Book Review – China Rx

China Rx: Exposing the Risks of America’s Dependence on China for Medicine by Rosemary Gibson and Janardan Prasad Singh; 2018, Prometheus Books China RX

I rarely write book reviews for my blog, but China Rx touched a raw nerve and raises serious points regarding the United States pharmaceutical supply chain of which every American should be made aware.

In my first novel, The Pharm House, a fictional thriller set inside the global pharmaceutical world, I used the tag line “Do you ever wonder how drugs get in those little brown bottles? Read The Pharm House and you may give it a second thought.”.

The same tag line could easily apply to China Rx, a non-fictional description of how for the last thirty years, China has systematically and aggressively moved to take control of the global pharmaceutical final product, bulk drug and raw material supply chain.

Birth control pills, drugs for HIV/AIDS, Alzheimer’s Disease, High Blood Pressure, Antidepressants, Antibiotics, Epilepsy, Cancer and many others – often the best selling branded drug products, but particularly generic brands are manufactured in China.

In the 1990s, the United States, Europe and Japan manufactured 90% of the global supply of the key ingredients for the world’s medicines and vitamins/supplements. Now, China is the largest global supplier, with some estimates of nearly 80% of raw drug ingredients coming from China.

The U.S. Food and Drug Administration (FDA) has authority to inspect pharmaceutical and medical device facilities in China that supply product to the US, however due to limited resources, delay in timing (pre-announced inspections) and language (translators are required), the FDA oversight of Chinese facilities is far less than that of US companies.

Many pharmaceuticals sourced by the Pentagon for the U.S. Military are purchased from China, either the final product or the excipients/raw ingredients. What if during a conflict between the U.S. and China, the source was terminated or worse – intentionally contaminated?

Nearly 70 percent of Americans are on at least one prescription drug, and more than half take two. We are obsessed about where our foods come from; whether they are local, “natural” or “GMO”. Perhaps it is time we paid as much attention to where our drug products come from.

It’s not only pharmaceuticals that we should be concerned about, but also medical devices. Medical device products manufactured in China and sold in the U.S. include, magnetic resonance imagining equipment (MRIs), dental implants, screw systems used in spinal surgery, balloon catheters used to open up clogged arteries in the heart during angioplasty, speculums used during women’s gynecological exams, surgical gowns, examination gloves and wheelchairs. China is the largest exporter of medical devices to the United States.

The argument of the book is not that we should not source materials from China simply because it’s China. The argument is that materials sourced from China should meet the same stringent safety and quality standards as materials sourced within the United States, Europe and Japan.

China Rx is a must read for every American and certainly for our policy-makers in Washington. For decades, our leaders have been blinded by the fantasy that concession after concession made to China will result in them eventually wanting to be and behave like us, a Westernized open democracy. We could not have been more wrong. China has a plan and that plan is for them to dominate the manufacture, distribution and supply chain of pharmaceuticals (both final products and ingredients; both branded and generic) and medical devices. China has now positioned itself to be an existential threat to the health of the American public, our economy and our military (where do you think our military gets most of its pharmaceuticals?).

Do you know what’s in that little brown bottle you get from your drug store? Odds are whatever it is, it came from China where quality controls may be nonexistent, regulations poorly enforced and documentation may be falsified. China Rx is one of the scariest books I’ve ever read.

I gave China Rx a 5-Star Review. If you or anyone you care about takes prescription or non-prescription pharmaceuticals, vitamins and supplements, I recommend that you read this book, and while you’re at it – send a copy to your Congress person and/or Senator.

“The truth is that history will judge free trade with China, rather than fair trade, to have been a blunder of truly historic proportions from which America will never recover.”

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U.S. Color-Coded War Plans

What do most militaries do best and most often? If you guessed fight wars, you would be mistaken. The one thing that most militaries do best – plan to fight. Name a famous war planner you say? How about Dwight D. Eisenhower. During the lead-up to World War II, Eisenhower was one of George Marshall’s (Army Chief of Staff during WWII) top planners. Marshall sent Ike to England to plan for the eventual US –led invasion of mainland Europe. Eventually Marshall and President Franklin Roosevelt selected Eisenhower as Supreme Allied Commander. What makes this fact interesting is that Ike made his bones as a planner in the Army, not a fighter. Eisenhower, unlike many other ranking US military leaders, had never led troops in actual battle prior to World War II!

