Supply Chain Outsourcing Research Articles

Contract manufacturer encroachment via the customer‐to‐manufacturer strategy under different platform selling modes

AbstractThis paper considers an outsourced supply chain comprising a contract manufacturer (CM), an original equipment manufacturer (OEM) and an online platform. In addition to providing contract manufacturing services to the OEM, the CM enters the market using the customer‐to‐manufacturer (C2M) strategy. Two baseline models and four encroachment models with different selling modes are modeled to explore the interaction among CM encroachment, selling modes and the C2M strategy. We find that the CM will always encroach if brand substitution is sufficiently high. However, the CM will still encroach despite brand substitution being low if the platform charges the OEM a high commission rate in Scenario PR. The results also show that the CM may increase or decrease the wholesale price charged to the OEM according to his dependence on the OEM channel and direct channel. Finally, we find that after CM encroachment, the OEM is worse off, while the platform may be better or worse off. The profits of the CM, OEM, and platform decrease if customers are more concerned about production flexibility. Our work provides guidance for CM encroachment from the perspective of channel choice and product strategy and offers managerial insights into C2M practice.

Pharmaceutical supply chain: The importance of outsourcing

A vast web of organizations, companies, and teams involved in creating, researching, and producing drugs and associated products makes up the pharmaceutical sector. In this context, the term “supply chain” refers to the network of individuals, processes, information, and resources that transform raw materials and parts into finished goods and services before being supplied to customers. The pharmaceutical supply chain system, then, offers customers medications in the right amount, at the right time, with acceptable quality, and for the lowest feasible cost. Pharmaceutical companies are increasingly contracting out their supply chain activities due to the severe push to keep R&D expenses under control. Instead of being a cost-cutting measure, global supply chain outsourcing can be seen as a strategic competitive weapon that can improve positional advantage, offer production flexibility, and meet the ever-increasing expectations of final consumers. Global supply chain outsourcing is crucial for pharmaceutical firms to enhance performance and profit margins by leveraging core skills and resources beyond other strategies which can lower risk, increase flexibility, improve returns on capital, and improve a company’s ability to respond to the needs of its shareholders and consumers. Even while there is widespread recognition of the alluring advantages of global outsourcing, many of the related concerns are frequently disregarded. In addition to briefly discussing risk assessment methods, the goal of this work is to offer manufacturer-focused insight into supply chain-related outsourcing concerns within the pharmaceutical industry.

How does blockchain technology implementation affect the supply chain members' strategic decisions under the factory encroachment?

PurposeContract Manufacturers (CM, factory) can cultivate factory brand products by imitating Original Equipment Manufacturers' (OEM, brand owner) National Brand products, and compete with OEM through the online retailer, that is, factory encroachment. In practice, few consumers can identify the quality of those two products in the online market. Implementing blockchain technology (BTI) can help all consumers identify product quality but may change the operation decisions and incur implementation costs. This study aims to explore how will the BTI strategies affect participants' operation performance under the factory encroachment and delve into the decisions regarding NB product quality and CM encroachment.Design/methodology/approachThis study constructs a three-level outsourcing supply chain comprising one contract manufacturer (CM, factory), one original equipment manufacturer (OEM) and one online retailer. By utilizing the Stackelberg game, the authors first compared the results between two strategic decisions of BTI and no-BTI by online retailers under the factory encroachment scenario. Then, the NB product quality decision and the CM's encroachment decision are also investigated.FindingsBTI strategy can benefit all participants (triple win), which both occurs in exogenous and endogenous quality cases, and the triple win area will expand (shrink) as the BTI cost decreases (increases). In addition, the OEM will improve product quality to confront competition from the CM, and the OEM may not always benefit from the BTI, it depends on the maturity of the market. Interestingly, BTI could improve the consumer surplus when the proportion of novice consumers is low. Finally, this study also investigates the extended case that CM always encroaches into the market whether the online retailer choose BTI or not, which hurts OEM's profit and decreases the product quality.Originality/valueThis study sheds light on the strategic decisions of online retailers' BTI regarding supply chain members' profits, consumer surplus and social welfare under factory encroachment. It also demonstrates that the BTI strategy, under different quality decisions (endogenous and exogenous), can be more profitable for chain members and consumers.

