TBL QUARTERLY 1

Reducing pharma’s footprint in the National Health Service

+ interviews, videos, infographics and more

Four ways to make your production greener

Reviving the Brazilian Cerrado– the richest savannah

in the world

TBL QuarterlyQ2 2013

Responsible productionAddressing global challenges with a local touch

Novo Nordisk production site in Kalundborg, Denmark

In this issueCONSTANTLY IMPROVING PERFORMANCESenior Vice President for Product Supply, Henrik E. Wulff, discusses the two ingredients to a more efficient and environmentally friendly production.

FOUR WAYS TO MAKE YOUR PRODUCTION GREENER#1 Thinking environmental performance into the design in China#2 Exploring all options to find the one that is environmentally friendly and economically feasible in Japan#3 Setting ambitious goals that spur bottom-up innovation in France#4 Turning wastewater into energy through persistency and partnership in Denmark

REDUCING PHARMA’S FOOTPRINT IN THE NATIONAL HEALTH SERVICEThe NHS accounts for 25% of all public sector carbon emissions in England. Read how a group of pharmaceutical and medical device companies are working with the NHS to find new ways to reduce this footprint.

BEYOND THE FACTORY GATES– PRODUCING COMMUNITY VALUESee how Novo Nordisk employees are taking action to meet the needs in their local communities.

REVIVING THE BRAZILIAN CERRADO – THE RICHEST SAVANNAH IN THE WORLDFind out how Novo Nordisk combines land recovery with water and wastereduction in Brazil.

NOVO NORDISK’S GLOBAL PRODUCTION BY THE NUMBERSGet to know Novo Nordisk’s production sites across the globe.

SAFEGUARDING ENVIRONMENTAL STEWARDSHIP IN TIANJINLooking for a career in protecting the environment? Two of Novo Nordisk’s energy stewards tell you what it takes.

KALUNDBORG SYMBIOSISCheck out this cool infographic showing how the waste of one company becomes production input for another in a closed loop symbiosis.

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Constantly improving performance

As head of Novo Nordisk’s Product Supply, I share the responsibility together with close to 10,000 colleagues of delivering high quality products in due time to patients all over the world. Twenty-three million to be exact. Twenty-four hours a day, seven days a week, we work towards our goal of continuous improvement – on high quality products, on efficient processes and on fast and reliable delivery to the patients. There are two key ingredients to meeting our goals; understanding and control. Understanding and being in control is the foundation for producing high volume with high quality. When producing insulin in the volumes necessary to reach millions of patients, it is paramount that we are in control of all our processes. This is what makes it possible to identify deviations from what is ‘normal’ so we can understand problems, find solutions and get things back on track. Understanding the processes and being in control have become an increasingly complex and important task as our business has grown. What started out as a single production site in Gentofte, Denmark in 1927, has grown into a global operation. Today, Novo Nordisk has

production sites in six countries across four continents. Ensuring a high level of quality, efficient processes and fast and reliable delivery at the global production level also becomes an exercise in striking a balance between small and big steps. Novo Nordisk has global standards that guide actions across production sites. On the production line, it is the small efforts that improve performance. Many of these are identified as best practice and become instrumental in evolving our global standards. Product Supply’s responsibility to improve processes forms part of our responsibility to monitor and limit our environmental footprint. As our success in meeting patient needs leads to growing production and sales, we must rise to the challenge of meeting our long-term aspiration to keep minimising the total environmental impact of our operations. Being innovative and efficient is key in this and we work to continuously improve environmental performance by setting high targets, looking into new ways of doing things and integrating environmental considerations into daily business activities. Thus, it makes me very proud that we

Insulin production 1930

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have succeeded in decoupling the growth of our production from our environmental impact. In the Q2 issue of the TBL Quarterly, we show how our global environmental strategy, the big step, is carried out with local commitments. From water and waste reducing initiatives in France and Brazil to designing production sites that focus on energy reduction in China. It makes me proud to see the efforts and commitment of colleagues at Novo Nordisk’s production sites. And it is more than just inside the factory walls. They are living the company’s values in the communities that surround them, leveraging their numbers and passion to give back.

Protecting our environment through innovation is not only a global call to action, but also a personal one. I believe that all citizens - no matter if they live in cities or in the country side - should have access to fresh open air and water for short and long term health and society reasons. That creates the perspective for me to continuously find new ways to minimise our footprint. I don’t think I am alone in this.

Henrik E. WulffSenior Vice President, Product SupplyNovo Nordisk

“Protecting our environment through innovation is not only a global call to action, but also a personal one.”

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In total, 9,909 fulltime employees1 work with ensuring the continuous supply of Novo Nordisk’s products. Production takes place in six countries and altogether production sites cover

491,200 m2, an area which corresponds to the size of almost 70 football fields2. Learn more about the different production sites below.

