As you know all too well – Trump’s arraignment was today. There was a definite “It Will Be Wild!” theme to Trump’s communication with his folks, hearkening back to his tweets in December 2020, egging on his truest believers.
Of course, many of his truest believers are in prison – or have otherwise experienced the consequences of blindly following Trump’s mandates.
So today’s news – and yesterday’s news – and tomorrow’s news – will be about whatever happens in Florida.
So let’s talk about something different.
There are a few really important stories out there right now that haven’t gotten as much press as, say, a former president being indicted for violations of the Espionage Act.
One that I’ve been following closely is a drug shortage. Or should I say drug shortages.
There are hundreds of drugs in short supply in the U.S. right now. I’m just going to focus on two.
There is a U.S. – not global – shortage of two key cancer drugs. Cisplatin and carboplatin are the backbone of many, many chemotherapy treatments. Between 10-20% of all cancer patients receive a therapy that includes one of those drugs. We’re talking lung, bladder, testicular, cervical, ovarian, breast cancer – you name it. Pediatric cancers, too.
This isn’t a short, one-week shortage either. It’s been going on since March. And it’s gotten worse, not better. Ninety-three percent of United States cancer centers that were polled between May 23 and 31 said they have a shortage of carboplatin; 70% said they have a shortage of cisplatin.
Take a beat and consider that for a second.
Ninety-three percent of cancer centers in the United States of America are experiencing a shortage of two of the most commonly-prescribed, life-saving cancer drugs in the Year of our Lord 2023.
The U.S. consistently has most expensive healthcare – and drugs – in the world. But that cost is often explained away by folks who claim the U.S. has the best healthcare, or that we don’t have to wait for treatment like those plucky Canadians.
But today, somewhere in America, a woman was diagnosed with aggressive breast cancer and sat down with her oncologist, who calmly told her:
“The best treatment for this cancer is a regimen called TCHP, which uses a chemotherapy drug called carboplatin. That drug is in short supply right now. We don’t know when that shortage will get better. I am fairly certain that we will have sufficient supply to get you all six of the treatments you need, but we’ll have to take it as it comes.”
Imagine having to worry that the drug that’s going to save your life might just … not be available.
Imagine being an oncologist and seeing dwindling supply – trying to figure out how you can treat the patients you have with what you’ve got.
That’s what’s happening in cancer centers around the United States right now. Today.
You’re probably wondering why there’s a shortage. And it’s a good question. When I heard about it, I figured it was some strange global thing – with some chemical component being in short supply worldwide or being too expensive.
They’re not too expensive. In fact, cisplatin and carboplatin are about as expensive as a side of french fries at McDonalds.
That’s part of the problem. The reality is that these two drugs are generic. They’re not money-making machines for the big pharmaceutical companies. Generic manufacturers operate on a razor-thin margin, and there’s not much room for error (and they are incentivized to take short cuts when they can).
The headwinds facing the generics industry aren’t new. In the last year, one of the makers of Adderall said it’s scaling back its generics business. (Adderall is in shortage.) Another generics manufacturer announced a financial restructuring – they’re planning to file for bankruptcy. They make over 150 generics. Another generics manufacturer shuttered earlier this year, which contributed to shortages of heart drugs and – of all things – albuterol.
So when in the spring the FDA cut off the main U.S. supplier of cisplatin because of a “disastrous” inspection and quality control problems, it meant there wasn’t a quick competitor to take up slack.
Faced with a shortage of cisplatin, oncologists started prescribing more carboplatin, which can be substituted for cisplatin in some therapies.
And so, here we are.
Because of one supplier of Cisplatin – and because our legislators have consistently refused to put some guardrails around capitalism (particularly when it comes to pharma).
You’ll remember that last year we dealt with a really similar shortage situation, only it was baby formula. The shutdown of one manufacturer for quality control problems shocked the system so much that the news covered the movements of airplanes carrying pallets of formula.
The two stories have a lot in common, really. Both involve life or death situations. And both show just how useless our current government has been at providing thoughtful incentives, checks and balances, and regulations to keep pure capitalism in check.
Could Congress incentivize the production of cancer drugs – or other generics? Of course they could. They incentivize plenty of projects (and the fossil fuel industry).
Could they require a certain amount of key cancer (and other) drugs be stockpiled as part of our national security? Sure they could. We have strategic reserves of oil. Isn’t having a strategic reserve of life-saving drugs just a much a matter of national security?
Congress could act. And some of them have tried.
They just … haven’t gotten it done.
They’re too busy showboating on t.v., or sending me eleventy-billion fundraising emails, or bickering. Yes, they’re also fighting over whether or not we have a democracy and how to save it. It’s been a busy few years. I get it.
But they also need to grow up and get to work. This unfettered capitalism has led to supply chain emergencies in healthcare and serious national security risk.
That should be unacceptable to any self-respecting legislator.
The FDA has started to step up on the current cancer drug emergency, and is working on green-lighting cisplatin and carboplatin from other suppliers. (That has its own complications.) The Biden administration is working with what it’s got, having quietly assembled a task force that’s been collaborating with the FDA on solutions. And members of Congress have already started sending letters asking the FDA to do more.
But really, it’s the FDA’s turn to send a letter to Congress, and tell them to get to legislating.