Strategic analysis of supplier integration and encroachment in an outsourcing supply chain

To prevent suppliers from gaining full knowledge of production technology, original equipment manufacturers (OEMs) typically adopt a multisourcing strategy, wherein each supplier handles only a portion of the production tasks. However, a recent trend has emerged where suppliers are increasingly inclined to integrate and negotiate for control over the entire end market. The implications and impact of such integration strategies, particularly in the context of supplier encroachment, remain uncertain. In this study, we examine an OEM that outsources production tasks to two competing suppliers with varying production capabilities. The supplier with higher capacity has the potential to produce their own branded products and encroach upon the end market. To strengthen their bargaining power during the outsourcing process, the two suppliers may choose to integrate with each other. Our findings indicate that without integration, OEMs can adjust the outsourcing allocation ratio to prevent encroachment by capable suppliers. In cases of integration, although the OEM must outsource all production tasks to the integrated supplier, the likelihood of market encroachment may be reduced. Furthermore, we observe that in situations involving supplier integration and encroachment, both competitive suppliers, the OEM, and the entire supply chain can achieve a win–win–win outcome. This occurs because the supplier, acting as a market competitor, provides positive incentives for the OEM to enhance product quality, thereby maintaining market share and competitiveness. The strategic recommendations derived from our results can be valuable for supply chain members engaged in outsourcing decisions.

ACHIEVING SUSTAINABILITY AND RESILIENCE: A CASE STUDY OF NESCAFE'S GLOBAL SUPPLY CHAIN MANAGEMENT

This study delves into the complexities of managing a global supply chain. It examines the supply chain strategy employed by Nestle to produce and distribute its popular coffee brand, Nescafe. The main focus is on evaluating the key challenges faced by the company, including post-COVID-19 issues, sustainability concerns, climate change, and supplier profitability. In response to these challenges, Nestle has implemented a structured approach to develop a resilient, sustainable, competitive supply chain for Nescafe. The Nescafe Plan, a global sustainability initiative, has provided a competitive advantage to Nescafe’s supply chain. This initiative involves collaboration with suppliers, distributors, and customers at all levels, ensuring accountability and promoting ethical practices. Results show significant positive impacts, including local sourcing of coffee, reduced carbon emissions, and water withdrawal. Nescafe operates its coffee supply chain based on a lean strategy, ensuring supply and demand stability. Customer demand for Nescafe’s products is well-predicted, allowing for unique positioning, high service levels, and cost efficiency. To enhance supply chain resilience, Nescafe focuses on mitigating internal and external risks in coffee lands, addressing issues like labour shortage, child labour risks, climate change, and natural disasters. The study also explores Nestle’s approach to supply chain outsourcing and supplier selection processes. Furthermore, the study examines Nestle’s commitment to sustainable development, encompassing economic, environmental, and social aspects. The company invests in economic development by situating production in developing countries and ensuring growth and long-term success for stakeholders. To continue its journey towards sustainability, Nestle has set ambitious goals for the future, aiming for recyclable packaging, zero net gas emissions, and 100% sustainably produced materials by 2030. The company also plans to empower 10 million young people with economic opportunities globally by the same year. Generally, this study provides valuable insights into the strategies adopted by Nestle to create a resilient and sustainable global supply chain for Nescafe, offering lessons for other manufacturing companies seeking to achieve future success through effective supply chain management.

