Comment
Taking ‘the medicine’ EDITOR’S COMMENTwith LOUISE FRAMPTON
THE CLINICAL SERVICES JOURNAL Editor
Louise Frampton
louiseframpton@stepcomms.com
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At the time of writing this, we were celebrating ‘World Health Day’. It didn’t feel like much of a celebration, however. These are uncertain times, and they are about to become even more uncertain. There is a lot to unpick from the deluge of shocking announcements from the White House. So where exactly do we start? The health secretary has warned that Donald Trump’s tariffs could disrupt the supply of
medicines into the UK. We know from the pandemic how vulnerable global supply chains can be when countries operate protectionist policies. Let’s hope that the pandemic stress test has made us a little more resilient and prepared, as we face a new threat to global supply and trade. Lessons should certainly have been learnt about the vulnerabilities involved in off-shore supply chains – but only time will tell if they have been. Within a day of writing this column, I had to amend it – such is the unpredictability of the current US administration. Donald Trump has now made a U-turn on most of the highest tarrifs, except China; while a universal 10% levy for all countries
applies...This may change yet again by the time this edition is in print. However, it seems likely that costs to the NHS will go up at a time when it can least afford it. It isn’t just tariffs that are the issue, however. A Google search of the latest world news shows that vital scientific research, infection prevention and drug safety programmes have all been impacted by recent events in the US, and the repercussions will be felt across the globe in ways we are yet to fully comprehend. According to a report by Reuters, mass firings at the Food and Drug Administration (FDA) have
removed employees critical to reviewing new medicines, “setting back years of effort to bring promising treatments to patients more quickly.” The firings also include all staff responsible for managing records – such as new product applications – at FDA divisions that oversee biotechnology therapies and medical devices. At least 230 employees in the FDA office, charged with regulating devices, are reported to have been fired. Ultimately, a weakened FDA will mean an increased risk of harm to the public, but it will also create barriers to innovation through delays in getting important medical technologies onto the market. The world’s media have also reported major cuts to federal health agencies, such as the National Institutes of Health, which have led to concerns over important Alzheimer’s research being halted, which could impact treatment options and the lives of patients and their families. (Source: CBS News) Scientists on the cusp of a major cancer breakthrough have also been hit by the huge Trump layoffs. (Source: The Washington Post). Organisations that have a vital contribution in global efforts to combat antibiotic resistance
have been hit hard, in this latest wave of ‘slash and burn’. At a time when the world is down to a single drug that can reliably treat gonorrhoea, the US has closed the country’s premier sexually transmitted diseases laboratory at the Centers for Disease Control and Prevention. The lab is a leading player in global efforts to monitor for drug resistance in the bacteria. (Source: Stat News) Experts in global health have also expressed their concern over the dismantling of the United
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States Agency for International Development (USAID), which distributes tens of billions of dollars’ worth of overseas aid every year. Health experts have warned of the spread of disease, as well as delays to the development of vaccines and new treatments as a result of the cuts. The World Health Organization (WHO) has already warned that funding cuts will have a “devastating impact” on tuberculosis (TB) programmes worldwide, given that the US has historically been the largest donor. Diseases do not respect borders as we know… Talent, knowledge, investment and resources are all being lost in swathes, in a chaotic and unfathomable attack on key healthcare organisations and programmes. It is shocking and incomprehensible. Donald Trump has spoken a great deal of our need to ‘take the medicine’. However, without the safeguards of the FDA, swallowing the medicine would of course be unwise…
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May 2025 I
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