of the challenges…
  • 38. Gender dimensions to consider ⚫ Agency (trade union; other organization; individual / collective voice & decision-making) ⚫ Aspiration (meeting goals, opportunities for advancement) ⚫ Dignity (treatment, behavior, attitudes) ⚫ Reward (wages, other benefits – including maternity, childcare etc.) ⚫ Safety (including sexual violence & harassment, safety to & from work & at work) ⚫ Security (job & income security, permanent / temporary contracts, formal/informal work)
  • 39. The way forward: Tackling human rights & gender equality in health supply chains 3 Pillars of the UN Guiding Principles for Business and Human Rights UN Guiding Principles on Business & Human Rights
  • 40. ETI human rights due diligence framework Human rights due diligence is the action taken by a company to both identify and act upon actual and potential risks for workers in its operations, supply chains and the services it uses Includes: ⚫Assessment of actual and potential human rights risks ⚫Mitigation of risk and remediation for workers impacted by human rights violations ⚫Identification of corporate leverage and responsibility, decision- making and actions needed ⚫Monitoring, review, reporting and continuous improvement Driving leadership and improvements in corporate operations and global supply chains
  • 41.
  • 42. CRITICAL ELEMENTS ⚫ Recognise complexity – no quick fixes ⚫ Recognise roles and responsibilities ⚫ Diagnose the problems and design appropriate solutions ⚫ Use leverage – government’s own procurement power is huge! ⚫ Build partnerships and foster collaboration ⚫ Carrot and Stick works ⚫ incentivise change but ⚫ hold those responsible to account ⚫ Rights, dignity and agency of workers respected & advanced ⚫ Better information to drive decision-making ⚫ Transparency & public accountability is key ⚫Review, learn, monitor, evaluate, share lessons
  • 43. OPPORTUNITIES ⚫ SDGs provide key opportunity for entry points ⚫ New legislation (UK MSA, EU Directives, French, Dutch law) ⚫ OSCE initiative to drive public procurement, transparency, labour monitoring and enforcement - engage with member states, use guidance ⚫Engage with government departments & local authorities providing health services & supplies. Insist on ethical procurement ⚫ Identify leaders & good practice (e.g. NHS Supply – Labour Monitoring and Assurance System) ⚫ Work with experts, engage with trade unions, civil society organisations, representatives of vulnerable workers
  • 44. THANK YOU! Guidance & more info: www.ethicaltrade.org • Human Rights Due Diligence Framework • ETI Base Code Guidance series • Blogs & briefings • Research reports • Training – through our website
  • 45. The Human Cost of Healthcare Ms. Arthy Hartwell Head of International British Medical Association PRESENTATION #3
  • 46. Many suppliers to the NHS outsource the manufacture of their products to factories around the world
  • 47. The Human Cost of Healthcare
  • 48. “Ethical procurement is about the overall practices of purchasing organisations and the steps they take to ensure that employment conditions and workers’ rights, in the supply chains of the products and services they procure, are maintained in line with internationally recognised conventions and local laws, as a minimum”
  • 49. “The provision of healthcare goods and services is big business” Department of Health NHS EnglandNHS Wales NHS Scotland Commissioning Groups NHS providers NHS Supply Chain ServicesGoods Scottish Health Supplies Welsh Health Supplies Procurement Hubs Healthcare Industry
  • 50. Department of Health NHS EnglandNHS Wales NHS Scotland Commissioning Groups NHS providers NHS Supply Chain Service s Goods Scottish Health Supplie s Welsh Health Supplie s Procuremen t Hubs Healthcare Industry Assured labour standards in contracts for surgical instruments & some textiles 2013 Gloves, procedure packs, disposable curtains, suction consumables2014 Polymer products, theatre clothing, continence products 2015 Wound care, office furniture, podiatry 2016 £18m £110m £142m £80m
  • 51. Labour Standards Assurance System ⚫Pioneering approach to include ethical procurement considerations into the tender for Surgical Instruments (2012) ⚫Covers a range of policies, procedures and practices to; identify labour standards issues, mitigate risks, and drive continuous improvement. ⚫Responsibility is on the supplier to demonstrate they have effective systems in place. Level 4 – Progressive demonstrates leadership level management of labour standards. Level 3 – Established Implementation robust system for managing labour standards in place. A more action-orientated level of compliance. Level 2 – Initiating Implementation Demonstrates progression from level 1 and started to implement processes and procedures to manage labour standards. Level 1 – Foundation Sets the building blocks for labour standards management in practice. Begun to consider how labour standards relate to its business.
