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antibiotics
World's Rivers Awash in Pharmaceuticals, Historic Study Reveals
Researchers who examined water samples from over 1,000 locations warn that "pharmaceutical pollution poses a global threat to environmental and human health."
Feb 14, 2022
Underscoring the value of collaboration, experts from around the world on Monday unveiled what they described as the first "truly global study" of pharmaceutical drugs contaminating rivers, which has "deleterious effects on ecological and human health."
"I hope the study will lead to projects that support and expand sewage treatment where it is needed the most."
The historic analysis, published in the journal Proceedings of the National Academy of Sciences, involved 127 authors from 86 institutions. They examined surface water samples from 1,052 sites in 104 countries--including 36 that had never been monitored before-- across all continents for 61 different active pharmaceutical ingredients (APIs).
Sample sites ranged from an Indigenous community in Venezuela where modern medicine is not used to highly populated urban areas such as Delhi, London, and New York City. Researchers also gathered samples from regions with political instability, including Baghdad, Nablus in the Palestinian West Bank, and Cameroon's capital, Yaounde.
The United States was the "most extensively studied" nation, with samples collected at 81 locations along 29 rivers across Colorado, Florida, Hawaii, Iowa, Missouri, Nevada, New York, and Texas. Samples were also taken in every European Union member state except Malta, which the paper explains "was not included due to the country's lack of rivers."
The paper notes that all four contaminants detected on every continent--caffeine, nicotine, acetaminophen or paracetamol, and cotinine--are "considered either lifestyle compounds or over-the-counter APIs." Another 14 APIs, including various antidepressants and antihistamines, were found on all continents except Antarctica.
"Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance," the study states. "Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals."
The Guardian's Damian Carrington reported that "the APIs end up in rivers after being taken by people and livestock and then excreted into the sewer system or directly into the environment, though some may also leak from pharmaceutical factories."
Lead author John Wilkinson of the University of York told Carrington that "the World Health Organization and U.N. and other organizations say antimicrobial resistance is the single greatest threat to humanity--it's a next pandemic."
"In 19% of all of the sites we monitored, the concentrations of [antibiotics] exceeded the levels that we'd expect to encourage bacteria to develop resistance," he said.
With the exceptions of Iceland and the Yanomami Village in Venezuela, "at least one API was detected in all of our study campaigns," the paper reveals. The highest concentrations were documented in Lahore, Pakistan; La Paz, Bolivia; and Addis Ababa, Ethiopia.
Overall, the most polluted samples came from African and Asian countries, the experts found. The most contaminated samples from Europe, North America, and Oceania were from Madrid, Spain; San Jose, Costa Rica; and Adelaide, Australia, respectively.
"While the majority of previous studies have monitored active pharmaceutical ingredients in rivers, these studies have often excluded many countries, have measured only a select few pharmaceuticals, and used different analytical methods," co-author Anna Sobek of Stockholm University said in a statement. "This means that it is difficult to make direct comparisons between studies and, hence, assess the scale of pharmaceutical pollution across the globe."
Though she emphasized that the study confirms the issue is global in nature, Sobek noted that "in general, the rivers with the highest level of pharmaceutical pollution were found in low- to medium-income countries where there are no adequate water treatment facilities and where high emissions from the manufacturing of pharmaceuticals are found."
"The findings of this study remind us that the medicines we buy in pharmacies can have a big impact on the environment of the countries they are manufactured in," Sobek said.
"Since we clearly show that access to sewage treatment facilities significantly improves water quality," she added, "I hope the study will lead to projects that support and expand sewage treatment where it is needed the most."
Wilkinson told Carrington that "we know good sewage connectivity and wastewater treatment is the key to minimizing, though not necessarily eliminating, pharmaceutical concentrations," but it "is extremely expensive as there's a lot of infrastructure involved."
In a statement, Wilkinson said the research project "is an excellent example of how the global scientific community can come together to tackle large-scale environmental issues."
The paper highlights that the authors' approach "could be applied to other APIs and other classes of pollutants, such as personal care products, endocrine-disrupting chemicals, pesticides, and metals," as well as "expanded to other environmental media, such as sediments, soils, and biota."
"As we move toward 2030, the new paradigm in environmental monitoring must involve a global, inclusive, and interconnected effort," the study concludes. "Only through global collaboration will we be able to generate the monitoring data required to make informed decisions on mitigation approaches required to reduce the environmental impacts of chemicals."
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What We Choose to Eat Has Everything to Do With This Pandemic--and the Next One
COVID-19, the environment, and animal suffering all point to the same conclusion
Apr 26, 2020
When the history of COVID-19 is written, will we finally name our obsession with eating animals as the original sin that led to a catastrophe of such profound consequence?
Will we have learned from the lesson of the Wuhan "wet market"--where COVID-19 is thought to have originated--that cramming wild animals into meat markets is dangerous? Will we have added to that lesson the one about the H1N1 swine flu of 2009 that originated in an intensive pig confinement operation in North Carolina? Will we have also added both these lessons to the H5N1 bird flu lesson in 1997, in which yet another deadly disease evidently originated in animal farms? Will we have factored in the tens of millions of illnesses each year that come from bacteria-contaminated meat? And will we have finally concluded that confining billions of animals annually into potentially lethal pandemic- and bacteria-breeding grounds didn't add up to anything good?
When we have carefully compared the number of people who died in the U.S. in April, 2020, not only from COVID-19 but also from heart disease, will we notice that the numbers were similar, but one disease--COVID-19--led us to shutter our economy and spend trillions of tax dollars to prevent more deaths, while the other--heart disease, largely preventable through reducing or eliminating our excessive consumption of meat and dairy--had been exacerbated through tax-subsidized animal agribusiness?
