Paper short abstract:

In 2017, Hurricane Maria hit Puerto Rico, a major global manufacturer of pharmaceuticals and medical supplies. I focus on the case of saline IV shortages on mainland U.S. as a means to explore the intersection of disaster risk reduction, climate change adaptation, and contingency planning.

Paper long abstract:

Medical supply chains are geographically expansive, both reliant on carbon-intensive transport (e.g. ships, planes) and vulnerable to climate change impacts (e.g. hurricanes, floods). Many medical products are sourced globally in low-wage, low-tax regions with minimal consideration of potential climate impacts. Puerto Rico is a global pharmaceutical manufacturing hub: more than 20 companies create products from scalpels to pacemakers. Located in the Caribbean, Puerto Rico is vulnerable to more frequent and intense hurricanes due to climate change. In 2017, Hurricanes Irma (Category 4) and Maria (Category 5) hit. Locally, healthcare was severely strained due to power outages, but there were also global effects: widespread saline IV solution shortages on mainland U.S.; uncertainty about the availability of blood transfusion products in the UK; and antibiotic shortages that drove prices beyond the reach of low resource countries like Malawi. I focus on the case of saline IV shortages (for which the most data is available) as a means to explore the intersection of disaster risk reduction, climate change adaptation, and contingency planning. How do these approaches fit together in the case of saline IV shortages specifically and medical supply chains generally? Grounded in the mobilities scholarship and using Puerto Rico as a starting point (a U.S. territory that occupies a liminal geopolitical space between Global North and South), I explore the cascading global consequences of severe weather on vital mobilities: movements of goods, people and information that impact life chances.