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Drug shortages disrupt healthcare delivery and pose a critical challenge to the resilience of pharmaceutical supply chains. This study investigates the drivers of drug shortages in Italy – Europe’s leading pharmaceutical producer – to identify the factors associated with supply disruptions and inform evidence-based health policy. Using national data from 2018 to 2023, we analysed 17,619 drugs across 3,013 groups of substitutes, covering community, dual-dispensed, and hospital distribution channels. Generalised linear mixed models were employed to assess how drug characteristics, market dynamics, and regulatory features influence shortage risk. Shortages were most prevalent among community drugs, where high market fragmentation and low-profit margins contributed to supply instability. Patent protection was associated with lower shortage risk for non-sterile drugs, while sterile drugs remained vulnerable regardless of patent status, likely due to manufacturing complexity. Notably, price effects were age-dependent: higher prices mitigated shortage risk, particularly for older drugs. This study offers a comprehensive evaluation of shortage patterns in a key pharmaceutical market, identifying structural risk factors and market vulnerabilities. The findings provide actionable insights for policymakers aiming to design targeted interventions, strengthen supply chain resilience, and ensure continuous access to essential medicines.
Chapter 5 analyses how to design more trustworthy and safer Clever Biometric Computing systems, that is, sensor technologies that read and computationally interpret the human body using AI. The complex socio-technical histories around facial recognition technologies (FRT) and emotion recognition (ERT) are presented, as key examples of Clever Biometric Computing. Discussion focuses on why they are ethically, legally, and socio-technically problematic. The chapter then explores the EU policy landscape around trustworthy AI and the EU Artificial Intelligence Act (AIA). The AIA formal legal requirements for design of AI systems are comprehensively analysed, particularly the turn to design for regulating high-risk AI systems (HRAIS). Some requirements that are analysed include human oversight, fundamental rights impact assessments, data governance, record keeping, and transparency. Different examples are presented too, such as ERT for safety in cars, industrial workplaces, and law enforcement use of live FRT. Ways to overcome challenges of operationalising the HRAIS requirements from an Accountable Design perspective are a key part of this chapter.
Worldwide vegetable production has increased, with onions and tomatoes being the most popular globally. Although technically a root, the potato is widely consumed as a vegetable. Unfortunately, people in rich countries are not eating enough vegetables. The types they do consume are often problematic as well – such as those in processed forms like crisps and sauces, or those that are air-freighted or grown in energy-intensive greenhouses. Emissions would be reduced if consumers changed their habits: eating more fresh, seasonal produce, being more accepting of cosmetic imperfections, and embracing traditional varieties. Though climate change adds risks, yields are unlikely to plummet in the coming decades. Production can be maintained while cutting emissions by modifying growing dates to take advantage of changing weather patterns and by improving soil health. Greenhouse production can be made more resource-efficient as well. In the long term, new varieties must be developed, but consumers ultimately hold the key to managing this transition.
Resource management is an opportunity for surgical services to preserve the significant revenue that is possible from a surgery department. Laser-focus while developing clear understanding, policies, procedures and reporting mechanisms leads to positive care and fiscal outcomes. All stakeholders and staff must be collaborative and accountable for the myriad of activities and controls necessary to ensure successful and sustainable results.
Much philosophical literature on sweatshop ethics assumes that the individual branded marketers that sell consumer goods either employ sweatshop workers or can strongly influence the conditions under which those workers labor. This oversimplification misidentifies the rationale for and details of the responsibilities of big buyers for the labor standards in their supply chains. Throughout this article, we illustrate how philosophers’ “vertical integration” and “control” assumptions distort our understanding of the internal dynamics within supply chains. Under the more realistic assumption that big buyers have “constrained influence” over labor conditions in their supply chains, we show that big buyers retain the responsibility to work toward social upgrading goals. However, fulfilling such a responsibility requires big buyers to collectively cede power to third parties in supply chains in formalized and accountable ways. Recent developments in transnational industrial agreements, such as the International Accord, are examples of this commitment.