  • 52. Ethical procurement for health workbook Provide practical guidance for organisations in the health and social care sector to embed labour standards considerations into procurement and supplier management activities. Promote awareness of labour standards risk in supply chains serving the health and care sector. Demonstrate that ethical trade is compatible with public contracting policy and regulation. Address the misperception that ethical trade is incompatible with public procurement law and/or value for money requirements.
  • 54. Legislative environment UK Modern Slavery Act 2016 EU Non-Financial Reporting Directive 2014/95/EU EU Public Procurement Directive 2014/36/EU UK Public Contract Regulations 2015
  • 55. UK Sweden Norway Germany Italy Netherlands Standardise criteria and methods Synchronised approach to effect market forces Engagement with European Commission
  • 57. Q & A
  • 58. GET IN TOUCH @ www.savinglivesustainably.org Twitter: @UN_SPHS We look forward to working with you on a more sustainable global health sector.

Editor's Notes

  1. Good morning, good afternoon and good evening everyone, and thank you very much for joining the first of the United Nations Informal Interagency task team on Sustainable Procurement in the Health Sector (SPHS) webinar series. Today’s webinar is on “Human Rights and Gender Equality in Health Supply Chains.”
  2. My name is Dr. Rosemary Kumwenda. I am the UNDP HIV Health and Development Regional Team Leader for Eastern Europe and Central Asia and Coordinator of the SPHS. I will moderate the webinar and briefly present the SPHS. I will start with introducing the speakers, and then we will continue with the presentations, after which we will have a Q&A session.
  3. Our first speaker today is Ms. Bharati Sadasivam, Gender Practice Team Leader from UNDP. As Regional Gender Advisor, she supports Country Offices and territories in the Eastern Europe and CIS region in advancing gender equality and women’s empowerment in policies and programmes. Bharati will focus on Gender Equality in the Global Health Supply Chains in her presentation. Our second speaker is Ms. Cindy Berman, Head of Modern Slavery Strategy from Ethical Trading Initiative. In her current role, Cindy leads ETI’s international work on modern slavery, research, engagement with the private sector and provides expert advisory support to international organizations such as the OSCE, and donors such as the UK Department for International Development. Cindy will focus on Human Rights and Gender Equality in Health Supply Chains, Our third speaker today is Ms. Arthy Hartwell, Head of International & Immigration, Professionalism, and Guidance, Policy Directorate from British Medical Association. Arthy Hartwell is an experienced global health policy specialist, who has established expertise in public policy, foreign affairs, international project management and political risk. Arthy will focus on the Human Cost of Healthcare. In case you have any questions during the presentation of our speakers, please feel free to submit them in the chat box. Thank you.
  4. Briefly, before we move to three highly interesting perspectives on Human Rights and Gender Equality in the Health Supply Chains, I would like to present to you UN informal Interagency Task Team on Sustainable Procurement in the Health Sector, which brought to you the SPHS Webinar Series. As a Coordinator of the SPHS Secretariat, I will offer insights into the UN perspective on how we, in collaboration with the Member States, the private sector and technical experts, work on sustainable global health sector, with the final aim of improving human health and well-being.
  5. I would like to begin with a brief introduction of the SPHS initiative, answering the question who we are. The initiative spun off from the momentum created by the UN’s Greening the Blue, a UN-wide campaign embedding sustainability throughout its operations to move towards climate neutrality. There was a rising interest in the UN procurement operations of health commodities and services. Staff of various UN agencies came together, realizing the agencies aims of improving human health and planetary health, could be further supported by lowering the environmental impact of UN procurement. The SPHS was officially established in May 2012 in Copenhagen, Denmark. The initiative has since grown to include 7 UN agencies and 3 multilateral health financing institutions and since 2015, the SPHS is hosted by the UNDP Istanbul Regional Hub. SPHS facilitates and coordinates the introduction of sustainable procurement in the health sector among its members through technical expertise and in addition, it leverages the normative mandate and joint procurement volumes of the SPHS member agencies to influence the global health sector and beyond towards greener health systems and green economies.
  6. In 2015, 23% of total UN procurement was related to the health procurement, which represents one of the most significant sectors for which the UN Agencies are procuring for. In addition, total SPHS UN Agencies health procurement accounted for an astonishing 97% of the total UN health procurement. This means that with the USD 4 billion cumulative purchasing power of SPHS UN Agencies in the global health sector, can be leveraged with the SPHS members’ standard-setting role, to engage actively and, where feasible, with suppliers and manufacturers to introduce and enhance sustainable procurement in public health.
  7. Looking at the 2013-2015 UN health procurement, we can see a steady increase, with a 9.3% growth from 2014 to 2015.
  8. Four key procurement segments that fall into the UN health procurement are shown on this slide and they are: Pharmaceuticals including contraceptives Medical equipment Healthcare services Laboratory and Testing Equipment. Pharmaceuticals represent the highest health-related procurement segment for the SPHS UN Agencies, with 72%. This segment also saw an increase of 13% between 2014 and 2015.
