45 – Healthcare Providers and Services, and Healthcare Technology

This table shows a list of topics identified as relevant by different stakeholder groups. They can be considered as stakeholders’ suggestions or requests 

for topics to be monitored or disclosed by organizations. 

Additional information about the project can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics- 

Research/Pages/default.aspx 

45 – Healthcare Providers and Services, and Healthcare Technology 

21 Topics 

Providers of patient health care services. Includes dialysis centers, lab testing services, and pharmacy management services. Also includes 

companies providing business support services to health care providers, such as clerical support services, collection agency services, staffing 

services and outsourced sales & marketing services. Owners and operators of health care facilities, including hospitals, nursing homes, 

rehabilitation centers and animal hospitals. Owners and operators of Health Maintenance Organizations (HMOs) and other managed plans. 

Companies providing information technology services primarily to health care providers. Includes companies providing application, systems 

and/or data processing software, internet-based tools, and IT consulting services to doctors, hospitals or businesses operating primarily in the 

health care sector. Distributors and wholesalers of health care products not included elsewhere. 

Sustainability 

Category 

Environmental 

Topic 

Toxic chemicals 

and materials 

Topic 

Specification 

(if available) 

Hazardous 

chemical and 

toxin use 

Explanation Reference(s) 1 Constituency 

Health care facilities around the world are reducing their 

use of hazardous chemicals and products. For example: 

More than 6,000 health care facilities in the U.S. are 

eliminating mercury-containing medical devices in favor 

of safer non-mercury alternatives 

Hospitals from Stockholm, to Prague, and throughout the 

U.S. are phasing out phthalate-containing PVC medical 

devices and switching to safer plastics 

232, 496 Business 

Sustainability Topics for Sectors: What do stakeholders want to know? 

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY 

May 2013 

Page 1 of 26


Category 

Topic 

Topic 

Specification 



Many hospitals are reducing pesticides by using 

integrated pest management techniques 

Many hospitals are choosing safer, less toxic building 

materials for new construction and renovation projects. 

Green chemistry is the design of products and processes 

that reduce or eliminate the use and generation of 

hazardous substances. Green chemistry seeks to reduce 

and prevent pollution at its source. 

High-priority chemicals and materials include: 

Mercury 

PVC (vinyl plastic) and phthalates 

Brominated flame retardants 

Glutaraldehyde and ethylene oxide 

Pesticides 

Volatile organic compounds in building materials 

Hazardous ingredients in cleaning products. 

Green chemistry is the design of products and processes 

that reduce or eliminate the use and generation of 

hazardous substances. Green chemistry seeks to reduce 

and prevent pollution at its source. 

The ubiquitous exposure to toxic chemicals in everyday 

life has increasingly become a health concern. 

Unfortunately, many products used in health care 

contribute to hazardous exposures — including cleaners 

and disinfectants, phthalates in medical devices, flame 

retardants in furniture, formaldehyde in furniture and 

solvents in labs. 

Emerging scientific research is raising the level of 



May 2013 

Page 2 of 26


Category 

Topic 

Topic 

Specification 



concern about the health impacts of chronic chemical 

exposures. We now know that: Even small doses of 

chemicals can cause disease — interfering with sexual 

development, disrupting hormones and causing cancer at 

very low levels. Children and developing babies are most 

vulnerable. Hundreds of synthetic chemicals are found in 

human breast milk and in the cord blood of babies in the 

womb. Chemicals can act like drugs in our body, 

disrupting systems at low levels of exposure, and 

potentially causing harm in combination. 

Chemical Related Diseases: As chemical use has grown in 

industrialized societies, so have chemical-related 

diseases, including cancer, asthma, birth defects, 

developmental disabilities, autism, endometriosis and 

infertility. Mounting scientific evidence links the 

incidence of these diseases in part to environmental 

toxicants. Health care institutions have a particular 

ethical responsibility to use products containing 

chemicals that pose less risk to human health — and due 

to their massive buying power, the health care system 

can play a key role in shifting the economy toward green 

chemistry. 

A growing number of hospitals are taking a "better safe 

than sorry" approach to chemicals — eliminating 

suspected hazards and switching to safer alternatives. 

Benefits of this approach to the bottom line can include 

reduced disposal costs, reduced liability and improved 

health for employees. 



