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Congress notices pot’s ill-health effects

The ideas and innovators shaping health care
Feb 06, 2023 View in browser
 
Future Pulse

By Ben Leonard, Carmen Paun, Ruth Reader and Erin Schumaker

WASHINGTON WATCH

An employee arranges glass display containers of marijuana on shelves at a retail and medical cannabis dispensary. | AP Photo

Residents can now buy weed to enjoy for fun in 21 states. | AP Photo

Foreboding research about marijuana’s ill-health effects raises the prospect that the loosely regulated marketplace for recreational pot, worth $13.2 billion last year and growing 15 percent annually, could come under pressure, Ben reports.

Few studies have been conducted on marijuana because of its status as a Schedule I controlled substance, which means the federal government believes it has no beneficial medical use.

But a steady stream of research is now accumulating, linking weed to emphysema, asthma in teens and the poisoning of kids, among other dangers.

Even some lawmakers most supportive of legalization on Capitol Hill, such as the co-chairs of the Congressional Cannabis Caucus, Reps. Earl Blumenauer (D-Ore.) and Dave Joyce (R-Ohio), are calling for more regulation and better oversight.

“One of the reasons I have fought so hard to be able to legalize, regulate and tax is because I want to keep this out of the hands of young people. It has proven negative consequences for the developing mind,” Blumenauer, Capitol Hill’s unofficial cannabis czar, said.

Last year, he and Joyce teamed on legislation, since enacted, to ease federal restrictions on researching cannabis for medical purposes and growing marijuana for research.

That could significantly improve understanding of the drug.

They’re now talking about dosing standards, stiffer consequences for selling pot to minors, mandates for childproof containers for edibles, and advertising restrictions aimed at protecting children. They’re also concerned about high-potency cannabis and its effects.

Federal agencies are also taking action. Last month, the FDA rejected applications from companies making products out of cannabis that sought regulation under the loose standards governing dietary supplements.

The agency said the use of cannabidiol, or CBD, an active ingredient in cannabis, poses safety issues and Congress needs to bolster safeguards to alleviate risk.

“We have not found adequate evidence to determine how much CBD can be consumed, and for how long, before causing harm,” Principal Deputy Commissioner Janet Woodcock said in a statement.

Public health advocates support the increased interest in pot’s health effects. But many in the public health world are frustrated that policymakers eager to get on with legalization missed the opportunity to mitigate the consequences in advance.

“We’re in a massive natural experiment,” David Jernigan, professor of health law, policy and management at the Boston University School of Public Health, said. “Are we learning the lessons from alcohol, tobacco and other drugs when we go to regulate cannabis?” he asked. “Absolutely not.”

 

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This is where we explore the ideas and innovators shaping health care.

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Jarbas Barbosa da Silva Jr.

Jarbas Barbosa da Silva Jr. has a five-year term atop the Pan American Health Organization. | Jarbas Barbosa da Silva Jr.

When Brazilian doctor Jarbas Barbosa da Silva Jr. takes the helm of the Pan-American Health Organization this month, he’ll be bringing ambitious plans for the agency with him.

PAHO, which covers the 49 countries of the Americas, is the regional branch of the World Health Organization, but it takes pride in having been established in the early 1900s, nearly 50 years before the global health body.

Barbosa, a former director of the Brazilian food and drug regulator Anvisa, will lead PAHO for the next five years. Here’s what he told Carmen he intends to focus on:

— Ending the pandemic. Coronavirus hit the Americas hard, and the images of coffins with Covid-19 victims on the streets of the Ecuadorian city of Guayaquil in 2020 are still etched in many people’s memories. Barbosa wants to help countries find ways to get more elderly people boosted by fighting vaccine misinformation and misperceptions.

“Sometimes we have lots of fake news about the vaccines; we have misconceptions; people think that because they had Covid, they don’t need to get the booster, so it’s very important to have a communication strategy … to provide the correct information.”

Barbosa also wants PAHO to help countries implement the lessons learned from the pandemic so they’re better prepared for the next outbreak. He hopes the world will learn from it and find a way to provide equipment, tests, vaccines and drugs equitably in a future outbreak without leaving poorer countries at the mercy of market forces.

— Creating more resilient health systems. “This is the moment to review carefully the strategies that we have to address maternal mortality, to address the preventable deaths related to noncommunicable diseases,” he said.

A solid primary health care system can take care of many of those and other issues, such as high blood pressure, he said: “Hypertension is the most important cause of death in the region.”

For every 100 people with high blood pressure in Latin America and the Caribbean, only 50 know they have it and only 25 have it under control, Barbosa said, calling for change.

— Increasing the participation of member countries in PAHO. “It’s important to put in place some measures to increase transparency, to increase our efficiency, to be able to provide better technical cooperation at the country level,” he said.

PAHO operates as an independent platform working with all the governments in the region, from the United States to Cuba and Nicaragua, according to Barbosa.

“We do believe that respect for human rights and the measures to reduce the social inequalities are very important for every country, but we are there, we are working in these countries, and this was crucial to their responses to the Covid-19 pandemic and to face other health priorities they have.”

 

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PANDEMIC

WASHINGTON - MAY 08:  The World Bank headquarters is shown May 8, 2007 in Washington, DC. Recent reports indicate that the global financial institution may soon resolve controversies surrounding its President Paul Wolfowitz.  (Photo by Win McNamee/Getty Images)

The World Bank will issue a formal call for pandemic preparedness proposals next month. | Getty Images

The World Bank’s Pandemic Fund has $300 million — and wants ideas on how to spend it.

The bank said Friday it’s gauging interest in $300 million in financing to help developing countries better prepare for and respond to future pandemics.

Low- and middle-income countries can express interest by Feb 24. A more detailed call for proposals will follow in March. The fund seeks ideas for strengthening disease surveillance and early warning, laboratory systems and public health workforce capacity.

The World Bank hopes to use this first solicitation to facilitate cooperation among countries if their plans have synergies.

Why it matters: This is the first time countries will get World Bank financing specifically for preventing, preparing for and responding to disease outbreaks. The Pandemic Fund is the first World Bank campaign to attempt to build on the lessons of the Covid-19 pandemic.

“The first round of funding will be a proof of concept, and we look forward to learning from it and adjusting as we go along,” Priya Basu, the executive head of the fund’s secretariat, said

What’s next: The World Bank and pandemic preparedness advocates hope it will help attract more contributions toward a goal of $10 billion in financing a year.

The fund has received $1.6 billion in commitments so far, including $450 million from the U.S.

 

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