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Today, most climate science is done with satellites, sensors and complicated computer models. But it all started with two glass tubes.

“A woman, about 170 years ago, used a very simple experimental setup – two glass tubes, two thermometers, an air pump – and was able to demonstrate that if you add carbon dioxide to the atmosphere, you warm it up. It’s basic physics,” says Annarita Mariotti, a climate scientist and program director of Modeling, Analysis, Predictions, and Projections at the National Oceanographic and Atmospheric Administration.

Eunice Foote, the woman behind that glass tube experiment, has largely been left out of the history books. Until about 10 years ago, John Tyndall was seen as the grandfather of climate science for setting the foundation for the understanding of the greenhouse gas effect. But Foote’s experiment, done three years prior, showed that air with more “carbonic acid,” or carbon dioxide, both heated up faster and cooled down slower than regular air.

“She actually did some really important work before John Tyndall even got going. So why was there this grandmother of climate science that had essentially been written out of the history books?” asks Katharine Wilkinson, a climate scientist and the executive director of The All We Can Save Project. “Some of the frustration is that her story is still all too relevant today, that there are still far too many women doing really important work that either flies under the radar or gets shoved under the radar.”

Foote’s study was relatively straightforward. In a series of experiments, she took two glass containers full of air and would pump different gasses – including carbon dioxide and water vapor – into one of the containers. She would then leave those containers in the sun and monitor how quickly they heated up and cooled down in the shade.

Her work was presented in 1856, at the annual meeting of the American Association for the Advancement of Science. It was the first work done by a woman to be presented at the conference – though she did not give the presentation herself. Rather, it was done by physicist and first secretary of the Smithsonian, Joseph Henry.

But Foote didn’t just pioneer the field of climate science. Mariotti says, “She opened doors for women in science and in general broader representation in sciences … She did not have a Ph.D. and she did not have sophisticated experimental set up. And still she did it.”

Foote was a pioneer in more ways than one. She was the first woman in the United States to publish papers on physics; she also advocated for women’s rights outside of academia. Foote helped organize the Seneca Falls Convention, which launched the women’s suffrage movement in the U.S. “There was something sort of intersectional, perhaps, in her thinking in her life,” Wilkinson says. “If we are not bringing critical lenses to understand the root causes of the climate crisis, if we’re not bringing critical lenses to understanding the need to embed equality and justice in the solutions to the climate crisis, we’re not going to get to a good outcome … There’s early seeds of that in Eunice’s story as well.”

Listen to Short Wave on Spotify, Apple Podcasts and Google Podcasts.

This episode was produced by Liz Metzger, edited by Rebecca Ramirez and fact-checked by Anil Oza. The audio engineer was Robert Rodriguez.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

This year’s federal tax filing deadline of April 18 is quickly approaching, and Americans generally pay some mixture of federal, local, and in most cases, state taxes. But the tax burden of some states significantly outpaces others, data shows.

WalletHub, a personal finance website, released a report this week analyzing total tax burden by state. Tax burden is defined as the proportion of a person’s income that goes toward taxes.

It measured a combination of the proportion of property tax, income tax and sales tax that people paid. These were the states with the highest and lowest tax burdens.

Highest tax burdens

1. New York – 12.47%
2. Hawaii – 12.31%
3. Maine – 11.14%
4. Vermont – 10.28%
5. Connecticut – 9.83%
6. New Jersey – 9.76%
7. Maryland – 9.44%
8. Minnesota – 9.41%
9. Illinois – 9.38%
10. Iowa – 9.15%

Lowest tax burdens

1. Alaska – 5.06%
2. Delaware – 6.12%
3. New Hampshire – 6.14%
4. Tennessee – 6.22%
5. Florida – 6.33%
6. Wyoming – 6.42%
7. South Dakota – 6.69%
8. Montana – 6.93%
9. Missouri – 7.11%
10. Oklahoma – 7.12%

When broken down by category, the states with the highest burden for property tax were Maine (5.33%), Vermont (4.98%) and New Hampshire (4.94%), while the lowest were Alabama (1.39%), Tennessee (1.66%) and Arkansas (1.68%).

The states with the highest burden for income tax are New York (4.72%), Maryland (4.21%) and Oregon (3.62%). There are seven states with no income tax – Nevada, Washington, South Dakota, Florida, Wyoming, Alaska and Texas.

