Corporate Social Responsibility in the Health Sector – Challenges and Opportunities

1. Corporate Social Responsibility in the Health Sector – Challenges and Opportunities Dr Sameen Siddiqi, WHO Representative, Iran 4th International Congress on CSR Organized by Mahak – 13 Feb, 2017, Tehran

2. Corporate Social Responsibility - CSR • The responsibility of enterprises for their impacts on society • Firms put in place processes to: • Integrate social, environmental, ethical, human rights; • Address consumer concerns into their business operations; • Include close collaboration with stakeholders as a core strategy Source: European Commission, 2015

3. Health Sector Reform or Right? Role of Market, Government, Corporate Sector • Health cannot be left to the market - needs government interventions • asymmetry of information • public good aspects of health care; and • reasons of externalities in health • For many developing countries governments’ have also not been successfulto provide essential health services of acceptable quality and protect population from the financial consequences of illnesses • Corporate sector also has not realized its social responsibility to promote better health and environment in which the population lives, grows and works.

4. There is good reason for optimism for CSR in Health!! • Pharmaceutical firms are experiencing increasing pressure from CSOs to act responsibly, are expanding or reforming their CSRs • UN Global Compact on Corporate Sustainability [2014] aligns objectives and interests of business and global community to develop innovative policies aimed at CSR • Country example - Government of India mandated CSR by requiring for-profit entities to give 2% of their net profits to charitable causes

5. CSR and the Health Sector • CSR in health by different industries and firms needs some caution • Inherent contradiction in asking the tobacco industry or the weapons industry to have a corporate social responsibility for health • “Breastmilk makes the world healthier, smarter, and more equal: these are the conclusions of a new Lancet Series on breastfeeding. The deaths of 823 000 children and 20 000 mothers each year could be averted through universal breastfeeding, …….savings of US$300 billion” [Lancet, 2016] • Industry that hinders universal breast feeding of children will have difficulty justifying a concomitant CSR

6. CSR and the Health Sector [2] • Pharmaceutical, medical devices, health insurance and food industries • offer benefits as well as pose risks to health • Pharmaceutical companies have developed the vast majority of medicines known to humankind, • but they have profited handsomely from doing so

7. Average profit margins of five main industrial sectors, 2013

8. Year 2013

9. Evolving role of Pharmaceuticals in CSR – Over last decade Product Involvement • Donation • Differential pricing sales for resource poor countries • Special licensing agreements for resource-poor countries Other areas • Loan & microfinance programs • mHealth initiatives • Social marketing • Health issue awareness campaigns • Research & Development Health Systems Strengthening • Training health care workers • Improved local manufacturing • Increased product distribution capacity • Infrastructure investment • Supply-chain support • Private or informal provider engagement • Promoting uptake of health insurance

10. Fast Food Industry and Health • Costs associated with the epidemic of obesity pose a severe threat to middle and higher income economies • Fast food industry has a social and ethical responsibility to act • ample evidence exists of its role in contributing to the obesity crisis • What options and actions can be done: • Innovative healthy advertising initiatives • Modification of portion sizes • Promoting greener and healthier options • Nutrition labeling so that consumers can make informed choices • As part of their CSR agenda some fast foods have committed to promoting healthy options from 2016 onwards • The impact has yet to be assessed

11. What motivates these industries for CSR engagement? Three broad reasons can be offered: • Reputational benefits • Perception of consumers, funders and stakeholders in general; • Competitive advantage • Entering new markets or expanding consumer base; and • Philanthropy and health impact • Increased patient access to necessary medicines or services

12. Role of WHO and CSR in Health • WHO has adopted a conservative approach in its engagement with for-profit non-state actors • reasons of conflict of interest as it globally sets norms and standard in health [defines levels of sugar, salt and fat in food] • Hence receiving resources from for-profit institutions that have a health interest is not possible for WHO • In May 2016, after several years of negotiations, WHO’s governing body passed WHO’s Framework of Engagement with the Non-State Actors [FENSA]

13. CSR and Civil Society Organizations • Awareness raising activities • Targeting not only companies but also consumers • Coalition and partnership building • Engaging in multi-stakeholder dialogue, involving businesses and governments and to assist in introducing change • Monitoring organizations • “Watch-dogs” function to monitor compatibility of business practices with human rights standards and adopted codes of conduct/policies • NGOs with certification and assessment expertise • Fill the vacuum in independent CSR assessments, to provide an objective and professional support to companies

14. Some Messages • The jury is still out there to delineate a clear path for the industry in respect of CSR and health; • CSR if done well, is of particular relevance to low and middle income countries where resources are limited; • CSR to succeed in health requires – • good corporate governance, sound legislation, enforcement and monitoring mechanisms, increased transparency and accountability; • CSO have an important catalytic and monitoring role in promoting a balanced approach to CSR in health

15. Thank You