Medical Care |

Medical Care

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ERSTE The ESG Letter January, February/2013 Edition RESPONSIBLE RETURN INVESTMENT BOARDHealthcare provision – a basic need not always met ENGAGEMENTAccess to Medicine COMPANY OF THE MONTHGlaxoSmithKline PLC PIN IT DOWNBitter pills & healthy capitalists?



ERSTE ASSET MANAGEMENT 02 When we wish each other a Happy New Year – as was the case just a few days ago – then the topic of health will almost always be at the forefront of our minds. As human beings, being healthy and staying healthy is accorded a high priority. The necessary healthcare provision is good to very good in large parts of Europe, despite the fact that even in these countries a debate about a „two-tier society in medical care" keeps emerging from time to time. In the developing countries, however, access to medicine does not go without saying. Consequently, four of the United Nations‘ eight Millennium Development Goals con- Wolfgang Pinner is Chief Sustainability cern an improvement in healthcare standards for the world‘s poorest regions.
Investment Offi cer and The sixth Millennium Development Goal deals with the fi ght against HIV/AIDS, malaria heads the Responsible and other serious diseases. For pharmaceuticals groups, access to medicine is a Investments team at Erste Asset Manage- multi-dimensional challenge. While the developing countries, in particular, constitute a market with huge potential, medicine is often unaffordable for the majority of their populations. The pharmaceuticals sector is now being closely scrutinised regarding this issue of access to medicine, and individual companies are being analysed in detail. In order to be able to do well in the rankings, companies can score for example with discounts, concessions on patent rights or with research programmes for currently neglected diseases. The improvements made in recent years give cause for optimism.
Wolfgang PinnerHead of SRI Team




ERSTE ASSET MANAGEMENT 03 The EAM Investment Board gives a structured form to the ongoing and responsive dialogue with and among sustainability research agencies. The Board provides the opportunity for the consultation pro-cess between own research and external research to take place. It also discusses rating details, the ESG‘s assessment of the IPOs of new issuers and sustainability issues in general.
Healthcare provision – a basic need that is not always accessible potential offered by other medici-nes. Although the above-mentioned Doha Agreement has strengthened the position of the developing na-tions, the details during cooperation often lead to protracted negotiations between governments and multina-tional groups. For the countries con-cerned, developing nations that are increasingly emancipating themsel-ves, this is not about development aid. They aim to become partners for the pharmaceuticals groups in their own right and offer favourable loca-tions for research and development in addition to patient proximity.
Consequently, donations and philan- 2020 thropy occupy an insignifi cant place in a critical evaluation of the indivi- Until the year 2020 the World Health Organisation wants to get a grip on dual pharmaceuticals companies in 17 neglected diseases. Some diseases like yaws and dracunculiasis should terms of access to medicine. More be eradicated by then. important are the organisation and Source: www.who.int; Photo: iStock management of the programmes themselves (for example, relating to nationwide supply at lower prices) as Outside the industrialised countries, trademark and patents) in that mem- well as the associated stakeholder access to suitable healthcare is cum- ber states are no longer to be pre- contacts to politics, competitors and bersome for many people. Various in- vented from tackling crises in the pu- consumers. The true focus of the eva- ternational initiatives are therefore blic healthcare sector: for example, luation is, however, on the areas of attempting to improve the access in the fi ght against HIV/AIDS in sub- R&D, price policy, sales channels and Saharan Africa.
patents and licenses. Access to medicine: The availability and affordability of „Access to medicine" status: medicine as well as acceptance and For the EAM Sustainability Research for the pharma sector health consciousness of patients all in the pharmaceuticals fi eld, ac- constitute major aspects of the ac- cess to medicine plays an impor- to medicine in the world‘s poorest cess to medicine issue. For the phar- tant role. This refers, in particular, countries. Both the Millennium De- maceuticals groups, the access to to the social dimension of the EAM velopment Goals of the United Na- medicine issue constitutes both an Responsible Rating. For the stake- tions dating from 2001 and the Doha opportunity and a risk. The research holder evaluation of companies in Agreement from the same year each costs for the development of new ac- the pharmaceuticals sector, the im- constitute a major step forward. They tive ingredients, patents and the ap- portance of „access to medicine" relativise the TRIPS Agreement (pro- proval of medicine in the individual amounts to 10%.