May 2013 

Page 3 of 26


Category 

Topic 

Topic 

Specification 



Toxins with an especially heavy impact in the health care 

sector may be found in: 

489 Business 

Cleaners and disinfectants 

Dioxin-containing byproducts 

Electronic equipment 

Flame retardants 

Fragrance chemicals 

Mercury-containing medical devices and wastes 

Pesticides 

Phthalates and DEHP 

PVC 

Health care institutions, like institutions outside the 

health care sector, regularly use a surprising number of 

highly toxic materials. These toxins affect patients, 

hospital staff, and hospital visitors. 

Plastics use and 

management 

Many of these toxins are defined and regulated by 

federal, state and local laws. Others are used daily but 

hardly regulated at all. They include carcinogens, 

materials that damage the skin and organs, and materials 

that corrode, irritate, or release other toxins in the 

course of normal use, storage, transportation or disposal. 

Plastic, a valuable material, can generate significant 

positive, or negative, impacts on economy, environment 

and society. Plastic should be treated as a resource and 

managed judiciously. 

A disclosure on management approach for plastics, 

353, 367 Civil Society 

Organization 



May 2013 

Page 4 of 26


Category 

Topic 

Topic 

Specification 



including governance, strategy, risks, opportunities, 

considering: opportunities for product redesign, 

increasing recycled content, implementing reclaim 

and/or reuse which could attract economies, brand 

loyalty, investment, employee goodwill, and; risks to the 

business, stakeholder health, environment and society 

(including reputational/social license to operate, 

regulatory, investor, insurer, and liability risks) for 

plastics that are directly harmful to stakeholders, or 

indirectly through plastics being wasted/littered. 

Performance indicators regarding the types and volumes 

of plastics being used, collected and/or distributed 

downstream; the portion that is made of post-consumerrecycled, 

bio-based, biodegradable, compostable, and/or 

oxobiodegradable material; the ratio of expected lifespan 

of plastic products/packaging in contrast to the 

duration of their intended use; these volumes broken 

down by end of life disposition. 

Most of this disclosure can be captured through the 

existing GRI framework (e.g. GRI G3 EC9, EN1, EN2, 

EN22), but commentary is needed to ensure disclosers 

appreciate the materiality of plastic; other questions can 

be added to the framework. Refer to the Plastic 

Disclosure Project ( www.plasticdisclosure.org ) for more 

details on the suggested questions. PDP will align its 

questions to GRI G4 to assist disclosers. 

Plastic are in high use in these "activity groups", and can 

have significant positive, or negative, impacts on the 

economy, environment and society: Economics: There 



May 2013 

Page 5 of 26


Category 

Topic 

Topic 

Specification 



are significant cost savings available to organisations that 

treat plastic as a resource (e.g. through redesign, use of 

recycled content, reclaiming, etc.) and risks of increased 

direct costs (regulation, liability, cost of capital, 

insurance) to organisations that do not lead in this area 

as well as indirect economic costs to impacted industries 

(e.g. food production, tourism). Environment: Plastics 

that are wasted or littered become extremely harmful to 

the environment, which will have a material effect on 

biodiversity and the global food chain, both nearby and 

far outside the local area of operations. Society: Some 

plastics are harmful to stakeholders during manufacture, 

use and/or disposal (e.g. due to phthalates, BPA), impact 

the wellbeing of society (e.g. effect of litter on 

community spirit and their interest in sustainability). 

While a valuable invention, which benefits society in 

many ways, the negative impacts associated with 

society's growing use of plastic are not fully recognised. 

Roughly 85% of plastic used in products and packaging is 

not recycled, and most plastic produced in the last 60 

years still remains in the environment today. Discarded 

plastics persist in the environment for dozens or 

hundreds of years, accumulating across the globe, often 

out of sight of the producers and users. The direct 

physical impacts of plastic are significant to the 

organisation in increased costs or missed opportunities, 

and related economies (e.g. over $1.2bn in annual 

damages to ocean-related industries in Asia-Pacific), the 

environment through harming habitats and species, and 



May 2013 

Page 6 of 26


Category 

Topic 

Healthcare 

waste 

management 

Topic 

Specification 


Healthcare, 

medical 

research 

facilities and 

laboratories 


to stakeholders health when exposed to the chemical 

ingredients; and are magnified if fragmentation of the 

plastic occurs, making it available for ingestion to 

additional species, who adsorb the chemical ingredients 

and/or the toxins carried on the plastic. These negative 

impacts could be avoided and turned into positive 

impacts, if plastic was treated as a resource to be 

managed judiciously (e.g. the US economy lost $8.3bn 

worth of plastic packaging in 2010) - "It is not good 

business practice to throw away valuable resources". 

