Remembering Thalidomide

Very rarely are new drugs and therapeutics sold legally in the U.S. nowadays, unless they undergo a lengthy FDA approval process, oftentimes consisting of decades’ worth of rigorous testing. This, however, hasn’t always been the case. Many of the regulatory agencies and processes that exist today are direct results of disasters like the thalidomide tragedy that occurred in the 1950s and 60s, during which thousands of infants were born with, among other things, physical malformations, internal organ damage, or congenital heart disease as a result of the mothers being prescribed the drug thalidomide. Thalidomide, used today to treat multiple myeloma and leprosy, was previously prescribed to pregnant women to aid with nausea and other symptoms. It is now a known teratogen—a substance that, if a pregnant woman is exposed to, can interfere with normal fetal development and lead to congenital disorders.[1]

Thalidomide, originating from the German pharmaceutical company Chemie Grünenthal (now known as just Grünenthal), was distributed and sold in 46 countries, having been marketed as completely safe.[2] Despite its being advertised as a drug to alleviate the symptoms of morning sickness, it had been approved in Germany without any clinical trials involving pregnant women.[3] Luckily, the application for sale of thalidomide in the U.S. was denied FDA approval thanks to the work of Dr. Frances Kelly,[4] but that doesn’t mean that Americans weren’t affected. Drug companies Smith, Kline & French (now known as GlaxoSmithKline), and Richardson-Merrell (now known as Sanofi) conducted poorly-documented clinical trials in the U.S. with the aim of hurriedly pushing the drug into the market for sale. None of the companies were transparent in their intentions when distributing thalidomide to doctors; Richardson-Merrell even went as far as to encourage doctors to not keep track of which patients took thalidomide during the trial.[5]

There are people alive today who are still dealing with the consequences of thalidomide. Because it often results in physical malformations, those affected report struggling to find and keep jobs. They face everyday mobility difficulties and have to fight tooth-and-nail in lawsuits against giant corporations to receive even the slightest compensation. Furthermore, their expenses tend to be much higher, as electric wheelchairs, adapted vehicles, and specialized medical devices to assist with sensory deficits don’t come cheap.[6]

The thalidomide tragedy remains relevant today for a multitude of reasons—the primary one being that it was entirely preventable, which speaks to the idea that marginalization can be, and oftentimes is, induced or manufactured. This story highlights the role of the pharmaceutical industry in “creating” bodies of people who are disadvantaged in medicine and healthcare. Of course, the responsibility doesn’t fall exclusively on drug makers who peddle misleading or deceptive narratives to boost sales, but also governing bodies who fail to do their due diligence and approve questionable substances for mass-use. Furthermore, if the administration of a drug is neither well documented nor transparent—to the point where mothers don’t even recall being prescribed thalidomide—then the affected children aren’t in a position to receive justice, and the rest of us aren’t in a position to remember such injustices.

Edited by: Harrison Pham

Graphic Designed by: Harris Upchurch

References

1. https://my.clevelandclinic.org/health/articles/24325-teratogens

2. https://onlinelibrary.wiley.com/doi/full/10.1002/bdrc.21096

3. https://www.nytimes.com/2020/03/23/health/thalidomide-survivors-usa.html

4. https://academic.oup.com/toxsci/article/122/1/1/1672454?login=false

5. https://www.nytimes.com/2020/03/23/health/thalidomide-survivors-usa.html

6. https://www.thalidomidetrust.org/about-us/about-thalidomide/

Mental Health Services During the Covid-19 Pandemic

As defined by the World Health Organization, health is “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” In the past, mental health

has received little attention due to the negative stigma surrounding it in various cultures and religions. Thus, individuals with mental health disorders were afraid to disclose their disorder publicly and speak about their symptoms. However, over time, mental health has played a more prominent role in public health discussions. As mental health issues and disorders become more “acceptable” in society, more people are becoming officially diagnosed with mental health disorders. Unfortunately, this increase in diagnoses has created a substantial gap between the supply and demand of mental health treatment services across the globe.

Prior to the pandemic, mental health resources were strained, and a major contributor to this was a lack of adequate funding. Globally, government health budgets only included an average of approximately 2% for mental health services in recent years. This problem was only exacerbated during the pandemic, as job loss, economic insecurity, isolation, and the staggering amount of death witnessed by essential workers worsened the mental health state of many individuals. As explained by The Lancet, an estimated 53.2 million additional cases of major depressive disorder and 76.2 million additional cases of anxiety disorders were diagnosed during the COVID-19 pandemic. With such an increase in diagnosed mental disorders, more treatment options and services were a necessity both during and after the pandemic. However, many treatment services were partially or fully disrupted by the onslaught of the pandemic. In a 2020 survey, the World Health Organization found that over 78 countries reported disruptions to mental health services for vulnerable people during the pandemic. Although the pandemic seems to be ending now and life appears to be returning back to normal, many individuals are still suffering from mental health disorders that developed or became more severe during the pandemic. Moreover, with the impending threat of more COVID-19 variants, it’s possible that another pandemic could take place, which would only worsen the already fragile mental health state of individuals across the globe. Thus, it is necessary to take steps to decrease the treatment gap for mental health disorders right now.

