When a profit-thirsty global corporation causes a devastating public health crisis, what should we think when it steps forward with a philanthropic pledge to address that crisis? Nothing good.
First some background.
The opioid epidemic—with its component scourges of addiction, overdose, death, crime and wrecked lives—has been in the news for years, now. In 2017, the U.S. Department of Health and Human Services declared it a public health emergency and unveiled a plan to combat the epidemic. But addicted Americans are still dying by the tens of thousands each year. In parts of the U.S., morgues have been overwhelmed by soaring deaths of young adults.
As we've reported, philanthropy has been slow to respond. While grantmakers have long supported drug and alcohol addiction services, this has never been a big area of funding. And about a decade ago, it got even smaller when the Robert Wood Johnson Foundation, the nation's largest grantmaker focused on health, wound down its substance abuse work. That left the Conrad N. Hilton Foundation as one of the few big national foundations working in this area when the devastating opioid epidemic began metastasizing during the Obama years. Even as the death toll rises, major foundations have yet to respond to the opioid problem with the numbers or dollars you'd expect in response to the nation's top public health emergency.
We've written frequently about the too-short list of funders who have started to steer serious grant money towards opioid treatment. Much of the opioid-related philanthropy comes from smaller funders working at the local level.
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Now, it looks like opioids are finally getting a dedicated, national-scale foundation—albeit one with modest resources. Last week, the global healthcare and pharma giant McKesson Corporation announced the formation of a new foundation dedicated to combating opioid abuse. McKesson has promised $100 million for the effort.
McKesson says its new opioid foundation will focus on education, policy and access to life-saving treatments, such as opioid overdose reversal medications. Details—about leadership, strategic priorities, and criteria for giving—will be announced in the coming months. The foundation is part of a larger set of initiatives on opioids by McKesson that involve tighter prescription controls, including efforts to reduce fraudulent prescribing, and development of limited-dose packaging. McKesson is already a supporter of the Opioid Safety Alliance, Allied Against Opioid Abuse, and Community Anti-Drug Coalitions of America.
But don't start cheering just yet.
These moves come as McKesson finds itself under legal attack by regulators who see its profit-hungry fingerprints all over the opioid epidemic. Among those going after the company is Kentucky Attorney General Andy Beshear, who filed a lawsuit against McKesson in January, stating,
Kentuckians can finally put a name to a major reason for the pill mills, drug epidemic and overdose deaths in our state. McKesson knowingly and intentionally distributed enormous quantities of prescription opioids throughout Kentucky with total disregard for our health and safety. This reckless behavior fueled our catastrophic drug epidemic that every community is facing.
Among other things, the suit alleges that from January 2010 through December 2016, McKesson distributed an eye-popping 18.4 million doses of prescription opioids in Floyd County alone—or 477 opioid pills for every person living in the county. The company also shipped millions of prescriptions to other counties in Kentucky. Nearly 6,000 state residents died of drug overdose deaths between 2012 and 2016.
The state alleges that McKesson ignored any number of red flags by "filling massive and/or 'suspicious' orders of unusual size, orders deviating substantially from a normal pattern, and ... shipping drugs into the Commonwealth without adequate policies and procedures in place to detect suspicious orders, failing to report to appropriate authorities such 'suspicious' orders, and failing to halt such excessive and suspicious shipments."
The company has denied Kentucky's charges. It faces nearly 200 other lawsuits for its role in the opioid epidemic, including one mounted by a county in West Virginia. It was also the focus of an explosive segment on 60 Minutes in December.
Now, after making billions from opioids, McKesson is investing relative chump change in a foundation to fight opioids. It's clearly looking to buy good publicity amid an onslaught of negative coverage. If the company were really interested in making things right, it would add another zero onto its philanthropic commitment.
That said, it's hard not to welcome more resources to the underfunded battle against opioids. Even if it's blood money, this new funding can still do some good.
McKesson's gift is hardly the first time that a bad actor has offered up ill-gotten winnings to achieve positive change. At Inside Philanthropy, we've often weighed the moral issues in these cases, and, in general, have concluded that nonprofits should take the money.
The new McKesson opioid foundation will be a separate entity from the company's philanthropic arm, the McKesson Foundation, which was created in 1943 and primarily funds work in cancer.