First and certainly foremost, our thoughts and prayers are with the people of Puerto Rico and those working to respond to the devastation caused by Hurricane Maria Sept. 20. Since then, the country has struggled without electricity, drinking water and medical supplies. The situation now is a humanitarian crisis, where it is reported nearly half the population lacks drinking water, hospitals struggle to stay open, food and medicine are in critically short supply, and 97 percent of the people have no power. It is our hope the U.S. federal government ramps up relief efforts quickly.


Our thoughts also eventually turn to the global nature of supply chains, especially since Puerto Rico is home to many pharmaceutical factories which supply the U.S. and other markets. Indeed, there are nearly 50 pharmaceutical plants on the island, and pharmaceuticals represent 72 percent of Puerto Rico’s 2016 exports, valued at $14.5 billion, according to the U.S. Bureau of Labor Statistics, a USA Today article reports.


Many large pharmaceutical companies report their factories didn’t sustain much hurricane-related damage. Nonetheless, power isn’t likely to be restored to the island for three to six months, and while factories run by global pharmaceutical companies generally have backup power generation, most employees are unavailable to help resume manufacturing because they face calamity in their personal lives.


“Companies are looking at what their production plans will be and what redundancies are in place,” Nicolette Louissaint, president of Healthcare Ready, a non-profit group that addresses emergency supply chain crises during the hurricane season, says in the USA Today article. “They’re beginning to look at how to best ensure there’s continuity of operations.”


A U.S. Food and Drug Administration Commissioner Scott Gottlieb said in an interview with The Wall Street Journal that the agency is taking steps to mitigate the possibility of hurricane-related drug shortages, including working with companies to ensure products are shipped. He said the agency is focused on avoiding shortages of a number of critical drugs which are made primarily in Puerto Rico.


“There’s a significant amount of manufacturing on the island,” Gottlieb said. “If those facilities can’t be restarted soon, we have concerns about the potential for drug shortages.”


In the meantime, for example, Baxter International says it has lost “multiple production days” at facilities in Puerto Rico due to Maria, and that will delay its ability to restore shipments of two products that were already in short supply on the U.S. mainland. The products—dextrose and sodium chloride, also known as saline—are intravenous fluids given to hospital patients. The company disclosed the delays in a Sept. 22 letter to U.S. hospitals and other customers, saying Baxter was still assessing hurricane-related damage to its facilities. U.S. hospitals already had faced shortages of the drugs due to manufacturing problems and other issues unrelated to the hurricanes.


Baxter also said in a statement that the company took steps to mitigate a potential disruption to supply by transporting finished products off Puerto Rico in advance of the hurricanes, the Wall Street Journal reports. The company said the product-allocation plan is designed to ensure equitable product distribution to customers.


Bristol-Myers Squibb has announced its plant in Humacao appeared to suffer some damage during the hurricane, but a second plant, in Manati, wasn’t harmed. The Humacao plant makes the bloodthinner Eliquis as well as some older drugs.


“Based on the contingency plans we executed, we believe we have mitigated the risk to product supply regardless of that damage,” a company spokesman told Reuters.


Finally, Pfizer said a preliminary assessment indicates that two of the company’s three manufacturing plants sustained minimal damage, while a third had “minimal to moderate damage to parts of the facility.” A spokesman told multiple sources the company is trying to repair the damage as quickly as possible, and is confident it can avoid interruptions to product supplies.


What are your thoughts on the situation in Puerto Rico—either the apparently slow relief efforts or when pharma manufacturing may resume?