The states with the highest sales tax burden are Hawaii (6.71%), Washington, (5.66%) and New Mexico (5.62%), while the states with the lowest sales tax burden are New Hampshire (1.07%), Delaware (1.09%) and Oregon (1.11%).

Copyright 2023 NPR. To see more, visit https://www.npr.org.

It was the Champagne pop heard around the economy. One year ago this week, a fired Amazon warehouse worker turned labor activist sprayed Champagne and then drank from the bottle outside federal labor offices in New York City.

Swarmed by supporters and media, Chris Smalls toasted a victory: the first Amazon union in the U.S., led by Smalls and other workers at an 8,300-person warehouse on Staten Island, a feat few believed they could pull off.

Since then, though, the Amazon Labor Union has gained little ground. It has yet to win another union election. And Amazon still refuses to sit down for contract negotiations.

In fact, despite the buzz around what seemed like a labor resurgence — the historic win at Amazon, as well as spirited campaigns at Starbucks, on college campuses and retail stores across the country — the overall picture for unions remains bleak.

This week, we may get a window into why. On Wednesday, fresh from his third stint as Starbucks CEO, Howard Schultz will head to Capitol Hill, where he’ll face questions about everything Starbucks is doing to discourage its workers from joining unions.

Only about 1 in 10 U.S. workers is a union member

Just 10% of American workers belonged to a union in 2022, the lowest in Labor Department records going back to 1983, when the rate was 20%.

Never mind that 71% of Americans approve of unions, the highest in nearly six decades and up from 48% in 2009, a Gallup poll conducted last summer found.

The bottom line is that labor law itself is tilted in favor of employers, say researchers who study labor movements, often making corporate hostility toward unions too hard to overcome. The recent groundswell of public support is far from enough to spark a union comeback.

“Those of us who have been watching this stuff for many decades have actually been pleasantly surprised by the success that has occurred, but it’s too modest in scope and too fiercely resisted by employers” to move the needle, says Ruth Milkman, a labor sociologist at the Graduate Center at the City University of New York.

Since December 2021, nearly 300 Starbucks stores — less than 3% of its company-owned locations in the U.S. — have unionized, and not without a fierce fight.

Unfair labor practice charges against Starbucks are piling up at the National Labor Relations Board. The agency’s regional offices have issued scores of formal complaints, and its administrative law judges have so far found that Starbucks violated labor law in eight separate cases across the country.

Starbucks denies engaging in unlawful activity. The enforcement actions taken by the National Labor Relations Board do not appear to be forcing a change of heart.

In fact, the law allows companies to engage in anti-union activities, including finding ways to slow down every stage of the organizing process, Milkman says.

One big weapon against unionization: delay, delay, delay

Starbucks, for example, insisted early on that individual stores, which often employ just 25 to 30 people, should not be allowed to hold union elections, but rather, all stores in a geographic region must vote together in one election, increasing the degree of difficulty for union organizers. Federal labor officials ruled against Starbucks, and elections proceeded at the store level, but not without significant delays.

Labor law also allows for a lengthy appeals process, which Amazon is using to great effect to delay collective bargaining at the Staten Island warehouse.

Following a marathon Zoom hearing last summer, federal labor officials found Amazon’s objections to the Staten Island union election to be meritless and in January ordered the company to begin negotiations with the union.

But Amazon has since formally requested a review of that decision. If that review doesn’t go in its favor, Amazon can still take its case to federal circuit court for another round.

Toothless penalties for violating labor law and a fix that’s going nowhere

Unions have fought back, filing hundreds of unfair labor practice charges over anti-union activities, citing things like companies closing stores, cutting hours, and threatening and firing organizers at stores that had or were trying to unionize. (Companies have also filed unfair labor practice charges against unions, but far fewer.)

But even where the NLRB has found violations of workers’ rights to organize, the board’s decisions don’t have much financial bite. The agency’s administrative law judges can only impose what are called “make whole” remedies, things like back pay, reinstatement and reimbursement for financial harms suffered as a result of unlawful activities.

“It’s a cost of doing business,” AFL-CIO President Liz Shuler said in Senate testimony earlier this month.

“Right now, you actually get a bigger fine for violating fishing laws in many states than you do for busting unions.”

President Biden and Democratic lawmakers have pushed for passage of the Protecting the Right to Organize Act, known as the PRO Act, to fix some of the weaknesses of current labor law, starting with civil penalties of up to $50,000 for violating workers’ rights.

But with a divided Congress, hopes for passage are slim. And without any change in the law, Milkman says it’s hard to imagine a significant uptick in the unionization rate in the U.S.