Research on corporate social responsibility and product quality in an outsourcing supply chain

<p style='text-indent:20px;'>In a supply chain with product outsourcing, it is crucial to identify which firm implements corporate social responsibility (CSR) leads to a higher CSR effort level, a higher product quality level, a higher quantity of outsourced products, and higher profits for supply chain members. In response to this question, we consider a decentralized supply chain with an upstream contract manufacturer (CM) and a downstream original equipment manufacturer (OEM). In this relationship, the downstream OEM outsources the product to the upstream CM and determines the quantity, while the upstream CM produces for the downstream OEM and determines the product quality and the wholesale price. Based on the scenario that each supply chain member can respectively implement the CSR effort (i.e., the CM model and the OEM model), we first investigate the impacts of the CSR demand-sensitivity coefficient, the CSR cost-reducing efficiency, and the CSR effort investment efficiency on the operational decisions and on the profits for supply chain members. Second, we compare the equilibrium results between the CM model and the OEM model. Finally, we study supply chain coordination. We find that (1) an increase in the CSR demand-sensitivity coefficient (the CSR cost-reducing efficiency and the CSR effort investment efficiency) is beneficial to the CSR effort level, the product quality level, the quantity of outsourced products, and the profitability for each supply chain member; (2) the CSR effort level is higher in the CM model than that in the OEM model, which in turn leads to a higher product quality level, a higher quantity of outsourced products, and a higher profitability of supply chain members; and (3) the proposed schemes consisting of quantity discount contracts, CSR effort investment cost sharing contracts, and quality investment cost sharing contracts can effectively coordinate the supply chain.</p>

Partnerships promote innovation in food supply chains

Partnerships promote innovation in food supply chains

PolyWorm: Leveraging Polymorphic Behavior to Implant Hardware Trojans

Owing to the various challenges looming over the integrated circuit (IC) supply chain for the sub-nm technology nodes, researchers are looking into emerging devices to design the next generation of high performance and low-power chips. The magnetoelectric spin-orbit (MESO) switch, developed by Intel™, is a front-runner in this search and is currently in a state of advanced experimental research. To ensure faster time-to-market and reap the existing supply chain’s benefits, it is envisioned that the upcoming MESO devices will be coupled and hybridized with the existing complementary metal-oxide-semiconductor (CMOS) industrial framework. However, adopting the existing CMOS framework and incorporating it’s outsourced supply chain increases exposure to various security threats such as design intellectual property (IP) piracy, overproduction of ICs, and insertion of hardware Trojans (HT) to leak information or cause denial-of-service. This article proposes and investigates a stealthy HT insertion technique, <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">PolyWorm</i> , leveraging the polymorphic capabilities of MESO gates in hybrid MESO-CMOS architectures. We evaluate the efficacy of <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">PolyWorm</i> on ITC-99 benchmarks and demonstrate two use-case scenarios, viz., corrupting the intended design functionality and leaking the secret key from a cryptographic core. We also present a low-footprint domain wall-based trigger for our polymorphic Trojan to evade structural and power-based testing.

Influence Of Procurement Best Practices On Performance Of Nca Registered Building Projects In Nairobi City County, Kenya

Purpose: The study aimed at establishing how reverse logistics management, supply chain outsourcing, strategic collaborations, and supply chain benchmarking influence the performance of NCA registered building projects&#x0D; Methodology: To achieve this, the researcher reviewed both theoretical and empirical literature and proposed the research methodology that addressed the gaps identified in the literature as well as answered the stipulated research questions. A descriptive survey design was adopted by the study. A total of 289 commercial building projects registered by National Construction Authority in Nairobi City County was the target population, as shown in NCA (2020) directory. Using Kothari (2015) sample size formula, the study got 167 commercial building projects. This study used simple random sampling to get the firms. The study preferred this method because it allowed an in-depth study of the subject. To gather data, structured questionnaires were used to collect data. Once collected, data was analyzed using descriptive and inferential statistics. Quantitative data was analysed using multiple regression analysis. The qualitative data generated was analyzed by use of the Statistical Package of Social Sciences (SPSS) version 21&#x0D; Results and conclusion: The current study obtained an R2 of 64.7% and should therefore be expanded further in futhe ture in order to include other procurement best practices that may as well have a positive significance to the performance of NCA registered build projects.The findings of the study indicated that reverse logistics management, supply chain outsourcing, strategic collaborations and supply chain benchmarking have a positive relationship with performance of NCA registered building projects in Kenya.&#x0D; Policy recommendation: the study recommended that institutions should embrace procurement best practices so as to improve performance and furtherresearchs should to be carried out in other institutions to find out if the same results can be obtained