Medical waste is all waste materials generated at health 

care facilities, such as hospitals, clinics, physician's 

offices, dental practices, blood banks, and veterinary 

hospitals/clinics, as well as medical research facilities and 

laboratories. 


The Medical Waste tracking Act of 1988 defines medical 

waste as "any solid waste that is generated in the 

diagnosis, treatment, or immunization of human beings 

or animals, in research pertaining thereto, or in the 

production or testing of biologicals." This definition 

includes, but is not limited to: 

blood-soaked bandages 

culture dishes and other glassware 

discarded surgical gloves 

discarded surgical instruments 

discarded needles used to give shots or draw blood 

(e.g., medical sharps) 

cultures, stocks, swabs used to inoculate cultures 



May 2013 

Page 7 of 26


Category 

Topic 

Topic 

Specification 



removed body organs (e.g., tonsils, appendices, limbs) 

discarded lancets 

Hospitals generate millions of tons of waste each year. In 

the past, many hospitals simply dumped all waste 

streams together, from reception-area trash to 

operating-room waste, and burned them in incinerators 

— and this is still common practice in many developing 

countries. 

Infectious waste 

Yet medical waste incineration is a leading source of 

dioxin, mercury, lead and other dangerous pollutants 

that threaten human health and the environment. 

Despite these dangers, many governments, public health 

agencies, international organizations and transnational 

corporations continue to promote incineration 

technologies as waste management "solutions." 

Infectious waste is waste that is suspected to contain 

pathogens (disease-causing bacteria, viruses, parasites, 

or fungi) in sufficient concentration or quantity to cause 

disease in susceptible hosts. The subcategories of 

infectious waste are (a) waste contaminated with blood 

or other body fluids; (b) microbiological cultures and 

stocks of infectious agents from laboratory work; and (c) 

waste from infected patients in isolation wards. Waste 

contaminated with blood or other body fluids include: 

free-flowing blood, blood components, and other body 

fluids (semen, vaginal secretions, cerebrospinal fluid, 

synovial fluid, pleural fluid, pericardial fluid, peritoneal 

527 Civil Society 

Organization 



May 2013 

Page 8 of 26


Category 

Topic 

Topic 

Specification 



fluid, amniotic fluid, saliva and other body fluids visibly 

contaminated with blood); dressings, bandages, swabs, 

gloves, masks, gowns, drapes, and other material 

contaminated with blood or other body fluids; and waste 

that has been in contact with the blood of patients 

undergoing hemodialysis (e.g. dialysis equipment such as 

tubing and filters, disposable towels, gowns, aprons, 

gloves, and laboratory coats). 

With regards to infectious healthcare waste, there are 

four approaches to healthcare waste treatment. A 

decentralized approach is one where the technology is 

installed on-site at the healthcare facility. By treating the 

waste as close as possible to the point of generation, this 

approach has the advantage of eliminating the transport 

of hazardous healthcare waste. 

Another approach is centralized treatment at an off-site 

facility designed to handle the waste from hospitals, 

clinics, medical laboratories, doctors‘ offices, and other 

health facilities in a large urban center, province, or 

region. This approach requires the transport of infectious 

waste from many sources to the central treatment 

facility and is only possible if there is a good 

infrastructure for collection, transport and temporary 

storage. Its major benefit is cost reduction as it takes 

advantage of the economies of scale. 

A third approach is cluster treatment wherein a hospital 

serves as a hub for treating waste from surrounding 

nearby hospitals, clinics, and other facilities. Cluster 

treatment is an option for small municipalities, parts of a 



May 2013 

Page 9 of 26


Category 

Topic 

Topic 

Specification 



province, or districts that may be too far from a central 

treatment facility but have an adequate infrastructure 

for collection and transport of infectious waste within 

their area. 