With the current Supreme Court, we can’t rely upon administrative agencies’ willingness to do the heavy lifting for Congress anymore.
Sometimes the people who represent us need to actually represent us.
Okay, friend.
Let’s get to work.
*Note: If you’re interested in learning more about the drug shortages – which have been going on in some form or another for years, you should check out this great report from the Senate Homeland Security and Governmental Affairs committee. The chair, Senator Gary Peters (D-MI), has been working on this issue for years.
Actions for the Week of June 13, 2023
Call Your Senators/Representative: What Are They Doing To Address These Drug Shortages?
Hopefully after reading about the drug shortage situation you’re ready to take some action! Get out your phone and let’s give our congresscritters a call.
There are a few pieces of legislation that have sputtered around, but nothing that seems to be gaining momentum. So rather than calling to support a specific bill, let’s call to ask the very pointed question: what is the Senator/Congress(wo)man doing to address these critical drug shortages?
Script: Hi, my name is ____ and I’m a constituent at ___. I’m calling because I’m very concerned about shortages in critical drugs, including chemotherapy drugs. This is a health issue and a national security issue. What is the Senator/Congress(wo)man doing to address these critical drug shortages?
Ohio!
The Ohio GOP has gerrymandered themselves into a supermajority – and that supermajority is BIG MAD that a citizen petition protecting choice will be on the ballot in November. So they rushed through a constitutional amendment that – if it’s passed by voters – will raise the threshold for passage from a simple majority to 60%. And they set that election for August – just before the November election.
Tricky, eh?
Yeah, Ohio Democrats are mobilized and fighting hard on this one – and need your help and support to get the word out to every voter in Ohio.
The special election will be on August 8. People can still register to vote, and – just like in any other election – there will be early voting.
So go to this website for more details on voting and on the issue.
Go to this mobilize link for phone banks and other ways to pitch in with the official campaign.
Jessica Craven of Chop Wood Carry Water has an Ohio-specific toolkit that she’s updating.
But one of the most effective things that you can do is also pretty darn simple:
Step 1: go through your phone or your Facebook friends, and see who lives in Ohio.
Step 2: Text them, message them, call them. “Did you know there is a special election in August that will make it harder for citizen petitions to pass? It’s super sneaky and very anti-democratic. Are you registered to vote?”
Step 3: Help them think through where, when, and how they’ll vote.
Step 4: Pat yourself on the back!
No Off Years in AZ!
A hat tip to Jess Craven for mentioning this ongoing postcarding campaign from the Northeast Arizona Native Democrats, who I had the pleasure of meeting virtually and who are the real deal in perennial organizing.
You might remember them from this post, where I described their ongoing work:
[I]n 2021, over 80,000 postcards were sent to Democrats in Navajo County.
That’s not a typo. 80,000 postcards have been sent to Democrats in a county with 100,000 residents. (They’re sending more.)
They also hired local Apache, Hopi, and Navajo community members as organizers. They’re building up the community from within. Rather than being the outsider pushing the community, bending it this way or that – they’re rising with the community itself.
Their respect for and connection with the community is maybe best shown by their Family Votes program, which trains and supports matriarchs who register their families and communities. (Read more about the program HERE.) Native culture is matriarchal. And, by simply honoring how the community naturally organizes itself, they’re reinforcing their relationship with that community – while expanding voter access and encouraging civic participation.
It’s just another example of how outreach and voter registration efforts are dictated by the people they’re trying to reach – not the other way around. There were other examples, just from our brief conversation. Like signs being written in native languages – meeting people where they are, not where we are. A simple thing, really. But illustrative.
And, as is the case in many rural areas, “the VAN” (the software/dataset that helps create lists of potential voters based upon their address and voting history) is often out of date. That makes targeted canvassing really hard. So what do they do? Knock on every door anyway, and record who lives there now.
They knock on every door.
If I went on to describe all of their initiatives and efforts this post would be far too long. Instead I’ll encourage you to check out their year-end review (available HERE) so you can get your creative organizing juices going.
Like I said – they’re the real deal. If you like to send postcards and you’re interested in helping out an amazing group of grassroots organizers, head over to their Mobilize link and get yourself some addresses!
Here’s that link again: https://www.mobilize.us/aznativeorganizingcampaign/event/527542/?utm_source=substack&utm_medium=email
New Disabled South Is Looking For a Development Director!
Have a passion for disability justice? Experience with nonprofit and political fundraising? Want to create change across the South? Apply to be New Disabled South’s Director of Development!
This is a full time position, working virtually 4 days a week. It’s a great organization, and a great position. Please share! Check it out here: https://smalldeedsdone.com/wp-content/uploads/2023/06/a95d0-directorofdevelopment-newdisabledsouth.pdf
WHEW! GO TEAM!
P.S.: Why don’t you make someone’s day and send this pep talk to a friend or two? I bet they need it.
If you’d like to sign up to get this pep talk and action list in your in-box each week, you can do that here. Welcome, friend!
P.P.S.: If you want to help support this work you can do so via Patreon at
https://www.patreon.com/smalldeedsdone or via paypal at https://www.paypal.me/smalldeeds
My deepest gratitude in advance.
Thank you for reading. Thank you for writing. I read and respond to every email! We’re in this together. Don’t you forget it.
Small Deeds Done 