visions on intellectual property rights, countries contrast with the market


The treatment of a HIV-infectionwith name brand drugs is 50 timesmore expensive than therapy with an Indian generic drug. The difference between 200 and 10.000 US-Dollar for annual therapy can save lives.
Source: www.geo.de; Photo: iStock


ERSTE ASSET MANAGEMENT 05 Engagement is of great importance for EAM‘s sustainable investment approach. It combines own in-itiatives with collaboration on a national and international level. The structured engagement process is based on the „EAM Engagement Guideline" which determines engagement issues, approach and procedures.
Focus on Access to Medicine The Access to Medicine Index eva-luates the world‘s leading pharma-ceuticals companies with regard to access to health care they provide. The index analyses the strategies, anti-corruption measures, research & development, pricing & marketing, patents, structural support measures and philanthropic initiatives adopted by companies. It is recalculated everytwo years. medical supply chains Photo: Roche Swiss pharmaceuticals group Roche The pharmaceuticals industry is gene- With regard to its drop in the ranking of currently ranks 10th out of 20 on the rally accused of generating big margins the Access to Medicine Index, Roche index and has dropped four places and incurring high marketing costs in argues that the company‘s efforts in since the last calculation.
contrast to the rather low level of R&D the areas of oncology, infl uenza and spending in the development of new hepatitis are insuffi ciently taken into Roche has, however, been actively medicines. But Roche does not accept account in the index – which focuses seeking to improve access to medici- this argument and refers to the neces- on other diseases and conditions. ne. Asked about the patent law issue, sary spending on diagnosis quality pro- Moreover, the company is trying to im- the group does not consider this to be grammes, training of doctors and aid prove the medical infrastructure rather the biggest problem in supplying the staff as well as awareness campaigns.
than supporting donation programmes world‘s poorest countries with medici- for medicines, which is not refl ected in nes. Roche regards the lack of a sui- the evaluation.
AIDS medicines at a table infrastructure, such as medical personnel and hospitals, as a more price below that of Roche is in contact with EAM‘s sus- serious issue. The company also says tainability specialists with regard to the that patients often lack awareness of „access to medicine" issue. The aim actually being ill and are unwilling to of the Engagement process is to help accept medical assistance.
In the HIV/AIDS segment, Roche produ- Roche improve its ranking in the 2014 ces tests and second-line products (In- Access to Medicine Index.
From Roche's point of view the phar- virase® and Viracept®). In LICs (low- maceuticals sector‘s initiatives mea- income countries) and LDCs (least sured by the index are triggered less developed countries), the tests are sold Status Roche: among the top 20 by the TRIPS and Doha Agreements at a substantially lower price; in these holdings in ERSTE RESPONSIBLE than by the desire to establish mar- countries the company cooperates with STOCK GLOBAL and ERSTE RES- kets for medicines in the longer term the Clinton Foundation and UNICEF. PONSIBLE STOCK EUROPE, ongo- – for the benefi t of producers and AIDS medicine is sold at no profi t: i.e. patients alike.
at prices below the level of generics. ERSTE ASSET MANAGEMENT 06 Photo: iStock In 2011 the Austrians brought about 74.800 tons of electrical waste to By taking back used such as Teradata themselves to recycling. Changes in the investment universe, January 2013 The defi nition of our investment universe is the corner stone in building our funds.
(sector: IT consulting & other services) is one of the world‘s largest providers of solutions in the database and business analytics fi eld.