In recent years, the manufacturing sector has seen an influx of artificial intelligence applications, seeking to harness its capabilities to improve productivity. However, manufacturing organizations have limited understanding of risks that are posed by the usage of artificial intelligence, especially those related to trust, responsibility, and ethics. While significant effort has been put into developing various general frameworks and definitions to capture these risks, manufacturing and supply chain practitioners face difficulties in implementing these and understanding their impact. These issues can have a significant effect on manufacturing companies, not only at an organization level but also on their employees, clients, and suppliers. This paper aims to increase understanding of trustworthy, responsible, and ethical Artificial Intelligence challenges as they apply to manufacturing and supply chains. We first conduct a systematic mapping study on concepts relevant to trust, responsibility and ethics and their interrelationships. We then use a broadened view of a machine learning lifecycle as a basis to understand how risks and challenges related to these concepts emanate from each phase in the lifecycle. We follow a case study driven approach, providing several illustrative examples that focus on how these challenges manifest themselves in actual manufacturing practice. Finally, we propose a series of research questions as a roadmap for future research in trustworthy, responsible and ethical artificial intelligence applications in manufacturing, to ensure that the envisioned economic and societal benefits are delivered safely and responsibly.
The adoption of the Deforestation-free Products Regulation represents a significant step forward in the protection of forests, both in the EU and in non-EU countries. In particular, it aims at minimising the risk of deforestation and forest degradation associated with products that contain, have been fed with, or have been made using certain commodities (cattle, cocoa, coffee, oil palm, rubber, soya, and wood). Environmental protection is achieved through provisions affecting the placing and making available of and export from the EU market of the relevant products, including a due diligence framework to ensure that such commodities are deforestation-free and legal under the law of the country of origin. While the Regulation has a clear environmental goal, it could also be seen as an operationalisation of the One Health approach as it tackles several drivers of environmental degradation (land-use change, biodiversity decline, and GHG emissions/climate change). In particular, this Regulation makes for a noteworthy case study in light of its extraterritorial reach, and it is examined in view of the unacknowledged ramifications for the One Health.
Pharmacies play a critical role in healthcare systems, especially during emergencies. Disruptions in the supply of medicines and consumables pose significant challenges in disaster response and recovery. Given the complexity and socio-political sensitivity of the resilient medicine supply chain, this study aimed to assess the resilience of the supply chain of medicines and consumables during disasters in Iran based on the World Economic Forum framework.
Methods
A cross-sectional, descriptive-analytical study was conducted using a validated questionnaire. Data were collected from 224 pharmacies in Shiraz city using the census method for hospital-based pharmacies and cluster and simple random sampling methods for city-level pharmacies. The collected data were analyzed and modeled using SPSS v.21 and Smart PLS v.3 software.
Results
The results confirmed the validity and reliability of the questionnaire developed for assessing the resilience of the supply chain of medicines and consumables during disasters based on the World Economic Forum framework. The results also demonstrated that participation (41.04), policy (30.22), information technology (26.72), and strategy (23.46) directly and positively contributed, respectively, to enhancing the resilience of the medicines and consumables supply chain during disasters.
Conclusions
According to the results, the medicines and consumables supply chain resilience in Iran can be improved by facilitating international partnerships, developing better relationships with suppliers, moving toward digital and information technology-based supply chains, having a strategic plan for the medicines and consumables supply chain in disasters, and developing coordinating policies and effective strategies.
Analysis of feeder and early weaned pig markets, important segments in pork production, is nearly nonexistent. We derive and estimate a structural econometric model relating demand and supply for market hogs, feeder pigs, and early weaned pigs. Estimates from the econometric model predict how disruptions are transmitted through hog and pig markets. Results indicate that hog and pig markets are most sensitive to hog processing plant utilization relative to capacity and that this sensitivity has increased compared to prior estimates. A set of counterfactual scenarios quantify the effects of shocks to hog processing capacity, wholesale pork demand, and supply response.