How does the power dynamics in the information technology outsourcing supply chain influence supplier's talent retention: a multiple case study

PurposeThe purpose of this paper is to investigate how the power dynamics between the client firm and the supplier firm in the information technology outsourcing (ITO) supplier chain influence the supplier firm's human resource management (HRM) practices, particularly talent retention.Design/methodology/approachA multi-case study approach was adopted comprising four supplier firms, three client firms and a total of 53 interviews. The transaction cost economics (TCE) is the theoretical lens that guides the interpretation of our findings.FindingsThe power dynamics between client and supplier firms in the ITO supply chain is one underpinned by TCE theory, characterised by an asymmetric client-dominated, transactional relationship, with the client firms controlling the “why”, the “what”, and the “how” dimensions of their collaboration. This “three-dimensional control” led to high talent turnover in supplier firms, which boomerangs to perpetuate the power dynamic, forming “vicious cycles of talent turnover” in the ITO supplier chain. Originality/valueNo previous study has analysed power dynamics as an external factor on ITO supplier firms' talent retention. The construct of the “three-dimensional-control” offers a framework to study power dynamics in the ITO supplier chain. The study’s framework of the “vicious cycles of talent turnover” is the first that explains the mechanisms through which the power dynamics in the ITO influences supplier's talent retention.

Outsourcing in supply chain: A bibliometric analysis

The purpose of this paper is to conduct a bibliometric analysis to analyze trends and patterns of outsourcing and supply chain research results using statistical and co-word analysis. The search results in the Scopus database yielded 787 relevant documents with the keywords outsourcing and supply chain from 1997 to early 2022. The results of the bibliometric analysis resulted in the number of publications, citations, subject areas, country, keywords, and topic clusters. The trend of outsourcing and supply chain research tends to increase every year although it had a significant decline in 2011. The documents with the most citations are related to supplier selection using analytical network processes, optimization of outsourcing partners, and ICT in the supply chain. The four fields that dominate the research area are business management, engineering, decision science, and computer science. The United States of America is the most productive country with the most citations. There are four cluster topics formed: the importance of supply chain management in outsourcing in industry and ICT in company activities, the impact of supply chain on business performance and outsourcing decisions, logistics outsourcing decisions to third parties and their effectiveness, lastly the benefit costs of outsourcing and the implications for product management. This paper provides an additional updated overview of the outsourcing and supply chain research map.

Global Outsourcing and Local Tendering Supply Chain Systems in the Public Healthcare Sector: A Cost Comparison Analysis, Namibia

ObjectivesTo compare supplier prices for local tendering and global outsourcing supply chain systems that are used to purchase pharmaceutical products by the Ministry of Health in Namibia and to compare the supplier prices for both systems to the international reference buyer median prices. MethodsThis study was quantitative in design and compared local and international supplier prices for a basket of vaccines, antiretrovirals, and anti-tuberculosis (TB) drugs from 2015 to 2020. Prices were retrieved from the procurement documents obtained from the Central Medical Stores division of the Ministry of Health, Namibia. The study also compared local and international supplier prices with the international reference buyer median prices obtained from the Management Sciences for Health International Drug Price Indicator Guide (2015 edition). ResultsIt was found that 77% of all the pharmaceutical products in the study were more expensive when obtained from the local suppliers than from international suppliers—that is, vaccines (70%), antiretrovirals (86.6%), and anti-TB drugs (67%). More than 50% of all the pharmaceutical products had local and international supplier prices, which were higher than the international reference buyer median prices. The price differentials were found to be higher for pharmaceutical products that were newly introduced into TB and human immunodeficiency virus treatment guidelines. ConclusionsThe study has concluded that local suppliers were costlier than international suppliers for vaccines, antiretrovirals, and anti-TB drugs. The international price comparisons have shown that there is a need for improving the pricing mechanisms in Namibia to reduce the prices of several essential medicines.

