With approximately 537 million adults in the world living with diabetes – a figure that is projected to rise to 783 million by 2045 if no action is taken. Diabetes places a great burden on health systems, and we are committed to working with health authorities and other partners to prevent and treat the disease.

The Novo Nordisk social responsibility strategy, Defeat Diabetes, includes long-term ambitions to accelerate prevention to halt the rise of diabetes, provide access to affordable care for vulnerable patients in every country and to continue to drive innovation to improve lives. 

Affordability of medicines is a global challenge and we know that some people in the USA living with diabetes are increasingly finding it hard to pay for their healthcare, including our diabetes medicines. Ensuring access and affordability is a responsibility we share with all involved in healthcare.

For information additional information about our approach to access & affordability, click here.

For information about how we work with prevention of chronic diseases, click here.

Performance
The estimated number of full-year patients reached with Novo Nordisk's Diabetes care products increased from 32.8 million in 2020 to 34.6 million in 2021. This 5% increase was primarily driven by growth in the GLP-1 franchise which increased by 1.3 million patients followed by the new-generation insulin franchise which grew by 0.7 million patients.

In 2021, the estimated number of patients reached with Novo Nordisk's Diabetes care products through the Access to Insulin Commitment was 1.7 million. Novo Nordisk also sold human insulin below the ceiling price of USD 3 in countries outside the commitment, reaching an estimated additional 2.2 million patients in 2021. During 2020, the ceiling price was lowered from USD 4 to USD 3 which affects the comparability of 2020 and 2021 results. Comparing 2021 and 2020 using the current ceiling price of USD 3, the result is an estimated increase of 40,000 patients reached in 2021. Using the previous ceiling price of USD 4, an estimated 3.4 million patients were reached in 2021 compared to 3.2 million in 2020. In addition to offering insulin at a low price, supply chain improvements and capacity building are also important levers in ensuring access to affordable care for vulnerable patients.

Type 1 diabetes (often referred to as childhood diabetes) is a lifelong, autoimmune condition which impairs the body’s ability to produce insulin. If left undiagnosed or untreated, excess glucose causes damage to organs which can result in severe health complications and, ultimately, in premature death. There is currently no prevention or cure and the only effective long-term treatment is multiple, daily injections of insulin.

Type 1 diabetes is one of the most common chronic childhood illnesses. The International Diabetes Federation (IDF) estimates that globally, more than 1.2 million young people under 20 years have type 1 diabetes and approximately 184,100 new cases are diagnosed each year. However, in low-resource settings, children with type 1 diabetes are often misdiagnosed or lack access to adequate healthcare services to manage their condition.

Changing Diabetes® in Children was established in 2009 as a public-private partnership to bridge these critical gaps in care. The partnership provides comprehensive diabetes care for children and youth living with type 1 in low- and middle-income countries. This includes free life-saving insulin and other medical supplies for persons up to 25 years of age.

Our ambition is clear: no child should die of diabetes. To learn more about Changing Diabetes® in Children, click here.

Performance
As part of Novo Nordisk’s Defeat Diabetes social responsibility strategy, Changing Diabetes® in Children aims to reach 100,000 vulnerable children and young people living with type 1 diabetes by 2030.

In 2021, 31,846 children were reached through Changing Diabetes® in Children, a 13% increase compared to the previous year.

The partnership is present in 18 countries by the end of 2021, following the addition of Ghana, Indonesia, Pakistan, and Peru during the year. Five more countries (Jordan, Lebanon, Malawi, Mozambique and Rwanda) are launching in early 2022 as part of an expanded partnership project with the World Diabetes Foundation.

We provide a workplace that is a safe and promotes both mental and physical health, and overall well-being. Our company culture also plays a strong role in ensuring a diverse, fair and inclusive working environment. Together, this is what determines our ability to attract and develop some of the best talent from all over the world.

Our responsibility to respect labour rights applies to our global operations as a global minimum standard of business conduct. We track labour rights performance for all our employees in the workplace and verify whether labour rights risks are being effectively addressed. 

