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Creating a well-integrated, resilient, and highly transparent supply chain is central to effective and safe patient care. But managing healthcare supply chains is complex; common challenges include the underuse, overuse, and misuse of health resources. This Element introduces the key principles and definitions of healthcare supply chains. Practical insights into the design and operation of healthcare supply chains are provided. Core characteristics of effective supply chain management such as performance management, systems thinking, and supply chain integration are examined along with the application of specific supply chain design and improvement approaches. Finally, the Element proposes areas that require further development both in research and practice. This title is also available as open access on Cambridge Core.
The United Nations International Labour Organization (ILO) has recently incorporated driver pay into its guidelines on the promotion of safe and decent work in road transport. ILO guideline 73 states that ‘the remuneration of … CMV [commercial motor vehicle] drivers should be sustainable and take into consideration the attractiveness and sustainability of the industry’. In the spirit of this, we explore the relationship between truck drivers’ relative income and intrastate motor carrier safety performance. We utilise the United States (US) Bureau of Labor Statistics Occupational Employment and Wage data for heavy and tractor-trailer truck driver median annual incomes and the US Census Bureau’s American Community Survey estimates of median household incomes to construct county level relative income ratios for truck drivers. This information is merged with public safety data to analyse the relationship between truck drivers’ relative pay and motor carrier safety performance. We find that, all else constant, carriers located in counties where driver earnings are relatively high tend to experience fewer crashes. This provides evidence that safety performance is better when driver pay is more attractive in the truck driver labour market and, consequently, validates the ILO’s assertion under guideline 73.
In the evolving landscape of technological discourse, non-fungible tokens (NFTs) have risen as pivotal instruments, notably within gaming and digital art. However, their implications are broader, touching upon real-world applications such as land titles and supply chain management. As the Web 3.0 architecture evolves, the role of NFTs in domain nomenclature and email addresses is increasingly significant. Yet, with the existence of alternate methods for these operations, a pertinent question emerges: Why opt for NFTs or blockchain-based solutions? Despite uncertainties surrounding adoption, many early adopters are zealously securing addresses on these avant-garde networks. This chapter delves into the conditions and reasons for considering this nascent technology.
This study explores how corporate social responsibility and risk management intersect in the fashion industry, aiming to promote sustainability. It emphasizes the importance of integrating responsible practices into business strategies to mitigate risks and enhance long-term profitability. By focusing on a multinational fashion supply chain, the study examines real-world examples to highlight the challenges and opportunities in balancing brand image with ethical supply chain management. The findings provide insights into how companies can safeguard their reputation, manage complex supply chains, and contribute positively to sustainability goals in the fashion sector.
Technical summary
This paper investigates the relationship between corporate social responsibility (CSR) and risk management within the fashion industry. It conducts an in-depth case study of a prominent multinational fashion supply chain, analyzing 11 suppliers through interviews, observations, and internal documents. The study underscores that integrating CSR principles into risk management strategies helps mitigate supply chain risks and capitalize on business opportunities. It addresses gaps in existing literature by presenting empirical evidence of CSR-driven transformations in the sector, rather than merely documenting unsustainable practices. The study contributes by offering practical insights for fashion businesses aiming to achieve long-term success through sustainable practices. Key implications include the necessity for strategic integration of CSR into operational frameworks to protect corporate image, manage risks effectively, and foster sustainable growth in the competitive fashion marketplace.
Social media summary
From risk management to sustainable success: how corporate social responsibility shapes the future of fashion.
Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic’s mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn’t, while identifying key factors affecting production ramp-up in this healthcare crisis.
Method:
In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers. Template analysis was used, and interview content was analyzed for signals, initiatives, actions, and outcomes, as well as influencing forces.
Results:
Key findings revealed many factors limiting ventilator production ramp-up. Supply chain strengths and weaknesses were identified. Political factors played a role in allocating ventilators and also supported production. Commercial considerations were not priority, but economic awareness was essential to support suppliers. Workers were motivated and flexible. Component shortages, space, production processes, and logistics were challenges. Legally based pressures were reported e.g., import and export restrictions.