Implementation of an intelligent supply chain control tower: a socio-technical systems case study

Despite the proliferation of Industry 4.0 technologies, there is little guidance concerning how companies can integrate them in their supply chains. This study examines the implementation of a supply chain (SC) control tower (SCCT) by a large manufacturing company aiming to create an intelligent supply chain. This study applies Socio-Technical systems (STS) theory using the technology typology (long-linked, mediating, intensive) in the context of industry 4.0. The company followed a three-phase implementation plan (I: Initiation, II: Live, III: Continuous improvement) to transit from outsourcing supply chain control to developing the SCCT control structure and then creating intelligent SC assets and capabilities. The study shows that the SCCT needs to integrate all three technology types to reflect the intelligent supply chain. Further, it shows that the interactions of technologies with the SCCT team, internal and external supply chain stakeholders are critical in managing the development, implementation, and growth of intelligent supply chains. It identifies transition barriers including system misalignment, poor socio-technical integration, and an invert of trust between internal and external supply chain stakeholders. The intelligent supply chain emerges as a result of managing socio-technical interactions systematically.

Price negotiation and coordination in outsourcing supply chain under yield and demand uncertainties

This paper considers the issues of pricing, lot-sizing decisions and coordination in a supply chain consisting of one original equipment manufacturer (OEM) and one contract manufacturer (CM). A Bayesian game accounting for asymmetric information is established to optimize the CM’s outsourcing price and the OEM’s selling price. A Stackelberg game incorporating yield and demand uncertainties is subsequently modelled to optimize the CM’s production quantity and the OEM’s order quantity. Finally, a shortage penalty with surplus purchase contract is proposed to coordinate the supply chain. It is found that the optimal outsourcing price is either the lower limit or the stationary point of the common price domain, while the optimal selling price is the upper limit. Whether the CM adopts a conservative or an aggressive production strategy depends on the threshold of the outsourcing price. Moreover, the coordination contract offers great flexibility in parameter selection. By setting the order quantity, penalty price and surplus purchase price properly, the supply chain can realize a win-win situation.

Managing raw and starting materials for viral vector manufacture: managing risk and staying flexible

<div class="authors authors-lg"><div class="author"><div class="author-img"><img src="https://cdn.insights.bio/uploads/Eric Hacherlsq.jpg" data-image="1"></div><div class="author-det"> Eric Hacherl holds a PhD in Chemical Engineering from Rutgers University. As the Head of Manufacturing, he is responsible for Internal and External Manufacturing, Materials Management, Shipping &amp; Receiving and Manufacturing Science &amp; Technology. Eric joined Spark in September 2020 with over 20 years of experience in the pharmaceutical industry. His functional expertise lies in Operations, Supply Chain and Manufacturing Science &amp; Technology. His focus has been primarily on vaccines and large molecule manufacturing. Prior to joining Spark, he was the Site General Manager and VP of Operations for Catalent Gene Therapy in Baltimore, MD. </div></div></div><div class="authors authors-lg"><div class="author"><div class="author-img"><img src="https://cdn.insights.bio/uploads/Klem photo 200x200.jpg" data-image="1"></div><div class="author-det"> Christopher Klem is an experienced professional specializing in technical and logistical oversight of external/contract manufacturing operations in the emerging gene therapy space. Effectively managed external manufacturing projects for over 15 years, specializing in relationship building and execution of program deliverables. Current experience in oversight of all aspects of outsourced supply chain partnerships: drug substance, drug product, secondary packaging and specialty distribution of commercial and clinical gene therapy products. Also have managed and directed internal Primary and Secondary operations in both pharmaceutical and biopharmaceutical manufacturing, directing large multi-tiered teams to meet internal manufacturing objectives. </div></div></div><div class="authors authors-lg"><div class="author"><div class="author-img"><img src="https://cdn.insights.bio/uploads/Galbraith photo 200x200.jpg" data-image="1"></div><div class="author-det"> Mark Galbraith has worked in the biopharmaceutical industry for 20 years, where he has gained diverse experience and knowledge in all phases of product development from preclinical to commercial. Mark began his career at Merck &amp; Co, where he held positions of increasing responsibility in several functional areas related to vaccine clinical development and vaccine commercial manufacturing including analytical R&amp;D, regulatory sciences, commercial analytical support, and quality control operations. Mark continued to develop his career in quality control management and analytical development by directing the quality control activities at Celldex Therapeutics, Bristol Myers-Squibb, and Gilead Sciences. Mark has gained a broad knowledge of vaccines, biotechnology products, sterile pharmaceuticals, and now gene therapy. Mark is currently serving as Head of Quality Control and Analytical Sciences for Spark Therapeutics Inc. in Philadelphia, PA. Spark is a leader in the field of gene therapy, seeking to transform the lives of patients by developing potential one-time, life-altering treatments for debilitating genetic diseases. </div></div></div><div class="authors authors-lg"><div class="author"><div class="author-img"><img src="https://cdn.insights.bio/uploads/Ryan Bartock sq.jpg" data-image="1"></div><div class="author-det"> Ryan Bartock is Vice President and Head of Technical Strategy &amp; Operations at Spark Therapeutics, a fully integrated gene therapy company and member of the Roche family of companies. Ryan joined Spark Therapeutics as Head of Supply Chain and Network Strategy in 2017 where he established the Supply Chain function and launched the first ever FDA approved Gene therapy. His current responsibilities include leading the Supply Chain and CMC Program Management functions, as well as strategic initiatives across Research, Technical and Commercial organizations. He is also interim Head of Technical Development, overseeing Process and Analytical development, Automation and Pre-Clinical Operations. Ryan holds BSc in Engineering and Business from Drexel University. His 18 years of industry experience spans pre-clinical and clinical development, manufacturing operations, supply chain, CMC, corporate strategy and new product launches at both GSK and Merck. </div></div></div>

