On this inaugural episode of Lit Health, host Tracy Granzyk is joined by Rosemary Gibson, author and Senior Advisor at the Hastings Center. Rosemary’s most recent book, China Rx, highlights the centralization of globally supplied medicines in a single country and the implications of this in the event of a global pandemic, natural disaster, or geopolitical event. Published in 2018, China Rx has been recognized as prophetic in the wake of the COVID-19 pandemic, and Rosemary’s expertise has subsequently been sought by the House Energy and Commerce Health Subcommittee, the CIA, and all fifty states’ emergency preparedness directors.
First, Rosemary discusses how she researched the then-untold story of US dependence on other countries for the supply of medicines. She traces the history of outsourcing drug manufacturing to China and the lack of standards there, which led to long supply chains (a particular problem during a global pandemic) and problems with the quality of medications. She also reveals that hospitals in the US suffered shortages and had to ration some medicines over the last year as global demand spiked and that this is directly related to the lack of generic medications manufactured domestically. Rosemary then discusses the problems with quality control of foreign-manufactured drugs, the harm that has been done to patients as a result, and the importance of being an engaged patient when dealing with prescription medications. Finally, she calls out US companies for prioritizing cheap products over high-quality ones and expresses her concerns at the diminishing power of the FDA to assure the quality and safety of medicines sold outside the US.
Highlights:
- Rosemary’s impressive resume.
- China Rx came about as a result of Rosemary searching for her next book topic and discovering how great the US’ dependence on other countries for medicines was, as well as how this affects patient safety.
- The early-to-mid-2000s push to outsource production of generic drugs to China, where there were virtually no standards.
- Long supply chains have become the norm, but they don’t work during a global pandemic.
- In 2020, the US was weeks away from not having access to sedatives that help people on ventilators and was rationing antibiotics.
- Allegedly, the US was dependent on China for about 90% of the core materials to make basic drugs used in hospitals, especially during COVID.
- The US does not make medicines including penicillin, aspirin, and even vitamin C. However, recently it was announced that a company based in Tennessee will buck this trend by making penicillin again.
- China has threatened to withhold medicines from the US, creating a national security issue.
- China Rx has had an impact on the drug industry, with companies making different and better decisions about their supply chains because of it.
- Medical harm due to poor prescription medication quality is hard to track, so the number of patients who die as a result of them isn’t known.
- The FDA couldn’t keep up with the onslaught of companies wanting to sell hand sanitizers to the US, with the result that some products containing methane slipped through and blinded customers.
- There are 900 footnotes in China Rx, and nobody has refuted anything in it.
- Rosemary is concerned by the diminishing role of the FDA in setting global standards.
- How to protect you and your loved ones from poor-quality medications.
- Country of origin is often missing from medicine boxes to avoid objections from customers.
- Find a pharmacist you can talk to and trust about these issues.
Quotes:
“There was the infant formula scandal, and even that, which happened around 2007 and 2008, that did not stop Western companies from outsourcing production to a country that had virtually no regulations.”
“This really is a concern that people have from all walks of life, and we have to make sure we have the medicines that people need, and that they’re safe, and that we can get them when we need them.”
“When the toilet paper is unavailable on the shelf, that’s one issue. I mean, that seemed like a crisis. But if you’re in the hospital, and you can’t get the drugs that you need when you’re in a critical care situation, that’s a whole ‘nother level. It’s public safety.”
“It has to be made exactly right. Every pill, every vial, every time.”
“We can’t make penicillin anymore. We can’t make aspirin anymore. We can’t even make vitamin C and so many other vitamins. That’s how bad it’s gotten.”
“Who would be counting toothpaste as a cause of harm? You wouldn’t think that, because we don’t even know where our toothpaste is really made.”
“Every time you go to the pharmacy, you have to ask questions, you really do. You have to be an engaged patient.”
“None of us are safe if our supply chain is being mismanaged.”
“Your research just validated things that people have known about and let happen. And that’s what blows me away. I mean, a lot of those people have probably retired and have boats.”
“People don’t understand the magnitude of the problem. I think they see a way to profit, and they forget about the downstream consequences of a short-term gain.”
“We’re becoming every day, more and more a global society. And if we are going to truly be global partners, we all have to have the same commitment to quality, to safety in the products we put out into the world.”
“The world looked to the FDA. And now what we’re talking about, it’s being proposed in Washington, is doing inspections of manufacturing plants by Zoom.”
“Engaging with a partner who’s alert, who’s aware of this, you’re absolutely right, you’ll do much better with a pharmacist and pharmacy, who’s attuned to this.”
“I hope people will take a look at the book China RX. We donate proceeds to good causes, and it’s written so my mother could read it.”
“We have made a lot of progress. But boy, we have so much work to do, and we have to get moving quickly.”