Conclusion:
Crisis response alone is not enough; preparation is essential. Coordinated international strategies are more effective than individual country responses. Supply chain resilience based on visibility and flexibility is key. This research can help public health planners and the medical device industry prepare for future healthcare crises.
The Rapid Acceleration of Diagnostics (RADx®) program’s success would be significantly diminished without the support of the Deployment Core. For a company to successfully bring to market an in vitro diagnostic (IVD) test, it requires expertise in a variety of areas. This is especially pertinent in a pandemic landscape, as timelines are greatly reduced and market demand is constantly changing. Within the RADx initiative, the Deployment Core was established to identify and provide these necessary resources. The Deployment Core was formed in May 2020 after the IVD companies’ needs became apparent, including the need for consultant expertise and various resources to support development and scale up. This chapter explores the challenges faced by many RADx companies and the lessons learned through the Deployment Core in addressing those needs.
The management of surplus dairy calves in Australia has traditionally been influenced by the economic viability of different practices. When beef prices are favourable, more surplus calves are raised for beef, and when beef prices are low, more calves are killed in the first few days of life. Early life killing of surplus calves may however threaten the dairy industry’s social licence to operate. The aim of this study was to describe the views of value chain stakeholders regarding the management of surplus calves. Representatives from seven post-farm gate organisations participated in semi-structured interviews and were asked about their views on current practices, alternatives to early life killing and how best to implement change. Responses were analysed using inductive thematic analysis and were organised into three themes: (1) ethics of surplus calf management; (2) economics of surplus calf management; and (3) moving towards solutions including approaches to affecting change. We conclude that stakeholders widely recognised early life killing of surplus calves as a threat to the industry’s social licence. Whilst technical solutions such as beef on dairy breeding programmes were cited as important, participants emphasised that implementing sustainable solutions will require collaboration, leadership, and commitment by all stakeholders along the value chain.
Personal protective equipment (PPE) supply chain disruptions force US health-care entities to adopt conservation strategies such as procurement from different respirator manufacturers. This research seeks to better understand how the number of respirator models on hand can serve as an indicator of N95 filtering facepiece respirator (FFR) supply chain stability or disruption.
Methods:
Researchers looked at differences in the mean number of N95 FFR models, averaged weekly, from 10 hospitals in a health-care system over 15 wk from June 1 to September 10, 2020. Participating hospitals entered near-daily PPE inventory data by manufacturer and model number.
Results:
A linear mixed effect model was run in SPSS v. 26 using a random intercept for hospitals, with week as a fixed predictor and mean number of respirator models (averaged weekly) on hand as the dependent variable. Each week showed a small but significant effect compared with the past week (P < 0.001), where the average weekly number of respirator models on hand decreased.
Conclusions:
The limited data may indicate a resolution of supply chain disruptions and warrant further investigation. Consequently, the number of respirator models may be applicable as an indicator of supply chain stability and be more easily ascertained and tracked by health-care entities.
Effective supply chain management is a critical pillar of well-functioning health systems ensuring that medical commodities reach those in need. In Liberia, the national neglected tropical disease (NTD) programme supports health systems strengthening for case management of NTDs. Integration of NTD commodities into the national health system supply chain is central to the integrated approach; however, there is minimal evidence on enablers and barriers. Drawing on qualitative evaluation data, we illustrate that perceived benefits and strengths to integrating NTD commodities into the supply chain include leveraged storage and management capacities capitalized at lower system levels; the political will to integrate based on cost-saving and capacity strengthening potential and positive progress integrating paper-based reporting tools. Challenges remain, specifically the risk of reliance on donor funding; difficulty in accessing commodities due to bureaucratic bottlenecks; lack of inclusion of NTD commodities within electronic data tools and poor coordination leading to an inability to meet demand. Collectively, the negative consequences of ineffective integration of NTD commodities into the supply chain has a detrimental impact on health workers (including community health workers) unable to deliver the quality of care to patients. Trust between affected populations and the health system is compromised when treatments are unavailable.
