August 11, 2023: Global News Roundup
“Sick development”— Healthcare workers on strike, chemotherapy drug shortages, imprisoned patients, and covid-19 vaccines
The Global News Roundup collects news stories from entirely international (non-US) media sources on variety of pressing global issues and events.
Following a 48-hour strike by 20,000 radiographers late last month over inadequate pay, this week more British healthcare workers voted to go on strike. The British Medical Journal (BMJ) reported junior doctors are preparing to strike from August 11-15, while medical consultants are planning to strike in September. The British government had offered doctors a 6% raise last month, an offer the British Medical Association (BMA) called a “savage real terms pay cut”, referring to the inability of the proposed pay raise to keep up with the cost of living. Speaking to the consultants’ plans to strike, BMA Consultants Committee chair Vishal Sharma stated, “No consultant wants to take strike action, but unless we take a stand we risk losing our most experienced doctors, putting the very future of the NHS at risk. It’s not too late to avert these strikes, and we call on the health secretary to meet with us urgently.”
(Image: “We will strike again if necessary”, British radiographers on strike, from the WSWS, 7/30/23, here).
Next, in the US and UK, cancer patients and their physicians are wrestling with an ongoing shortage of chemotherapy drugs, including cisplatin and carboplatin. Back in June, FT reported that, “The Society of Gynecologic Oncology, which is conducting a survey to determine the extent of the crisis, said initial results found shortages of key cancer drugs across 40 US states. “This is a public health crisis. We have never seen a shortage like this one,” said Angeles Alvarez Secord, president of the society.”
The shortage of cisplatin stems from quality control problems with a single critical manufacturer in India, Intas Pharmaceuticals, which supplies half of the cisplatin used in the United States. FT notes that downward cost pressures from major drug distributors have in recent years forced other producers out of the marketplace, with only a few remaining worldwide to manufacture the critical treatment. According to Craig Burton, senior vice-president of policy and alliances at Association for Accessible Medicines, “consolidation in the drugs purchasing market had enabled bulk purchasers to squeeze manufacturers on price in both the retail and hospitals market. Three big purchasing groups — Red Oak Sourcing, the Walgreens Boots Alliance Development and ClarusOne, which includes Walmart and McKesson — control about 90 per cent of the retail prescription market. The market to supply generics to hospitals is similarly concentrated.”
News this week indicated the severity of the shortages, with governments scrambling to shore up supplies. The UK’s Express reported on Sunday that, “The Department of Health and Social Care and NHS England sent out an alert warning to hospital drug buyers to order unlicensed imports of cisplatin, carboplatin and oxaliplatin “to meet the needs of patients”.” New supplies of properly licensed cisplatin are not expected until September. In the US, the FDA has authorized the import of chemotherapy drugs from China, which the Cancer Network reported is helping alleviate shortages.
The China Daily reported late last month on the extent of drug shortages in the US, including but not limited to cancer treatments: “There were 309 active national drug shortages as of June, including 177 sterile injectables, according to the American Society of Health-System Pharmacists (ASHP), which tracks drug shortages. That is an increase from 295 at the end of last year and the highest total since 2014. The shortages include antibiotics, medication like Adderall for attention deficit hyperactivity disorder (ADHD), a diabetes drug Ozempic and chemotherapy drugs.” Pointing again to structural problems along the supply chain—with a mere handful of factories responsible for producing many essential medications—the report indicated that more shortages may be forthcoming following the destruction of a Pfizer plant in North Carolina in June by a tornado. The factory produced 25% of Pfizer’s sterile injectables, including anesthesia drugs needed for surgeries.
Moving on, an alarming report from the UK-based nonprofit Oxfam published this summer, entitled Sick Development, raises serious concerns about European and World Bank investments in private hospital systems in Kenya and India, among other countries. According to the report, the Nairobi Women’s Hospital in Kenya—recently funded by UK’s British International Investment (BII), France’s Proparco, Germany’s Deutsche Investitions- und Entwicklungsgesellschaft (DEG) and the World Bank’s International Finance Corporation (IFC)—was found to be “regularly imprisoning patients until their bills were paid”: “One newborn baby was reportedly held for at least three months, and a schoolboy for 11 months. Bodies of those who have died have been held for up to two years.”
In India, “Patients interviewed by Oxfam said that they were blocked from using their government health insurance cards at Narayana and CARE Hospitals in India, and suffered financial hardship due to bills that they should not have been charged.” Narayana Health “was funded by the UK’s BII until 2023; CARE Hospitals is funded by the UK’s BII, France’s Proparco and the World Bank’s IFC.” The report goes onto detail other worrisome practices by Western-funded private hospitals, including denying emergency medical care in India, “profiteering” from covid-19 in Uganda, and “pushing” patients to undergo “unnecessary treatments”.
Turning to vaccine markets and politics, in late July, South Africa’s Health Justice Initiative (HJI) took the South African government to court, seeking “access to the vaccine procurement contracts concluded with vaccine manufacturers and suppliers, and the records of negotiation with those parties”. According to IOL News, and recollecting the ongoing investigation into secret dealings for vaccine procurement in the European Union, the case before the North Gauteng High Court in Pretoria is “one of the first cases in the world where civil society is forcing a government to reveal the details of Covid-19 vaccine contracts made during the height of the coronavirus pandemic”.
