Rappahannock’s population is older than most. So as a typical aging Rappahannock resident, I begin each day with a regimen of prescription pills and vitamin supplements.
I say typical because, according to the latest statistics, 90 percent of seniors routinely rely on such medications; 40 percent use five or more; 12 percent ingest 10 or more different medications. Overall, prescription drug use by seniors accounts for a third of all prescriptions dispensed in the U.S.
As with my fellow seniors, my pill-popping is an act of faith. I don’t have a clue about the chemistry involved, much less any way of checking the purity of the active ingredients. So I must trust the doctors who prescribed them, the pharmacists who filled the prescriptions and the medication manufacturers who stock the drug stores.
But news came recently that India, which supplies as much as 40 percent of the over-the-counter and generic prescription pills that we Americans ingest, is coming under increased scrutiny by the Food and Drug Administration for safety lapses, falsified drug testing results and selling fake medicines.
China, which is also a top drug supplier for the American market, is even less transparent in allowing inspections that would prevent counterfeit manufacturing.
The dramatic change in the manufacture of pharmaceuticals in recent years is due to globalization and outsourcing, of course — driven by the constant search for the ever cheapest. Thus, 40 percent of finished drug products and 80 percent of the active drug ingredients and bulk chemicals used to make drugs are now imported from 150 countries across the globe. The number of registered foreign manufacturing sites — almost 4,000 — now exceeds the number of domestic drug manufacturing facilities.
When I was young and idealistic, free trade — together with the unfettered international movement of labor, capital and services — seemed the answer to most of the world’s ills. Now, older, maybe wiser, certainly unhealthier, I have my doubts. Without common standards and enforceable regulations, our ills might be just beginning.