Steady reduction of energy consumption for cooling and heating of offi ce buildings and data centres and increased use of cloud and virtualisation technology 45% reduction in greenhouse gas emissions by 2014 (basis 2008) Product research and development with a focus on energy effi ciency Extensive commitment to data protection and strict measures to implement the requirements, ISO/IEC 27001 certifi cation of the information security management system Launch of the "Used Equipment Program" to take back used hardware from the end-user (sector: paper products) is a company in the paper and pulp industry with global operations. The company produces paper, pulp, wood and timber products.
Most production sites are equipped with environmental management systems certifi ed in accordance More than 80% of the forests owned by the company are certifi ed in accordance with Forestry Stewardship Council (FSC) guidelines Extensive code of conduct with a special focus on fair business practices Measures to increase the quota of women in managerial positions would be desirable Signatory of the UN Global Compact in 2008, no progress reports on this issue since 2011 (sector: integrated telecommunications services) is the leading provider of telecommunications services in Australia. The company provides fi xed network and mobile telephony, internet access, TV and associated Underdeveloped supply chain management with low minimum standards in the areas of social respon- sibility and protection of the environment Media reports in June 2012 according to which the company‘s sole supplier in the fi xed network business violated labour rights at its Chinese production sites; Telstra Corp Ltd. suspended sales of these products for a week and then considered the matter closed Repeated accusations by the Australian Privacy Commission and Australian Communications and Media Authority for violations of data protection provisions Outside of Australia, attempts at digital integration are minimal ERSTE ASSET MANAGEMENT 07 Company of the month:GlaxoSmithKline PLC GlaxoSmithKline („Glaxo"), one of the world‘s largest pharmaceuticals groups, produces pharmaceuticals and vaccines along with healthcare and hygiene products. In the SRI Universe of Erste Asset Management, the group numbers among the top pharmaceuticals companies. Since the introduction of the Access to Medicine Index (2008), Glaxo has consistently ranked fi rst among the 20 largest global pharmaceuticals groups. The key topics within this sector are access to medicine, product quality and safety, ethical marketing and business practices. Access to medicine and vaccines in the developing The Malaria cycle countries. Here, Glaxo focuses in particular on With the bite of an infected improving the affordability, availability Mosquito, an infective form and research and development of me- called sporozoite attacks dicines and vaccines. In the least de- the red blood cells. veloped countries, the price for medi-cines to combat malaria, diabetes and Fever occurs, inhibiting the asthma is restricted to 25% of the pro- blood supply of vital organs. duct price charged in the UK if Gla- The infected person will now xo is the sole local provider. With the transmit the disease to the support of NGOs, 20% of the income mosquito biting her/him. thus generated is reinvested in structu-rally weak countries in order to expand the local healthcare infrastructure. In countries with average incomes, pa- rameters such as income, order size and contract length are used in the negotiations with the relevant govern- tration (FDA) sent a warning letter to was sentenced to a record fi ne of USD ment to determine prices. New medi- the company after two contamina- 3 billion in July 2012 due to mislea- cines and vaccines to treat rare tropi- ted product samples were found at ding marketing and the failure to point cal diseases are researched not only its plant in Worthing (UK). The prob- out the side-effects of several medi- internally but also through public-pri- lem has since been resolved.
cines (Paxil, Welbutrin, Avandia) du- vate partnerships.
ring the period from 1998 to 2007. Moreover, the company is alleged to Product quality and safety.
business practices. have used various incentive systems Glaxo follows the guidelines of Good The company has established a code in the attempt to persuade physicians Manufacturing Practice and commits with ethical behaviour standards for to prescribe Glaxo products. The EAM its suppliers to adhere to the Third its employees while, at the same time, engagement process focuses on im- Party Code of Conduct. Nevertheless, defi ning an Employee Guide to Busi- proving the internal and external con- in 2011 the Food and Drug Adminis- ness Conduct. Nevertheless, Glaxo trol mechanisms.
