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A Taste of Our Own Medicine: What Happens When Our Lives Depend on Their Drugs?
January 21, 2009
India and China are the dominant — and in many cases sole — suppliers of active pharmaceutical ingredients and other raw materials for many life-saving drugs needed by U.S. patients, reports Monday’s New York Times. “The critical ingredients for most antibiotics are now made almost exclusively in China and India,” the article states. “The same is true for dozens of other crucial medicines, including the popular allergy medicine prednisone; metformin, for diabetes; and amlodipine, for high blood pressure.” Dr. Yusuf K. Hamied, who runs the large pharmaceutical ingredient supplier Cipla, remarks on the vulnerability of the drug supply chain to disruption: “If tomorrow China stopped supplying pharmaceutical ingredients, the worldwide pharmaceutical industry would collapse.” Noting the limited ability of the U.S. Food and Drug Administration to even track the geographic origin of key pharmaceutical inputs let alone fully assure their quality, the article focuses on the potential risks for health in the United States in the event that the source countries have lax safety controls or restrict access to drugs as a means of exerting pressure during political disputes.
After decades in which the global pharmaceutical industry was based primarily in the U.S. and closely allied countries, we are getting a taste of our own medicine. We’re learning what many low- and middle-income countries have always known: that national security and welfare is vulnerable without reliable access to drugs and vaccines — a hard objective to achieve when supply chains are fragmented and controlled outside of national borders. The tempting response is to seek self-sufficiency in the production of essential medicines. We’ve seen this as part of Brazil’s approach to health and industrial policies, in India’s public policies that favor the expansion of the domestic pharmaceutical industry, in Cuba’s production of vaccines, and in the attempts of other countries to make drugs at home. In the U.S., the New York Times reports, the impulse is the same: “Experts and lawmakers are growing more and more concerned that the nation is far too reliant on medicine from abroad, and they are calling for a law that would require that certain drugs be made or stockpiled in the United States.”
Seeking self-sufficiency in drug manufacture is a hard way to go, and may not be the best route to reliable supply of quality medicines. First, it requires counteracting the market forces that are leading to outsourcing and the growth of manufacture in countries where labor and other inputs are relatively inexpensive. India and China, which have massive and fast-growing domestic markets and are attractive to both local and multinational firms, will certainly have only more significant pharma sectors in the future. Their engagement in global markets should be welcomed rather than defended against. Second, only those countries with significant technical capacity, a decent regulatory authority and access to credit markets have a chance of growing or re-growing drug manufacturing at large scale. Other countries, many of which depend on the relatively low-cost products from emerging manufacturers, will be in the same boat they are now in, or worse if we focus on inward-looking solutions to drug supply and quality.
A sounder approach, and one that would benefit a much broader set of countries, is to work toward stronger multilateral collaboration to assure the quality of pharmaceutical ingredients and the dependability of supply chains. This is admittedly a complex task, particularly in setting out the roles of national regulatory authorities and establishing internationally acceptable standards. In that complexity, it’s similar to other contemporary global problems in which nations’ fates are intertwined — financial markets, for example, and carbon emissions. But if we don’t take on the challenge and push for a truly global approach and instead focus on go-it-alone reactive solutions, the existing inequalities in drug access will be exacerbated and we won’t all benefit from the potential efficiencies of global supply chains. This is one of the important tasks that could and should be part of the agenda of the to-be-named new head of the FDA.
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4 Responses to “A Taste of Our Own Medicine: What Happens When Our Lives Depend on Their Drugs?”
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January 21st, 2009 at 11:13 am
Ruth – What a striking example of interdependence! We indeed need to learn to work better with others.
January 25th, 2009 at 7:50 pm
There are interesting parallels with Indonesia’s nationalist stance on local pharmaceutical manufacturing (as reported by FT): http://www.ft.com/cms/s/0/017c.....fd2ac.html.
January 27th, 2009 at 2:50 pm
Interesting concept, but always still “thinking inside the box”!
How about if we start putting some greater thought emphasis on weaning ourselves from the tremendous media & psychological induced fear pressures: Pressures that have made so many people around the world virtually addicted to drugs, & dependency on the deep-pocket “Pharma’s” totally protected (by patents), thereby monopolistic, hold on this field.