A fourth approach is mobile treatment. In this approach, 

the treatment technology is mounted on a mobile 

platform, such as a specially designed mobile container 

or a flatbed truck, and is brought to hospitals and other 

health facilities within a service territory. The mobile 

treatment system treats and converts infectious waste 

into regular waste as the mobile unit is parked on the 

hospital grounds. After treatment, the system is driven 

to the next healthcare facility. 

Pharmaceutical 

products and 

items for 

handling them 

Improper treatment and disposal of healthcare waste 

pose serious hazards of disease transmission due to 

exposures to infectious agents among waste pickers, 

waste workers, health workers, patients, and the 

community in general. 

For a healthcare facility, several practical options exist 

for small quantities of pharmaceutical waste: return of 

expired pharmaceuticals to the donor or manufacturer; 

encapsulation and burial in a sanitary landfill; chemical 

decomposition in accordance with the manufacturer‘s 

recommendations if chemical expertise and materials are 

available; and dilution in large amounts of water and 

sewer discharge into a sewer for moderate quantities of 

relatively mild liquid or semi-liquid pharmaceuticals, such 

as solutions containing vitamins, cough syrups, 

intravenous solutions and eye drops. 

527 Civil Society 

Organization 



May 2013 

Page 10 of 26


Category 

Topic 

Topic 

Specification 



Pharmaceutical waste includes expired, unused, spilled, 

and contaminated pharmaceutical products, drugs, 

vaccines, and sera that are no longer needed. The 

classification also includes discarded items used in the 

handling of pharmaceuticals, such as bottles, boxes, 

gloves, masks, vials, and tubing contaminated with 

pharmaceutical residues. 

Improper treatment and disposal of pharmaceutical 

healthcare waste pose risks, because for example waste 

scavengers might collect the expired, unused, spilled, 

and contaminated pharmaceutical products, drugs, 

vaccines, and sera that are no longer needed, and take or 

sell them. 

The huge quantities of medicines ending up in waste or 

in aquatic systems are a major environmental health 

issue. The increasing documentation of low-dose health 

effects makes pharmaceuticals a priority area from an 

environmental health perspective. Hundreds of different 

active pharmaceutical compounds are being discovered 

in waterways all over the world. Concern is increasing 

about the harm these might be doing to human health 

and the environment. 


Although levels are usually too low to result in acute 

effects such as organ damage, there are two cases where 

drugs have had drastic effects: where the antiinflammatory 

diclofenac has virtually wiped out the 

vulture population of Asia, while man-made estradiol has 



May 2013 

Page 11 of 26


Category 

Topic 

Topic 

Specification 



caused fish to start changing sex. 

Although the levels of other drugs don't cause acute 

reactions, there is little or no information about the nonacute 

effects which low doses might have on wildlife and 

humans. 

There are suggestions in research that contaminated 

water affects fish in subtle ways, such as changing 

breeding behaviour. This may cause declines in 

populations, or even be an indicator of other problems. 

Ordinary risk assessment is of limited value in 

determining the environmental hazard posed by low 

levels of pharmaceutical compounds, as it only looks at 

acute effects, struggles to assess the potential effects of 

mixtures of compounds, and has no way to anticipate 

freak reactions. 

What we do know is that pharmaceutical compounds are 

biologically active and they are detectable in our 

waterways. We can be sure that it would be better if 

they were not there. Therefore, we need to take steps to 

deal with the problem. 

While patients should be allowed access to the best 

available pharmaceutical treatment, other things being 

equal, we should consider the medicine's PBT 

(persistence, bioaccumulation and toxicity) when 

developing, manufacturing, prescribing, purchasing, 



May 2013 

Page 12 of 26


Category 

Topic 

Topic 

Specification 


Technology for 

waste 

sterilization 

and/or 

destruction 


donating and disposing of medicines. Our collective aim 

should be to protect people and the environment from 

contamination of hazardous chemicals that wouldn't 

otherwise be there. 

A wide range of alternative technologies are now 

commercially available. Steam sterilization in autoclaves 

is the most common alternative treatment method. 