For more information, download our Novo Nordisk Labour code of conduct (PDF)

We employ people in 80 countries globally. Since 2014, we have been a part of the living wage programme with an external global non-profit business network and consultancy. The objective is to ensure that all our employees are paid a living wage, i.e. adequate to purchase basic goods and services necessary to achieve a basic standard of living, based on calculations of living wages in the countries we operate in.

Performance
The number of employees increased in most areas, with the highest growth in Product Supply Quality & IT, partially countered by North America Operations.

The employee turnover rate increased from 7.9% in 2020 to 11.0% in 2021 which is comparable to turnover rates in years prior to COVID-19.

We employ more than 48,000 people worldwide, all of which have a fundamental right to a healthy and safe working environment. Supporting physical health and mental well-being is fundamental to grow personally and professionally. 

We offer a healthy and engaging workplace, supported by a comprehensive Health & Safety programme. To this end, we have implemented our Health & Safety management system across our entire global organisation to ensure such conditions for all employees and contractors. Below are some of the actions we have taken globally:

  • Developed global leadership guidelines to promote mental well-being and support managers taking responsibility for creating healthy workplaces. On an annual basis, we monitor levels of stress symptoms reported by employees. We train and educate our human resources experts and managers to have open dialogues with teams, so that issues in the psycho-social working environment, which could affect employees, are quickly identified and addressed.
  • Emphasised transport and traffic as a major risk area, particularly for medical representatives working in countries with poor public infrastructure. We have identified measures on transport accidents. Based on these, several initiatives to prevent transport accidents has been initiated in the organisation.
  • Continued to monitor the level of work-related pain annually. Heavy manual lifting has been an ongoing challenge in production facilities and so we have limited this to a 15 kg maximum load. Since 2016, we have minimised these routine heavy lifts in the production facilities. Sedentary work for long periods of time is posing a risk to employees’ short- and long-term health. To overcome this challenge, we have developed and launched a global toolbox offering guidance, tools, and inspiration to drive behavioural change through increased workday activity.
  • Maintained workplace health promotion with our novohealth programme. The programme enables employees to act on their health and provides a framework for integrating health promotion into the workday. Managers are responsible for supporting implementation of novohealth and provide opportunities to: engage in physical activity, enjoy healthy food and beverages, work in a smoke-free environment and attend regular health checks. The programme is adapted locally by novohealth ambassadors and its content is co-created by employees across the organisation. 

Performance

The average frequency rate of occupational accidents with absence was 1.3 accidents per million working hours in 2021, which is unchanged compared to 2020. The increase of 6.5% in the number of occupational accidents with absence (99 in 2021 compared to 93 in 2020) was counter-balanced by an increase in the number of employees. In 2021, Novo Nordisk had zero (0) work-related fatalities compared to one (1) in both 2019 and 2020. Novo Nordisk works with a zero-injury mindset and has a long-term commitment to continuously improving safety performance.

Being a sustainable employer offering an inclusive and diverse working environment is an integrated part of being a sustainable business. While a number of initiatives have been launched to progress gender diversity in Novo Nordisk, only gradual progress has been made as the current share of women in senior leadership positions is 36% in 2021 compared with 35% in 2020 (defined as vice presidents, corporate vice presidents, senior vice presidents and executive vice presidents).

To underline Novo Nordisk’s commitment, accelerate progress and ensure leadership accountability, Novo Nordisk has defined the following global aspirational targets:

  • Create an inclusive culture where all employees have a sense of belonging and equitable opportunities to realise
    their potential
  • Achieve a balanced gender representation across all managerial levels
  • Achieve a minimum of 45% women and a minimum of 45% men in senior leadership positions by the end of 2025

Balanced is defined as the range between 45%-55% to leave up to 10% flexibility for women and men and also allow for non-binary gender recognising that some employees may not wish to be categorised.

While gender is one dimension of diversity, Novo Nordisk fully recognises that diversity is any dimension that differentiates people and enables a diverse line of thought.

Performance
All management teams, from entry level upwards, are encouraged to focus on enhanced diversity, with the aim of ensuring a robust pipeline of talent for management positions. Gender diversity in management overall is 57% men and 43% women in 2021 compared with 59% men and 41% women in 2020. Among employees as a whole, the gender split is 49% women and 51% men in 2021, the same as in 2020. Gender diversity at BoD level for 2021 is 67% men and 33% women, compared with 62% men and 38% women in 2020.