Will we wonder why meat sales surged during the pandemic? Will we have mourned the employees in slaughterhouses who died after hundreds were infected in crowded, dangerous conditions that left no room for safe distancing, as well as mourned those who died after being exposed to these COVID-19-infected people?
Will we have also mourned the pigs themselves, the abuse of whom was so torturous that anyone treating a dog or cat the way we treat pigs (as well as lambs, cows, calves, chickens, and turkeys) would have been guilty of a crime?
When we remember the 50th anniversary of Earth Day that occurred during the pandemic, will we notice how little mention was made of our animal-based diets, which were largely responsible for rainforest destruction, water pollution, and aquifer depletion, as well as a huge contributor to climate change?
Will we still disdain vegans, who are so often disliked in our society?
Perhaps something different will have transpired by the time the pandemic history is written. Maybe we will have finally decided to change our food systems and dietary habits in order to protect ourselves from future pandemics and preventable diseases, as well as reduce the rate of runaway global warming. Maybe we will have resolved to put an end to the animal cruelty that future generations will be utterly appalled by.
When our children ask us the question, "How could you have been so foolish, selfish, and cruel?" perhaps we'll honestly admit that for too long we cared more about temporarily pleasing our tastebuds than about their future. And then we'll quickly add that we finally changed our systems, and it turned out not to be so hard to do.
We'll describe how even the biggest meat companies began producing plant-based proteins that tasted identical to animal flesh, while other companies produced clean meat by growing animal cells, obviating the slaughter of animals and the use of antibiotics in farming, which had caused antibiotic resistance that gravely threatened human health.
We'll tell them that we finally transformed the political systems that had enabled animal agribusiness to influence legislation for so long, and we put an end to subsidizing the foods that were killing us and harming our planet.
We'll point to the sustainable food systems we created that nourished billions of people safely, and which simultaneously helped protect other species' habitats, stemmed the rate of extinction, and slowed the warming of the planet.
We'll remind them of what, by then, they would already know well - that our educational system had shifted to ensure that they learned how to be solutionaries who could bring their good minds and big hearts to bear on solving real-world problems in ways that enabled all to thrive.
We'll be able to tell our children that COVID-19 made us finally change what we put in our mouths to nourish ourselves, and our children will thank us.
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As Superbugs Infect Millions and Kill Tens of Thousands Each Year, CDC Chief Warns Post-Antibiotic Era 'Already Here'
"On average, someone in the United States gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies."
Nov 13, 2019
Bolstering concerns about the "continuing threat" that so-called superbugs pose to human health, the Centers for Disease Control and Prevention released a report Wednesday that found antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths annually in the United States.
"Stop referring to a coming post-antibiotic era--it's already here."
--CDC Director Robert R. Redfield
"That means, on average, someone in the United States gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies," the CDC said in a statement announcing the report, Antibiotic Resistance Threats in the United States 2019 (pdf).
"When Clostridioides difficile, a bacterium which is not typically resistant but can cause deadly diarrhea and is associated with antibiotic use, is added to these," the statement continued, "the U.S. toll of all the threats in the report exceeds three million infections and 48,000 deaths."
The new release follows the CDC's 2013 AR Threats report (pdf). Since the first report, CDC Director Dr. Robert R. Redfield told reporters Wednesday, "we've reduced the number of deaths from antibiotic-resistance by 18% overall and by nearly 30% in hospitals alone." However, the 2019 report says that "CDC is concerned about rising resistant infections in the community."
"This is a problem that ultimately affects all of us... It literally has the potential to affect every person on the planet."
--Michael Craig, CDC
"This is a problem that ultimately affects all of us," Michael Craig, a CDC senior adviser on antibiotic resistance, told CNN. "It literally has the potential to affect every person on the planet."
The new report also says that "the emergence and spread of new forms of resistance continues to alarm CDC experts," noting that "antibiotic-resistant germs can share their resistance genes with other germs and can make them untreatable." Craig described the interplay as "essentially crowdsourcing."
The CDC classified carbapenem-resistant Enterobacteriaceae (CRE), Neisseria gonorrhoeae, and Clostridioides difficile as urgent threats in 2013 and added two more with this year's report: drug-resistant Candida auris and carbapenem-resistant Acinetobacter. The new report lists 18 antibiotic-resistant bacteria and fungi sorted into three categories: urgent, serious, and concerning.
Reporting on the CDC's findings Wednesday, CNN shared the story of Peggy Lillis, "a healthy, vibrant 56-year-old teacher in Brooklyn, who woke up one morning 10 years ago with severe diarrhea."
Her son Christian Lillis said that "being a kindergarten teacher, she just assumed that she caught something from one of the kids or maybe she had food poisoning. She did not think it was a serious threat. None of us did."
According to CNN:
Five days later, Peggy was so sick she could barely move.
Doctors immediately admitted Peggy to the intensive care unit. She had Clostridioides difficile, or C. diff, one of the urgent threats on the CDC's list.
Peggy's kidneys were starting to fail, and she was going into septic shock.
The hospital gave Peggy an antibiotic called vancomycin, both intravenously and by enema. But she died the next day--less than a week after becoming ill.
"The doctors at the hospital where she was treated--they did everything they could for her," Christian said. "But bacteria are evolving at a rate that we are not keeping up with."
Christian says they'll never know exactly where or when his mother picked up the C. diff bacteria.