Novo Nordisk production site in Hilleroed, Denmark

Novo Nordisk’s global production by the numbers

Clayton, NC, USA

Denmark

Koriyama, Japan

Montes Claros, Brazil

Chartres, France

Tianjin, China

1. As of July 20132. 105 m x 68 m = 7140 m2

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Main activities:Production of active pharmaceutical ingredients for Diabetes Care and Biopharmaceuticals, formulation and filling, tabletting, assembly, packaging, device and needle manufacturing

Began operations in 1927

DENMARK298,600 m2 production area (spread over 8 locations)

6,927fulltime employees

Main activities:Device manufacturing, packaging, formulation and filling

832 fulltime employees

64,000 m2 production area

Began operations in 1996

CHINATianjin

Main activities:Formulation and filling, assembly, packaging

802 fulltime employees

47,000 m2 production area

Began operations in 2003

BRAZILMontes Claros

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61 fulltime employees

8,300 m2 production area

Main activities:Packaging

Began operations in 1997

JAPANKoriyama

740 fulltime employees

33,000 m2 production area

Main activities:Formulation and filling, assembly, packaging

Began operations in 1961

FRANCEChartres

USAClayton, NC

Main activities:Formulation and filling, assembly, packaging

547fulltime employees

40,300 m2 production area

Began operations in 1993

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Reviving the Brazilian Cerrado– the richest savannah in the world

Six hundred and eighty-two kilometres north of Rio de Janeiro lies the city of Montes Claros. An industrial hub, the city is home to half a million Brazilians as well as the largest factory of condensed milk in the world, the seventh largest cement factory in Brazil and the biggest insulin production site in Latin America.

In contrast to the thriving industry in Montes Claros, a particular type of savannah, known as ‘Cerrado’, surrounds the city with an enormous range of plant and animal biodiversity. The World Wide Fund for Nature named the Cerrado the biologically richest savannah in the world. Since the first detailed account of the Brazilian Cerrado was provided by Danish botanist Eugenius Warming in 1892, about 10,000 plant species and ten endemic bird species and nearly 200 species of mammals have been identified in the Cerrado.

With the arrival of the first cattle ranchers in 1707, followed by a steady growth in agriculture, much of the Cerrado has been converted to human use. Today, only 20% of the original vegetation remains intact. Yet, according to the World Wide Fund for Nature, less than 3% of this area is currently protected by law.

Conservation efforts are on the increase and the Brazilian government continues to designate sections of the Cerrado savannah as protected areas.

Ensuring the sustainability and resilience of the Cerrado for generations to come takes large efforts and it also requires other actors in society in addition to the government to address the challenge. Novo Nordisk has found its very own way to play a small but not insignificant role.

A local touch Before 2001, Biobras had been Brazil’s sole producer of insulin – one of only three insulin production sites in all of Latin America. But when Novo Nordisk acquired Biobras, the production site in Montes Claros was expanded to its current size of 47,000 m2 and around 800 employees. The site is responsible for the formulation, filling, assembling and packaging of insulin pen devices.

In line with the company’s environmental policy, site Montes Claros has achieved reductions in its use of resources and made steps to limit the environmental impact from its activities.

In 2008, senior management at site Montes Claros saw an opportunity to take environmental responsibility a step closer to home. They didn’t have to look far to support national and international efforts. In fact, the answer was right outside their backdoor.

The rise of industry in Montes Claros in the 1970’s resulted in areas of the Cerrado being cut down to make way for construction. When the

Montes Claros is surrounded by the Cerrado savannah

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first production site was built for Biobras, a large area of the surrounding Cerrado was deforested. Once construction was completed, a six hectare area, roughly the size of eight football fields, was left degraded.

After Novo Nordisk completed the expansion of site Montes Claros, the degraded area became an inspirational idea for Cerrado recovery. The idea became an employee driven initiative, known to both employees and the surrounding community as NovoECO.

A holistic value proposition “In simple terms, NovoECO is an initiative to revive the degraded area surrounding site Montes Claros,” says Paulo Emilio Gomes Nobre, Environmental Supervisor at site Montes Claros. Starting in 2009, Novo Nordisk employees have been bringing the degraded area back to life. “So far, more than 1,200 seedlings from native flora species have been planted and the area is now recovering back to its Cerrado roots,” he adds.

The recovered area has also helped site Montes Claros reduce CO2 through ‘trapping’. The trees that have sprung up have helped trap more than eight tons of CO2 since 2009. NovoECO is also focusing on waste handling. A composting area has been designated where the organic waste produced in the site is transformed into compost to be used in the green areas. Prior to NovoECO the organic waste was sent to a landfill site.

When it comes to water, the benefits of NovoECO continue to spread. By using treated waste water for irrigation of the site’s gardens

and grass, instead of buying the water from the local water treatment company, site Montes Claros has saved a daily consumption of 210 m³ of water and realised daily savings of R$1394 (approx. 4000 DKK).

One of the biggest victories of NovoECO is the return of native wildlife to the recovered area. In recent years, marmosets, ducks, birds, lizards and foxes have been making NovoECO their home, much to the delight of local universities and the community. The area attracts biologists and botanists that have used the site to study the efficacy of different methods of degraded area recovery. In 2012, more than 600 students have visited the recovered Cerrado at NovoECO, many of them conducting research on how successful recovery can be achieved.

Lastly, one other very important stakeholder group has also come to find NovoECO inspiring and motivating – the people who work at site Montes Claros every day. The initiative and resulting recovered green area has given employees a place to relax during breaks. The area is used by teams for meetings where the backdrop is a living demonstration of how Novo Nordisk is doing its part to reduce the environmental impacts from production.

The pride and satisfaction comes in taking a small step to make it possible for others to enjoy the wealth of beauty of the richest savannah in the world.

Starley de Assis Ribiero Fonseca at NovoECO, Montes Claros, Brazil

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Four ways to make your productiongreener

So what happens after environmental targets are set? How are CO2 reduction percentages translated into concrete actions? At the end of the day, ambitious targets are only achieved if management and employees on and around the production line are designing smart factories, finding new sources of energy inputs, rethinking processes and engaging in partnerships.