Since autoclaves have been used in the treatment of 

infectious waste for many decades, their operation is 

well established. Several types of steam sterilizers or 

autoclaves are available: gravity-fed, pre-vacuum and 

pulse or multivacuum cycle autoclaves. Unlike 

incinerators, autoclaves heat the waste to temperatures 

high enough to disinfect but not hot enough to burn and 

create air pollutants such as dioxins and furans. A posttreatment 

shredder or grinder could be used if the waste 

is to be rendered unrecognizable and if reduction of 

waste volume is desired. Microwave treatment is 

another type of alternative technology. For years, the 

most common microwave device has been a medium- to 

large-scale, semi-continuous system using an internal 

shredder, rotating internal screw, and industrial 

magnetrons to generate microwave energy. There are 

also commercial dry heat treatment technologies. Moist 

heat has been shown to be more effective than dry heat 

in achieving disinfection, so dry heat systems generally 

require longer exposure times and higher temperatures 

to meet minimum disinfection levels. 


Medical waste incineration is a leading source of dioxin 



May 2013 

Page 13 of 26


Category 

Topic 

Topic 

Specification 



pollution, one of the most potent carcinogens known to 

science. Fortunately, there are viable alternatives to 

incineration that are safer, cleaner, do not produce 

dioxin, and are just as effective at disinfecting medical 

waste. These technologies can be used on all types of 

medical waste, including pathological and chemotherapy 

waste. 

Given that alternatives to incineration are available, a 

complete phase-out of medical waste incineration is 

possible and appropriate. This will require changes in 

state laws, persuasion of hospital systems that non-burn 

approaches are both effective and environmentally 

preferable, public education, and better segregation and 

reduction of waste by hospitals. Pathological and 

chemotherapeutic wastes can be treated using alkaline 

hydrolysis technology which combines steam sterilization 

with tissue digestion using sodium or potassium 

hydroxide. 

Investment and commitment in the management of 

health care waste (a by-product of healthcare that 

includes sharps, non-sharps, blood, body parts, 

chemicals, pharmaceuticals, medical devices and 

radioactive materials). 

445 Mediating 

Institution 

Poor management of health care waste potentially 

exposes health care workers, waste handlers, patients 

and the community at large to infection, toxic effects and 

injuries, and risks polluting the environment. 

Healthcare waste is a by-product of healthcare that 

includes sharps, non-sharps, blood, body parts, 

593 Mediating 

Institution 



May 2013 

Page 14 of 26


Category 

Topic 

Topic 

Specification 



chemicals, pharmaceuticals, medical devices and 

radioactive materials 

Social Migrant workers Recruitment 

and 

employment 

Poor management of healthcare waste exposes 

healthcare workers, waste handlers and the community 

to infections, toxic effects and injuries 

Recruitment and employment of migrant workers 

Number of migrant workers employed 

Countries of origin 

Gender of workers 

Positions within company 

Length of contracts 

Recruitment channels 

Any fees for recruitment 

Passport retention 

Migrant workers both internal and external are a 

significant and growing feature of all company activities. 

There are over 200 million migrants in the world. They 

are found within nearly all business sectors and across all 

regions. Many migrant workers, particularly those 

working in unskilled jobs are subject to discrimination 

and are vulnerable to exploitation and abuse. 

For many migrants exploitation begins during 

recruitment. Exorbitant fees and other charges, often at 

usurious rates of interest can leave many migrant 

workers effectively bonded labour whatever the 

subsequent conditions of employment. 

253 Mediating 

Institution 



May 2013 

Page 15 of 26


Category 

Topic 

Privacy of 

medical records 

and genetic data 

Topic 

Specification 



Company due diligence and reporting should therefore 

extend into the supply chain for labour. 

The storage and uses made of health records and the 

results of genetic tests raise questions in relation to the 

right to privacy. 

66 Mediating 

Institution 

Access to quality 

medical 

treatments 

Care quality 

Racial and 

ethnic 

disparities 

Staff training, 

staffing ratios 

per patient and 

turnover rates 

This case raises questions about the right to privacy of 

the people from whom the samples were taken. There 

has, for example, been concern that samples of this kind 

could be used in paternity suits or to assess health 

insurance risks. AT the other hand, Retention of the 

samples has significant potential public health benefits, 

such as retrospective diagnosis from the stored blood 

spot, even after the individual is deceased, to help 

provide counselling to the family. Approved research can 

provide information that is of public health interest or 

information that can provide a better understanding on 

how diseases develop, identifying potential opportunities 

for intervention. 

Measures taken to eliminate racial and ethnic disparities 

in providing treatments. 