Redfield, in the report's foreward, outlined four actions the United States "must" take to address antibiotic resistance:
- Stop referring to a coming post-antibiotic era--it's already here. You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy. The time for action is now and we can be part of the solution.
- Stop playing the blame game. Each person, industry, and country can affect the development of antibiotic resistance. We each have a role to play and should be held accountable to make meaningful progress against this threat.
- Stop relying only on new antibiotics that are slow getting to market and that, sadly, these germs will one day render ineffective. We need to adopt aggressive strategies that keep the germs away and infections from occurring in the first place.
- Stop believing that antibiotic resistance is a problem "over there" in someone else's hospital, state, or country--and not in our own backyard. Antibiotic resistance has been found in every U.S. state and in every country across the globe. There is no safe place from antibiotic resistance, but everyone can take action against it. Take action where you can, from handwashing to improving antibiotic use.
Redfield told reporters Wednesday that "antibiotic resistance remains a significant enemy and we need to ensure our interventions are effective and monitored through the programs we institute. We must remain vigilant."
Through the CDC's AR Solutions Initiative, he said, "we will continue to invest in our country's public health infrastructure and in states essential programs such as the antibiotic-resistant lab network and by more than 500 local AR experts who will rapidly detect and prevent the spread of antibiotic-resistant germs."
The CDC collaborates with the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, other federal partners, data analysts, healthcare providers, and veterinarians to improve antibiotic use. The agency also works with private industry to improve food safety, medical devices, and surveillance capabilities, and supplies drug and diagnostic test developers with samples of resistant germs from the CDC's AR Isolate Bank so they can undercover new drugs and treatments.
"We've invested $110 million dollars in researchers who are studying prevention strategies... and we will support these kinds of important discoveries," said Redfield. "Our nation's health departments, protecting us on the front lines, need even stronger lab capacity and specialized technologies, more boots on the ground to stop the spread of bacteria and fungi, and tailored interventions to improve the antibiotics that are used in humans, animals, and in the environment."
"The global community needs more innovation, new treatment options, reliable diagnostics, and better data that will help protect people and animals," Redfield added. "And our detection, prevention, and innovation strategies that have proven effective in the United States should be scaled up worldwide, where appropriate."
In April, as Common Dreams reported, the U.N. Interagency Coordination Group (IACG) on Antimicrobial Resistance warned that globally, superbugs could kill 10 million people per year by 2050 without urgent action. Already, according to that report, 700,000 people around the world die annually from drug-resistant infections.
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If We Want Antibiotics to Work, Consumers Have to Put Big Pressure on Factory Farms
On March 1, Denny's stopped purchasing chicken treated with medically important antibiotics for its U.S. restaurants. Many consumers might expect to see such promises at Whole Foods or their local farm-to-table restaurant, but why is a chain like Denny's (i.e., one that is enjoyed more for its assortment of inexpensive breakfast foods than its moral standards) joining the trend to reduce antibiotics in meat?
Jun 15, 2019
On March 1, Denny's stopped purchasing chicken treated with medically important antibiotics for its U.S. restaurants. Many consumers might expect to see such promises at Whole Foods or their local farm-to-table restaurant, but why is a chain like Denny's (i.e., one that is enjoyed more for its assortment of inexpensive breakfast foods than its moral standards) joining the trend to reduce antibiotics in meat?
In fact, Denny's joins a growing group of major fast food and fast casual chains (McDonald's, Wendy's, KFC, Chipotle, and others) that have established policies prohibiting the use of medically important antibiotics in chicken. This is not the same as "antibiotic-free" claims, to be clear ("medically important" antibiotics are those used in human medicine; there are other antibiotics only used in animals), but it is a critical change that has been rippling through the food system for the past several years to protect human health. To explain the significance of this trend, a quick history of the problem that companies are trying to address is useful.
According to the World Health Organization, antibiotic resistance is one of the top 10 threats to global public health in 2019. When antibiotic medications are overused or misused, resistant bacteria can spread, causing treatments for common (and often serious) illnesses to become ineffective. According to the Centers for Disease Control and Prevention, at least 2 million Americans contract an antibiotic-resistant infection every year, and 23,000 will die from it.
The use of antibiotics in animal agriculture is a major part of the problem. More than 70 percent of the medically important antibiotics sold in the U.S. are sold for use in food animals. This is not because cows are particularly susceptible to strep throat; the majority of antibiotics used on animal farms are not used as treatment for diagnosed diseases in animals. Rather, most animals raised for food are raised on factory farms, or Concentrated Animal Feeding Operations (CAFOs). To produce animal products cheaply and on a large scale, animals are packed together, creating crowded, stressful and unsanitary conditions. Such conditions are inherently disease-promoting for animals. To deal with the likelihood of infections and disease associated with poor conditions without actually changing those conditions, antibiotics have become a convenient Band-Aid. As factory farming has become the predominant model for raising animals for food, more farmers have resorted to practices of routinely administering antibiotics (sometimes even delivering drugs to chicks still in the egg) to keep animals "healthy" enough to bring to slaughter. As more antibiotics are used in these conditions, more antibiotic-resistant bacteria are released into the environment.
Pressure from public interest organizations, consumers, scientists, investors and government has led to significant reductions in the use of antibiotics in food animals over the past several years, though much work remains. Consumer demand for meat raised without medically important antibiotics has steadily risen as awareness of the threat of antibiotic resistance has grown. According to Consumer Reports surveys from last year, almost80 percent of Americans think meat producers should stop giving antibiotics to healthy animals and almost 60 percent of survey respondents said they would be willing to pay more for meat raised without antibiotics. Consumer Reports and five public interest groups have jointly published four editions of their Chain Reaction report and scorecard, which urges fast food chains to respond to changing consumer preferences and reduce the impacts of their meat supply chains on antibiotic resistance.