From the late 1800s until post-World War II, the United States military (Army and Navy) developed a series of color-coded war plans that outlined potential U.S. strategies for a variety of hypothetical war scenarios. The plans were developed by the U.S. Army/Navy Joint Planning Committee, which later evolved into the Joint Chiefs of Staff.

In 1904, the Joint Planning Committee adopted a system of colors to represent countries – potential adversaries. Many war plans became known by the color of the country to which they were related; this convention lasted through World War II.

Here are some of the details. First, at some point, the U.S. had plans to militarily engage just about every major power on earth. In fairness, they all had similar plans to engage the U.S.

The plan that has received the most consideration was War Plan Orange, a series of contingency plans for fighting a war with Japan alone that was first outlined in 1919. Plan Orange actually formed some of the basis for the actual campaign against Japan in World War II and included pre-war economic blockade of Japan that the U.S. imposed and the plans for interning the Japanese-American population living in the mainland U.S.

War Plan Orange: The U.S. Strategy to Defeat Japan, 1897 – 1945 by Edward S. Miller is an excellent read on the subject.

 

 

U.S. Color-Coded War Plans – 1938

 

 

U.S. Plans for Canadian Invasion

War Plan Red was a plan for war against Britain and Canada. British territories had war plans of different shades of red – the UK was ‘Red’, Canada “Crimson’, India ‘Ruby’, Australia ‘Scarlet’ and New Zealand ‘Garnet’. War Plan Red was kept updated as late as the 1930s and caused a stir in American – Canadian relations when declassified in 1974.

War Plan Black was a plan for war with Germany. The best-known version was conceived as a contingency plan during World War I in case France fell and the Germans attempted to seize French possessions in the Caribbean and launch an attack on the eastern U.S. seaboard. The plan actually called for the U.S. to cede southeastern U.S. territory to an invading German Army/Navy and to make a stand along the mid-Northeastern U.S. coastal area.  

War Plan White involved U.S. military engagement during an internal uprising in the United States. Communist insurgents were considered the most likely threat by the authors of War plan White.

The color-coded U.S. war planning system is still of historical relevance, but militarily outdated. No doubt the U.S. military still very actively engages in war planning, but those plans are kept secret, unless and until needed.

In addition to war planning, there is of course post-war planning.

Why my interest in this? War planning and post-war planning are referenced in The Lost Codicil.

                       

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Ancient Words and Symbols

In an upcoming Harding Family Story (The Lost Codicil) ancient words and symbols are a small, but important part of the storyline. No, I’m not trying to go Dan Brown, but as usual, I’m weaving real history into the fictional story and some of that refers to ancient words and symbols.

Saeculum is a length of time roughly equal to the potential lifetime of a person or of the complete renewal of a human population from a given event or point in time. The term was first used by the Etruscans and adopted by the Romans. Originally it meant the period of time from the moment that something happened (for example a major war or the founding of a city) until the point in time that all people who had lived at the first moment had died. At that point a new Saeculum would start. According to ancient legend, the gods had allotted a certain number of saecula to every people or civilization; the Etruscans believed that they had been given ten saecula.

By the 2nd century BC, Roman historians were using the Saeculum to periodize their chronicles and track wars. At the time of the reign of emperor Caesar Augustus (first emperor of Roman Empire) the Romans decided that a Saeculum was 110 years.

The term Saeculum evolved to common usage in which it stands for a period of about 90 years. The Romans divided it into four “seasons” of approximately 22 years each; these seasons represent youth, rising adulthood, midlife and old age.

In the Romance languages the word has evolved to mean “century”.

I first came across the term Saeculum when reading Strauss-Howe Generational Theory by authors William Strauss and Neil Howe and what they describe as a recurring generational cycle in American history. I thought, I must use this in a story.