One relatively effective method to treat mental health issues that has been growing in popularity is telehealth medicine. In short, telehealth medicine is a remote way to deliver patient care, monitoring, and treatment. It became widely popular during the pandemic as it eliminated the need for face-to-face contact between doctors and patients. Overall, telehealth medicine helped decrease the spread of the virus by keeping hospitals below capacity, reducing the likelihood of transmission in hospitals. While telehealth medicine was an important advancement, it is also important to recognize that not everybody is able to benefit from such services. Namely, people in Low and Middle Income Countries (LMIC) may not have the resources needed to not only operate telehealth systems but get people to attend telehealth appointments. As such, more research needs to be conducted in order to develop more equitable ways to streamline mental health services, but this can only be done if governments increase funding for all mental health services and treatments.

Edited by: Anne Sacks

Graphic Designed by: Eugene Cho

References

1. “The widened gap in mental health services during the pandemic,” The Lancet, https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(21)00229-7/fulltext.

2. “The widened gap in mental health services during the pandemic,” The Lancet, https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(21)00229-7/fulltext.

3. “Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic,” NIH National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/34634250/.

4. “Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic,” NIH National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/34634250/.

5. “Telehealth and Telemedicine during COVID-19 in Low Resource Non-U.S. Settings,” Center for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/telehealth-covid19-nonUS.html.

Breast Cancer is Financially-Blind

In human nature we have an intrinsic drive for progress and innovations when developing solutions to a challenge that has never been solved before. However, what is the use of such advances if 61% of the world’s population cannot afford to employ such innovations?

I am talking about breast cancer treatment.

Breast cancer is the most commonly diagnosed type of cancer among women worldwide and is the leading cause of cancer death in more than 100 countries. However, 61% of breast cancer patients find it hard or impossible to afford the care that will alleviate their pain. While we celebrate the invention of new high-tech breast cancer treatments, we often lose sight that such innovations are only helping a fraction of people around the world who are financially capable of investing in this type of care. But what about the majority of breast cancer victims? How can they get the care they need?

Let’s break down the finances of breast cancer and why this is a problem we should care about in the first place. Depending on the stage of breast cancer, treatment costs can range anywhere from $71,909 to $182,655 per patient. However, the average personal income in the United States is just $63,214 making it difficult for an average American to afford the best advances in breast cancer care. Even more concerning is that in low- and middle-income countries, the average individual income is much lower than that of the US and access to health care is even more scarce. That said, we can only imagine the desperation these women face while evaluating the treatment options that could save their lives and prevent suffering, although a vast majority simply cannot afford treatment.

You might be asking, what now or how can we change this tragic reality? Donating to allow individuals to afford breast cancer treatment is one step forward; however, with two individuals being diagnosed with breast cancer every minute in the US, donation is not a long-term solution for breast cancer patients across the US and the world to receive the care they deserve and need. We must also embrace new innovations and treatments that allow for low-cost, effective breast cancer treatment with sustainable scaling opportunities.

Although it may not be innate to human nature to encourage continued discovery of an alternate solution to a problem that some may think has been solved, by this, I mean finding an alternative treatment to breast cancers that are currently treatable; human nature should value this type of research if it means millions of breast cancer patients around the world will be able to return to living in remission without pain, suffering, and death.

Edited by: Joshua Sarafian

Graphic Designed by: Acelo Worku

References

1. “Breast Cancer Facts & Statistics for 2022.” National Breast Cancer Foundation, 17 Oct. 2022, https://www.nationalbreastcancer.org/breast-cancer-facts#:~:text=On%20average%2C%20every%202%20minutes,cancer%20in%20the%20United%20States.

2. Economic Evaluations of Breast Cancer Care in ... - Wiley Online Library. https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13841.

3. “Survey: Majority of Cancer Patients Struggle to Afford Cancer Care.” American Cancer Society Cancer Action Network, 15 Dec. 2021, https://www.fightcancer.org/releases/survey-majority-cancer-patients-struggle-afford-cancer-care#:~:text=According%20to%20the%20latest%20Survivor,difficult%20to%20afford%20their%20care.