A public shaming expected on Capitol Hill

With the PRO Act going nowhere, Sen. Bernie Sanders is turning to public shaming of those in power. Earlier this year, Sanders threatened to subpoena Schultz, calling on him to end the “relentless union-busting campaign” at Starbucks.

While Schultz’s testimony this week may generate fireworks, it’s unlikely to have much long-term impact.

Schultz is expected do what he’s done proudly for decades, outlining the competitive wages and industry-leading benefits that Starbucks affords workers, including free college tuition and company stock, even for part-time employees.

He’ll likely make the same case he’s made for the past year and a half — that Starbucks employees don’t need unions to fight on their behalf.

At a shareholder meeting last week, Starbucks’ new CEO Laxman Narasimhan and other executives did not indicate any change in the company’s feelings about unions, stressing the importance of maintaining a direct relationship with its employees.

There is some outside pressure for Starbucks to reconsider its anti-union stance. At that same meeting, shareholders voted on a proposal, brought by heavyweight investors including New York City’s pension fund, for a third-party audit of the company’s labor practices.

Results are expected this week, but even if the proposal wins a significant number of votes, it’s unclear how much weight it would have. In encouraging shareholders to vote down the proposal, Starbucks said it had begun its own third-party human rights impact assessment.

Editor’s note: Amazon is among NPR’s financial supporters and pays to distribute some of our content.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Just before Christmas, federal health officials confirmed life expectancy in America had dropped for a nearly unprecedented second year in a row – down to 76 years. While countries all over the world saw life expectancy rebound during the second year of the pandemic after the arrival of vaccines, the U.S. did not.

Then, last week, more bad news: Maternal mortality in the U.S. reached a high in 2021. Also, a paper in the Journal of the American Medical Association found rising mortality rates among U.S. children and adolescents.

“This is the first time in my career that I’ve ever seen [an increase in pediatric mortality] – it’s always been declining in the United States for as long as I can remember,” says the JAMA paper’s lead author Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “Now, it’s increasing at a magnitude that has not occurred at least for half a century.”

Across the lifespan, and across every demographic group, Americans die at younger ages than their counterparts in other wealthy nations.

How could this happen? In a country that prides itself on scientific excellence and innovation, and spends an incredible amount of money on health care, the population keeps dying at younger and younger ages.

An unheard alarm

One group of people are not surprised at all: Woolf and the other researchers involved in a landmark, 400-page study ten years ago with a name that says it all: “Shorter Lives, Poorer Health.” The research by a panel convened by the National Academy of Sciences and funded by the National Institutes of Health compared U.S. health and death with other developed countries. The results showed – convincingly – that the U.S. was stalling on health advances in the population while other countries raced ahead.

The authors tried to sound an alarm, but found few in the public or government or private sectors were willing to listen. In the years since, the trends have worsened. American life expectancy is lower than that of Cuba, Lebanon, and Czechia.

Ten years later, here’s a look back at what that eye-popping study found, and why the researchers involved believe it’s not too late to turn the trends around.

Beyond bad habits

Americans are used to hearing about how their poor diets and sedentary lifestyles make their health bad. It can seem easy to brush that off as another scold about eating more vegetables and getting more exercise. But the picture painted in the “Shorter Lives” report could shock even those who feel like they know the story.

“American children are less likely to live to age 5 than children in other high-income countries,” the authors write on the second page. It goes on: “Even Americans with healthy behaviors, for example, those who are not obese or do not smoke, appear to have higher disease rates than their peers in other countries.”

The researchers catalog what they call the “U.S. health disadvantage” – the fact that living in America is worse for your health and makes you more likely to die younger than if you lived in another rich country like the U.K., Switzerland or Japan.

“We went into this with an open mind as to why it is that the U.S. had a shorter life expectancy than people in other countries,” says Woolf, who chaired the committee that produced the report. After looking across different age and racial and economic and geographic groups, he says, “what we found was that this problem existed in almost every category we looked at.”

That’s why, says Eileen Crimmins, professor of gerontology at the University of Southern California who was also on the panel that produced the report, they made a deliberate choice to focus on the health of the U.S. population as a whole.

“That was a decision – not to emphasize the differences in our population, because there is data that actually shows that even the top proportion of the U.S. population does worse than the top proportion of other populations,” she explains. “We were trying to just say – look, this is an American problem.”