The climate change and the new regulations imposed to slow down this process have pushed major actors around the world to apply sustainable measures in order to meet governmental obligations. The packaging industry has a major role in fighting climate change and the environmental social and financial disasters. In fact, packaging requires substantial number of natural resources and is often disposed of in ways that harm the environment. Supply chain managers realized that packaging design is the root to solve all the problems packages create throughout their entire life cycle. Therefore, a thorough study about influencing the design process should be prioritized. This paper provides a systematic review of industrial packaging eco-design applied to the supply chain. It aims to conceptualize the definition of industrial packaging eco-design and supply chain sustainability to categorize main parameters to its implementation and to identify the limitations of current research and its prospects.
This article argues for domestic legislative regulation of global value chains to protect offshore workers. First, it outlines the policy reasons necessitating such legislation. Empirical evidence confirms that global value chains are a dominant feature of the global economy. It is contended that lead firms wield influence in global value chains in a manner which leads to poor outcomes for offshore workers. Second, the article sets out the minimum steps necessary for a domestic state to attribute the responsibility for transparency of global value chains to lead firms. Then, it proceeds to explore the possibilities and limits of the proposed scheme of regulation. Despite some complexities with implementing the scheme, it is argued that if domestic legislative regulation of global value chains strengthens even to a small extent the monitoring of global labour issues, it is worth pursuing.
Supply chain security presents numerous challenges to governments interested in defending against terrorist threats. While most approaches stress technological solutions, scholars and policy-makers tend to overlook economics, labour market issues, and industrial relations. Applying agency theory from behavioural economics, this article analyses threats to the US supply chain and opportunities for efficient solutions. Using data from a sophisticated web-based survey of owner-operator cost-of-operations, it shows that drayage drivers are among the lowest paid truck drivers and workers in the US. We provide evidence that low pay is associated with both safety and security risk. Low-wage labour and subcontracting present challenges to US and foreign supply-chain security because the market attracts workers who have few other employment options. In this environment, principals and agents currently make inefficient and inequitable contracts because markets do not reflect the complete costs associated with low-probability/high-impact events like cargo theft and transport security.
Major transformations in the organisation of labour are having a profound effect on the moral character of the labour-capital contract. Using two small case studies undertaken in Singapore as a starting point, this article reflects on the moral economies of supply chain capitalism. Detailing examples of the human impacts of down-sourcing risk through ‘flexible’ modes of transnational employment, it analyses the strategies whereby firms and governments distance themselves from these consequences. Precarious forms of employment based on pyramid subcontracting arrangements allow a disruption of the moral relation (however tenuous) that is present in traditional face-to-face employment arrangements. The article explores four strategies of moral detachment on the part of the employers, contractors and brokers in the supply chain.
Equitable access to health products is a key condition and an indicator for countries’ progress towards Universal Health Coverage (UHC). Access to healthcare, including essential medicines, is a fundamental human right. Realization of this right involves various combinations of public and private financing and service provision arrangements. The pharmaceutical system is an integral subset of the health system which requires mature regulatory structures and robust supply systems to ensure that health goals are achieved and support country efforts to effectively advance UHC. The landscape of pharmaceutical systems is rapidly changing with increasingly complex technologies, often without clear regulatory approaches or mechanisms to achieve equitable access, especially in low and middle-income countries (L&MICs). Medicines are life-enhancing and lifesaving commodities. For a health system to achieve public health goals, medicines should be available in sufficient quantities and be affordable to the population. Health products must also be safe, quality assured, efficacious and used appropriately to achieve desired health outcomes.