Ouroboros is an ancient symbol depicting a serpent or dragon eating its own tail.

What the heck, you ask, is that!

Ouroboros is an ancient symbol depicting a serpent or dragon eating its own tail. The Ouroboros originated in Ancient Egyptian iconography and was adopted as a magical symbol by the Greeks and medieval alchemists and modern symbolism. It is often taken to symbolize introspection or cyclicality in the sense of something constantly re-creating itself. It can also represent the infinite cycle of nature’s endless creation and destruction, life and death and despair.

In The Lost Codicil, Nicholas Harding and his friend Don Marshall run into a group calling themselves the Saeculum who are trying to make sure that a long lost secret remains secret.

If you’re interested in reading more on Strauss-Howe Generational Theory, see the reference below.

  • Howe, Neil; Strauss, William (1997). The Fourth Turning: What the Cycles of History Tell Us About America’s Next Rendezvous with Destiny. New York: Broadway Books.

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The NY Park Avenue Armory

A few years ago, I attended the New York Antiquarian Book Fair at the Park Avenue Armory (or the Seventh Regiment Armory). It’s that castle-like building at 693 Park Avenue on the Upper East Side. The Armory is a beautiful Gothic Revival architectural style building that fills an entire city block in New York’s Upper East Side. The building was opened in 1880.

Well, even better, a few weeks ago, I got to attend a tour and lecture on the history of the Armory! What a treat.

The Park Avenue Armory originally served as the headquarters and administrative building for the 7th New York Militia, known as the Silk Stocking Regiment due to the disproportionate number of its members who were part of the city’s social elite and included some of  New York’s most prominent Gilded Age Families including the Vanderbilts, Van Rensselaers, Roosevelts, Stewarts, Livingstons and Harrimans. The building is known for detailed interior rooms that are furnished with ornamental woodwork, marble and stained glass. Built as both a military facility and a social club, the reception rooms on the first floor and the Company Rooms on the second floor were designed by the most prominent designers and artists of the day including Louis Comfort Tiffany, Stanford White, Herter Brothers and Pottier & Stymus.

The Seventh Regiment of the National Guard built the Park Avenue Armory from 1877 to 1881 at a cost of $650,000. The original Armory was three stories and had a bell tower. In 1909, significant modifications were made, adding a fourth and fifth floor and removing the bell tower, thus giving the façade the feeling of a fortress.

Board of Officers Room

In 2000, the Armory had fallen into disrepair and was considered to be an endangered historic site. A non-profit group has taken over the task of renovations and manages a calendar of events, exhibits and performances. In addition, the National Guard still uses the Armory.

Below are pictures of some of the renovated rooms and the 55,000 square-foot drill hall. The hall was designed to look like a great European train shed.

First Floor Hall

Veterans Club Room designed by Louis Comfort Tiffany

Company Room

Second Floor Hall

Second Floor Hall

Drill Hall

For more information on the Park Avenue Armory, see http://www.armoryonpark.org

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Just Where Do Drugs Come From?

US Pharmaceutical sales topped $450 billion in 2016. This is a mega-industry with considerable political clout in the US. So, who watching the Big Pharma guys to make sure they play by the rules? Who is looking out for the rest of us who take the medicines they produce?

That would be the Food and Drug Administration (FDA). The FDA was started in 1906 under President Theodore Roosevelt (see photo and yes, he’s one of my favorite POTUS) when he signed the Food and Drug Act. This act was the basis for the modern USDA, being originally given the name of the Food, Drug, and Insecticide organization. The name eventually was shortened to the Food and Drug Administration (FDA) a few years later.

The FDA as it now exists is an agency of the US Department of Health and Services. The current FDA mandate gives it responsibility for protecting and promoting public health through the regulation and supervision of food safety, tobacco products, dietary supplements, prescription and over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions medical devices, electromagnetic radiation emitting devices (ERED), and veterinary products. This role gives the FDA sway over a vast swath of the American society and economy.