Our overall guiding principle within taxation is to have a 'sustainable tax approach', emphasising our business anchored approach to managing the impact of taxes while remaining true to the Novo Nordisk values of operating our business in a responsible and transparent manner. This means that we pay tax where value is generated and always respect international and domestic tax rules.

As a global business, we conduct cross-border trading, which is subject to transfer pricing regulations. We apply a 'Principal structure' in line with OECD principles, meaning all legal entities perform their functions under contract on behalf of the principals and are allocated an activity-based profit according to a benchmarked profit margin. The tax outcome of this operational model is reflected in the overview above, which shows our corporate income taxes by region. To ensure alignment between taxing authorities about the allocation of profit between our entities, we have Advance Pricing Agreements in place for geographies representing around 65% of our revenue worldwide. 

Our tax policy has been approved by the Board of Directors. Read more about our Tax Policy here.

Performance
The total tax contribution in 2021 amounted to DKK 32,593 million split with 57% on taxes borne and 43% on taxes collected. In 2020, the split was 52% on taxes borne (DKK 13,676 million) and 48% on taxes collected (DKK 12,700 million).

The overall increase in total tax contribution from 2020 to 2021 is primarily related to ‘Corporate income taxes paid’. In 2020 the calculated corporate tax payable exceeded the prepayment of corporate income taxes in Denmark. These additional corporate income taxes have been paid in 2021. Furthermore, the profit before tax has increased for 2021, also resulting in an increase in ‘Corporate income taxes paid’.

Novo Nordisk makes annual donations to the World Diabetes Foundation (WDF), an independent trust, supports sustainable partnerships and acts as a catalyst to help others do more, and the Novo Nordisk Haemophilia Foundation (NNHF).

Performance
The WDF, an independent trust, supports sustainable partnerships and acts as a catalyst to help others do more. The amount granted to WDF has decreased from DKK 138 million in 2020 to DKK 92 million in 2021 as the donation in 2020 included a special one-off contribution of DKK 50 million. In 2021, the WDF Board of Directors approved funding to 13 partnership projects in 16 countries. See note 5.2 in the consolidated financial statements and worlddiabetesfoundation.org for additional information.

The NNHF supports programmes in low- and middle-income countries. Initiatives focus on capacity-building, diagnosis and registry, awareness and advocacy. Novo Nordisk agreed to a donation of DKK 20 million to NNHF in 2021 but due to financial considerations from NNHF the donation was not paid out. Since 2005, the NNHF has provided funding for 289 programmes in 83 countries. See nnhf.org for additional information.

We are committed to meeting our responsibility to respect human rights as defined by the UN Guiding Principles on Business and Human Rights. That means we recognise our responsibility to respect all internationally recognised human rights across our own activities and business relationships. Read Novo Nordisk’s Human Rights Commitment here .

Governance
Our Human Rights Commitment  is an integral part of Novo Nordisk Business Ethics Code of Conduct  which applies to all Novo Nordisk employees.  Business ethics including human rights is overseen by the Business Ethics Committee, comprising the Chief Executive Officer, Chief Compliance Officer and the Chief Legal Officer among others. 

Novo Nordisk’s human rights responsibility is anchored in the Business Ethics Compliance Office (BECO). Novo Nordisk’s Global Business Ethics Compliance Programme has integrated respect for human rights in all its key elements, i.e. governance, training, risk management, monitoring, tracking and evaluation. 

The Global Compliance Forum representing the Global Compliance Organisation meets quarterly to discuss operational matters to drive implementation of the Global Business Ethics Compliance Programme.

Embedding respect for Human Rights
Our Human Rights Commitment has been translated into the Novo Nordisk corporate human rights requirements that set human rights expectations to all our employees globally. Novo Nordisk requires employees to reflect respect for human rights in their daily decisions and actions, which are in short:

1)     Avoid causing or contributing to negative human rights impacts in all business activities

2)     Set human rights expectations to our business partners, with focus on high-risk activities

3)     Report human rights concerns to the Novo Nordisk Compliance Hotline. Prevent and mitigate recurrence of actual negative human rights impacts, with focus on severe impacts.