In line with growing public concern and the rampant growth of antibiotic-resistant superbugs, U.S. Food and Drug Administration (FDA) guidelines, which took effect in 2017, eliminated the use of medically important drugs for the purposes of growth promotion or feed efficiency. Voluntary changes by large meat purchasers are also propelling this downward trend.
The good news is that there is momentum for shifting the industry towards a healthier, more sustainable, and less destructive future. The FDA recently reported that from 2015 to 2018, sales of medically important antibiotics for use in farm animals declined by 43 percent. Consumer demand, federal regulatory trends, advocacy group pressure and shareholder action have combined to fuel this progress.
The bad news is that the uphill battle to change the food system gets a bit steeper from here. Much of the progress made so far has come from the chicken industry. While chicken producers have been able to make fairly swift changes to reduce their antibiotics use in recent years, this is not the case for other industries like beef and pork. The supply chains for those animals are more complex. So far, in the fast food industry, which has made so much progress establishing policies to avoid chicken raised with antibiotics, McDonald's is the only major company to set meaningful standards for the use of antibiotics in the beef it purchases.
Ultimately, eliminating antibiotics in the rest of the meat supply chain will require real changes in the way conventional farming works. Furthermore, the problem of antibiotic resistance is only one of many negative consequences of the factory farming system. Factory farms are major contributors to greenhouse gas emissions, air and water pollution, and deforestation; and from a moral standpoint, the quality of life for animals raised in factory farming conditions is shockingly poor.
Antibiotics provide a window into the deep problems in the animal agriculture system that produces the majority of our meat. The current model is broken. At the same time, the progress in reducing medically important antibiotics in the chicken industry over just a few years sheds light on the potential for change. When consumers demand more responsibly raised meat, the market will respond.
Power to drive change comes in several forms. Consumers can vote with their dollars every time they purchase food that is safe, nutritious, sustainable and transparent. Purchasing food from companies that are working to support these values will help create a food system which prioritizes health and sustainability. Health and environmental advocacy groups voice concerns on behalf of consumers and communities, helping to drive policy change. Investors in food companies also have the ability to weigh in on the risks of poor company policies through engaging with the companies they own and voting in favor of resolutions requesting healthier, less harmful practices. When all of these advocates work toward a common goal, a better food system seems possible.
This article was produced by Earth | Food | Life, a project of the Independent Media Institute.
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Trump: Importing Dangerous Medicines and Food and Keeping Consumers in the Dark
Messrs. Trump, Azar, and Perdue better wake up before innocent Americans lose their lives due to corporate indentured government officials failing to properly do their jobs
May 16, 2019
Conservatives favor consumer choice. Consumer information is vital to make that choice meaningful. Corporatists, masquerading as conservatives, do not care about informed consumer choice. Donald Trump is a corporatist, as are the vast majority of Republicans in his Cabinet and in Congress. Corporatists do not even want you to know where products are made. Today, producers and retail sellers do not have to tell you the "country of origin" for meat and pork products. Before 2015, when Congress bowed to the dictates of the World Trade Organization (WTO), Congress had enacted a law that required country of origin labels on meat products.
People wanted to know whether the beef and pork sold in their local stores was from the U.S., or Canada, Brazil, China, Mexico, or South Africa, among other importers. But after the WTO judges in Geneva, Switzerland decided, bizarrely, that "country of origin" labeling was an impermissible non-tariff trade barrier, Congress meekly passed a bill that repealed the labeling law and President Obama signed this legislation into law.
While Donald Trump claims to reject "free trade" treaties, he has been silent on country of origin regulations. State Cattlemen's Associations want laws mandating country of origin labels, believing that consumers are more trusting of the U.S. meat industry than the meat industries in most other countries. These associations know that the U.S.D.A. Food Safety and Inspection Service has a much less rigorous inspection process for imported meats. Unfortunately, the rest of the meat industry likes to import meat, without labeling, and mix it up with the U.S. products. Trump - a prodigious meat eater has yet to tweet in favor of the American cattle industry, even though many people in this part of the U.S. meat industry voted for him in 2016.
Even worse, we cannot tell where our drugs are being manufactured. Rosemary Gibson, author of China Rx: Exposing the Risks of America's Dependence on China for Medicine thinks American patients are endangered by imported medicines. Gibson is about to testify before Congress on her very disturbing findings regarding importation of medicines from China. I've been trying to get the attention of Donald Trump, his Secretary of Health and Human Services, Alex Azar, and the Secretary of Agriculture, Sunny Perdue, regarding risks with importation of food and drugs. Letters, emails, and calls have been met with silence. By not responding, they're telling us who they primarily support--corporate profiteering interests. That is one reason why Trump has broken his promise to the American people to bring down staggeringly high drug prices.
It will be harder for the Trump administration to ignore journalist Katherine Eban . Eban provides us with a terrifying glimpse of her new book, Bottle of Lies: The Inside Story of the Generic Drug Boom, in a New York Times article published on Sunday May 11, 2019. The article, "Americans Need Generic Drugs, But Can They Trust Them?" exposes the widespread unsafe conditions in many Indian and Chinese labs and plants that manufacture generic drugs for the U.S. market (generics amount to 90 percent of the U.S. supply of drugs). One of her sources was an intrepid Food and Drug Administration (FDA) inspector, Peter Baker (he has since left the agency).