For almost two decades, Novo Nordisk has been setting targets and reporting on water, waste,

energy usage and CO2 emission. But a target is more than a number; it is a series of actions that integrate environmental considerations into daily activities.

Here are four examples of how Novo Nordisk works towards meeting targets, continuously improving global standards and challenging the status quo.

Novo Nordisk production site in Kalundborg, Denmark

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#1 DESIGNDesigning for greener production Novo Nordisk’s second largest production site is located in Tianjin, China, about 180 km (112 mi) from Beijing. The site covers an area of 64,000 m2 and has more than 800 employees.

In 2008, when Novo Nordisk decided to make additional investments at the Tianjin site, a decision was made to achieve energy savings of 20% compared to the company’s production site in Montes Claros, Brazil. But reaching the target would be a challenge.

The biggest challenge was the CO2 intensity of the site’s energy source. In Tianjin the power plants are mainly coal fired and thus emit more CO2 when producing electricity than the power plants in other Novo Nordisk sites, where lower carbon emissions are supported by hydro- and nuclear power and wind energy.

The answer to the 20% savings challenge proved to be in the design.

A step-by-step approach Before the first shovel hit the ground, Jens Frederik Studstrup from Global Environment, Health and Safety and Ulla Thomsen from Diabetes Finished Products Manufacturing Development looked into the construction plans for the new site expansion. By systematically working through a ‘long-list’, ensuring no ideas or possibilities were left off the table, the team scrutinised every step in the design for the new factory. What their environmental assessment revealed was substantial potential for improving the heating, ventilation and air-conditioning systems, what the environmental specialists refer to as ‘HVAC-systems’.

“The requirements for obtaining clean classified rooms for sterile filling of insulin pen devices are very strict and call for special handling and filtering of air,” says Studstrup, a specialist within environmental stewardship at Novo Nordisk. “One might think this means big fans and ventilation systems. But the sweet spot is a design that is intelligent and powered appropriately.”

Though it may not sound like a high impact area, when the planned HVAC-system design was analysed, the team discovered that they could cut the size of the motor fans in half while still achieving the same sterile environment in the filling rooms.

The team went about improving the design, reducing pressure losses, using otherwise wasted energy for heating, cooling, humidifying or dehumidifying air, and most importantly, ensuring the size of the HVAC-system matched the site’s needs.

“Oversizing the HVAC-system is like driving a race car in the centre of the city during the rush hour,” says Studstrup. “Unless you are trying to show-off, you have an engine that can never reach its full potential and is extremely inefficient.”

Direct impact on the bottom line Through the team’s improved technology and efficiency for fans, motors, variable speed drives, valves/vanes, filters, heating and cooling coils, savings of approximately 35% compared to site Montes Claros were achieved. Not only did the improved design save 10 million kWh in electricity but also cut operation cost by more than six million Danish kroner (one million US dollars) a year.

A Novo Nordisk employee inspecting the ventilation system

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“The bottom line is don’t think of heating, ventilation and air conditioning, including the design of cooling systems, as low status systems when designing new facilities and looking for green opportunities at your production site,” recommends Thomsen. “Very often these systems are the top energy consumers.”

#2 GREEN SOURCINGThe switch to renewable energy in Japan Since the 1970s, Japan invested heavily in nuclear power and natural gas to reduce its dependence on oil. However, after the earthquake in 2011 and the subsequent nuclear disaster in Fukushima, converting to alternative energy sources has been a key priority.

Novo Nordisk’s production site in Koriyama has relied primarily on natural gas, coal and oil. For years, the site has been exploring the switch to a renewable energy supply. But sourcing of green energy requires more than simply switching one power plug to another.

“We needed to find a solution that would be both environmentally friendly and economically viable. However, this was not an easy task,” says Sakata Katsuhiko, one of the site’s directors responsible for energy supply.

Exploring all options The first possibility considered was on-site wind generation, but it turned out that the average wind speed around site Koriyama was too low.The next alternative explored was geothermal power generation. However, Katsuhiko and his team found that investing in geothermal energy is very challenging in Japan due to high exploration costs and time consuming construction. There

were also environmental risks associated with this type of energy supply.

Having explored both wind and geothermal, the team turned to solar. The original vision was for solar panels to be placed on the roof. Unfortunately, unforeseen challenges also arose. First of all, the building’s construction was not designed to carry the weight of the solar panels. Even if this was addressed, calculations also showed that the cost effectiveness of solar power was too low.

As the list of viable energy alternatives shortened, Katsuhiko and his team remained determined to find a solution.

At last, an alternative emerged. In fact, it was a solution that Katsuhiko had already come across a couple of years earlier, but back then the timing had not been right.

The solution: green power certificates When it is not economically feasible to source renewable energy directly, a possibility is to source it through a green power certification scheme. In such a scheme, companies buy certificates from a green energy producer through an intermediary fund that secures the continuous maintenance and development of the green energy grid. The scheme that site Koriyama chose is fully acknowledged by the World Wide Fund for Nature, who has defined strict criteria for certificate schemes they can support. To be certified, the scheme must drive development in the energy system towards increased renewable energy.

From 2013, green power certificates secure site Koriyama with 100% renewable energy from biomass and wind, corresponding to 1,900,000

Novo Nordisk’s production site in Koriyama, Japan is now supplied with renewable energy from biomass and wind

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kWh a year. This is roughly the same as the annual energy consumption of approximately 400 Japanese households1. The certificates will be funded by financial savings generated from energy reduction initiatives that have taken place in recent years. These include improvements in the air conditioning system, an upgrading of pumps and humidifiers, and the use of more energy efficient lights. On average, site Koriyama has saved 0.7 million DKK (approx. 130,000 US dollars) annually from 2005 to 2012.