HJI had previously requested information about the contracts through South Africa’s Promotion of Access to Information Act, but the government refused to release them. The request specified documents related to vaccine procurement and contracts with “Janssen Pharmaceuticals/Johnson & Johnson; Aspen Pharmacare; Pfizer; Serum Institute of India; Cipla; Sinovac/Coronavac; the African Union Vaccine Access Task Team (AU AVATT); Covax (with the Global Vaccine Alliance, Gavi, or otherwise) and the Solidarity Fund”.
According to the Daily Maverick, Fatima Hassan, director of HJI, cited the power of global pharmaceutical companies and the pressure for secrecy they brought to bear on governments during the covid crisis in her statements about why the suit was brought:
There is a heightened need for transparency and accountability especially during a national disaster, where several of the usual checks and balances are limited.
Disclosure is even more important in the health sector following serious allegations that globally, powerful pharmaceutical companies bullied countries into signing secret contracts at the time and locally, that corruption has diverted millions of rands away from Covid-19 relief measures and other health services.
The Department of Health has argued in its legal papers it cannot make the contracts public because it is bound by confidentiality clauses that preclude disclosure and that disclosure ‘would prejudice it and the vaccine manufacturers in future engagements’.
Essentially, our government traded secrecy for scarce supplies at the behest of very powerful vaccine manufacturers and intermediaries, who made huge profits on sales. Our government should stand up to these companies. By agreeing to these onerous Non-Disclosure Agreements (NDAs) our government is enabling secrecy that only pharma companies benefit from.
So far, no ruling has been made by the High Court.
In Australia, representatives from US-based pharmaceutical companies Pfizer and Moderna were called before the Senate Employment Legislation Committee last week to answer questions about vaccine effectiveness and covid-19-related vaccine mandates. A heated exchange ensued between Senator Pauline Hanson and Pfizer Head of Regulatory Affairs Dr. Brian Hewitt. The Daily Mail recounted the back-and-forth as follows, noting that Pfizer and Moderna had initially “refused” to attend:
At one point during the tense proceedings, Dr Hewitt rejected the claim Australians were 'forced' to take the Covid vaccine.
Senator Hanson was sceptical of this assertion made, asking Dr Hewitt: 'You were in Australia during Covid-19?
'You must've been fully aware that people - nurses, doctors - people to have their jobs, to keep their jobs, were forced to have the vaccination.
'Now, do you retract your statement that they were not forced?'
Dr Hewitt rejected the claim once again, stating he 'firmly believed... nobody was forced' to take the Covid vaccine.
'Mandates or vaccine requirements are determined by governments and health authorities,' he added.
'I believe everybody was offered an opportunity to get a vaccine or not get a vaccine.'
Senator Hanson fired back, telling the Pfizer representative: 'A lot of Australians will disagree with you on that one.'
The hearing is associated with proposed legislation—the Covid-19 Vaccination Status (Prevention of Discrimination) Bill 2022—to prevent discrimination against workers who have not been vaccinated. Hanson told the Daily Mail Australia that, “It's my concern that people lost their jobs because of [mandates]. Firefighters, defence personnel, federal police, nurses. To this day people still can't return to their jobs because of the mandate.”
In related news, Pfizer—which has sold almost 650 million doses of its covid-19 vaccine, more than any other manufacturer in the world and four times more than its closest competitor (Moderna)—announced last week that it is considering “cost-cutting programs” for its covid vaccines owing to “plunging demand”. Sales of the Pfizer-BioNTech vaccine (Comirnaty) were down 83% in second quarter 2023, while sales of its anti-viral treatment Paxlovid were down 98% “amid low infection rates globally”, according to Reuters. The Financial Times reported that Pfizer’s 2nd quarter revenues were down 50% owing to lagging demand for covid-related products, and that “Pfizer is racing to launch 19 new medicines over an 18-month period to help it manage the fall in sales…”.
Things I’m keeping an eye on:
1. Niger: The military junta now governing Niger took a meeting with US Acting Deputy Secretary of State Victoria Nuland this week. The government denied Nuland’s request to see President Bazoum, who is being held captive by the coup leaders, and also dismissed the US’s suggestions to “restore democratic order”. Though the West African ECOWAS alliance has said “all options” remain on the table, including the use of military force to intervene, the group has so far refrained and is instead emphasizing diplomacy.
2. Corporate bankruptcies: Some heavy hitters were down for the count this week as the US and European economic crises deepened, the US-based Yellow trucking company and the UK-based discount retailer Wilko.
3. Great Power politics: Lots of tit-for-tat escalation between the US-EU bloc and the China-Russia bloc. Following many months of US naval patrols and drills in the Taiwan Strait, Sea of Japan, and South China Sea (including some with Japan, South Korea, and the Philippines), this week China and Russia conducted a joint naval patrol in international waters off the coast of Alaska. The US then sent its own warships to patrol the area. Russia also froze some of Goldman Sach’s Russia-based assets this week. And US President Biden issued an executive order directing the Treasury to restrict US investment in Chinese semiconductors and microelectronics, quantum computing, and artificial intelligence.
4. Black Sea: Following two drone attacks on Russian ships in the Black Sea, Ukraine announced that it had established a “humanitarian corridor” for ships bearing Ukrainian grain stuck in the Black Sea following last month’s collapse of the grain deal that had previously permitted safe passage. “[I]t could be a major test of Ukraine's ability to reopen sea lanes at a time when Russia is trying to reimpose its de-facto blockade… Shipping and insurance sources expressed concerns about safety,” reported Reuters.