OUR CURRENT HEALTHCARE CRISIS AND THE CHINA CONUNDRUM
By: Dr. Victor M. Sternberg, D.M.D.
While you are reading this you should be aware that our office has taken a medical hiatus at the recommendation of the American Dental Association. We will be open for all dental emergencies and for all patients that have an immediate need to be seen for non-elective procedures. Otherwise, when we return to the office, something we will evaluate weekly, we will contact our patients.
In the course of doing research on the Coronavirus I came across disturbing information, much of which I was not aware of.
It has to do with the American dependence on Chinese manufacturing of our drugs and medications. Approximately 90% of all of our generic medications have their critical ingredients manufactured in China. We no longer manufacture Advil, Tylenol or Penicillin and derivatives Amoxicillin in this country. This disturbing discovery led me to continue to read about how this all came about.
Years ago many of our drug components were made in Puerto Rico. Puerto Rico had been given a low tax status that encouraged manufacturers to have facilities there. However, during the 90's and early 2000's, tax laws changed which drove pharmaceutical companies to find other sources of low tax environments in which to produce their products. This drove manufacturers to China and India where the tax rate was extremely low and where workers could be paid minimum wages, lowering the cost of production of either drugs directly or their ingredients.
This is almost analogous to having the Russians manufacture our nuclear warheads at a lower cost so the manufacturers of weapons in the United States can make a greater profit. Obviously something we would never do to endanger our national security by letting a country without our best interest manufacture our weapons.
In the case of pharmaceuticals, we have allowed a nation that does not have our best interest at heart to produce much of the drugs and ingredients of drugs that we need for our health and survival.
Let's trace back how this could happen.
Chinese manufacturerers whispered in the ears of American pharmaceutical companies that they could increase their profits and lower their costs by manufacturing drugs and components of drugs in China. The pharmaceutical industry representatives would then lobby their congressmen and senators to encourage the exporting of manufacturing of key ingredients in drugs to China.
Theoretically this should have lowered the cost of both generic and brand name drugs, but obviously it has not. The end result is that this has increased the profits of pharmaceutical companies and endangered our drug supply, putting it in the hands of a nation that should not have that kind of control over the health of Americans.
We have not produced Penicillin or Amoxicillin in this country since 2004. It is hard to believe that a drug, which is the most commonly prescribed drug for a myriad of infections, albeit dental or medical, is not produced in the United States.
Our defense department is particularly concerned that we have outsourced the drug industry and made ourselves vulnerable. They see this as a serious threat to our security.
A second and equally important facet of outsourcing our drug manufacturing is the quality control of drugs made in China. In 2008, Heparin, which is a drug used in blood clotting and made in China, resulted in the death of 149 Americans. The Heparin was tainted during the manufacturing process in China and that imperfection was not picked up by the FDA until we lost nearly 150 Americans.
The FDA has a very difficult time overseeing quality control in China. There are long waits to get into factories and there is evidence that the Chinese have falsified data. During inspections that did take place, up to 75% of the products were found to be sub-optimal and corrections had to be made. The FDA is very much overworked in China and under represented. They have found cancer causing ingredients in blood pressure medication and disease causing imperfections in others.
An article in a Chinese newspaper said that if we continue to give China grief, they will cut us off from our drug supply. The Chinese believe that if they stop exports of their drug ingredients they could shut down western medicine. A frightening thought. And more frightening is that fact that we allowed ourselves to be in this position.
Another country that also supplies us with many of the ingredients for our generic drugs is India, and we have a similar problem with quality control in that country as well. FDA supervision is very challenging.
There is a solution to this that a number of people have proposed. There are many factories in the United States that have closed down. It would be possible, with government financing, to employ some of the newer equipments that could manufacture drugs very cheaply, and employ Americans in the manufacturing process. This would take a capital investment by our government, but I cannot think of a better way to spend our money than helping American industry produce products that are vital to the health and welfare of America, taking that control away from our adversaries.
Economists and scientists have proposed having Puerto Rico return as a drug manufacturing mecca; they certainly could use the additional income on an island that is struggling financially. This would be of enormous help. By setting up lower rates of taxation in Puerto Rico, and encouraging manufacturing on the island, we could both improve the economy of a downtrodden territory and increase the safety and security of the United States.
Scientists around the world, as you are reading this, are working on various approaches to treat patients with the Coronavirus. Some are using medications that have been around for 50 years to treat malaria, combined with the Zithromax antibiotic. This has brought some remarkable results in France in treating a number of patients in which the virus disappeared within days. Other scientists are working creating antibodies to defeat the virus once one is infected. A vaccine is a long way off, but treatment for the patients that are ill may be much closer than a vaccine. We should all follow closely these developments.
Governments around the world, and especially in America, should be doing everything possible to provide our scientific community with what they need.
We have spent trillions of dollars over the last 70 years developing weapons that can end life on this planet within 2 hours We have failed to be as focused and committed to preserving our health and lives against epidemics and pandemics. Hopefully this is a wake up call.
This is one world. Although there are lines drawn on a map to separate us as people, as well as languages that separate us, it is obvious that a little virus doesn't recognize walls, languages or cultures. Mankind depends more on how we see ourselves as one race, living on one planet. G-d willing this virus will be a wake up call.
As always, I welcome your opinions.
Dr. Victor M. Sternberg, D.M.D.
By Westchester Center for Periodontal & Implant Excellence
April 24, 2020