GlaxoSmithKline employs a workforce of more than 97,000 worldwide. With sales of more than EUR 32 billion, it ranks in seventh place among the world‘s largest pharmaceuticals groups. Alongside its main business of Pharmaceu- ticals (67%), the company comprises the Vaccines (18%) and Consumer Healthcare (15%) businesses. The focus in the Pharmaceuticals business is on conditions and diseases such as asthma, HIV/Aids, malaria, depression, migraine, diabetes and cancer and in the Vaccines business on hepatitis, diphtheria, tetanus, typhoid and fl u. In the Consumer Healthcare business, the company‘s best-known products include Odol, Sensodyne, Dr. Best, Pa- radontax and Chlorhexamed, Zovirax, Panadol and Cetebe. ERSTE ASSET MANAGEMENT 08 Responsible fundsat a glance Erste Asset Management recognized the importance of responsible fund management early on.
Over the course of the past decade we have developed and successfully introduced a broad rangeof sustainable funds. The following funds are available in line with Erste Asset Management's„Responsible Investment Approach".
All funds are denominated in Euro.
ERSTE RESPONSIBLE STOCK GLOBAL ERSTE RESPONSIBLE STOCK EUROPE ERSTE RESPONSIBLE STOCK AUSTRIA ERSTE RESPONSIBLE STOCK EUROPE ERSTE WWF STOCK CLIMATE CHANGE ERSTE WWF STOCK UMWELT Performance calculated according to the OeKB (Österreichische Kontrollbank AG) method, as of 31 December 2012. The management fee is included in the performance. Subscription fees applicable at the time of purchase of up to 5.00% and other fees that may reduce returns, such as individual account and deposit fees, are not included in this presentation. Past performance is not a reliable indicator of the future performance of a fund. Please note that it is not possible to draw any conclusions on the volatility or risk of an investment from annualized averages for multi-year periods.
A The ERSTE RESPONSIBLE STOCK GLOBAL ERSTE RESPONSIBLE STOCK EUROPE, ERSTE RESPONSIBLE STOCK AUSTRIA, ERSTE RESPONSIBLE STOCK EUROPE EMERGING, ERSTE WWF STOCK CLIMATE CHANGE, and ERSTE WWF STOCK UMWELT funds may display increased volatility due to the composition of the portfolio. As a result, share values may be subject to signifi cant fl uctuations even over short periods of time.
B The ERSTE RESPONSIBLE STOCK GLOBAL, ERSTE RESPONSIBLE STOCK EUROPE, and ERSTE RESPONSIBLE STOCK EUROPE EMERGING funds may invest signifi cant amounts in derivative instruments (including swaps and other OTC derivatives) pursuant to Paragraph 73 of the InvFG 2011 (Investment Fund Act, Austria).
C The ERSTE RESPONSIBLE STOCK AUSTRIA fund is an index fund pursuant to Paragraph 128, section 5 line 1 in conjunction with Paragraph 75 of the InvFG 2011 (Investment Fund Act, Austria). The aim of the investment strategy is to emulate the VÖNIX (VBV Austrian Sustainability Index).
D The ERSTE RESPONSIBLE STOCK AUSTRIA and ERSTE RESPONSIBLE STOCK EUROPE EMERGING funds may invest signifi cant amounts in sight deposits or deposits with a maturity of no more than 12 months pursuant to Paragraph 72 of the InvFG 2011 (Investment Fund Act, Austria).
* Fund inception during the fi scal year ERSTE ASSET MANAGEMENT 09 Bond funds, mixed funds All funds are denominated in Euro.
ERSTE RESPONSIBLE LIQUID ERSTE RESPONSIBLE BOND ERSTE RESPONSIBLE BOND ERSTE RESPONSIBLE BALANCED Performance calculated according to the OeKB (Österreichische Kontrollbank AG) method, as of 31 December 2012. The management fee is included in the performance. Subscription fees applicable at the time of purchase of up to 3.50% and other fees that may reduce returns, such as individual account and deposit fees, are not included in this presentation. Past performance is not a reliable indicator of the future performance of a fund. Please note that it is not possible to draw any conclusions on the volatility or risk of an investment from annualized averages for multi-year periods.
a) The ERSTE RESPONSIBLE BOND fund may invest signifi cant amounts in derivative instruments (including swaps and other OTC derivatives) pursu- ant to Paragraph 73 of the InvFG 2011 (Investment Fund Act, Austria).
b) The ERSTE RESPONSIBLE BALANCED fund may invest signifi cant amounts in investment funds (UCITS, UCIs) pursuant to Paragraph 71 of the InvFG 2011 (Investment Fund Act, Austria).