Armed conflicts add another dimension to the trade in wildlife and its products that is regrettably well-developed in peacetime. The implementation and compliance mechanisms for preventing and combatting wildlife trafficking, as foreseen in the respective international treaty regimes or developed in practice, are in general not well suited to promote and ensure the protection of animals in conflict-affected countries. Some lessons can be learnt from more recently emerging instruments dealing with conflict minerals. Their focus on the whole supply chain might even potentially result in a more effective prevention and suppression of the illegal trade in wildlife outside the context of war
The COVID-19 pandemic has underscored emerging vulnerabilities in the US research and development (R&D) ecosystem. While an open and collaborative environment has been essential for advancing R&D, this approach exposes university-based R&D to a variety of security threats including state-supported efforts, attacks by malicious actors, and insufficient internal mitigation. As the pandemic led to more remote work and online collaboration, the incidence of exploitation has expanded. Increased security measures are needed to insulate and protect the R&D ecosystem, and US innovation more broadly, while maintaining the fundamental qualities that have contributed to its historical success. In this article, we present the Research Integrity Security Certification (RISC) framework. This concept preserves the autonomy of the US higher education system while also suggesting a mechanism whose effect would be a general enhancement of the security of the US university R&D enterprise with minimal additional state involvement. Much of the work in the proposed model is done by market mechanisms and self-interested microeconomic calculations that generate beneficial aggregate effects. The RISC framework modernizes the university R&D enterprise while strengthening it to operate in this evolving security environment.
As humanitarian organizations become more active in the digital domain and reliant upon new technologies, they evolve from simple bystanders to full-fledged stakeholders in cyberspace, able to build on the advantages of new technologies but also vulnerable to adverse cyber operations that can impact their capacity to protect and assist people affected by armed conflict or other situations of violence. The recent hack of the International Red Cross and Red Crescent Movement's Restoring Family Links network tools, potentially exposing the personal data of half a million vulnerable individuals to unauthorized access by unknown hackers, is a stark reminder that this is not just a theoretical risk but a very real one.1
The 2020 cyber operation affecting SolarWinds, a major US information technology company, demonstrated the chaos that a hack can cause by targeting digital supply chain components. What does the hack mean for the humanitarian cyberspace, and what can we learn from it? In this article, Massimo Marelli, Head of the International Committee of the Red Cross's Data Protection Office, draws out some possible lessons and considers the way forward by drawing on the notion of “digital sovereignty”.
In this chapter we consider supply chains, meaning the sequence of markets in an industry. For example, when the artist Damien Hirst hosted an auction of his own work at Sotheby’s London in 2008, he bypassed his dealers, leapfrogging over a stage of the typical supply chain. Supply chains are also sometimes vertically integrated markets, meaning the same firm owns many stages of these sequential markets. Vertical integration is the process by which a firm enters into the business area of its supplier or its customer, via acquisition, competition, or long-term contract. Vertical market power is often motivated by power or avoidance of different forms of market failure. Here, we are not (as in Chapter 4) talking about failure of the alignment of price and value but failure to transact reliably and without risk or undue cost. We explore related concepts of asset specificity and then business strategy models that take the supply chain as their spine.
As part of the roundtable, “Ethics and the Future of the Global Food System,” this essay examines how the key decisions within the global system of food production are shaped by the organization of the global political economy. The understanding of the global political economy follows standard definitions that focus on the dominant market practices and the institutional structures within which those practices are embedded. I identify examples of market practices and institutional policies that structurally impair the ability of states to secure the human rights of their citizens, and explain specific issues of structural injustice raised by each example. The conclusion provides a survey of a range of alternative solutions for transforming the global political economy and creating the conditions for a more just and ecologically sustainable food system. Ultimately, our conception of human rights and the mechanisms for their protection and enforcement must change in order to address the scale and gravity of problems affecting the future of agriculture and our ability to feed the world.
As a result of increasing vertical specialization in East Asia, interstate relations have a greater potential to influence global supply chains in the region. Despite these growing linkages, the IPE literature has yet to develop a theory for understanding the pathways through which geopolitical disputes generate shifts in supply chains. This chapter proposes a theoretical framework for the effects of nonviolent geopolitical disputes on the topology of supply chains in East Asia. Using case studies of ongoing geopolitical disputes in East Asia, it illustrates how legal actions, security actions, and trade barriers lead to contractionary or diversionary shifts in the topology of supply chains. The case studies also show that only security actions with high degrees of uncertainty are sufficient to trigger shifts in the topology of supply chains. These conclusions are critical for states to understand the implications of even non-economic actions for international trade relations and the makeup of global supply chains. This chapter theoretically advances the literature on supply chains by considering the impact of interstate relations on their makeup and distribution.