OUTSOURCING SUPPLY CHAIN: SYSTEMATIC LITERATURE REVIEW ON INNOVATION DRIVER FACTORS TOWARDS COLLABORATIVE NETWORK

Innovation and collaboration are essential to every organization in order to compete with its competitors. Outsourcing is done to distribute part of the responsibility of the parent organization so that it can be focused on its core business. The purpose of this literature review study is to determine innovation in collaborative networks related to the outsourcing supply chain. The SLR methodology was used in this study, while the database was taken from 6 sources, i.e., Emerald, Sage Journal, SpringerLink, IEEE, ScienceDirect, Wiley Online Library, and obtained 50 appropriate articles relevant to the topic. The literature review resulted that there are six trend innovations as collaboration network drivers. The future trends of innovation will be the dominance of research leading on three innovation trends, namely collaborative innovation, Innovation ecosystem, and open innovation in line with the development of technology and information disclosure.

2.5D Root of Trust: Secure System-Level Integration of Untrusted Chiplets

Dedicated, after acceptance and publication, in memory of the late Vassos Soteriou. For the first time, we leverage the 2.5D interposer technology to establish system-level security in the face of hardware- and software-centric adversaries. More specifically, we integrate chiplets (i.e., third-party hard intellectual property of complex functionality, like microprocessors) using a security-enforcing interposer. Such hardware organization provides a robust 2.5D root of trust for trustworthy, yet powerful and flexible, computation systems. The security paradigms for our scheme, employed firmly by design and construction, are: 1) stringent physical separation of trusted from untrusted components, and 2) runtime monitoring. The system-level activities of all untrusted commodity chiplets are checked continuously against security policies via physically separated security features. Aside from the security promises, the good economics of outsourced supply chains are still maintained; the system vendor is free to procure chiplets from the open market, while only producing the interposer and assembling the 2.5D system oneself. We showcase our scheme using the Cortex-M0 core and the AHB-Lite bus by ARM, building a secure 64-core system with shared memories. We evaluate our scheme through hardware simulation, considering different threat scenarios. Finally, we devise a physical-design flow for 2.5D systems, based on commercial-grade design tools, to demonstrate and evaluate our 2.5D root of trust.