* Fund inception during the fi scal year Microfi nance funds All funds are denominated in Euro.
ERSTE RESPONSIBLE MICROFINANCE Performance calculated according to the OeKB (Österreichische Kontrollbank AG) method, as of 31 December 2012. The management fee is included in performance. Subscription fees applicable at the time of purchase of up to 3,00% and other fees that may reduce returns, such as individual account and deposit fees, are not included in this presentation. Past performance is not a reliable indicator of the future performance of a fund. Please note that it is not possible to draw any conclusions on the volatility or risk of an investment from annualized averages for multi-year periods.
x) The ERSTE RESPONSIBLE MICROFINANCE fund may invest signifi cant amounts in investment funds (UCITS, UCIs) pursuant to Paragraph 7 line 1 of the InvFG 2011 (Investment Fund Act, Austria): Warning pursuant to the InvFG 2011 (Investment Fund Act, Austria): The ERSTE RESPONSIBLE MICROFINANCE invests entirely in assets pursuant to Paragraph 166, Section 1 line 3 of the InvFG 2011 (Alternative Investments), which represent a higher investment risk compared to traditional investments. In particular, these investments may result in a loss or even a total loss of capital invested.
Renaming of Funds New Name as of 30.11.2012 ERSTE RESPONSIBLE STOCK GLOBAL ESPA VINIS STOCK GLOBAL ERSTE RESPONSIBLE STOCK EUROPE ESPA VINIS STOCK EUROPE On 30 November 2012, all ERSTE RESPONSIBLE STOCK AUSTRIA ESPA VINIS STOCK AUSTRIA ESPA VINIS funds were rebran- ERSTE RESPONSIBLE STOCK EUROPE EMERGING ESPA VINIS STOCK EUROPE EMERGING ded to ERSTE RESPONSIBLE ERSTE WWF STOCK CLIMATE CHANGE ESPA WWF STOCK CLIMATE CHANGE funds. The fund names of the WWF product family remained ERSTE WWF STOCK UMWELT ESPA WWF STOCK UMWELT the same, while the prefi x ESPA ERSTE RESPONSIBLE LIQUID changed to ERSTE. The profi le ERSTE RESPONSIBLE BOND of all sustainable funds remai- ERSTE RESPONSIBLE BOND EURO-CORPORATE ESPA VINIS BOND EURO-CORPORATE ned completely unchanged.
ERSTE RESPONSIBLE MICROFINANCE ESPA VINIS MICROFINANCE ERSTE ASSET MANAGEMENT 10 Closing words byWolfgang Pinner healthy capitalists? The higher the health expenses, the healthier we are?", Wolfgang Pinner wonders Medicine is costing us more and more drugs coming from India in the medi- money. And if, when all is said and cal fi eld. The list of pharmaceuticals done, it doesn‘t help us, it may even groups with patent law issues in In- cost us our lives! The fact that the dia has by now become a long one.
fountain of youth is, unfortunately, But is it legitimate to violate laws yet to be discovered and that human- because health has to rate above kind is frantically attempting to keep fi lthy lucre? We must not forget the death a taboo subject while at the costs associated with the develop- same time increasing life expectancy, ment of new medicines. Pharmaceu- provides the very best conditions for ticals groups worldwide are con- a prospering pharmaceuticals indus- fronted with the costly test phases try. Demographic trends in the in- required by national healthcare au- dustrialised nations are also play- thorities. In order to cut costs, they ing into the hands of Pfi zer & Co.