The association between the industry and the FDA has morphed over the years into a partnership/adversarial/enforcement relationship that can work or it can look like a love-hate thing gone bad.

Suffice it to say that in The Pharm House, there are some goings on at Marshall Pharmaceutical Company that the FDA finds most interesting. What, you ask? Well, you’ll have to read the book!

In The Pharm House, Marshall Pharmaceutical Company is developing a new anti-viral drug that could potentially be a “blockbuster” (have peak annual sales greater than $1billion). But “things” start to happen and Nicholas Harding finds himself in the middle of those “things”.

Do you know how new drugs are discovered, developed and marketed? Unless you have worked in the pharmaceutical industry or are related to or know someone who is, I’m guessing you don’t.

Even though it is a multibillion-dollar powerful business sector, the pharmaceutical industry remains rather insular and professionally incestuous. In other words, unless you are an insider, it is unlikely you will know the internal machinations of the industry. The scientific and business professionals in the trade make up a rather small group that tend to move from company to company, hence the professional incest.

In order to get one new drug to market, you have to go back in time to start 10-15 years prior, start with 10,000 to 12,000 new chemicals to eventually narrow them down to one that is both safe and efficacious and you would need roughly $1.5 billion plus! That’s right, the whole process of drug discovery/development takes on average 10 plus years and one billion plus dollars! It’s a high stakes business, which can bring out the best in some and the worst in others.

Don’t get me wrong; the pharmaceutical industry does tremendous good for our society. Look at all the drugs that have significantly improved both the quality of our lives and our lifespans. But at the end of the day, these big mega-corporations exist to generate a return on investment for their shareholders.

What happens when a company has invested many years and hundreds of millions of dollars only to find a “dry hole” that yields zero return? Trust me, you don’t want to be around when that happens!

Come join Nicholas at The Pharm House and see what “things” start to happen…

Posted in Author Bill Powers, Drugs, Medication, Pharmaceuticals | Leave a comment

Weaving History Into Fiction

I may have mentioned before that I love history and consider myself a bit of an amateur historian (emphasis on amateur). I am fascinated by the Civil War era and turn of the century (19th to 20th) American history. It’s fun to sprinkle tidbits of historical references in my fictional writing. In The Pharm House, Nicholas and Don, also students of history, use the symbolism of Civil War events as an allegorical reference to one of their current situations.

“A collection of twelve original letters from Abraham Lincoln to his generals during the Civil War. Including some to Sherman and Grant. And one to McClellan, telling him to get off his ass and attack Lee.” Don went on, fascinated with his story. “Of course, he (McClellan) didn’t move his ass and Lincoln fired him.”

“Only to bring him back after Hooker lost at Antietam.” Nicholas added.

“Very good Dr. Harding. But alas, it was a short-lived return engagement. Lincoln was forced to re-fire Little Mac when he returned to passive form and refused to move his Army. Tell me Dr. Harding, what do you think of General McClellan?”

“I’ve always thought him one of the most fascinating characters of the Civil War, yet relatively little has been written about him. After all, at the age of 35, he gained command of the most powerful army on Earth and then proceeded to do absolutely nothing with it.” Nicholas expounded.

“And went on to become?” Don inquired gleefully knowing he had a playmate of equals on the topic.

What did Major General George B. McClellan (above on the
right) go on to do after the Civil War?

A little background, then I’ll let Nicholas and Don Marshall give you the answer. McClellan and Lincoln shared a common background prior to the Civil War. McClellan was a previous Vice-President of the Illinois Central Railroad and Lincoln, who was actually our first corporate lawyer president, was a prior legal counsel for the Illinois Central Railroad. The two men’s paths likely crossed during their corporate stent with the Railroad.

“And went on to become?” Don inquired gleefully knowing he had a playmate of equals on the topic.

“A losing presidential Democratic candidate against Lincoln in 1864 and then elected Governor of New Jersey in 1877.” Nicholas replied. “Though few know that. In fact, few probably remember who McClellan was.”