  9. For the SPHS Secretariat, it is important to understand the linkages between our work, the SPHS focus areas and the SDGS. The SPHS initiative represents a great example of financing and implementing the SDG, by gathering the public and private sector connected to sustainable health procurement. The SPHS initiative is linked to many of the SDGs, however I’d like to highlight four of them in particular today, which are Goal 3: Ensure Healthy Lives and Promote Well-Being for all at all ages, Goal 12: Ensure Sustainable Consumption and Production Patterns, Goal 17: Strengthen the Means of Implementation and Revitalize the Global Partnership for Sustainable Development.
  10. Our initiative is more global than ever, and the SPHS Secretariat has strongly focused on strengthening its partnership with various partner organizations from around the world. We currently have more than 4,700 contacts in our global network of collaborators. By identifying top technical experts in various SPHS focus areas, we were able to share nearly 400 collaboration opportunities, which are shown on our platform www.savinglivesustainably.org. And lastly, through our Member Agencies, we are covering 177 countries.
  11. We started with three pillars to our work. Normative, Operational and Financial Of course, our financial pillar focuses on our collective purchasing power Operationally, we engage UN procurement officers, suppliers and manufacturers and other key health actors to introduce and operationalize sustainable procurement practices in the health sector The establishment of evidence-based standards on what constitutes sustainable procurement in the health sector, and activities to address research gaps constitutes some of our normative work.
  12. As mentioned previously, the SPHS online engagement platform represents an important channels for sharing good practices. Novel online platform named savinglivesustainably.org, was generously supported by our donors Skoll Foundation, UN Foundation, Danish Government and UNDP Innovation Facility. The platform serves as a knowledge-hub of on sustainable production and procurement, and it offers you hundreds of examples of cross-cutting innovations, how other public institutions, hospitals, private companies contributed to the SDGs and how this resulted in more sustainable supply chains. Besides the SDGs and focus areas, you can also explore the content based on your geographical location of interest. It is meant to be used as a meeting point for decision-makers, policy-makers, procurement practitioners, academia, suppliers and manufacturers, hospitals and other interested institutions and individuals to share best practices and lessons learnt. We aim to help bridge the gap between the procurement practitioners and health suppliers and manufacturers and become ‘two-way street’ showcasing not only the SPHS examples, but also encouraging all stakeholders interested in sustainable health procurement to share their own success stories.
  13. The SPHS Secretariat conducts due diligence process when it comes to its network, and on this slide I would like to share with you the distribution of our network per organizational types and areas of expertise. Most of our network are suppliers and manufacturers (67%) followed by technical experts (13%) and governmental organizations (10%). When it comes to the areas of expertise, 23% network is specialized in sustainable development, 21% in medical products, 10% in resource efficiency, and the rest you can see on this slide.
  14. It is extremely important for the SPHS Secretariat to communicate about the key achievements of its Member Agencies and its collaborators. We had a good year for communications, and in 2016 we had nearly 14 million media impressions. Our network focus was initially on the SPHS newsletter, which later moved to the SPHS platform. The SPHS platform serves as no. 1 media channel for the SPHS, accounting for 95% of the total network engagement. 2 out of 3 visitors come back to the platform, spending on average 11 minutes. Besides the platform, we have 6 additional communication channels, on which we share our presentations, documents, and other resources and we invite you to visit them.
  15. As we look forward into phase two of our initiative, we continue to set our sights on the broad horizon: We want to develop universally adaptable criteria and standards Foster sustainable procurement in the health sector Foster sustainable manufacturing of health products And finally measure the success and impact of these efforts, to continue to learn from them.
  16. For more information on our work and current projects; you can also follow us on twitter , and receive regular updates on the SPHS initiative by subscribing to our Newsletter. In case you have any questions, please do not hesitate to ask. Thank you.
  17. Working hours: Involuntary overtime may add stress to women in balancing their jobs with their caregiving and home duties. Overtime also raises security issues for women because traveling to and from work very early in the day or late in the evening may put them at risk of abuse and violence outside of the workplace. Freedom of association and collective bargaining: Women may not know their rights, or they may not be recruited by trade union representatives, who often discriminate against non-permanent workers, who are usually women. Trade unions or committees may also fail to include women at meetings. Finally, women may face gender-based retaliation for participating, or may self-censor due to prevailing social norms. Forced labor: Women and girls represent the greatest share of the 21 million people in forced labor globally. Of that number, 14.2 million are victims of forced labor exploitation in economic activities, such as agriculture, construction, domestic work, mining, or manufacturing. Women are often concentrated in informal labor sectors, without legal protections, and are therefore more exposed to forced labor. Horizontal and vertical job segregation, gendered divisions of labour: relevant to health sector, as medical business sector is largely dominated by men.