Digging into the ‘why’

The researchers were charged with documenting how Americans have more diseases and die younger and to explore the reasons why.

“We were very systematic and thorough about how we thought about this,” says Woolf. The panel looked at American life and death in terms of the public health and medical care system, individual behaviors like diet and tobacco use, social factors like poverty and inequality, the physical environment, and public policies and values. “In every one of those five buckets, we found problems that distinguish the United States from other countries.”

Yes, Americans eat more calories and lack universal access to health care. But there’s also higher child poverty, racial segregation, social isolation, and more. Even the way cities are designed makes access to good food more difficult.

“Everybody has a pet thing they worry about and say, ‘it’s oral health’ or ‘it’s suicides’ – everyone has something that they’re legitimately interested in and want to see more attention to,” says John Haaga, who was the director of the Division of Behavioral and Social Research at the National Institute on Aging at NIH, before he retired. “The great value of an exercise like this one was to step back and say, ‘OK, all of these things are going on, but which of them best account for these long-term population level trends that we’re seeing?’ ”

The answer is varied. A big part of the difference between life and death in the U.S. and its peer countries is people dying or being killed before age 50. The “Shorter Lives” report specifically points to factors like teen pregnancy, drug overdoses, HIV, fatal car crashes, injuries, and violence.

“Two years difference in life expectancy probably comes from the fact that firearms are so available in the United States,” Crimmins says. “There’s the opioid epidemic, which is clearly ours – that was our drug companies and other countries didn’t have that because those drugs were more controlled. Some of the difference comes from the fact that we are more likely to drive more miles. We have more cars,” and ultimately, more fatal crashes.

“When we were doing it, we were joking we should call it ‘Live free and die,’ based on the New Hampshire slogan, [‘Live free or die’],” Crimmins says. “The National Academy of Sciences said, ‘That’s outrageous, that’s too provocative.’ ”

There are some things Americans get right, according to the “Shorter Lives” report: “The United States has higher survival after age 75 than do peer countries, and it has higher rates of cancer screening and survival, better control of blood pressure and cholesterol levels, lower stroke mortality, lower rates of current smoking, and higher average household income.” But those achievements, it’s clear, aren’t enough to offset the other problems that befall many Americans at younger ages.

All of this costs the country tremendously. Not only do families lose loved ones too soon, but having a sicker population costs the country as much as $100 billion every year in extra health care costs.

“Behind the statistics detailed in this report are the faces of young people – infants, children, and adolescents – who are unwell and dying early because conditions in this country are not as favorable as those in other countries,” the paper’s authors wrote.

Little action, despite the stakes

“Shorter Lives” is filled with recommended next steps for the government, especially the NIH, which has a budget of more than $40 billion annually to conduct research to improve Americans’ health.

The NIH should undertake a “thorough examination of the policies and approaches that countries with better health outcomes have found useful and that may have application, with adaptations, in the United States,” the authors wrote.

In other words: let’s figure out what they are doing that works in other places, and do it over here.

Dr. Ravi Sawhney, who helped conceive of and launch the “Shorter Lives” study at NIH before he left the agency, had high hopes that the report would make a mark. “I really thought that when the results came out, they would be so obvious that people would say: Let’s finally do this,” he says.

Ten years on, how much of the detailed action plan has been done?

“To be brief, very little of that happened,” Woolf says. At the time, he says, NIH officials didn’t seem very interested in raising awareness about the panel’s findings or in following up on its proposed research agenda. “There was some media coverage at the time that the report rolled out, but NIH was not involved in trying to promote awareness about the report.”

Crimmins agrees. “There was a little bit more research, but there wasn’t any policy reaction,” she says. “I thought there might be, because it’s embarrassing, but it just tends to be ignored.” Those who are interested in this issue, she notes, tend to be those invested in “marvelous things they think are going to delay aging,” even though people older than 75 are the only age group in the country that already does comparatively well.

Haaga, the former NIH division director, also thinks the response at the agency was lacking. “Not nearly enough has been done, given the stakes and given what we could learn,” he says.

In response to NPR’s request for comment for this story, NIH pointed to a subsequent panel on midlife mortality, several initiatives the agency has undertaken on disparities between subgroups within the U.S., and a recent paper funded by NIH that looked again at international life expectancy.

Outgoing NIH Director Francis Collins told NPR in 2021 that it bothered him that there hadn’t been more gains to American life expectancy during his tenure. In his view, the success of NIH in achieving scientific breakthroughs hadn’t translated to more gains because of problems in society that the research agency had little power to change.