An example of how a touch of history can be weaved into a fictional story. You’ll have to read The Pharm House to see how Nicholas and Don use the story of General McClellan in reference to their situation and to see how other historical references are weaved into the story.

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The Marshall Family Estate

The drive from the Marshall Farm Business Complex to the Marshall family estate and mansion was only about 10 minutes. The Marshall estate was situated well off the main roads of Florham Park, so that none of the buildings on the estate could be seen from any public street.

As the car turned into the gated driveway of the estate, it appeared to be entering a heavily wooded forest, but after about half a mile, opened up into wide manicured lawns. The tree-lined drive led to a stonewall with another large gate. Beyond the stonewall gate the driveway became cobblestone and much wider. Once through the last gate and onto the cobblestone drive, the main mansion became visible.

The Marshall mansion and the surrounding grounds exuded the concept of money and power.
The mansion was a classical early 20th century style. Sweeping copper roofs, turreted towers and gables, four floors visible, expansive gardens and fountains. This was the result of the toil of two generations of Marshall work. Nicholas had read that the mansion had seventeen bedrooms and that Donald Marshall I – the founder – had built it to intimidate the locals. Must have worked, he thought.

The limousine pulled up through an arched cover by the front door and stopped. The front door of the house opened and a uniformed servant stepped forward to open the car door.

“Good morning Dr. Harding, this way please.” Said the servant as he led Nicholas into the house. He was middle aged – maybe early 50’s, obviously British and black. “If you’ll be so kind as to wait here.” He said as they entered a large open room that was obviously a library. “Mr. Marshall will join you shortly.”

When the servant left the room, Nicholas had an opportunity to explore. There were two levels with a mezzanine on the upper level. A large fireplace was on the wall to the right as you entered the room. Across the room, positioned so you could see the fireplace was the largest rolltop desk that Nicholas had ever seen. Nicholas had a fondness for rolltop desks. It was a dark heavy wood with dozens of small drawers and compartments. It was a beautiful piece of furniture. On the wall over the fireplace were two portraits of two middle-aged gentlemen who clearly resembled each other.

Nicholas recognized the two men as the founder of Marshall Pharmaceutical –Donald Marshall I and the II, Don’s father. No sign of the current Don’s portrait anywhere. There were literally thousands of books organized neatly and efficiently as any private library. Some appeared to be rare collector’s items. The outside walls had large eight-foot tall windows with a beautiful view of the manicured lawns. From the mezzanine windows you could make out the faint outline of the New York skyline. The windows had heavy velvet drapes of a rich dark blue that could be pulled to shield the books from sunlight.

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The Pharm House – Setting

The Pharm House is set in the present with the main portion of the story taking place in western New Jersey, the Morristown area. A lot of folks who have never visited New Jersey may have a rather jaded view based on what they see on television (think The Sopranos) or in movies (think Wise Guys). When they think of NJ, they may think of Newark or the Turnpike, but there’s a reason that Jersey is called “The Garden State”.

New Jersey is rich in history; in the winter of 1779/1780, George Washington encamped the Continental Army at Jockey Hollow, near Morristown. As an amateur history buff, I have sprinkled several Civil War references throughout The Pharm House.

Western New Jersey is known for its rolling hills of farmland and horse country; a well-hidden secret. After the Civil War, the US industrial boom created a new class of wealthy industrialist working out of New York. Many of these industrialists and financiers amassed great fortunes and looked to build large estates mimicking European aristocracy. The open spaces of western New Jersey were a perfect locale.

Railroad lines took these captains of industry into New York, while their families remained on their estates in the small towns of western New Jersey, e.g., Morristown, Bernardsville, Peapack, Mendham, Florham Park, etc. Many of the manor homes of these estates, which ranged in size from 50 to 500 acres, have been lost to time and development, however several remain even today.

In The Pharm House, Marshall Pharmaceutical is located in the middle of Marshall Farms, now a sprawling private industrial park, but once the home of a manor house and estate at the end of the 19th century.
Parts of The Pharm House also take place in Manhattan, Washington, D.C. (with a few more historical tidbits), London and Tokyo.