  18. The Women's Empowerment Principles are a set of Principles for business offering guidance on how to empower women in the workplace, marketplace and community. They are the result of a collaboration between UN Women and the United Nations Global Compact and are adapted from the Calvert Women's Principles®. More details: http://www.weprinciples.org/
  19. Procurement figures: -23% of total UN procurement is health procurement -97% of total UN health procurement is purchased by SPHS UN member agencies -US $ 4.027 billion (4,027,000,000) = total supplies and services procured by the SPHS UN agencies in 2015 -- The following measures should be considered while designing the strategy and guidelines: -          Consider women led businesses or businesses that employ more women for procurement contracts; consider companies that employ 50%  women or have clear gender equality policies in place. -          Target companies that implement preferential gender responsive procurement policy for award of contracts. -          Recruit, train and promote women in public procurement: The public procurement policy should have a provision that emphasises the recruitment of more women in the procurement profession and allocation of budget for career enhancement training to enable women move to leadership and decision making positions in public procurement. Currently, procurement as a profession seems to be a fairly male dominated sector. Please address this issue in all capacity building activities by motivating women to participate. -          Simplify tendering processes: The tendering process should be less complicated to motivate women-owned businesses to participate. If possible, budget should be allocated for training of business women on how to participate in public tenders. -          Include gender-responsive evaluation criteria: Revision of solicitation documents to include gender-responsive evaluation criteria for bidders. In the RFP for instance, offerors should be encouraged to include information on the percentage of women employed in their businesses/companies, percentage of women in leadership positions, and percentage of women-owned businesses that are usually sub-contracted. It should be indicated in the RFP that where there are two identical offers (i.e. exact total points in the case of cumulative evaluation methodology and/or same price in the case of most technically compliant/acceptable offer) the contract will be awarded to the organization with 51% or more women ownership/leadership or employs 51% or more women. -          Encourage signing of voluntary agreement: Develop voluntary gender responsive agreements for successful bidders: The voluntary agreement is to be signed by successful bidders in addition to the contract to pledge their commitment to promote gender equality and women’s empowerment in the execution of the awarded contract. -          Disaggregate procurement data: Encourage and develop capacity to disaggregate procurement data such as number of contracts awarded to men owned and women owned businesses; etc. Given the fact that public procurement spending accounts for approximately 15-30% of the GDP globally, incorporating this element in public procurement policy could ensure that procurement of goods, services and civil works will equitably benefit men and women.  
  20. Our mission is to improve labour standards and working conditions in global supply chains through collaboration with key stakeholders, recognising that companies, trade unions and civil society organisations have a critical role to play. We also engage with governments and the international community, recognising that they need to set the right enabling environment for labour rights to be recognised, protected and implemented.
  21. The Ethical Trading Initiative (ETI) is a leading alliance of companies, trade unions and NGOs that promotes respect for workers' rights around the globe. Our vision is a world where all workers are free from exploitation and discrimination, and enjoy conditions of freedom, security and equity. Around 90companies based around the globe with a combined annual turnover in excess of £180 billion and the Well-known brands such as Tesco, Next, Jaeger, Orsay, Mr. Price, Inditex, Jabong, Primark, Pacific Brands, H&M, C&A and supplier members including Fyffes, BidvestFresh and Union Hand-Roasted. Some of our business members are entire holding companies and some are specific business units such as Stella McCartney. Some of the largest trade unions in the world, including the Trades Union Congress, International Trade Union Confederation and Council of Global Unions representing nearly 160 million workers globally. NGOs operating in 40 countries, including large charities like Save the Children, CARE and Oxfam, as well as more specialized NGOs like Partner Africa, Dalit Solidarity Network and Homeworkers Worldwide.  
  22. Our code of labour standards – the ETI Base Code – was developed by our tripartite members in 2000. It’s based on the relevant conventions of the International Labour Organisation and underpins all our work. ETI’s members are committed to integrating the Base Code and corresponding implementation process into core procurement processes and relationships. They drive continues improvement for their business, their sector and their workers and share successes and lessons learned.
  23. Adopted 2011, international framework, unanimously adopted. Guides global approach to responsible business
  24. Thank you and happy to take any questions.
  25. For more information on our work and current projects; you can also follow us on twitter , and receive regular updates on the SPHS initiative by subscribing to our Newsletter. In case you have any questions, please do not hesitate to ask. Thank you.