“The formula is simple. We save on energy saving projects and we allocate these savings to renewable energy. Purchasing power certificates secures us a green energy supply and on top of that we are supporting the development of renewable energy in Japan,” says Katsuhiko.

#3 TAKING A BOTTOM-UP APPROACHRunning longer per litre in Chartres With its production site in Chartres, France, Novo Nordisk is one of the largest consumers of water in the area. Water is a key resource in the production and preparation of penfill insulin devices. All the water used for running the site and the production comes from city water supplies. Back in 2004, site management came to realise that in the event of a water shortage, Novo Nordisk would face a considerable risk of having to shut down production for an unknown period of time. The realisation prompted a sense of urgency among employees and led to a clear, and much needed, business case. Reducing water consumption would be a way to reduce future operational risks, lower costs of production and improve the environmental footprint of the site. All at the same time.

Small ideas with a large impact To make the reductions happen, the site looked for ideas from those who knew best – the people

working on the production line. Based on a participatory approach, ideas, from simple to complex, were put forth, considered and evaluated for effectiveness. In the end, the commitment of everyone in the implementation of the best ideas has contributed to a continuous water reduction improvement programme. As part of the programme, a monitoring system has been put in place to achieve savings through accurate analysis of water consumption in all steps of the production.

One example is the reuse of soft water.2 Before, soft water which is used in production for cooling vacuum pumps went directly to waste. The idea from employees was to recover soft water and use it for other purposes in a closed-loop. This enabled the site in 2012 to reuse 100% of the soft water, decreasing water consumption by more than 80,000 m3 and savings more than 127,000 DKK (22,000 US dollars).

According to Xavier Roques, Utility Manager in site Chartres, “90% of the savings realised on the site has been achieved thanks to ideas from employees, without additional equipment, which means that it is feasible everywhere! Our target was really to improve our existing system.”

Decoupling water usage from production growth The bottom-up approach has helped reduce water consumptions considerably. In 2005, it took 2.24 litres to produce a 3 ml cartridge of insulin. Today it only requires 0.47 litres. This corresponds to a 79% reduction in water, which has been achieved while production volumes have been increasing significantly. In total, annual water consumption on site Chartres has decreased from 224,000 m3 to 78,000 m3 between 2005 and 2012. This includes not only water used in the production process, but also water used throughout the entire site.

“We haven’t stopped following up on our water use. We still work on that today,” explains Xavier. “As we begin implementing a new production line for insulin vials, we will look to the floor for inspiration to continue our journey. Today, we have the best performance within Novo Nordisk’s diabetes

2012 78,000 m3

Total water consumption for site Chartres

2005 224,000 m3

2012 0.47 L2005 2.24 LWater consumption for the production of one cartridge of insulin

1. Agency for Natural Resources and Energy, 2009. Available from: http://www.enecho.meti.go.jp/policy/saveenergy/save03/h22_bunsekityosa.pdf (accessed 7 August 2013).

2. Water containing little or no dissolved salts of calcium or magnesium

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production sites regarding water consumption.”Beyond the reductions in costs and environmental impact in Chartres, benefits from the water savings have also been felt in Africa. Employees suggested that part of the money saved from the decrease in water consumption should be set aside for the rehabilitation of wells in Burkina Faso for people with limited access to water. An initiative that has added new meaning and increased motivation for water savings at site Chartres.

#4 PARTNERING TO DO MORETurning wastewater into energy What started as wishful thinking more than ten years ago is now a reality in Kalundborg, Denmark. As of June 2013, Novo Nordisk and Novozymes, both world leaders in biotechnology, inaugurated a new biogas reactor that produces energy from production wastewater. This symbiosis is the result of a long and close collaboration.

A long partnership history Kalundborg has been home to Novo Nordisk’s and Novozymes’ production for many years. Together with local farms, municipal utilities and other companies, they form part of an industrial ecosystem known as the Kalundborg Symbiosis (see a video about the symbiosis here: http://www.symbiosis.dk/en/video). The symbiosis is a closed loop. The waste product of one company becomes a resource for another. Novo Nordisk and Novozymes already share wastewater treatment facilities, but the construction of the new biogas reactor is a further developmental step. A step that took a while to take.

“Back in 2002, Novo Nordisk and Novozymes started a pilot project to investigate whether it would be possible to convert wastewater from both companies into energy. However, at the time, the project was not assessed to be economically feasible,” says Jan Hoff, senior vice president of Diabetes Active Pharmaceutical Ingredients at Novo Nordisk. “But things have changed during the past ten years. Energy prices have gone up and biogas technology has become more advanced. Employees from both

companies were also persistent enough to keep the idea in mind.”

A world-class biogas reactor The new biogas reactor is one of the most efficient in the world and can produce 47,000 MWh of electricity a year – the equivalent of the annual electricity consumption of 12,000 households. But the beauty is in the fuel source.

When Novo Nordisk produces insulin in Kalundborg, the wastewater must be cleansed before it is sent to the municipal wastewater treatment plant. In traditional wastewater treatment, a lot of energy is used pumping air into the wastewater so the microorganisms that clean the wastewater have a supply of oxygen. The process creates heat and CO2, both of which are emitted into the atmosphere.