Join Nicholas and friends and see parts of New Jersey that most Americans have never seen.

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Characters of “The Pharm House” Part 2

Jack O’Connor – Nicholas’ boss at Marshall Pharmaceutical

Jack was a Senior Vice President and a member of the Marshall Board of Directors. Tall, barrel-chested with gunmetal gray crew-cut hair, Jack was one of those over-testosteroned manly men who thought that regardless of whose company he was in, his was the superior intellect present and by default, the leader.

O’Connor’s office was on the R&D building executive – fifth- floor. As head of all Marshall R&D, both clinical and non-clinical, Jack ruled his global empire with an iron fist. Nicholas had read an article on James Baker, Secretary of State under George H. W. Bush. Baker was described as ‘the velvet hammer’, someone who welded extreme power, but with finesse and class. Given that, O’Connor’s style could be described as ‘the rusty spiked hammer’. When Jack was in the room, there was space for only one opinion – his.

Nicholas had some degree of technical respect for O’Connor, but felt that his bullying, micromanaging style was about 30 years outdated. As a member of the Marshall Board of Directors, Jack carried considerable clout. He’d long ago wiped out all potential enemies and competition and the rumor was he lusted after the company C.E.O. position.

O’Connor’s lair was spacious and designed to intimidate; a large open anteroom with chairs for waiting victims far away from the workspace of his secretary, Roberta. That way if you’re waiting for Jack, you can’t see what she’s working on. And Roberta was a piece of work. She ruled over all the R&D secretaries like the Wicked Witch of the East ruled her flying monkeys. Roberta was one of those secretaries who took glee from using her bosses’ power to terrorize everyone else in the organization.

Nicholas learned long ago that two people you absolutely never want to piss off are the bosses’ secretary and spouse in that order. So, every Secretary’s Day or Administrative Assistant’s Day or whatever the current politically correct term was, even though he hated it as holiday created by and for Hallmark and the florist industry, every Christmas and on her birthday, Roberta received flowers and candy from Nicholas. Consequently, Roberta, Queen of the Vampires, had a soft spot in her cold, hypertrophied heart for Nicholas.

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Characters of “The Pharm House” Part 1

Beth Cowlings

Beth is Nicholas’ attorney. She is from Raleigh North Carolina and is an old friend of Nicholas’ mother, Dorothy Harding. Beth and Dorothy had met and become friends in the racially charged segregated south in the later half of the 20th century.

Beth is licensed to practice law in New Jersey and at Dorothy’s request, she comes to NJ to help Nicholas with the mess he seems to have gotten himself entangled in at Marshall Pharmaceutical.

“Beth Cowling was the type of person who became the center of attention, no matter where she was. A tad on the short side, compensated for by high-heels, her favorite color was white. And today, she was a vision of flowing white from her shoes, to her white pantsuit with long floor-length vest. She had piercing grey wolf-like eyes, but the most striking aspect of Beth today and most others was her hair – snow white and shoulder length. Somehow the white hair actually made her look younger than the mid 50’s she was.

Nicholas had quietly entered living room where Beth was holding court with Dorothy, Michael and Andrea.

She had that slow melodious swaying southern accent – the kind used by refined southern ladies. And could lull you into a false sense of superiority. Nicholas had always been fascinated by the fact that the average American hearing a southern accent automatically deducted about 15 IQ points. That same person hearing a refined British accent would add 15 IQ points to the speaker. He suspected that Beth made ample use of this trick and had been under estimated by many a foe – mostly likely to their serious detriment.

“I hope you don’t go skiing in that outfit.” Nicholas said from across the room.

“Not to worry. Why I’d just melt the snow with my charm.” She said walking towards Nicholas, extending her hand.

Waiting for the others to arrive, Nicholas stared at Beth as she sat slowly smoking her cigar and drinking her brandy.

“Why what is it Nicholas, dear?” She purred.

Nicholas laughed. “I’ll bet you have six inch fangs.”

“I’ve never heard it put quite that way, but very perceptive dear, very perceptive.”

Beth turns out to be quite the charmer…

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