About 20 years ago, my teenage nephew, following a knockdown/drag-out fight with his mother, came to live with me and my ex-wife. The recipient of two heart transplants, he brought with him a mountain of anti-rejection medication, for which we cleaned out an entire storage closet.
When our nephew ultimately reconciled with his mom and moved back in with her, he left behind much of that medicine, as his cardiologist had made alterations in his daily medication regimen. Not knowing what to do with all those unused and unexpired meds, we started calling hospitals, cardiac clinics, pharmacies and any other organizations that might be interested in accepting a donation of life-saving medicine. We got nowhere -- the anti-rejection drugs were rejected by everyone. Recycling medication was, and still is, illegal in the U.S. So we wound up tossing thousands of dollars worth of Prednisone and Cyclosporine in the garbage. With health-care costs soaring and people without health insurance in desperate need of therapy, it seemed an almost criminal waste of resources. And we felt sick about it.
Meanwhile, across town, a young HIV/AIDS counselor at St. Vincent's Hospital in downtown Manhattan was feeling the same frustration. Jesus Aguais was seeing people die every day from lack of treatment while life-sustaining HIV meds were being discarded or sold on the black market. But he came up with a way of turning that potential garbage into gold. If he couldn't recycle the meds here in the U.S., he reasoned, he could still ship them to people living with HIV and AIDS in the developing world, where the AIDS epidemic was claiming millions of lives every year and very few people had access to proper treatment.
Since 1996, the organization that Jesus founded, AID FOR AIDS International, has managed to collect more than $70 million worth of antiretroviral medication in the U.S. and redistribute it free of charge to thousands of needy recipients in 35 developing countries. In a neat little case of synchronicity, an employment agency placed me in a part-time job at AID FOR AIDS seven months ago, giving me the opportunity to atone for throwing out those life-saving meds all those years ago.
But the frustrations haven't ceased. A morally, and nearly financially, bankrupt American healthcare system still puts big pharma profits ahead of the rights of U.S. citizens to benefit from a safe and appropriately regulated recycling market.
In Latin America and the Caribbean, where AID FOR AIDS distributes most of its free meds, many governments remain less than enthusiastic about getting on board with the recycling train. Blame this on the stigma and discrimination that surround HIV in that part of the world -- especially when it comes to doing something to help lesbian, gay, bisexual and transgender (LGBT) people. While some Latin governments have begun providing first-generation HIV/AIDS therapy to their citizens, supplies of those medications are limited and intermittent at best. Those who have become resistant to the older HIV therapies must now depend on AID FOR AIDS as their only source of new-generation antiretroviral treatment.
And here's where it gets really dicey. An economic climate that encourages potential donors to sell their unused meds on the street has caused donations to AID FOR AIDS' recycling program to decline for the past two years. This has not only forced the organization to reject new applications from clients and their doctors, but has put supplies to existing clients at risk. Dying is one thing; dying after you've received what you thought was the gift of life is something else.
Nevertheless, it is only fair to note that big-money politics is not the sole reason for the American ban on domestic recycling. Many physicians take a dim view of recycling, whether it's conducted by a service organization like AID FOR AIDS or a street-level drug dealer.
"They're concerned about degradation of the potency of the medication and the lack of quality control mechanisms," says the administrator of a large government HIV agency who asked not to be identified. Opponents of domestic recycling also note that in states like New York, with large populations of people living with HIV or AIDS (PLWHA), there are no waiting lists for AIDS Drug Assistance Programs. This would seem to suggest that everyone in the U.S. is getting treatment he or she requires.
"The concerns are reasonably valid," says the AIDS administrator, "but they could all be readily addressed if we had the willingness to attack the enormous waste of medical resources. The success of AID FOR AIDS proves that we can institute safe and effective quality control procedures here in the U.S., and I'm not at all convinced that every American is being served with appropriate treatment."
Like green energy, a great idea that seems to forever stay an idea. There is gold in them thar' landfills, if we choose to mine it.