Modern supply chains are vital to global commerce, but they are also major contributors to greenhouse gas (GHG) emissions. As climate change intensifies, achieving carbon neutrality – particularly through supply chain decarbonisation – has become a global imperative. While organisations have made strides in reducing direct emissions, addressing indirect supply chain emissions presents greater complexity and urgency. We invite academic contributions that examine the challenges, enablers, potential risks, strategic approaches and innovative practices related to decarbonisation across a wide range of sectors, including manufacturing, service industries and humanitarian logistics. Emphasis is placed on holistic, multi-stakeholder approaches aligned with the GHG Protocol. The issue welcomes interdisciplinary research employing varied methodologies – ranging from empirical studies to conceptual frameworks – to inform practice, policy and sustainability transitions. By showcasing sector-specific insights and cross-cutting solutions, this issue aims to advance knowledge and action in building low-carbon, resilient supply chains.
Blockchain, an emerging technology exhibiting swift growth, significantly bolsters transparency within a given supply chain, enabling secure traceability, backtracking, and info tracing. Blockchain technology holds substantial promise for the dairy sector, offering enhancements unnecessary market intermediaries, thereby broadening access to credit and insurance for farmers, particularly in developing economies Such advancements could lead to more sustainable, efficient, and resilient livestock practices. However, the technology faces challenges, including the need for sophisticated infrastructure, cross-platform software, and skilled personnel with advanced expertise. Divergence in technological capabilities between developed and developing nations may hinder trade and exacerbate disparities. Regulatory barriers could also restrict blockchain's application. Thus, it is imperative to enhance blockchain knowledge among trade authorities and policymakers to facilitate its broader adoption. The objective of this review is to discuss principles of blockchain and proposed future work pathways for its use in the dairy industry.
Precarious work, the problems it poses in terms of labour standards/regulation, and remedies to this, have sparked considerable attention from researchers and policy-makers over the past three decades. This paper examines industrial relations (IR) legislation introduced by the Australian Labor government elected in 2022, and which, amongst other things, has addressed precarious work. These initiatives are placed in historical context, noting how essentially similar problems shaped IR regulation a century earlier. The article also examines the more immediate precursors to the legislation, by reviewing state and federal inquiries into precarious work and related issues in Australia from the 1990s onwards. Placing the new legislation into historical context enhances our understanding of the law and surrounding policy debates. The Albanese federal Labor government package of industrial relations laws introduced between 2022 and 2024 marked a paradigm shift from earlier measures. While these reforms are rooted in Australian institutions, law and industrial relations history, they provide an alternative policy template for addressing the problems wrought by neoliberalism on labour standards, especially if accompanied by synergistic reforms in other areas, such as immigration and economic policies promoting manufacturing.
This article discusses the EU supply chain legislation, by virtue of the recently adopted Corporate Sustainability Due Diligence Directive (CSDDD) which aims to reduce negative sustainability impacts in global supply chains with regard to a list of human rights and environmental standards specified in its Annex I of the CSDDD.
We argue that the CSDDD marks a fundamental change on the EU level, from disclosure duties to mandating prevention of, and compensation for, adverse sustainability impacts in supply chains.
We further find that the CSDDD is a legal transplant combining the principles laid down in the OECD Guidelines for Multinational Enterprises on Responsible Business and those of the UN Guiding Principles on Business and Human Rights, along with elements of French supply chain legislation from 2017 (which relies on a private enforcement model) and the German supply chain law from 2021 (which is based on a public enforcement model). Like all legal transplants, the resulting legal text generally prompts questions about consistency and specifically raises doubts as to whether combining all of the components of a private and a public enforcement model is proportionate for the purpose of the CSDDD which is to ensure that companies take effective steps to counter violations of human rights and environmental standards in global supply chains. The scope provisions (including smaller in-scope EU firms while leaving non-EU peers of a similar size aside) paired with significant high compliance burden provide grounds to argue that the CSDDD impacts on the competitiveness of these smaller in-scope EU companies, and thus the EU economy at large.
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.