But in a biogas reactor, the wastewater is treated in an anaerobic process meaning that no oxygen is required and therefore less energy is needed. Once the anaerobic process gets underway, the microorganisms clean the water, turning organic material in the wastewater into biogas. The gas is used in a combustion engine to produce electricity and district heating.

A good business case The investments for the reactor have been shared by Novo Nordisk and Novozymes. Ownership and operating responsibility sits with Novozymes, which also oversees the large plant for water purification that is a part of the reactor. The electricity is sold to the electricity grid and the district heating is used by Novo Nordisk and Novozymes.

“Basically, we are pulling the energy out of the wastewater before disposing of it – this makes good business sense,” says Jan Hoff. “First of all, the costs of treating our wastewater are reduced. Another advantage is that compared to traditional wastewater treatment, the biogas reactor creates a lot less biomass which is a waste product. In terms of environmental benefits, the biogas reactor contributes to expanding the green energy grid and reducing the CO2 emissions associated with our wastewater treatment.”

In Kalundborg, wastewater from insulin production is converted into energy

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In 2006, Novo Nordisk joined the World Wide Fund for Nature’s Climate Savers Programme. A commitment was made to cut CO2 emissions from global production sites by an absolute 10% from 2004 to 2014. To carry out its commitment, Novo Nordisk launched a global energy saving programme which has now become an integral part of the company’s environmental management system.

The system specifies that all production sites must appoint an energy steward and conduct energy screenings every three years. Today, 30 energy stewards continue to implement efficiency projects and serve as challengers at the production facilities, always looking for new ways to improve.

Here you will meet two energy stewards from Novo Nordisk’s production site in Tianjin, China: Bohua Shao, Global Environmental, Health and Safety Engineer, and Zhanqiang Wang, Black Utility Manager.

What are the primary responsibilities of an energy steward?

Zhanqiang: I monitor the energy consumption status for the daily performance board meetings and review energy consumption on a weekly basis. In case of abnormal consumption, we will take actions and conduct a system running analysis immediately. I also organise the engineers in our department in the drafting of an energy savings guideline which covers maintenance, operations and energy projects.

The people driving sustainability Safeguarding environmental stewardship in Tianjin

Zhanqiang Wang and Bohua Shao, Novo Nordisk production site in Tianjin, China

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Bohua: In addition to reporting on energy consumption, my tasks have expanded to include training, coordination and analysis. For example, I have been involved in the development of training courses on basic energy management for my colleagues. In this way, we seek to promote an energy saving mind set across the department. I have also pushed myself as an analyser as I try to create more precise forecasts of energy and water by breaking consumption into smaller units based on functions, building areas, etc. This makes it easier to analyse consumption and identify issues.

What background does someone need to have to be an energy steward?

Bohua: I have a university degree with a major in Environmental Engineering. I was recruited by Novo Nordisk to maintain our environmental programme and later I got the opportunity to work as an energy steward, coordinating energy management at the production site here in Tianjin.

Zhanqiang: To be a good energy steward, I believe you need to have relevant technical engineering experience, data collection and analytical skills, system overview and cross-functional communication competence, strong sense of environmental responsibility and a strategic mind set.

What are some of the challenges you face in your work?

Bohua: Our site has key performance indicators on energy and water use. Water is the biggest challenge for us. Water consumption is rising as we use more to meet the increase in the sterile production of insulin penfills. Therefore we have to find ways to control and optimise the usage as well as do our best to maintain and track the system to avoid leakage.

Zhanqiang Wang works as Black Utility Manager at Novo Nordisk production site in Tianjin, China

Zhanqiang: Although we continuously work to improve, I will also say that it can sometimes still be a challenge to promote an energy saving mind set among everybody at the whole site. Basically, it comes down to changing people’s daily behaviour which is not always easy.

What would you say has been your biggest personal success as an energy steward?

Zhanqiang: In my area of responsibility, I have taken part in implementing several energy savings projects. Last year, we saved one million kWh due to optimisation of the heating, ventilation and air conditioning system and by switching lights off in selected areas. During 2013 and 2014, we plan to save another two million kWh on new efficiency projects. In this way, we reduce both our environmental impacts and financial costs.

Bohua: I think it is too early for me to talk about my biggest success as I have only been in this role for two years, but if I have to point something out, then it would be the energy screening that I coordinated last year. I managed to cover two sites and I was very happy with the result. Also, the role as energy steward has given me the opportunity to grow myself and learn useful technical skills, develop systematic management methods and widen my understanding of environmental responsibility.

How do you collaborate with headquarters and other energy stewards across production sites?

Zhanqiang: On a daily basis we share data and then we have annual global energy meetings where we have the opportunity to get to know each other, learn from experiences and facilitate the exchange of best practice across the organisation.

Bohua: We have a close collaboration with colleagues in the Global Environment, Health and Safety department in headquarters. They are always ready to give guidance or propose solutions. The same goes for my collaboration with energy stewards across the other production sites.

Would you say that there are many differences between being an energy steward in China compared to Novo Nordisk production sites in other countries?

Zhanqiang: I would say that on an overall level, the targets are the same.

Bohua: However, I still think each energy steward’s work is different. Firstly, the energy

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Bohua Shao works as Global Environmental, Health and Safety Engineer at Novo Nordisk production site in Tianjin, China

generating source is different from country to country. The Danish site is using windmills for energy generation, but we still rely on coal. This makes it challenging to decouple environmental impacts from production growth. Besides this, the approach to energy savings and environmentally friendly development in China may not be as advanced compared to other Western countries. But on the other hand, we still have advantages. For example, the Tianjin area has recently increased its focus on energy saving awareness. The government is offering financial subsidies to companies that implement energy saving projects or energy screening. Also, we are a fairly new production site, so energy efficiency has been thought into our design from the beginning.

