surgical instruments

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Labour Standards in Pakistan’s Surgical Instruments Sector: A Synthesis Report (2019)

This report is a component of a multi-stakeholder programme led by the Ethical Trading Initiative in partnership with the Pakistan Institute of Labour Education and Research (PILER) started in 2018.

Pakistan is a major exporter of high-quality surgical instruments, produced in the Sialkot region, that are used in public and private health authorities
in Europe and the USA. Over the past decade a number of in-depth studies have highlighted instances of severe labour exploitation and child labour within the industry. There have been some improvements in compliance with international labour standards from exporting factories in Sialkot. However, there is little visibility or oversight of the lower tiers of the supply chain where exploitation is known to be prevalent.

This report builds on existing knowledge of the sector and its challenges. It set out to understand the root causes of poor labour standards and to identify the actual and potential roles and responsibilities of all of the key stakeholders in the global value chain. The aim was to identify recommendations that could deliver long- term solutions to these complex, endemic problems.

Click here to view and download the full report:

Labour Standards in Pakistan’s Surgical Instruments Sector:
a Synthesis Report

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Winds of Change

WHILE debate on the contradictions of capitalism, its ruthlessness and vulgarity, gains momentum on the margins of global discourse, capitalism glides smoothly along on the back of its modus operandi: the global supply chains. Termed as the foundation of 21st-century trade, global supply chains account for 80pc of global trade, benefitting Western populations through the availability of cheaper products manufactured by the low-wage, abundant labour of developing countries.

Pakistan is one of the low-cost production centres in Asia. In this country, Sialkot is a hub of several industrial clusters producing surgical instruments purchased by the healthcare industry in the West through global supply chains. According to a 2012 report by the Trade and Development Authority of Pakistan, 2,300 units in Sialkot, employing 150,000 workers, produce 150 million surgical instruments every year. Sialkot manufacturers sell to suppliers at a very small margin of profit; the suppliers then sell to the end users at much higher rates. For example, according to an estimate quoted in the 2010 report of the Rawalpindi Chamber of Commerce and Industry, a pair of surgical scissors costs $1 to produce, is exported from Pakistan to Germany at a price of $1.25 and, probably, sold to a hospital for about $80.

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