Minorities can be treated in a disadvantageous way in 

health care as in all other areas in life 

Adequate and properly trained staff are critical to 

healthcare, oil and gas and financial services. 

Healthcare providers, including hospitals, nursing homes 

and home health care need to report on staffing ratios 

per patient and their turn-over rates. This information 

494 Business 

245, 362 Labor 



May 2013 

Page 16 of 26


Category 

Topic 

Topic 

Specification 



directly indicates the quality of care provided. 

with the Volker rule (US Dodd-Frank) are critical to 

solvency. 

Clinical trials 

Disease spread 

control 

Food quality 

Consent 

processes 

Health care 

facilities 

Catering 

services 

Extensive academic research and judicial decisions as 

well as federal and state legislation make these material 

indicators for sustainability. See, for example, "Hospital 

Nurse Staffing and Patient Mortality, Nurse Burnout, and 

Job Dissatisfaction," JAMA. 2002; 288(16):1987-1993. 

doi:10.1001/jama.288.16.1987; 

Article 7 states that “no one shall be subjected without 

his free consent to medical and scientific 

experimentation”. Several companies and research 

bodies have faced media and legal scrutiny over consent 

processes used in clinical trials, irrespective of their 

medical success or failure 

Acute respiratory diseases during health care may 

constitute a public health emergency of international 

concern as defined in the International Health 

Regulations 

Healthcare providers should take into account the 

following topics when designing the menu for their 

patients: 

* Antibiotics 

*Chemicals in the food system 

Genetically engineered foods 

*greening serviceware 

*hospital food environments 

*climate change (by buying local products for example) 

66 Mediating 

Institution 


Organization 

357 Business 



May 2013 

Page 17 of 26


Category 

Topic 

Health service 

effectiveness 

Topic 

Specification 


Cost 

effectiveness of 

key health 

interventions 


Health care facilities across the continent are 

recognizing that the food system — how our food is 

produced and distributed — is misaligned with dietary 

guidelines, and is largely reliant on methods of 

production and distribution that harm public and 

environmental health. 

The food system is inherently a deeply complex and 

interwoven concept that must be considered from an 

integrative, ecological perspective in order to develop 

solutions that nourish our health and that of the planet. 

Healthy Food in Health Care has selected a broadreaching 

scope of topics of concern that form the basis 

for our work. These issues, like antibiotic resistance, for 

example, cut to the core of a hospital’s operations. 

Others, like climate change and genetically engineered 

foods, are matters of serious public health concern that 

we believe the health care community has a capacity and 

power to influence. 

Some systems devote resources to expensive 

interventions with small effects on population health, 

while at the same time low cost interventions with 

potentially greater benefits are not fully implemented. 

The impact of interventions on population health is vital. 

But it is also important to determine the role of different 

interventions in contributing to other socially desirable 

goals, such as reducing health inequalities, and being 

responsive to the legitimate expectations of the 

population 

584 Mediating 

Institution 

The impact of interventions on population health is vital. 



May 2013 

Page 18 of 26


Category 

Topic 

Medicines 

management 

Topic 

Specification 


Patient safety 

and 

environmental 

impacts 


But it is also important to determine the role of different 

interventions in contributing to other socially desirable 

goals, such as reducing health inequalities, and being 

responsive to the legitimate expectations of the 

population 

Rational use of medicines requires that "patients receive 

medications appropriate to their clinical needs, in doses 

that meet their own individual requirements, for an 

adequate period of time, and at the lowest cost to them 

and their community 

590 Mediating 

Institution 

Corruption 

Access to and 

quality of 

treatments 

Irrational use of medicines is a major problem 

worldwide. WHO estimates that more than half of all 

medicines are prescribed, dispensed or sold 

inappropriately, and that half of all patients fail to take 

them correctly. The overuse, underuse or misuse of 

medicines results in wastage of scarce resources and 

widespread health hazards 

Measures taken to avoid corruption in the following 

processes: provision of services by medical personnel, 

human resources management, drug selection and use, 

procurement of drugs and medical equipment, 

distribution and storage of drugs, regulatory systems, 

and budgeting and pricing 


Because of the complexity of health care systems and 

services, and the significant amount of money involved, 

the risk of corruption is high, that can result in the 

inequality of access to and quality of treatments. 