Woolf calls it a misconception to assume that America’s great scientific minds and medical discoveries translate to progress for the health of the population. “We are actually very innovative in making these kinds of breakthroughs, but we do very poorly in providing them to our population,” he says.

‘We can’t touch everything’

Department of Health and Human Services Secretary Xavier Becerra answered NPR’s question at a press conference earlier this month about work the agency was doing to address lagging life expectancy by mentioning COVID-19 and vaccine hesitancy, along with mental health issues and gun violence.

“There’s so many things that we’re doing,” Becerra said. “We can’t touch everything. We can’t touch state laws that allow an individual to buy an assault weapon and then kill so many people. We can only come in afterwards.”

CDC Director Rochelle Walensky responded by listing some of the agency’s work on mental health and vaccines, and acting NIH director Larry Tabak pointed to research on health disparities.

HHS did not answer a follow up question about whether the agency has considered a national commission or similar effort to address American life expectancy and poor health.

Sawhney thinks the federal government should try harder to fix the problems documented in the “Shorter Lives” report. He doesn’t think lack of public awareness is the problem. “I really think that most Americans know that Americans are more overweight and obese and that we have higher rates of disease and live shorter lives than other countries,” he says, “It’s just the NIH and the CDC that don’t want to take the responsibility for that failure or to do anything about it.”

Crimmins says, in her experience, lawmakers and federal health officials don’t like talking about how the U.S. is lagging behind other countries.

“I convened a meeting in Washington with the National Center for Health Statistics [part of CDC] about increasing healthy life expectancy,” she recalls. “It was a relatively small meeting, but we brought experts from Canada.” An official at the time gave what she calls a “typical” response, saying: “Oh, we can’t have anything but an American solution to these issues – we can’t listen to other countries.”

“International studies are not the flavor of the month – they never will be,” says Haaga. “The problem with foreign countries is that they’re not in someone’s congressional district.”

It’s more than a missed opportunity, says Woolf. It’s a tragedy.

“If you add up the excess deaths that have occurred in the United States because of this unfolding problem, it dwarfs what happened during COVID-19, as horrible as COVID-19 was,” Woolf says. “We’ve lost many more Americans cumulatively because of this longer systemic issue. And if the systemic issue is unaddressed, it will continue to claim lives going forward.”

Small victories are possible

Taking stock of the many ways in which Americans are sicker and die younger can be overwhelming, says Haaga. “It’s such a long list, that might partly be why the issue doesn’t grab people,” he says. “They just go, ‘Oh, my gosh, that’s depressing, what’s on the other channel?’ But there’s a lot of things that could be done, and small victories are victories.”

According to the “Shorter Lives” report, “the important point about the U.S. health disadvantage is not that the United States is losing a competition with other countries, but that Americans are dying and suffering at rates that are demonstrably unnecessary.”

Rather than feel overwhelmed at the immensity of the problems, Sawhney suggests, the focus should instead be on the fact that every other rich country has been able to figure out how to help people live longer, healthier lives. That means that Americans could do it too, he says.

He believes that the changes might not be as hard as some policymakers and health officials seem to think. “You look at these healthier countries, they’re free countries – England, France, Italy – they’re not banning delicious foods. They’re not chaining people to treadmills,” he says. “Americans love to travel to Europe, to Australia, to Canada to enjoy their foods and their lifestyles, and so the idea that we might say, ‘Hey, maybe we could bring some of those lifestyles back’ – I don’t think people are going to go up in arms that we’re taking away their freedoms.”

Getting policy ideas from other countries is just an obvious move, Woolf adds. “If a martian came down to earth and saw this situation, it would be very intuitive that you [would] look at other countries that have been able to solve this problem and apply the lessons learned,” he says.

In historical research he’s been doing, “I found that there are dozens and dozens of countries on almost every continent of the world that have outperformed the United States for 50 years,” he says. “It’s worth taking a look at what they’ve done and Americanizing it – you don’t have to take it right off the shelf.”

Some of the policies he’s identified as helpful include universal, better coordinated health care, strong health and safety protections, broad access to education, and more investments to help kids get off to a healthy start. These policies are “paying off for them,” he says, and could for Americans, too.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

If you’re planning a summer getaway outside of the country, make sure you get your paperwork in order sooner rather than later.