So many – in fact in the US, especially, virtually the entire Medical & Health Service professionals’ “establishment” – now fall under the sway of this influence: To the extent that their synthetic drugs that don’t work at all, &/or have “side-effects” that are often worse than the affliction they are designed to curb or cure, just get glossed over with “ho/hum, what else is new” mentalities.
In this atmosphere, anyone that even dares attempt to introduce something that is NOT a Pharma-produced & protected product, gets swamped; even to the extent of having the Agencies whose staffs we, the tax-paying public, maintain to protect us, doing everything in their bureaucratic power to keep sound, solid, even overwhelmingly proven “natural” curatives from the market.
Even the terms “natural” or “homeopathic” are by now so “hot button” in the health field, some practitioners don’t even dare to discuss them, for fear of being “branded” by their peers.
At the same time, my work in this field – in Africa, Asia & Latin America – has introduced me to highly educated/dedicated medical service providers working in what we call in Africa “bush clinics”, providing daily miracles with the totally natural products they have, or can make, locally available. This includes the now pandemic afflictions of HIV (curbing the cell growth, to help the immune system stabilize & ward off killer diseases; mostly water, food & domestic sanitation-borne); Malaria (restoring the Red Blood Cells, to alleviate normal Chills>Fever>Chills symptoms, & eventually destroying the system’s balance; Cholera, Dengue Fever, Guinea Worm, River Blindness, plus too many more to list here, are now – & have been for decades!! – all totally stoppable/controlable, without a single “Pharma” prescription!
From these personal experience observations, I’m only suggesting – by way of a Swiftian “Modest Proposal” – that we at least LOOK into getting society “un-hooked” from chemicals & pharmaceuticals (that steal natural ingredient ideas from the indigenous peoples, then – under patent protection – synthetically reproduce them in their labs, at very great costs to all concerned).
We’ve heard – at least many, if not most of us – the horror stories re: Mutated & drug-resitant strains of pathogens, that have by now made not only our hospitals, but our schools & other public places not only “unsafe”, but deadly! E.g., MSRS/Staph infections, that virtually thumb their noses at any/all antibotics.
However how many have even heard of, let alone know, that there are totally natural, non-toxic, NO “health side-effects” solutions that can be applied, to check/reverse these run-away monster pathogens in days, if not hours; and simply by virtue of their dealing with/dispatching pathogens in an entirely different manner than do drugs or chems.
So instead of so much focus & concern on by whom/where all these pharmaceuticals are being produced, how about backing up a couple of steps and asking ourselves: “Is this trip really necessary?” Do we really need to depend, for example, exclusively on antiretroviral treatments & rigid regimens – that 25-50% of the developing nation HIV-infected drop out of after only short periods, because they can’t follow regimen requirements &/or afford even the “discounted” cost of them?
The UN has developed some fairly ambitious new Goals & Objectives for Mortality/Morbidity reductions from major diseases, in connection with its Millennium Development general plan. Included are major reductions in Water & fresh food (produce)-borne pathenogenic diseases. However, just a single one of these – Diarrheic dehydration – has been taking the lives of some 2.2-MILLION Infants/young children annually, year in and year out, without any significant overall abatement. We’ve been mostly dependent on the Chem industry’s “panacea” product, by now the worldwide “default” purification agent (even recently being. on recommendation of FDA, used to “rinse” the Salmonella & e-Coli et al pathogens off freshly harvested field produce). But even with this “wonderful” chem, we’ve seen little, if any, improvement in overall mortality &/or morbidity stats for this area. I wonder why!
Albert Schweitzer once mused on his observations of people who persisted on doing things the same way, over and over, then were perplexed as to “why” they weren’t getting desired results! Either he, or another wit, at some point noted this kind of conduct was an apt description for “being crazy”.
Are we crazy, or just addicted? Either way, if we don’t seriously start “thinking outside the box”, were all just Gerbils on the Pharma’s media exercise wheels.
January 27th, 2009 at 2:50 pm
Interesting concept, but always still “thinking inside the box”!