Would you say that energy stewards are common in production sites in China?

Bohua: Based on my work experience, I don’t see it as something common in China. But I think it will be in the future because energy costs are continuously increasing, and companies and the Chinese government are paying more attention to promoting an energy saving mind set. In this context, I think Novo Nordisk can play a leading role in the field of energy management and sustainable development.

What kind of future career opportunities do you see for energy stewards in Novo Nordisk?

Zhanqiang: In my position, I think we will always have to think of ways to further develop energy savings, not only for the benefit of the company but also for the environment we are part of.

Bohua: I see a bright career opportunity as an energy steward in Novo Nordisk. The company considers sustainability to be a serious matter and it is a part of our company strategy. In my opinion, energy savings is exactly the way to implement the Triple Bottom Line business principle in site Tianjin.

“In my opinion, energy savings is exactly the way to implement the Triple Bottom Line business principle in site Tianjin.”

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Reducing pharma’s footprintin the National Health Service

A group of top professors called climate change one of the biggest threats to health in a 2009 paper published in The Lancet1. They argue that the effects of climate change on health will be felt by most populations and put the lives and wellbeing of billions of people at increased risk. The influence from climate change can be seen in patterns of disease, water and food security, population migration and urbanisation. All have an impact on the ability of people to lead healthy lives.

As a provider of care, the healthcare sector plays an important role in finding solutions to these health problems. But the healthcare sector is also a contributor to greenhouse gas (GHG) emissions. It is energy intensive and has a large carbon footprint.

According to a 2008 study, the National Health Service in England generates over 18 million tonnes of carbon dioxide emissions every year which amounts to 25% of all public sector CO2 emissions2. In the United States, a 2009

study by researchers from University of Chicago published in The Journal of the American Medical Association, showed that the American healthcare sector accounts for nearly a tenth of the country’s carbon emissions3.

The National Health Service Sustainable Development Unit (NHS SDU), a unit supporting the national health care system in England to become a more sustainable organisation, is taking the first steps towards addressing this issue. Together with a handful of companies, including Novo Nordisk, NHS SDU is working to find new ways to reduce the carbon footprint of pharmaceuticals and medical devices.

The full picture of healthcare sector emissions The healthcare sector covers a vast number of areas and processes that have an impact on the environment. To carry out its responsibility, the healthcare system requires energy and water for use in hospitals and healthcare facilities, it must dispose of waste, and indirectly, GHG emissions

1. Costello et al. Managing the health effects of climate change. The Lancet, 2009; 373: 1693-1733. Available from: http://www.ucl.ac.uk/global-health/project-pages/lancet1/ucl-lancet-climate-change. pdf (accessed 7 August 2013).

2. NHS England Carbon Emissions; Carbon footprint study, 2008. London: Sustainable Development Commission & Stockholm Environment Institute. 3. University of Chicago. Health care accounts for eight percent of US carbon footprint, 2009.

Available from: http://www.uchospitals.edu/news/2009/20091110-footprint.html (accessed 7 Aug 2013).

Pharmaceuticals and medical equipment account for a large share of the NHS’ carbon footprint

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come from the transportation of patients and from the procurement of goods and services, such as pharmaceuticals and medical equipment.

According to the NHS procurement accounted for as much as 65% of its GHG emissions4. On closer inspection, pharmaceuticals and medical devices accounted for 22% and 8% respectively of the total GHG emissions5.

The University of Chicago study found that hospitals were by far the largest contributor of CO2 emissions in the healthcare sector. However, the second largest healthcare contributor to the overall carbon footprint was the pharmaceutical industry. This contribution to CO2 emissions is not going unnoticed. Pharmaceutical and medical device companies are starting to explore solutions.

Companies are taking a wider scopeResource scarcity, tightening regulation and reputational concerns have encouraged many companies to consider how they can measure and reduce their direct carbon emissions. But with growing demand for sustainable products and increasingly higher expectations for environmental responsibility, management agendas are now shifting towards understanding the wider carbon impact of the organisation. The scope is now bringing into view the full carbon footprint of the value chain. This is why Novo Nordisk’s in its environmental strategy has also started looking beyond the doors of its factories.

“Our stakeholders increasingly expect us to address the impacts from activities up and down the value chain, from sourcing materials to disposal by end users”, says Lise Kingo, executive vice president and chief of staffs at Novo Nordisk. “To meet these expectations, we need to work together with our business partners.”

This has motivated Novo Nordisk to broaden its perspective on its environmental footprint and enter into the industry collaboration spearheaded by NHS SDU.

Collaboration on carbon calculationIn their efforts to understand the environmental footprint of their businesses and products, six companies, including AstraZeneca, Baxter, GlaxoSmithKline, Johnson & Johnson, Pfizer and Novo Nordisk, have entered into collaboration with NHS SDU.

In 2011, an international alliance was formed and in November 2012 the group published the first international guidance for calculating the carbon footprint of pharmaceuticals and medical devices (see link below). The guidance document was developed following the methodology of the GHG Protocol Product Life Cycle Accounting and Reporting Standard6 and has received the “Built on GHG Protocol Mark”, which is the internationally recognised standard Novo Nordisk adheres to.