Passports are in “unprecedented demand,” U.S. Secretary of State Antony Blinken said Thursday during a House Appropriations subcommittee budget hearing. In 2022, the State Department issued a record 22 million passports — and 2023 is “on track to break” that record, Blinken said.

The U.S. State Department is fielding half a million passport applications a week, Blinken said. “That’s 30 to 40% above last year, so it’s dramatic.”

The standard processing time for a passport is 10-13 weeks, and an expedited request takes about seven to nine weeks. That doesn’t include mailing time, which can take up to two weeks each way.

“Processing times fluctuate throughout the year depending on demand and we anticipate that they will rise, especially as we approach the busier travel season,” according to a State Department news release.

During the pandemic, “demand went way down,” Blinken said, and the department pulled back the number of staff dedicated to processing passport and visa requests. “Emerging from COVID, we’ve had to build back.”

He said the State Department has hired more staff, authorized overtime and opened satellite offices to process passport applications more quickly.

As pandemic restrictions eased, travel ramped up, with 52% of Americans planning to travel in the next six months, according to the U.S. Travel Association. Travel spending and demand for flights are both higher than 2019’s pre-pandemic levels.

Demand used to be cyclical, with a busy season starting in March and ending in late summer, Blinken said, but now it’s consistently high.

Americans who already have a passport soon will be able to renew it online. The department halted a pilot program “to make sure that we can fine-tune it and improve it before we roll it out in a bigger way,” Blinken said, but “65% of renewal customers for passports will be able to do so online, once this program is fully up and running.”

For those looking to travel to the U.S., the median wait time for visitor visa interview appointments is about two months, half as long as a year ago, and it’s shorter in many parts of the world. Blinken said the department is prioritizing visas with economic impact, like those for students, temporary workers and business travelers.

“In category after category, we’re actually getting back to and even better than pre-pandemic levels,” Blinken said, touting the fact that so far in fiscal year 2023, the department has issued 18% more non-immigrant visas than the same period in fiscal year 2019.

Immigrant visas “are a whole other issue,” Blinken said.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

It’s not just your imagination: Drugs such as children’s flu medication, common antibiotics and ADHD treatments are getting harder to buy, according to a Senate report published Wednesday.

Democrats on the Homeland Security and Governmental Affairs Committee say the number of new drug shortages rose by 30% between 2021 and 2022, an increase that has had “devastating consequences” for patients and doctors.

Towards the end of 2022, a peak of 295 individual drugs were considered in short supply — impacting treatment for everything from colds to cancer.

What’s behind these shortages?

The report says the pandemic stretched supply chains thinner, right when demand for over-the-counter respiratory relief was spiking.

But even before the pandemic, the U.S. had struggled to overcome essential supply shortfalls. More than 15 “critical care drugs,” such as common antibiotics and injectable sedatives, have remained in short supply for over a decade, the report says.

Reliance on foreign manufacturers is the top reason the U.S. struggles to head off shortages, says Sen. Gary Peters, the Michigan Democrat who chairs the Homeland security committee.

“Nearly 80% of the manufacturing facilities that produce active pharmaceutical ingredients […] are located outside of the U.S.,” he said during a hearing about the issue on Wednesday.

That’s also creating an “unacceptable national security risk,” he says.

The Administration for Strategic Preparedness and Response told the committee staff that 90 to 95% of injectable drugs used for critical acute care rely on key substances from China and India. In other words, a severe breakdown in the supply chain could leave emergency rooms scrambling.

What could be done to solve the drug shortages?

The report also found that the federal government and industry regulators lack visibility into the supply chain for such drugs, making it harder to predict shortages. The Food and Drug Administration doesn’t know, for example, the amount of starting material a manufacturer has available, or, in some instances, how many manufacturers are involved in producing the final drug.

And even in cases where they do have this kind of data, they’re failing to retain it in ways that would help predict shortages. The data stays “buried in PDFs,” the report says. To fix this, the FDA could create a central database of starting-materials levels and track production volume.

Committee Democrats are also recommending that a team of federal agencies pair up to perform regular risk assessments on the supply chain, increase data sharing requirements on private manufacturers, and then increase data sharing between agencies and industry partners.

Increasing federal investments in drug manufacturing would also help wean the U.S. drug supply off foreign countries, according to the report. That might mean incentivizing domestic production or building academic-private partnerships to advance research and development capabilities.

Peters said he’s planning to propose legislation to try to make these long-term recommendations a reality in the near future.

Copyright 2023 NPR. To see more, visit https://www.npr.org.