Baker was a bold and honest auditor. He refused to announce lab inspections in advance, as is FDA's lackadaisical practice. From 2012 to 2018, Baker discovered "fraud or deceptive practices in almost four-fifths of the drug plants he inspected" in India and China. Indian and Chinese manufacturers engaged in data manipulation that could prove deadly.
At one firm, the Wockhardt plant in India, Baker caught the company knowingly releasing insulin vials containing metallic fragments from a defective sterilizing machine into Indian and foreign markets. Eban reports that "[Baker] learned that the company had been using the same defective equipment to make a sterile injectable cardiac drug for the American market." Two months later, the FDA banned imports from that plant.
Eban continues, shockingly: "In some instances, deceptions and other practices have contributed to generic drugs with toxic impurities, unapproved ingredients and dangerous particulates reaching American patients." This is nothing new. In 2008, at least 81 American patients died in hospitals after being given heparin, a blood thinner that contained a contaminated ingredient from China.
You'd think that the FDA would demand from Trump more inspectors abroad and the U.S. Department of Agriculture would ask the White House for more U.S.D.A. Food and Safety inspectors, along with tougher laws and penalties on unsafe imports to transmit to Congress. After all, the sheer scope of U.S. drug companies going to China and India to produce drugs cheaply, so as to swell their already swollen profits, is simply stunning.
Another chilling statistic from Eban is that "Nearly forty percent of all our generic drugs are made in India. Eighty percent of active ingredients for both our brand and generic drugs come from abroad, the majority from India and China... America makes almost none of its own antibiotics anymore" (My emphasis). The outsourcing of the production of drugs to foreign countries presents vast challenges for health and safety regulators.
One would think this surrender to imports, whose sole purpose is to fatten U.S. drug companies' profits, would be considered both a consumer safety threat and a national security matter. Why isn't Trump doing anything to keep Americans safe from dangerous foreign products, as he crows about tariffs?
Of course the FDA responds with their usual phony assurances about its reliable inspections, putting out a statement that reads: "The F.D.A. inspects all brand-name and generic manufacturing facilities around the world which manufacture product for the U.S. market."
Is that why the FDA, which has largely conducted unannounced inspections of U.S. plants, still allows pre-announcement of the vast majority of its foreign inspections? Eban reports, the FDA investigators are treated as "the company's guests and agree on an inspection date in advance...Plant officials have served as hosts and helped to arrange local travel."
Messrs. Trump, Azar, and Perdue better wake up before innocent Americans lose their lives due to corporate indentured government officials failing to properly do their jobs. Do they want a major disaster to land on their derelict desks?
They are on full public notice.
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Lawsuit by 44 States Accuses Pharma Giants of 'Multi-Year Conspiracy' to Hike Drug Prices by Over 1,000%
"We have hard evidence that shows the generic drug industry perpetrated a multi-billion dollar fraud on the American people."
May 12, 2019
A far-reaching lawsuit filed Friday by the attorneys general of more than 40 states accused some of the nation's largest generic drug manufacturers of conspiring to inflate prices, in some cases by over 1,000 percent.
"We have hard evidence that shows the generic drug industry perpetrated a multi-billion dollar fraud on the American people," Connecticut Attorney General William Tong, whose state led the probe into the companies' practices, said in a statement.
"Teva and its co-conspirators embarked on one of the most egregious and damaging price-fixing conspiracies in the history of the United States." --Lawsuit
"We have emails, text messages, telephone records, and former company insiders that we believe will prove a multi-year conspiracy to fix prices and divide market share for huge numbers of generic drugs," said Tong.
The suit names 20 major drug manufacturers--including Pfizer, Teva, Novartis, and Mylan--as well as more than a dozen senior executives, who the complaint accuses of deleting evidence after the states began their investigation in 2014.
"The industrywide scheme affected the prices of more than 100 generic drugs," the New York Times reported Saturday, "including lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for ADHD.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants."
Americans pay far more for prescription drugs than the people of any other industrialized nation. Alluding to this fact, Colorado Attorney General Phil Weiser--who joined the multi-state lawsuit--tweeted on Saturday: "If you are angry about rising drug prices, you should be. Particularly because a major cause of price increases is illegal collusion by generic drug companies."
As the Washington Post reported, the 465-page lawsuit accuses drug company executives of "coordinating consistently to obstruct" government investigations into drug prices, including after Rep. Elijah Cummings (D-Md.) and Sen. Bernie Sanders (I-Vt.) launched a probe into generic drug pricing in 2014.
"Apparently unsatisfied with the status quo of 'fair share' and the mere avoidance of price erosion, Teva and its co-conspirators embarked on one of the most egregious and damaging price-fixing conspiracies in the history of the United States," states the complaint.
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Farm Country: Don't Get Fooled Again
Big ag companies killed family farms and polluted our water, while politicians blamed our immigrant neighbors. Let’s not turn on each other again
May 03, 2019
I'm a retired public school teacher living in Des Moines.
I grew up here close to the city limits, with an easy escape to the countryside that was once dotted with miles and miles of small family farms. The sight and even the smells of those small farms were a welcome respite from the congested and busy neighborhood life I was growing up around.
There were cows, pigs, sheep, chickens, and usually lots of cats. Barns were exciting and full of life. It's an idyllic memory many Iowans still relish today.
In contrast, pig production now happens inside gigantic industrial buildings warehousing thousands of animals subjected to a rectangular cubicle for life. They're left to eat and drink in these confined spaces, and in about five months they're slaughtered.