therefore often take the bull by the horns and establish new, bigger cor- However, some resistance to the porate units. Hence, the Pac Man hegemony of the pharmaceutical game dynamic continues to prevail giants is forming. Epidemics and in the pharmaceuticals sector. If the contagious diseases have brought prey ultimately proves indigestible, countries in sub-Saharan Africa, the problem can, after all, no doubt in particular, to an impasse. There be treated by means of drugs.
seems, in some cases, no way out of the social and economic para-lysis. Governments, strengthened by international initiatives, are there-fore increasingly agreeing with the For more than 10 years Wolfgang pharmaceutical companies on „deve- Pinner has been active in the fi eld of lopment cooperation" – essentially, sustainable investments. He has writ- market access in return for reduced ten two books on this topic and repre- sents Austria at the industry associati-on „Forum Nachhaltige Geldanlagen". On the other hand, there are also countries that – albeit less needy – Wolfgang Pinner is Chief Sustaina- are not too fussy about patent protec- bility Investment Offi cer at the Ers- tion. The accusations often levelled te Asset Management and leads at China and its plagiarisms in the the Responsible Investments at the industrial sector apply to the pirated of European women abuse tranquilizing drugs. The number of men ab- of European women abuse tranquilizing drugs. The number of men ab-using tranquilizers "only" amounts to about 8 %. using tranquilizers "only" amounts to about 8 %. Source: www .unodc.org, World Drug Report 2012, p. 14; Photo: iStock ource: www.unodc.org, World Drug Report 2012, p. 14; Photo: iStock ERSTE ASSET MANAGEMENT 11 Our long-term partners in sustainability Erste Asset Management GmbH Erste Asset Management GmbH 1010 Wien, Habsburgergasse 1a Communications & PRTel.: +43 (0)5 0100 – 19982E-mail: [email protected] This document is an advertisement. All data is sourced from ERSTE-SPARINVEST Kapitalanlagegesellschaft m.b.H., Erste Asset Management GmbH and RINGTURM Kapitalanlagegesellschaft m.b.H. unless indicated otherwise. Our languages of communication are German and English. The fund prospectus (including any amendments) was published in Amtsblatt zur Wiener Zeitung in accordance with the provisions of the InvFG 2011 in the currently amended version. The fund prospectus and the key investor document (KID) are available free of charge at the domicile of the Management Company and at the head offi ce of the custodian bank. The exact date of the most recent publication of the fund prospectus, the languages in which the key investor document is available and any additional locations where the documents can be obtained can be viewed on the web site www.erste-am.com.
This document serves as additional information for our investors and is based on the knowledge of the staff responsible for preparing it at the time of preparation. Our analyses and conclusions are general in nature and do not take into account the individual needs of our investors in terms of earnings, taxation and risk appetite. Past performance is not a reliable indicator of the future performance of a fund. Please note that investments in securities entail risks in addition to the opportunities presented here. The value of shares and their earnings can rise and fall. Changes in exchange rates can also have a positive or negative effect on the value of an investment. For this reason, you may receive less than your originally invested amount when you redeem your shares. Persons who are interested in purchasing shares in investment funds are advised to read the current fund prospectus(es), especially the risk notices it or they contain, before making an investment decision.
Please consult the corresponding information in the prospectus for restrictions on the sale of fund shares to American citizens. Misprints and errors excepted.

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Microsoft word - supakit_31_36

Original Article 31 EFFICACY OF VERNONIA CINEREA FOR SMOKING CESSATION Supakit Wongwiwatthananukit1,∗, Preeda Benjanakaskul2, Thanapat Songsak3, Somporn Suwanamajo4 and Viroj Verachai4 1Department of Pharmacy Practice, College of Pharmacy, University of Hawaii at Hilo, Hilo, Hawaii 96720, USA 2Department of Pharmacy, Siriraj Hospital, Bangkok, Thailand 3Department of Pharmacognosy,

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