The Intersection of Climate Change, Chronic Kidney Disease, and Drug Distribution: A Call for Action

The Intersection of Climate Change, Chronic Kidney Disease, and Drug Distribution: A Call for Action

Introduction:

The impact of climate change is far-reaching, affecting various aspects of our lives, including our health and well-being. As temperatures rise and extreme weather events become more frequent, the world is witnessing the emergence of new diseases and the exacerbation of existing health conditions. One such condition is Chronic Kidney Disease of Non-traditional origin (CKDnt), which is poised to become the black lung of climate change. This article explores the connection between climate change, CKDnt, and the inefficiencies in the drug market, highlighting the urgent need for action and policy reform.

The Rising Prevalence of CKDnt:

CKDnt, also known as Mesoamerican nephropathy, was first documented among sugarcane workers in El Salvador 21 years ago. This disease primarily affects outdoor laborers who work under grueling conditions of high heat. As global temperatures continue to rise, CKDnt cases are increasing, making it arguably the world's first occupational disease caused by climate change. The need for workplace safety standards to prevent CKDnt, similar to the prevention of black lung in coal miners, is evident.

The Impact of Climate Change on Kidney Health:

Beyond CKDnt, extreme weather events and rising temperatures pose a significant risk to kidney health. Dr. Farhad Modarai, a chief clinical officer for population health at Strive Health, highlights the increased risk of acute kidney injuries across the United States due to climate change. Outdoor laborers, who bear the brunt of excessive heat waves and air pollution, are particularly vulnerable. Excessive sweating, dehydration, and fatigue can lead to urinary tract infections and kidney stones, ultimately causing cumulative kidney damage. Additionally, the smoke from wildfires, which has become more prevalent, adds another stressor by carrying microscopic particles that can reach the kidneys and cause long-term damage.

The Inefficiencies in the Drug Market:

In the realm of healthcare, the growth and problems of contract pharmacies have created significant distortions and inefficiencies in the drug market. The use of external pharmacies by 340B covered entities to dispense 340B drugs to patients has dramatically increased in number and size. This practice has led to a lack of transparency and accountability, as well as the potential for duplicate discounts. Addressing these issues is crucial to ensure that patients in need receive the appropriate discounts and that the program operates more efficiently.

Policy Recommendations for Reform:

To improve the 340B program and its contract pharmacy arrangements, Adam Fein, an industry expert, proposes several policy recommendations. These include mandating discounts for needy patients, limiting the number and scope of contract pharmacies, ensuring transparency and accountability, and preventing duplicate discounts. Implementing these guidelines would not only streamline the drug distribution process but also ensure that the program benefits those who require it the most.

Actionable Advice:

• 1. Advocate for Workplace Safety Standards: As individuals and communities, we can raise awareness and advocate for the implementation of workplace safety standards that protect outdoor laborers from the adverse effects of high heat conditions. By supporting organizations and initiatives focused on this issue, we can contribute to preventing CKDnt and other climate change-related occupational diseases.

• 2. Support Climate Change Mitigation Efforts: Taking steps to reduce our carbon footprint and support climate change mitigation efforts can have a positive impact on kidney health. By reducing greenhouse gas emissions and promoting sustainable practices, we can help alleviate the extreme weather events and air pollution that contribute to kidney damage.

• 3. Engage in Policy Reform Discussions: Stay informed about the inefficiencies in the drug market, such as the issues surrounding contract pharmacies, and actively participate in policy reform discussions. By voicing our concerns and supporting proposals that promote transparency, accountability, and equitable access to discounted medications, we can contribute to a more efficient and fair healthcare system.

Conclusion:

The intersection of climate change, chronic kidney disease, and the inefficiencies in the drug market calls for urgent action and policy reform. By addressing workplace safety standards, mitigating climate change, and advocating for transparency in the drug distribution process, we can work towards a future where the health of individuals, particularly outdoor laborers, is protected from the detrimental effects of climate change. It is crucial for governments, healthcare organizations, and individuals to come together to prevent CKDnt from becoming the black lung of climate change.