The stench from millions of gallons of manure percolating under their feet and spread on fields travels across our countryside and is toxic and nauseating to breathe.
Iowa is now close to being decimated for the sake of massive profits for a few giant corporations like Smithfield, Iowa Select, Prestage Farms, Hormel, and Tyson Foods.
For 40 years, my biggest worries focused on my middle school students: Were there enough new grammar books? Could they get to school in the snow? Did they have enough to eat at home? But eventually, I started worrying if they, or any of us, should be drinking or cooking with the water coming out of our facets, or swimming or fishing in the water in our countryside.
Those small family farms in the countryside have given way to an explosion of more than 7,000 factory hog sites. Iowa is now close to being decimated for the sake of massive profits for a few giant corporations like Smithfield, Iowa Select, Prestage Farms, Hormel, and Tyson Foods.
These concentrated animal feeding operations (CAFOs) are practically unregulated and unmonitored. Our state's factory farm inspectors can't even begin to keep track of what happens at thousands of sites.
Tons and tons of manure laden with nitrate, phosphorus, antibiotics, and other chemicals soak into the ground or run off fields and flow into the Des Moines water system. Both of our rivers, the Des Moines River and Raccoon River, are polluted regularly with high levels of nitrate. Iowa taxpayers and water customers have shelled out millions of dollars to clean the poisoned water.
Less discussed are the people who work in these factories and the slaughterhouses where the animals are butchered. Thousands of immigrants fill these brutal and dangerous jobs.
For decades, politicians spread nasty lies about these workers that have wormed their way into the public mythology in Iowa: that immigrants are taking our jobs, driving up our medical costs, or overcrowding our schools.
We know these families. They go to church with us, we pass them in the grocery aisles and at the post office, and sit next to them at the grandkids' soccer games. No one should believe these lies, but they've seeped into our community like the factory farm manure that poisons our rivers.
It's in the best interest of the factory farm, slaughterhouse, and feedlot owners--and the politicians they support--to keep us at each other's throats. They pit us against each other and make us fear each other. Imagine what would happen if all all of Iowa's struggling rural families and workers cooperated and worked together?
We'd fight wage theft, and demand higher wages and better conditions in the slaughterhouses. We'd crack down on hog factories and clean up our waterways. We'd give more money to our schools so everyone has a great education. We'd fight to get profits out of health care and have Medicare For All.
Iowans, and people in other rural states, were fooled once. I hope we won't be fooled again -- and certainly not pitted against each other. Take it from this retired schoolteacher: we've learned our lesson.
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'Superbugs' Could Kill 10 Million Annually Without Urgent Action, Warns New Report
"Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation," says new publication.
Apr 29, 2019
A new report on antimicrobial resistance calls for greater action by stakeholders at all levels lest so-called "superbugs" claim 10 million lives a year.
"There is no time to wait," says the report, released Monday by the U.N. Interagency Coordination Group (IACG) on Antimicrobial Resistance.
"Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation," IACG says.
The threat of antimicrobial resistance (AMR) is already deadly, with 700,000 people dying each year as a result of drug-resistant diseases.
There is also problem of inequity and lack of affordable access, which the report links to the deaths of "nearly 6 million people annually, including a million children who die of preventable sepsis and pneumonia."
Fast forward to 2050, the report adds, and AMR could cause as many as 10 million deaths each year under a worst case scenario.
Beyond claiming lives, says IACG, unchecked AMR would also unleash economic damage on the order of "the shocks experienced during the 2008-2009 global financial crisis as a result of dramatically increased healthcare expenditures; impact on food and feed production, trade and livelihoods; and increased poverty and inequality."
The problem is not limited to low- and middle-income counties; it is global in its reach.
"Alarming levels of resistance have been reported in countries of all income levels, with the result that common diseases are becoming untreatable, and lifesaving medical procedures riskier to perform," the report says.
"Antimicrobial resistance is one of the greatest threats we face as a global community," said Amina Mohammed, U.N. deputy secretary-general and co-chair of the IACG, in a statement.
"This report reflects the depth and scope of the response needed to curb its rise and protect a century of progress in health," she said.
Driving the threat of AMR are a number of factors, including misuse and overuse of existing antimicrobials in humans, animals, and plants; lack of sanitation and clean water; transmition of resistant pathogens along the food system; and poor waste management by healthcare, pharmaceutical, and agricultural facilities.
To tackle the multifaceted threat, the report recommends a "One Health approach" on a scale on par with the threats.
Among the recommendations are ending the use of antimicrobials for growth promotion in healthy animals; increased investment in new antimicrobials; improved waste manage tools; and the development of alternatives to antimicrobials.
Jose Graziano da Silva, director-general of the Food and Agriculture Organization of the U.N.(FAO), commented on the food system's role in addressing AMR.
"The report's recommendations recognize that antimicrobials are critical to safeguard food production, safety and trade, as well as human and animal health, and it clearly promotes responsible use across sectors," said da Silva. "Countries can foster sustainable food systems and farming practices that reduce the risk of antimicrobial resistance by working together to promote viable alternatives to antimicrobial use, as laid out in the report's recommendations."
According to IACG's Mohammed, the report "rightly emphasizes that there is no time to wait."
"I urge all stakeholders to act on its recommendations," she said, "and work urgently to protect our people and planet and secure a sustainable future for all."
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Earth Day 2019: We Don't Have Time
"Although our planet faces major tipping points on climate change, the environment is not a top-tier political issue. Anywhere!"