How about if we start putting some greater thought emphasis on weaning ourselves from the tremendous media & psychological induced fear pressures: Pressures that have made so many people around the world virtually addicted to drugs, & dependency on the deep-pocket “Pharma’s” totally protected (by patents), thereby monopolistic, hold on this field.
So many – in fact in the US, especially, virtually the entire Medical & Health Service professionals’ “establishment” – now fall under the sway of this influence: To the extent that their synthetic drugs that don’t work at all, &/or have “side-effects” that are often worse than the affliction they are designed to curb or cure, just get glossed over with “ho/hum, what else is new” mentalities.
In this atmosphere, anyone that even dares attempt to introduce something that is NOT a Pharma-produced & protected product, gets swamped; even to the extent of having the Agencies whose staffs we, the tax-paying public, maintain to protect us, doing everything in their bureaucratic power to keep sound, solid, even overwhelmingly proven “natural” curatives from the market.
Even the terms “natural” or “homeopathic” are by now so “hot button” in the health field, some practitioners don’t even dare to discuss them, for fear of being “branded” by their peers.
At the same time, my work in this field – in Africa, Asia & Latin America – has introduced me to highly educated/dedicated medical service providers working in what we call in Africa “bush clinics”, providing daily miracles with the totally natural products they have, or can make, locally available. This includes the now pandemic afflictions of HIV (curbing the cell growth, to help the immune system stabilize & ward off killer diseases; mostly water, food & domestic sanitation-borne); Malaria (restoring the Red Blood Cells, to alleviate normal Chills>Fever>Chills symptoms, & eventually destroying the system’s balance; Cholera, Dengue Fever, Guinea Worm, River Blindness, plus too many more to list here, are now – & have been for decades!! – all totally stoppable/controlable, without a single “Pharma” prescription!
From these personal experience observations, I’m only suggesting – by way of a Swiftian “Modest Proposal” – that we at least LOOK into getting society “un-hooked” from chemicals & pharmaceuticals (that steal natural ingredient ideas from the indigenous peoples, then – under patent protection – synthetically reproduce them in their labs, at very great costs to all concerned).
We’ve heard – at least many, if not most of us – the horror stories re: Mutated & drug-resitant strains of pathogens, that have by now made not only our hospitals, but our schools & other public places not only “unsafe”, but deadly! E.g., MSRS/Staph infections, that virtually thumb their noses at any/all antibotics.
However how many have even heard of, let alone know, that there are totally natural, non-toxic, NO “health side-effects” solutions that can be applied, to check/reverse these run-away monster pathogens in days, if not hours; and simply by virtue of their dealing with/dispatching pathogens in an entirely different manner than do drugs or chems.
So instead of so much focus & concern on by whom/where all these pharmaceuticals are being produced, how about backing up a couple of steps and asking ourselves: “Is this trip really necessary?” Do we really need to depend, for example, exclusively on antiretroviral treatments & rigid regimens – that 25-50% of the developing nation HIV-infected drop out of after only short periods, because they can’t follow regimen requirements &/or afford even the “discounted” cost of them?
The UN has developed some fairly ambitious new Goals & Objectives for Mortality/Morbidity reductions from major diseases, in connection with its Millennium Development general plan. Included are major reductions in Water & fresh food (produce)-borne pathenogenic diseases. However, just a single one of these – Diarrheic dehydration – has been taking the lives of some 2.2-MILLION Infants/young children annually, year in and year out, without any significant overall abatement. We’ve been mostly dependent on the Chem industry’s “panacea” product, by now the worldwide “default” purification agent (even recently being. on recommendation of FDA, used to “rinse” the Salmonella & e-Coli et al pathogens off freshly harvested field produce). But even with this “wonderful” chem, we’ve seen little, if any, improvement in overall mortality &/or morbidity stats for this area. I wonder why!
Albert Schweitzer once mused on his observations of people who persisted on doing things the same way, over and over, then were perplexed as to “why” they weren’t getting desired results! Either he, or another wit, at some point noted this kind of conduct was an apt description for “being crazy”.
Are we crazy, or just addicted? Either way, if we don’t seriously start “thinking outside the box”, were all just Gerbils on the Pharma’s media exercise wheels.