One of the world's biggest buyers of medicine is also the one who can make the biggest difference. Every year the UN Children's organization, Unicef purchases medicines for billions of dollars in order to make a difference for poor children worldwide.
The majority of the medicines are purchased in India and then flown to the UNICEF warehouses in Copenhagen or directly to the countries that need them most. The medicines are treating malaria, HIV / AIDS and hepatitis, and they must be as cheap as possible, in order for Unicef to help as many people as possible.
In the end, the UN organization buys in for taxpayers' money, and as much medicine as possible must be secured for the money. In 2020, Unicef purchased drugs and medical devices worth $ 3.4 billion in India.
And this is where the dilemma arises. Because the production of large amounts of life saving drugs is destroying life in the locations where it is produced.
A Danwatch investigation documents how UNICEF is distributing drugs manufactured by Indian pharmaceuticals convicted of breaking the Environmental law in India. The pollution has destroyed the environment and human lives in the Indian town of Hyderabad, killing the fish and making agriculture difficult.
Read the story: Vores medicin og de døde søer
Eight pharmaceuticals were fined in February 2022 for violation of India's Environmental Law. The companies paid compensation to Indian farmers ranging from 21.000-43.000 dollars. Three of them are Aurobindo, Mylan og Hetero Lab who are delivering drugs to UNICEF.
“We are in dialogue with the companies” UNICEF responds, not saying much more than that.
We have asked UNICEF for a comment on the fact that three of their suppliers have been convicted of breaking the law. But the UN organization does not give interviews on the matter, says head of communications Stephanie Brickman in an email to Danwatch.
In the mail she states that UNICEF has been in touch with Aurobindo, Mylan og Hetero Labs in relation to “standards by Indian authorities and the UN” and has asked the suppliers to confirm their “future commitment to uphold these standards”.
Stephanie Brickman adds that UNICEF is choosing suppliers carefully “in order to secure children's welfare” referring further questions on procurement guidelines found on the home page of the Word Health Organization, WHO.
- How much medicine does UNICEF buy from India?
According to our Annual Report https://www.unicef.org/supply/media/8246/file/Supply-Annual-Report-2020.pdf
UNICEF procurement in USD aggregating local, country to country and international procurement came to a value of 503,089,554 for 2020 (the latest available information).
- Which companies in India does UNICEF buy from?
The latest list is from 2020 and is available in our Annual Report https://www.unicef.org/supply/media/8246/file/Supply-Annual-Report-2020.pdf
See page 46 of the PDF, page 88 in the printed version.
- How does UNICEF ensure due diligence ensuring that the procurement does not have an adverse effect on human rights or the environment?
UNICEF carefully selects its suppliers with the best interests of children in mind. We evaluate and register all suppliers we do business with and require them to support our core ethical values in order to protect accountability, integrity, fairness and transparency across our supply chains.
UNICEF is not a regulatory body and relies on other UN agencies to engage with regulators to set or improve standards. We then procure goods in line with these standards.
UNICEF observes the standards of the World Health Organization’s Good Manufacturing Practices and request that all suppliers adhere to the UN Supplier Code of Conduct, which includes labour, human rights, environmental and ethical provisions. We only work with companies that are lawfully established as well as licensed and authorized by competent regulatory bodies within the countries where they operate. In case of suspension of such a license, procurement would cease.
Please also refer to the following UNICEF web pages: https://www.unicef.org/supply/about/ethics#:~:text=UNICEF%20suppliers%20shall%20operate%20in,engage%20only%20in%20fair%20trade
- How much and from whom does UNICEF buy medicines in India?
Please refer again to the latest information as listed in our Annual Report https://www.unicef.org/supply/media/8246/file/Supply-Annual-Report-2020.pdf
(Page 46 of the PDF, page 88 in the printed version.)
- Does the figure of $ 503,089,554 only cover medicines from India or is it divided into several product categories?
This figure covers various categories of product including medicines, vaccines and other supplies.
- If so, how much does UNICEF spend on medicines and medical devices in India?
We don’t report on product groups by country, however some detailed information is available in the Annual Report https://www.unicef.org/supply/media/8246/file/Supply-Annual-Report-2020.pdf
- As you probably know, Aurobindo, Mylan and Hetero were fined in February this year for violating environmental laws by not handling their wastewater properly. I would like to ask for a comment on that decision? (attached)
We have sought clarification from the companies in question with regards to their observance of standards set by national authorities and the UN, as well as their assurances that they have clear goals toward meeting these standards in the future. Discussions are ongoing.