Apr 21, 2019
Generally speaking, humans have demonstrated over and over a remarkable ability to cooperate in a crisis. The tragic fire at the beloved Notre Dame's Cathedral was a case in point. Firemen and even members of the public rushed into the inferno, while millions of people around the world paced in front of their TV sets, wanting to jump in an help, anxiously waiting for the fire to be put out, and breathing a collective sigh of relief that there was hope for its survival. Donors rushed in behind first responders, generating a billion euros in financial support to rebuild within 24 hours.
Humans have also aligned themselves around seemingly perpetual, slow burning crises to advance social and civil rights issues. Togher with governments, people have established a number of functioning democracies, have mostly abolished slavery, and in a remarkable show of global support, the Paris Agreement on Climate Change opened for signature on Earth Day on April 22, 2016. The Climate Agreement was a reminder of what can happen with the planets of science, people's movements, bureaucracies, and economic interests come into alignment around a crisis.
Yet despite that global consensus, the world's annual carbon emissions reached an all-time high last year; a year that was the fourth hottest on record and saw massive wildfires, continued Antarctic ice mass loss, astonishing accelerating species losses, and a harrowing IPCC report warning humanity that going above the Paris lower limit of 1.5 degC global warming will have catastrophic consequences. The slow burning climate crises has turned into its own massive inferno. The quantifiable impacts of climate change's environmental destruction are orders of magnitude greater that any single storm, fire, flood. These impacts have been documented by legions of physicians, epidemiologists, chemists, climatologists, conservation biologists, economists, and other experts. But they are politically inconsequential.
Scientists and environmentalists have been the first responders, but we have been overwhelmed with fires, both literal and figurative, and slow government action, lacking coordination, funding, and most important determination. Worse, some government leaders are backing away from commitments and will be remembered for centuries in the future--Nero-like puppets, playing fiddles built with fossil fuel money.
In the meantime, public support for the environment remains broad-based but it has been remarkably mild-mannered in the face of the acceleration of climate change. Although our planet faces major tipping points on climate change, ocean acidification, fresh water depletion, topsoil loss, toxic chemicals, antibiotic-resistant diseases, and an epidemic of extinction, the environment is not a top-tier political issue. Anywhere! Most people do voice care about the environment. But very few of them vote for candidates primarily based on their environmental stances. Politicians know they can shred environmental safeguards without suffering political consequences. The very enormity of environmental threats produces self-defeating responses: (1) flat-out denial; (2) a sense of personal impotence; or (3) paralysis. We pay attention to problems where we can identify the victims and where our actions appear likely to make a difference.
Faced with this lack of urgency, a consensus has developed that only an authentic, broad based, tactical, coordinated and diverse citizen action campaign will be effective. On the ground organizing and social media are the tools that should be wielded against anti-environmental or uncommitted corporations and spiritless or purchased politicians. In raising the stakes, the movement will focus on demonstrating that the failure to support policies and technologies that solve the climate crises will have consequences. The goal of our strategy is to intensify support for environmental values to the point where it will produce sweeping consequences.
Behind the scenes a new social and political movement is growing, aided by a coordinated environmental coalition along with high school kids, faith groups, mayors, and investors who are standing up to politicians and corporations that put profits above people and the planet. This network and the platforms that we will use will focus on elections, consumer campaigns, and corporate governance and decision-making processes. Our goals are to mobilize a huge, diverse, intense movement in the recognition that the crisis is urgent and that we don't have time.
Earth Day 2019 is a great day to launch this global initiative. It is the people's day, the one inspired by 20 million boots on the ground in 1970. The world is mobilizing again, tapping into the power of a conscious, concerned, and coordinated global citizenry to meet a crisis that can't wait another minute.
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A Healthcare Industry Built on Premature Death
On the cruelty of private healthcare corporations
Mar 28, 2019
In Indiana, a school superintendent is facing three felony charges after using her son's insurance in January to help a sick student access a doctor and prescription antibiotics. Dr. Casey Smitherman, who on February 1 resigned from Elwood Community School Corporation, has helped the 15-year-old student before, according to reports: She purchased his clothes, and even helped clean his house. This time, she had noticed his absence from school and took it upon herself to bring him to a medical center. In an apologetic public statement, the superintendent explained that she was aware that the student didn't have insurance and so, out of concern for his well-being, wanted to do all she could "to help him get well." Court documents reveal the total insurance claim was $233.
Nearly one year ago, Dr. Smitherman was a celebrated presence in Elwood. In June of last year, she received a glowing profile in Indiana's Herald Bulletin and enthusiastic approbation from James Snapp, Superintendent of the Brownsburg Community School Corporation. "I think in a time when our students were facing greater challenges with poverty increasing, Casey really connected with families, whether that was connecting them with the food pantry or the clothing pantry," Snapp explained to The Herald Bulletin. Smitherman's attitude was made explicit in this profile: "Kids can't learn if they're hungry and are scared to go home," she told The Herald Bulletin. The number of children living in poverty in the state of Indiana is a staggering 301,000. In Smitherman's district alone, at least 78 percent of students qualify for free or reduced-cost lunches. The poverty rate in Elwood: 24.2 percent.
It apparently isn't enough to watch Americans fall into incapacitating debt in order to access life-saving medical care: Those who provide succour in times of hardship must be held to even greater account.