The guidance is primarily intended for use by practitioners carrying out GHG assessments of pharmaceutical and medical device products, but it can also be used for a wider audience such as healthcare services, policy makers, producers and procurement professionals.

“We believe that standardised guidance is essential if the NHS and other health systems are to create a model for sustainable healthcare,” says Sonia Roschnik, Sustainable Development Unit for the National Health Service, public health and social care in England. “Accurate greenhouse gas accounting and reporting requires detailed processes and measuring GHG emissions consistently on a global level will help to identify emission ‘hot-spots’. This is where we initially need to focus our attention to achieve the greatest impact.”

4. NHS Sustainable Development Unit. NHS England Carbon Footprint, 2012. Available from http://www.sdu.nhs.uk/documents/publications/NHS_Carbon_Footprint_Published_2012.pdf (accessed 7 August 2013).

5. NHS Sustainable Development Unit. Greenhouse Gas Accounting Sector Guidance for Pharmaceutical Products and Medical Devices, 2012. Available from: http://www.sdu.nhs.uk/documents/Pharma_Full_Guidance_GHG_Nov_2012.pdf (accessed 7 August 2013).

6. A standard that provides requirements and guidance for companies and other organisations to quantify and publicly report an inventory of GHG emissions and removals associated with a specific product.

Want to know more?Read the Greenhouse Gas Accounting Sector Guidance for Pharmaceutical Products and Medical Devices. http://www.ghgprotocol.org/feature/pharmaceutical-and-medical-device-sector-guidance-product-life-cycle-accounting

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The guidance covers the full life cycle of pharmaceutical and medical device products and includes research and development, production of intermediates and final products, marketing, distribution and delivery, use and end-of-life. As an example, GlaxoSmithKline has started using the guidance to conduct carbon footprint tracking in the recycling and recovery scheme for their respiratory inhalers. Their calculations show that if every patient using an inhaler in the UK returned all their inhalers for one year, 512,330 tons of CO2 would be saved. This corresponds to driving a VW 1.4TSI Golf around the world 88,606 times7.

Sustainable procurement is gaining groundWhen it comes to public procurement, carbon footprint tracking of products and services is expected to become a standard practice going forward. A few countries have already started developing sourcing strategies to reduce the indirect carbon emissions generated by their healthcare suppliers.

In England, some local NHS units have started to include sustainability requirements in their procurement contracts. This is a result of the

NHS Carbon Reduction Strategy which has set a voluntary target for all NHS units to reduce carbon emissions by 10% by 20158.

The Swedish Environmental Management Council has introduced public procurement criteria that consist of proposals for environmental and social requirements to be used when purchasing pharmaceutical products. All criteria are based on a holistic view of environmental aspects, including a life cycle analysis9. In addition, the European Union is expected to launch a green public procurement standard by the end of 2013.

These can be seen as the first steps on the journey towards a low carbon future. One where companies operating in the healthcare sector will need to play a more prominent role in reducing the environmental impact of the healthcare system.

After all, we need to ensure that our efforts to improve health don’t come at the expense of the planet’s.

7. GlaxoSmithKline. Giant inhaler marks launch of first UK-wide inhaler recycling scheme, 2013. Available from: http://www.gsk.com/uk/consumers/complete-the-cycle/complete-the-cycle-press-release.html (accessed 7 August 2013).

8. NHS Supply Chain. Sustainability Report 2011. Available from: http://www.supplychain.nhs.uk/~/media/Files/Misc/Sustainability%20report%202011.ashx/ (accessed 7 August 2013).

9. Swedish Environmental Management Council. Our procurement criteria. Available from: http://www.msr.se/en/About/Procurement-criteria/ (accessed 7 August 2013).

The NHS is looking to reduce its carbon footprint beyond the transportation of patients and personnel

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Beyond the factory gatesproducing community value

Employees at Novo Nordisk’s production site in Clayton, North Carolina, USA

Production sites are most often thought of in terms of inputs and outputs. Raw materials go in and finished products come out. But between the ‘in’ and the ‘out’ are thousands of people who bring their energy and commitment to the workplace. Sometimes this energy gets taken beyond the workplace to the local communities where families, friends and neighbours live. It is what Novo Nordisk calls ‘TakeAction’.

Here are three examples of volunteering from across Novo Nordisk’s global production.

RAISING MONEY FOR MEALSClayton, North Carolina, USAIn North Carolina, 316,000 children live with hunger every day1. Though the majority of these children are enrolled in the state’s school lunch programme, many of these children still go hungry on weekends.

Research has shown that skipping meals can influence a person’s metabolism and can contribute to the development of type 2 diabetes. Working with the production of insulin every day, employees at Novo Nordisk’s production site in Clayton, North Carolina know all too well the

importance of healthy eating and living.In the spirit of giving back and improving health in their community, departments across site Clayton created the ‘Cash and Coin Wars’. The ‘Wars’ are a fundraising competition that pits departments against department to raise money for Backpack Buddies, a nation-wide campaign that provides meals and school supplies to school-aged children.

“Being married to a teacher for over 14 years, I see first-hand the needs of those less fortunate in the community,” said Chad Henry, one of the directors at the site. “I was so proud of our department and Novo Nordisk for making it possible for our youngsters to have the essential nutrition and supplies they need – both in and out of school.”

