Would You Feel Safer With Bernie And Elizabeth Warren Running America? You Would If You Use Medicine

I just got back from the hospital, where I go every 4 months for a little tune-up chemo-light infusion. Not fun, but... well, worth it to stay alive and functioning. And I love seeing my doctor and the nurses-- especially Cindy, the nurse who takes my blood samples before the infusion. The first thing she does is flush my port with saline. And at the end of the blood drawing she cleans the port with Heperin. It's the last thing everyone does before an IV. So, really important for a national hospital system that is always struggling to keep up to begin with.

And wasn't I surprised just as I was getting ready to head out, when a friend sent me this post at Naked Capitalism by Yves Smith, China Rx: How the US Depends on China for Its Drugs. Her post was passed a recent book, China RX: Exposing the Risks of America’s Dependence on China for Medicine by Rosemary Gibson and Janardan Prasad Singh. Gibson describe some of the key points from the book in the interview below:



With a madman, moron and trade warrior sitting in the White House-- Putin's dream president-- there's more than just steel and aluminum on the trade agenda that Trump is screwing up so badly. It turned out that the U.S. relies on China for the production of active ingredients in drugs and in many cases, of the medications themselves, to the degree that we would have a public health crisis if supplies were interrupted. From the interview above: "if China shut the door on exports, within months, pharmacy shelves in the United States to be empty, and hospitals would cease to function.

And don’t assume generics king India would step into the breach. India gets many of the active ingredients for its pharmaceuticals from China. Gibson forecasts that China will overtake India in generics manufacture within a decade.

As Gibson explains, the US no longer makes its own penicillin, in part because China dumped penicillin in 2004, driving the last US plant out of business.

The medications where the US relies on China include heparin, a blood thinner that among other things is used for IV drips. No heparin, no IV treatments. Due to the difficulty in tracing the source of drug company ingredients, the authors could make only case by case investigations, but they China production to be critical for treatments for Alzheimer’s HIV, depression, schizophrenia, cancer, epilepsy, and high blood pressure.

Dependency is not the only risk. US drug companies shifted production to China not just to save cost but to escape regulation. The FDA has only limited access to Chinese factories, with the Chinese having well over 700, yet the FDA able to inspect only 15 a year on average. As Gibson said on C-SPAN:

The FDA is trying to get inspection on site in China. The Chinese have severely restricted the number of inspections that they will allow and the whole program has become completely ineffective.

And the Chinese are often less than cooperative. Gibson describes even then how the agency has been directed to a Potemkin facility, as in the goods were made somewhere else…and the FDA was not able to figure out where. Similarly, reports presented by the health authorities to the FDA is understood to be as reliable as Chinese economic data.

This picture is particularly troubling given China’s poor record on production quality and sanitation. And worse, the US can’t even afford to bar imports of all substandard products. Gibson again:

In 2015, the FDA inspected a plant in China. It did that because it was getting a lot of customer complaints, presumably industry complaints, about the active ingredients that they were getting from this plant. There was bacterial contamination, some of the products. They did not have full therapeutic value. If that’s an antibiotic or chemotherapy, that could be devastating.

So the FDA went in and they found what they called systemic data manipulation. This is a plant that had passed muster by the FDA, the Chinese FDA and other inspections over many years. So the FDA banned 29 different products from coming into the United States. But because the United States is so dependent, the FDA had to exempt 14 of those products from its own ban. Some of those included antibiotics or ingredients for antibiotics and ingredients for chemotherapies, because the FDA was concerned about drug shortages in the United States. That is how dependent we are as a country.

It’s telling with the trade battle of wills with China a daily news item for months, that this critical piece of the picture is absent from the debate. One has to assume that it’s because Big Pharma doesn’t mind.

One of my friends at the hospital today told me that if the standards aren't meticulously upheld-- for example, if a company seeks to fatten the bottom line by replacing highly skilled compliance workers, with less expensive ones who dodn't know what they're doing-- well, mold is one problem. And the facilities don't like shutting down even when mold is discovered. Alas, this isn't a hypothetic situation-- and it happens in the U.S., where rules and regulations force the reluctant bottom line-oriented pharmaceutical companies to address it. In China, who knows how long it takes to be addressed-- or how far bribes go to make sure it isn't addressed. My friend who sent me Yves' article mentioned that "Lenin wrote about how capitalists would sell you the rope you use to hang them. The Chinese have taken this to heart."