There seems to be one thing after another emerging in today’s world that makes achieving or maintaining good health seem near impossible. Take access to common and necessary maintenance pharmaceuticals — from amoxicillin (prescribed to treat certain infections caused by bacteria) to epinephrine (for emergency situations for severe allergic reactions) to etoposide (a drug for treating cancer) to rifampin (an antibiotic prescribed for treating bacterial infections) to aspirin and eye drops.
As reported by Parade magazine in January, according to Matt Soder, director of ambulatory pharmacy at Cleveland Clinic, drug shortages in this country have been a reality for more than a decade. “Many of these shortages are short-term in nature, and currently, some interruptions are due to logistical issues stemming from COVID-19,” he notes.
That there is an increase in shortages of these and other medications may not be news to you. That the shortage has been deemed a “national security threat” certainly should. As reported by The New York Times, according to a recent report as well as testimony at a Senate homeland security hearing that generated such a response from committee members. As testified by Dr. Andrew Shuman, a cancer surgeon in Michigan, shortages in his field have come to “represent a tragedy that’s happening in slow motion.”
A University of Michigan hospital system and the Veterans Affairs Ann Arbor Healthcare System reported to the committee stated that “drug shortages increased by nearly 30 percent last year compared with 2021, with an average shortage lasting 18 months and some spanning 15 years. They include common antibiotics, anesthetics and sterile fluids used to keep intravenous drug tubes clean.”
Explains Dr. Shuman, the drug etoposide was recently in such scarce supply that he had to weigh which patients, young and old, should receive the limited number of doses. “As a doctor who has devoted my life to fighting cancer, it’s hard to express how horrible that is,” he adds. He also cited other troubling shortages, including of eye drops that “literally keep people from going blind that cost a few dollars a month.” He said patients with glaucoma who do not get the drops could be faced with surgery instead.
“Many of the cheapest products tend to be manufactured in regions of India and China where they are inexpensive to produce, but the concentration of facilities creates an extra layer of vulnerability to problems such as natural disasters or political unrest,” writes Times investigative journalist Christina Jewett.
And problems exist not only at the receiving end of the equation but also at the distribution point.
The Washington Post reports that, due to staffing shortages, people may soon be faced with a frustrating new reality at their local drugstore, especially at those large chain stores. “As essential jobs at retail outlets go unfilled, and hours are reduced at many chains, the likelihood of spotty service and potential mistakes at pharmacies has grown,” writes Post reporter Marc Kaufman. As has occurred with many other health care workers, the pandemic has “slammed pharmacists,” writes Kaufman. He goes on to say that pharmacy groups report conditions as now more stressful and demanding, leading to burnout, and people leaving the profession resulting in staffing shortages.
In a 2021 National State-Based Pharmacy Workplace Study, 75% of the pharmacists in a survey disagreed with the statement, “Sufficient time is allocated for me to safely perform patient care/clinical duties,” and 71% said there were not enough pharmacists working to meet such duties. The survey included approximately “6,400 pharmacists in a variety of workplaces — large and small retail chains, independent stores and hospitals,” says Kaufman.
Reports the board of trustees of the American Pharmacists Association (APhA) in December 2021, due to stress from the pandemic, “workplace conditions have pushed many pharmacists and pharmacy teams to the brink of despair.” In February, APhA interim chief executive Ilisa Bernstein added “that little has improved since the 2021 survey.”
David Mott, a professor in the University of Wisconsin-Madison School of Pharmacy and the principal investigator on the new survey, says that “more than 60 percent of the community pharmacists who responded said they don’t have enough time to perform their work activities … It’s a scary situation; not healthy.” In February, APhA interim chief executive Ilisa Bernstein added that “little has improved since the 2021 survey.”
On the heels of this troubling news comes another disturbing report.
In 2006 and 2007, I had the great privilege of visiting with America’s troops stationed in Iraq, both men and women. The military helicopter pilots ferrying us from remote camps to major facilities were often women. During one trip, I was honored to meet a group of women Marines representing the Lioness Program, a highly trained group of female Marines attached to a combat unit to counter the insurgent practice of using women to smuggle contraband or act as suicide bombers, knowing that, because of religious principles, men were not allowed to search them.
It was an important reminder of a long military tradition in this country of women serving courageously and skillfully, especially during times of war. A similar program was enacted in Afghanistan as women of the Army’s Cultural Support Team were employed alongside elite special operations forces on combat missions in Afghanistan.
According to a Washington Post report, more than 300 women participated in the program between 2009 and 2021. “Many sustained life-changing injuries as a result of their work, only to find that they have had to prove to the federal government their need for specialized health care because the Pentagon never classified them as ‘combat’ veterans,” writes Hope Hodge Seck. Recently, a group of House Republicans and Democrats, all military veterans, introduced the Jax Act, which would require that these women’s personnel records be updated to reflect their frontline duties so they can get the post-service care they so greatly deserve.
“This is about more than just amending a military record,” says Rep. Darrell Issa (R-Calif.), an Army veteran and the bill’s primary sponsor. “It’s about telling the truth, recognizing courage under fire, and ultimately defending those who defended all of us.”
Amen to that.