- What do you do to ensure that your suppliers do not emit excessive amounts of drug residues into the environment? Drug residues in sewage have been a problem in Hyderabad since 2008. It is understandable that UNICEF should make the best price agreements to ensure as much medicine for the money as possible, but I would like to talk to you about this dilemma?
Please see the answer to questions 3 and 7.
- An expert in corporate responsibility points out that you as a customer have a responsibility to influence your supplier to stop the pollution in hh. UNGP and OECD Guidelines for Multinational Enterprises. I'd like to hear your comments on that?
UNICEF carefully selects its suppliers with the best interests of children in mind. We evaluate and register all suppliers we do business with and require our suppliers to support our core ethical values in order to protect accountability, integrity, fairness and transparency across our supply chains. As mentioned above we have reached out to the companies in question. Discussions are ongoing.
Part of the solution
The case for Unicef is complicated, says Karin Buhmann. She is a law professor from Center for Law, Sustainability and Justice at University of Southern, Denmark.
It is complicated for several reasons. UNICEF is an international organization, which is not covered by the part of international law that regulates relations between states. Furthermore, the organization is a public procurer obliged to get the most value for money.
On a larger scale, India is a large and important member of the UN and the pharmaceutical industry a significant contributor to the Indian economy just as UNICEF is dependent on access to cheap Indian drugs.
Apart from that, UNICEF is helping one of the world's most important target groups - the poorest and most disadvantaged children in developing countries and conflict areas.
Having said that, the UN Guiding Principles on Business and Human Rights (UNGP) applies to all companies around the world regardless of form and location, Karins Buhmann explains.
And when the UN Children's body is buying supplies, it is an important player, who can make a significant impact on Indian pharmaceuticals polluting the environment by discharging drug residues with their wastewater.
“Now that they are aware of the pollution problem of their Indian suppliers, they should be part of the solution as well” says the professor.
The first step that UNICEF should take is to investigate the scope of the problem and enter into a dialogue with their suppliers to figure out how the problem can be solved.
“As an UN organization, UNICEF has expert knowledge about local conditions that should be put to use in order to prevent the production from harming the environment and the surrounding society. After all, it is not just the environment that is damaged here, the pollution affects agriculture, health and welfare of the Indian population,” Karin Buhmann adds.
Drugs should heal, not harm
The dialogue with suppliers will not be concluded next week or month, she says. It could take years, because the process of cleaning waste waters involves not just the suppliers but also Indian authorities.
“But if the pollution is so serious that the price for the exposed population is too high, then UNICEF should consider buying their drugs elsewhere. They can make this decision and still continue the dialogue with the companies and local authorities”, Karin Buhmman says:
“The production of drugs, which are meant to heal, should not harm the health of others”.
The professor highlights another dilemma, should Unicef consider finding new suppliers.
“Being such a large customer you have a large amount of influence. You can create change but if you withdraw from the contracts it will affect a lot of Indians, who might lose their jobs, leaving them without means to support their families. And there is no European welfare system to catch them. That's another dilemma that UNICEF has to deal with”.
No easy solutions
Aurobindo, Mylan and Hetero say that they clean their wastewater, however the technology involved is controversial, says Martijn van Gerven, project manager in the Dutch-based ngo, Access to Medicine Foundation.
“There are no easy solutions and there is disagreement about whether the companies or the authorities are responsible for wastewater treatment”, he says.
Access to Medicine Foundation monitors discharge of wastewater pollution caused by pharmaceuticals. Among other things, they focus on antibiotic resistance, called AMR, which is the consequence of antibiotics discharged into lakes and rivers. A problem, which will pose the biggest threat to world health in 2050, according to the World Health Organization.
Read the story: The future killer
During the last six years, a team from Access to Medicine Foundation has interviewed more than 17 pharmaceuticals and their 800 subcontractors about the level of drug residue in their wastewater.
And the situation is improving, Martijn van Gerven explains. But the starting point was also very bad.
“The problem is that even if the companies claim to be complying with the wastewater regulation they have a lot of subcontractors that do not”.
Secondly, the levels of drug residues provided by the pharmaceutical companies in India, are not based on actual samples of their own wastewater, he explains. The companies own figures are based on a calculation of the amount of wastewater they discharge, when it is mixed with water in the lake or river it is discharged into.
If the Indian companies actually measured their level of drug residue in their own wastewater, it would be unfiltered and therefore far higher, Martijn van Gerven says.
To make this change, the companies should begin to commit themselves to complying with the wastewater regulation - and then making sure that their suppliers adhere to the same standards.
“Right now the industry itself is setting the targets on a voluntary basis and checking whether regulations are complied with or not. Authorities (in India ed.) have to develop legislation on the level of antibiotics that companies are allowed to discharge into the environment”, Martjin van Gerven says.