Critical incidents of outsourcing processes in pharmaceutical supply chain: A mixed-methods approach

Purpose: In this paper, a practical framework is presented for the successful integration of buyers and contract organizations based on the Critical Incident Technique (CIT).Methodology: The initial pool of situations was developed inductively according to qualitative data provided by ten experts in the field of outsourcing in pharmaceutical supply chain. Another group of experts evaluated these situations with regard to their degree of realism as well as relevance and allocated them to the five constructs (1) employee competence, (2) management commitment, (3) communication between organizations, (4) organizational culture, and (5) regulatory framework.Findings: The findings of the study show that communication appears to be the most frequent reason while regulatory framework seems to be the last frequent reason for critical incidents during outsourcing. Contract giver and service provide show diverging perceptions about the situations’ degree of realism and relevance. Analysis of the interrater agreement shows that the allocation to a single construct is a challenge due to the critical incidents’ complexity and multidimensionality.Originality: The critical incidents database and the presented framework serve as preventive behavioral-based quality management for the pharmaceutical supply chain.

Japan: health cuts and outsourced supply chains left a health system under-prepared

36 | International Union Rights | 27/1-27/2 FOCUS | UNIONS, WORKERS’ RIGHTS, AND THE COVID-19 PANDEMIC Japan: health cuts and outsourced supply chains left a health system under-prepared The Japan Federation of Medical Workers’ Unions (JFMWU) represents 7 national unions and 47 prefectural unions in health and care sector in Japan. Since our formation in 1957, we have promoted campaigns and struggles for enough staffing and better working condition of medical doctors, nurses and care workers as well as for providing decent and better health care. Japanese health systems have been suffering from chronic understaffing, then we are working under the pandemic of COVID-19. Long working hours JFMWU has conducted a survey in every five years on working condition of nurses. The most recent one from 33,402 corresponded found that 71.7 percent says they have chronic fatigue, 67.5 percent says they have health concerns, 74.9 percent thinks to quite their job. These reasons are; 47.7 percent responded they have hard working condition due to understaffing, 30.0 percent responded their wage is low and difficult to take enough holidays. We also conducted nightshift work survey every year, and we found 39.3 percent nurses are working in 2-shift. And at 2-shift workplaces, 39.3 percent experience more than 16-hour work. Japanese nurses generally have more night-work than other countries, and 46.0 percent experiences less than 8-hour interval between shifts. To achieve safe and decent health and care, we have committed to promote strong campaign for better working condition and sufficient staffing. We demand ‘8-hour work day’, ‘more than 12-hour interval’ and ‘32-hour work week’, as well as more medical staff and better social security system. Reduction in designated medical institutions and community health offices Since the 1980s, the Japanese government has maintained its policy to reduce medical expenditure from the public budget, under the name of ‘administrative reform’ or ‘structural reform’. In recent years, Prime Minister Abe promoted so-called ‘Social Security System Reform’ in order to restore a balanced budget and to reduce social security expenditure. The number of beds for special infectious disease in 1998 was 9060 beds at 409 hospitals across Japan, but it is now only 1869 beds at 407 hospitals. It is important to note that 94 percent of these beds belong to public or government hospitals. The number of the public health offices was more than 850 in 1990s and now we have only 472 offices in 2019. Working conditions of medical workers under the pandemic When the Ministry of Health, Labour and Welfare issued a notice to request medical institutions to be ready for the COVID-19, JFMWU conducted an emergency survey for mostly public hospitals in March where we represent those workers. Even rather big and supposedly wellequipped institutions reported their concern and anxiety to respond to the outbreak, since they do not have sufficient medical staff and specialised facilities for dealing with infectious diseases. They have been forced to close loss-making sections such as TB sections, and do not have enough Personal Protective Equipment (PPE) and technical skills to treat infectious disease. Some hospitals say they accept COVID-19 patients while they stop certain surgery or outpatient department. In April, we experienced shortages of PPE at hospitals. According to the survey from 152 hospitals in 35 prefectures, we found some serious cases, both for safety and health of patients and health workers and sustainability of the hospitals. Some workers have only 1 mask per week. Another PPE and N95 mask are used repeatedly. Raincoat or garbage plastic bag are used for PPE. Sharp decrease of inpatients has huge impact for financial situation of hospitals and clinic, and there is a threat to cut wage and lump-sum payments in the coming months. Hospital workers have experienced discrimination and prejudice in community. JFMWU issued statements on these serious problems and demanded the governments to take immediate action. The Ministry reported 428 thousand COVID-19 inpatients, of which 222 thousand were hospitalised, The global supply chain system for PPE - based on neoliberal ideology - is clearly not working Shinobu Morita is President of the Japan...