Managers and directors across the site also made additional commitments by matching personal dollars for their area’s contributions. The dedication from the top greatly contributed to the site’s fundraising efforts. In 2012, the 500+ workforce at Clayton raised 1,280 US dollars – all of which is being matched with site dollars – along with in-kind donations of back packs, school supplies and healthy snacks. According to Backpack Buddies, 350 US dollars provides a child with a BackPack filled with nutritious food each weekend for the entire school year2.

1. Action for Children North Carolina. North Carolina’s hungry children.Available from: http://www.ncchild.org/press-release/north-carolinas-hungry-children-raleigh-news observer (accessed 3 July 2013).

2. Food Shuttle. Meeting the needs of hungry children when other resources are not available.Available from: http://www.foodshuttle.org/program/backpack-buddies (accessed 7 August, 2013).

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THE ART OF BRINGING A COMMUNITY TOGETHER Montes Claros, Brazil Symbiosis is a word often used when discussing eco systems. It’s nature’s way of making one plus one equal three. Since February 2007, the employees at site Montes Claros have been volunteering to give symbiosis a local definition - NovoArtes.

The goal of NovoArtes is to bring community members together to create small business opportunities and help reduce waste sent to landfills. A simple idea with a large impact.

Waste, including old glassware, uniforms and scrap, is turned into handmade art at community workshops (see a video about NovoArtes here: http://novonordisk.com/sustainability). The art is then sold in local and regional markets, providing not only income generation, but also social integration as members of the community, young and old, take part. In 2012, 34,882 kg of waste from site Montes Claros was reused.

“When my mother began participating in NovoArtes, my intention was to give her an opportunity to join in a community social activity,” says Flavio Gomes de Sales, production support at site Montes Claros. “But as she became more involved in creating art, her self-esteem and health improved. NovoArtes helps many in the community to realise that they are able to develop their skills, regardless of their age or other limitations.”

TURNING WISHES INTO ACTIONS Tianjin, China A group of employees from Novo Nordisk’s production site in Tianjin, China, has teamed up to make small wishes come true for less fortunate

children. What might come as a surprise is what the children wished for. It wasn’t just toys and footballs.

The initiative was started by Jing Yuan who works in site Tianjin’s Quality System department. She reflected on her own childhood when parents and other family members had always helped realise her wishes. She wanted to find ways in which she and her colleagues could reach out to children in the community who unfortunately had not been so lucky.

In November 2012, Yuan and her colleagues had their first visit to Hongde House, which is home to 60 children ages 7 to 16 who have lost their parents. To begin with, Novo Nordisk employees focused on food and clothes donations, but quickly realised that they wanted to move beyond merely providing materialistic things.

Yuan came up with the idea to set up a “dreams collection box” at the orphanage so that children could write down their wishes and see them come true.

“After sorting through the wishes we were surprised to find that most of the children didn’t want material things, rather they wanted to improve themselves by doing better in their studies or helping others to be healthy and happy,” says Yuan.

The team from Novo Nordisk discussed how they could best use their skills to help make the children’s wishes come true. They decided to team up with 10 university students from Tianjin University. In collaboration, they began providing English training and study coaching to the children. So far, they have conducted three educational sessions at Hongde House during first half of 2013. In the second half, four more sessions are planned.

“We are all hoping to contribute to preparing the children for a better future,” says Yuan.

Providing children with skills for the future at Hongde House

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KalundborgSymbiosis

At the Kalundborg Symbiosis in Denmark, public and private enterprises buy and sell waste products from industrial production in a closed cycle. Residual products, including steam, dust, gases, heat, slurry or any other waste product that can be physically transported from one enterprise to another, are traded.

The outcome is huge. A residual product originating from one enterprise becomes the raw material of another enterprise, benefiting both the economy and the environment.

Take a deep dive into the symbiosis in the infographic below.

Find out more about each of the nine symbiosis enterprises here: http://www.symbiosis.dk/en/partnere

1. Surface Water

2. Gas

3. Surface Water

4. Biomass/NovoGro

5. Fly Ash

6. Heat

7. Heat

8. Steam

9. Steam

10. Surface Water

11. Cooling Water

12. Yeast Slurry

13. Sulfur Fertilizer

14. Tech. Water

15. Gas

16. Gypsum

17. Waste Water

18. Drain Water

19. Sludge

20. Fly Ash

21. Deionized Water

22. Water

23. Waste

24. Sea Water

25. Steam

26. Condensate

27. Straw

28. Bioethanol

29. Lignin

30. C5/C6 sugars

November 2013

About sustainability at Novo Nordisk

Headquartered in Denmark, Novo Nordisk is a global healthcare company with 90 years of innovation and leadership in diabetes care. The company also has leading positions within haemophilia care, growth hormone therapy and hormone replacement therapy. Novo Nordisk strives to conduct its activities in a financially, environmentally and socially responsible way. The strategic commitment to corporate sustainability has brought the company onto centre stage as a leading player in today’s business environment, recognised for its integrated reporting, stakeholder engagement and consistently high sustainability performance. In 2013, Novo Nordisk received the Pharmaceuticals and Biotechnology industry group top ranking on Corporate Knight’s list of Global 100 Most Sustainable Corporations.

We want to hear from you!Novo Nordisk believes that reaching out to stakeholders helps us to reconcile dilemmas and find common ground for more sustainable solutions. If you have any questions, comments or suggestions regarding this issue of the TBL Quarterly, please send us a mail at sustainability@novonordisk.com or send us a tweet to @novonordisktbl

For a deeper look at how Novo Nordisk works with sustainability, visit our website at novonordisk.com/sustainability