To implement the corporate human rights requirements across the company, human rights training of business areas including global operations are conducted regularly by our internal human rights expert. Training tools are also provided to business areas in order to support local implementation of the corporate human rights requirements.

In addition, other channels are used to continuously motivate managers and employees to continuously develop human rights awareness and ethics mindset. These include Human Rights Day campaign activities across the global operations and HQs, e-learning, games, monthly Business Ethics newsletters, quarterly webinars, internal articles and internal social media campaigns. 

Human rights risk management and due diligence
Novo Nordisk has human rights risks and data protection risks integrated to Novo Nordisk’s bi-annual global business ethics risk reporting process. All business areas are required to identify, assess, mitigate, prevent, track and report human rights risks along with anti-bribery and corruption risks and data protection risks. 

The scope of human rights risks includes Novo Nordisk’s potential and actual impacts on all internationally recognised human rights. Training of global legal and compliance professionals has been conducted, which guides that ‘risk to people’ is the starting point of human rights risk management. Human rights risks regarding i) patients, ii) employees, iii) other workers and iv) community members and other individuals, are reported into our internal risk reporting and management platform. 

Our risk assessment methodology includes consideration of ‘irremediability’ and scale of ‘harms to people’.  Top risks from across the global organisation are elevated for review and approval by the Global Compliance Forum, which then submits the top business ethics risks to the Business Ethics Committee for review and approval.  The top risks are reported to the Board of Directors annually. We are committed to continuously improving the quality of human rights risk management through continued awareness and training on human rights risks.  

Novo Nordisk is on a journey to continuously improve the management of risks of involvement in negative human rights impacts through our business relationships. For example, it is our corporate requirement that contractual agreements with all our third party representatives, among other business partners, should include our Business Ethics clauses that set human rights expectations according to the UN Guiding Principles on Business and Human Rights. We have been implementing risk-based business ethics due diligence for third party representatives. We conduct risk assessment for each third party representative to determine individual risk level. 

Our Human Rights impacts
Among the human rights impacts we have identified through the above-mentioned risk management and due diligence, the following were determined as our salient human rights issues and important human rights impacts. 

These have been prioritised for due diligence and reporting. Find out below how we manage each of these human rights issues and impacts:

  •  Access to essential medicines
  • Human biosamples
  • Clinical trials
  • Personal data protection & privacy (see Business ethics)
  • Counterfeit products (see Patient safety & product quality)
  • Patient safety (see Patient safety & product quality) 
  • Human rights in supply chains (see Supplier audits)
  • Safe and healthy working conditions (see Health & safety)
  • Labour in the workplace (see Employees) 

 

Stakeholder engagement and collaboration
We engage with peers and experts to seek continuous improvements in our approach, including:

The Global Business Initiative on Human Rights (GBI)

The Nordic Business Network for Human Rights (NBNHR)

The UN Global Compact

The Pharmaceutical Supply Chain Initiative (PSCI)

The Danish Ethical Trading Initiative (DIEH)

Remediation
Novo Nordisk requires all employees to report concerns of all potential and actual severe human rights impacts to the Novo Nordisk Compliance Hotline, and encourage them to report all their human rights concerns anyway. This is part of our corporate human rights requirements and employees receive training as described above under Embedding respect for Human Rights. The Novo Nordisk Compliance Hotline receives complains and concerns about human rights from third parties and any individuals.  Please note that customer complaints, side effects or falsified products should be reported to Report a side effect (novonordisk.com)

Our corporate human rights requirements that apply to all Novo Nordisk employees require that actual negative human rights impacts caused or contributed by Novo Nordisk’s activities or decisions should be provided with remedy. For remediation of negative human rights impacts in our salient human rights issues, see above each salient human rights issue.  

Modern Slavery Statement
Read our latest and previous statements on the UK and Australia Modern Slavery Acts

2020  -  2019  -  2018  -  2017