May 2013 

Page 19 of 26


Category 

Other 

Topic 

Corporate 

governance 

Topic 

Specification 


Healthcare 

systems and 

services 

Gender 

participation on 

governance 

bodies 


Corruption in hospitals, informal payments for health 

care, in pharmaceutical sector and HIV/AIDS 

Fighting corruption in the health sector is a complex 

challenge. At one end of the scale are doctors and nurses 

who charge small informal payments to patients to 

supplement inadequate incomes. At the other end, and 

far more pernicious, are the corrupt suppliers who offer 

bribes, and the health ministers and hospital 

administrators who accept bribes, or siphon millions of 

dollars from health budgets, skewing health policy and 

depleting funds that should be spent building hospitals, 

buying medicines or employing staff. 

GOVERNANCE / EUROPE: boardroom lady boom: is it 

possible without quotas? 

On 22 June, the CapitalCom agency published its 2011 

survey into the boardroom gender mix of CAC 40 

companies, with fairly encouraging results: the 

proportion of women on the board has doubled in recent 

years, from 10.5% in 2009 to 20.8% in 2011. 


Organization 

389 Financial 

Markets & 

Information 

Users 

In January, the French parliament adopted legislation 

imposing quotas for the proportion of women on the 

board of major companies. Under the measures, the 

development of female board membership is mandatory 

and gradual: 20% for listed groups, public companies of 

an administrative, industrial and commercial nature by 

January 2014, rising to 40% by January 2017. The law 

also stipulates that companies with no women present 

on their board must appoint at least one within six 



May 2013 

Page 20 of 26


Category 

Topic 

Topic 

Specification 



months of it being on the statute books (voted on 13 

January 2011). In France, some 2,000 companies are 

affected (the 650 largest listed firms and companies with 

more than 500 employees and those generating sales in 

excess of €50bn). In terms of sanctions for 

noncompliance, appointments that run counter to the 

parity principles are to be declared null and void and 

attendance fees are to be temporarily suspended. 

At the European level and at the instigation of the Vicepresident 

of the European Commission, Viviane Reding, 

the European parliament will decide in March 2012 on 

whether to adopt common legislation on this matter (a 

mandatory proportion of women in decision-making 

positions of 30% in 2015 and 40% in 2020). This will 

depend on the level of improvement seen based on the 

selfregulation of European companies, in accordance 

with the equality initiative adopted by the European 

Commission in December 2010 and the European 

parliament resolution of 17 January 2008 calling for the 

Commission and member states to promote a balance 

between women and men on company boards, 

particularly where member states are shareholders. 

Europe as a whole illustrates the degree of hesitation 

between a soft-law approach and conventional 

legislation (quotas in this instance), but it is clear from 

the experience at national level that the second method 

tends to get much better results. 



May 2013 

Page 21 of 26


Category 

Topic 

Political 

accountability 

Topic 

Specification 



There are various measures of political accountability 

that can be measured (contributions, disclosure, board 

oversight). 

Note that this topic is applicable to more than the three 

industries noted. Essentially the political accountability 

practices of any company that is owned by public 

stockholders. Political contributions, the amount of 

disclosure and board oversight are among the data items 

that would be helpful in a sustainability report. 

394, 616 Financial 

Markets & 

Information 

Users 

In making investment decisions (especially for investors 

interested in socially responsible investing) is would be 

helpful to understand how a given company is exposed 

to political risk (i.e. are they backing the winning 

candidate, are they subject to potential retribution, why 

do they find it necessary to make political contributions, 

etc.). 

I have found the information I reference to be helpful in 

constructing investment portfolios that take into account 

this attribute of sustainability. Since it is not currently an 

established parameter in the socially responsible 

investment industry (www.ussif.org), adoption by the 

Global Reporting Initiative would go a long way in 

moving the topic of political accountability forward. 



May 2013 

Page 22 of 26


Category 

Topic 

Public health 

service 

effectiveness 

Topic 

Specification 


Laboratory 

readiness - 

Outbreaks of 

novel, emerging 

and dangerous 

pathogens 


Laboratories readiness and response for rapid detection 

and containment of outbreaks of emerging and 

dangerous pathogens 

Outbreaks of emerging and dangerous pathogens are a 

great risk for public health 

591 Mediating 

Institution 

1 

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