Indiana prosecutor Rodney Cummings has argued that while Smitherman's actions shouldn't jeopardize her career, "there have to be some consequences." It apparently isn't enough to watch Americans fall into incapacitating debt in order to access life-saving medical care: Those who provide succour in times of hardship must be held to even greater account. The impulse to discipline acts of solidarity is especially cruel in a system that leaves the poor to fend for themselves. Smitherman's case further emphasizes the intensity of the healthcare industry's aggravation of class inequality, the result of which leaves impoverished communities at the mercy of exploitative pop-up emergency clinics and volunteer-based roadside medical services that compel families to camp out in their vehicles sometimes two days in advance for a chance at care.
The recent death of attorney and disability rights activist Carrie Ann Lucas demonstrates the cruelty of private healthcare corporations, which act as the veritable death panels the poor were told to fear if the private health insurance market were meaningfully challenged. Forty-seven-year-old Lucas, a legal assistant for the Colorado Cross-Disability Coalition, was forced to ration insulin, the price of which has been rising steadily. UnitedHealthcare, the private insurer tasked with facilitating the medical treatments Lucas needed to live, denied her access to a specific inhaled antibiotic in order to save themselves $2,000. The company raked in a total revenue of $56.5 billion in 2018. Her death came "after an arbitrary denial from an insurance company caused a plethora of health problems, exacerbating her disabilities and eventually leading to her premature death," Lucas' obituary reads.
The death of Lucas is not the first, nor will it be the last, of its kind. In 2015, a crowdfunding campaign was published on behalf of an Oklahoma mother, Oranna Cunningham, diagnosed with stage 4 nasopharyngeal cancer. In 2014, her insurer Aetna not only denied her CAT scans, but denied funding for Proton beam therapy, which would have cost $92,000 and possibly saved her life. Aetna's 2015 financial data reveals that in 2014 the company's total revenue was roughly $58 billion. Aetna's CEO at the time was Mark Bertolini, who has overseen the insurance giant since 2010, is "the richest person in Hartford," according to Forbes, with a fortune of $180 million.
The description of the fundraiser for Cunningham reveals the full barbarity of insurance companies like Aetna, and the pain of the families who are forced to beg for somebody--anybody--to help them. The family was only able to raise $17,810, and in May 2015 Oranna died at the age of 54. In November 2018, an Oklahoma jury awarded the family $25.5 million, one juror saying that Oranna Cunningham was "failed at every turn," and another juror declaring that "Aetna needed to pay."
Victims of predatory insurance companies are hanging on by the thinnest of ropes, oftentimes working themselves to the bone even when their bodies cannot handle it.
Victims of predatory insurance companies are hanging on by the thinnest of ropes, oftentimes working themselves to the bone even when their bodies cannot handle it. Take, for example, legendary guitarist Dick Dale, who passed away on March 16 at the age of 81. He was left touring in his final years in order to stay alive. "I can't stop touring because I will die. Physically and literally, I will die," he said in 2015. Despite his medical needs, and the fact that he was "double insured," insurance companies were refusing to pay for necessary supplies Dale required to avoid stoma infections that resulted in excruciating pain and humiliating colostomy bag ruptures, in one case while he was on tour, just before he was about to take the stage. "My fecal matter went down my legs, up my pants, my beautiful cowboy shirt--everything," Dale revealed to Billboard. "We didn't have a backup pair of pants, because it was a one-off. [My wife] took everything off and washed my jeans, my stockings, my shoes, my shirt, every part of me. Then we wrung them out wet, and I did the concert with wet pants and shirts. After that, I sat at the merch table, and signed for five and a half hours, me still in my wet clothes."
A report from Dallas Morning News tells the story of Heather Powell who, after being shot and left paralyzed, needed in-home aids to wash her body and cook her food. In 2017, Powell's insurer Superior HealthPlan decided to cut the hours she'd be under the care of an aid from 12 hours to 7, declaring the services "not medically necessary." The Dallas Morning News report discloses, "Alone for 17 hours a day. Unable to move. In pain. Powell began to plan her suicide."
This is no fault in the system: The industry is an architecture of misery, extracting profits from suffering. According to a report published in 2017 by The Doctor-Patient Rights Project, insurance companies "denied treatment coverage to one-in-four (24 percent) patients with a chronic or persistent illness or condition; 41 percent of the patients denied coverage were denied once, while 59 percent were denied multiple times." Thirty-four percent of patients who had been denied coverage were forced to put off treatment, despite having a chronic illness. An astounding 70 percent of treatments for a chronic illness denied by insurers were for conditions referred to as "serious." The grim reaper disguises himself in many forms, in this case that of an insurance agent.
The case of Dr. Casey Smitherman unveils the boundless ruthlessness of the healthcare system, one which punishes the sick, denying them the care that they are rightfully deserving of. "I'm not justifying what I did," Smitherman told CBS News in January. "But I also think it's hard to look in the face of that sick kid and so until you're in that boat you don't know."
Dr. Adam Gaffney, instructor in medicine at Harvard Medical School and a pulmonary and critical care doctor at the Cambridge Health Alliance, tells In These Times that his experience as a physician has continued to reaffirm the need for a "de-commoditized, free-at-point-of-use national health program."
"You see people harmed by our system--patients going without needed care, skipping doses of medications because they can't afford copays, avoiding tests," he says. "You quickly realize that the idea that patients need 'skin in the game' to ensure they appropriately 'consume' healthcare is a moral travesty of an idea, an insult to the sick: almost nobody wants healthcare they do not need." Being a patient and navigating the traumatic and unfamiliar medical world is difficult enough, Dr. Gaffney says. "We need not compound that suffering," he argues, "with financial worries, medical bills, the anxiety of insurance networks and high deductibles, the fear of bankruptcy."
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