Japan: health cuts and outsourced supply chains left a health system under-prepared

36 | International Union Rights | 27/1-27/2 FOCUS | UNIONS, WORKERS’ RIGHTS, AND THE COVID-19 PANDEMIC Japan: health cuts and outsourced supply chains left a health system under-prepared The Japan Federation of Medical Workers’ Unions (JFMWU) represents 7 national unions and 47 prefectural unions in health and care sector in Japan. Since our formation in 1957, we have promoted campaigns and struggles for enough staffing and better working condition of medical doctors, nurses and care workers as well as for providing decent and better health care. Japanese health systems have been suffering from chronic understaffing, then we are working under the pandemic of COVID-19. Long working hours JFMWU has conducted a survey in every five years on working condition of nurses. The most recent one from 33,402 corresponded found that 71.7 percent says they have chronic fatigue, 67.5 percent says they have health concerns, 74.9 percent thinks to quite their job. These reasons are; 47.7 percent responded they have hard working condition due to understaffing, 30.0 percent responded their wage is low and difficult to take enough holidays. We also conducted nightshift work survey every year, and we found 39.3 percent nurses are working in 2-shift. And at 2-shift workplaces, 39.3 percent experience more than 16-hour work. Japanese nurses generally have more night-work than other countries, and 46.0 percent experiences less than 8-hour interval between shifts. To achieve safe and decent health and care, we have committed to promote strong campaign for better working condition and sufficient staffing. We demand ‘8-hour work day’, ‘more than 12-hour interval’ and ‘32-hour work week’, as well as more medical staff and better social security system. Reduction in designated medical institutions and community health offices Since the 1980s, the Japanese government has maintained its policy to reduce medical expenditure from the public budget, under the name of ‘administrative reform’ or ‘structural reform’. In recent years, Prime Minister Abe promoted so-called ‘Social Security System Reform’ in order to restore a balanced budget and to reduce social security expenditure. The number of beds for special infectious disease in 1998 was 9060 beds at 409 hospitals across Japan, but it is now only 1869 beds at 407 hospitals. It is important to note that 94 percent of these beds belong to public or government hospitals. The number of the public health offices was more than 850 in 1990s and now we have only 472 offices in 2019. Working conditions of medical workers under the pandemic When the Ministry of Health, Labour and Welfare issued a notice to request medical institutions to be ready for the COVID-19, JFMWU conducted an emergency survey for mostly public hospitals in March where we represent those workers. Even rather big and supposedly wellequipped institutions reported their concern and anxiety to respond to the outbreak, since they do not have sufficient medical staff and specialised facilities for dealing with infectious diseases. They have been forced to close loss-making sections such as TB sections, and do not have enough Personal Protective Equipment (PPE) and technical skills to treat infectious disease. Some hospitals say they accept COVID-19 patients while they stop certain surgery or outpatient department. In April, we experienced shortages of PPE at hospitals. According to the survey from 152 hospitals in 35 prefectures, we found some serious cases, both for safety and health of patients and health workers and sustainability of the hospitals. Some workers have only 1 mask per week. Another PPE and N95 mask are used repeatedly. Raincoat or garbage plastic bag are used for PPE. Sharp decrease of inpatients has huge impact for financial situation of hospitals and clinic, and there is a threat to cut wage and lump-sum payments in the coming months. Hospital workers have experienced discrimination and prejudice in community. JFMWU issued statements on these serious problems and demanded the governments to take immediate action. The Ministry reported 428 thousand COVID-19 inpatients, of which 222 thousand were hospitalised, The global supply chain system for PPE - based on neoliberal ideology - is clearly not working Shinobu Morita is President of the Japan...