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Fernando Gallegos, community health worker and pharmacy tech, assists a patient at Share Our Selves, a community health center in Costa Mesa, California. Direct Relief supports health centers and free clinics across the U.S. with ongoing medication support. (Photo by Donnie Hedden for Direct Relief)
Direct Relief today announced it has donated and delivered more than $2 billion in medicine and medical supplies since 2008 to address chronic gaps in the U.S. healthcare system. The organization is the largest channel for donations of prescription medications and medical supplies in the United States.
Direct Relief’s medicine and supplies reach individuals in medically underserved communities across the United States primarily through thousands of non-profit, local health clinics. These clinics form the key strands of the nation’s healthcare safety net.
The donations include more than $1 billion in medicine and supplies donated to community health centers (Federally Qualified Health Centers or FQHCs) providing primary care to 31.5 million – one in 11 – Americans in medically underserved communities. Direct Relief partners with more than 1,000 of these FQHCs, with an average partnership length of nine years.
The donations also include more than $1 billion in medical aid to free and charitable clinics and pharmacies, which are often volunteer-driven and offer care to people with few other options. These clinics served 1.7 million patients in the United States in 2022, 93% of them without any form of public or private health insurance.
At the Chicago free clinic CommunityHealth, a dentist and dental volunteer offer free dental services to those in need. (Courtesy photo)
“Direct Relief is a huge part of how we provide medication access to our patients, particularly insulin,” said Megan Doerr, Vice President, Strategy & Operations at CommunityHealth, a free clinic in Chicago. “Medication access and adherence is crucial to overall health, and being able to offer patients medications for free is invaluable. It seems almost too good to be true for individuals that hear about our services that they’re going to be able to manage their chronic diseases free of charge and not have to choose between filling their medications and paying rent or getting food.”
Direct Relief’s extensive U.S. medical aid program incorporates individual initiatives, including resilient power for health clinics, high-volume donations of insulin and the opioid overdose-reversing drug naloxone, women’s health programs like the provision of IUDs for uninsured patients at no cost, funding of mobile healthcare clinics to reach people without local transportation, and much more.
The domestic program includes continuing support during normal times and rapid response to natural disasters. Direct Relief has invested heavily in building capacity to provide medical aid to communities hit by hurricanes and wildfires, as well as public health crises such as the Covid-19 pandemic and the opioid overdose epidemic.
In addition to the more than $2 billion in donated medicine and medical supplies, Direct Relief has made $186 million in cash grants since 2004 to nonprofit healthcare providers. The grants support projects for disaster preparedness, health equity initiatives, and resilient power, and include donor-funded awards for community health innovations.
Direct Relief has reached this milestone as more Americans than ever rely on these safety net providers, with the FQHC patient population growing 30% between 2015 and 2022. Yet funding is volatile, with government shutdown threats this fall making it harder for FQHCs to commit to making hires amid a nationwide shortage of clinical staff.
In 2022 FQHCs received 43% of their revenue from Medicaid, the jointly funded state and federal healthcare program for people with limited financial resources. But more than 10.6 million people have been disenrolled from Medicaid this year through Nov. 14 as pandemic-era funding dried up.
Amy Simmons Farber, associate vice president at the National Association of Community Health Centers (NACHC), recalls Direct Relief’s role in helping health centers remain in operation at the start of the Covid-19 pandemic. “The early days of the pandemic were an extraordinary time in which community health centers mobilized and in a matter of days transformed their clinical practice. With a scarcity of resources, health centers launched testing sites, converted their facilities, transitioned to virtual visits, and diverted nonacute Covid cases from overwhelmed hospitals. Direct Relief came through with a critically needed solution, donating PPE and medicines and dollars, and that was amazingly helpful to these health centers in keeping their doors open.”
“Direct Relief is a true champion and friend of free and charitable clinics,” said Nicole Lamoureux, President & CEO of the National Association of Free & Charitable Clinics (NAFC). “We often say free and charitable clinics feel like the healthcare world’s best-kept secret, but Direct Relief’s consistent commitment and support make us feel seen, known, and appreciated. We would not be able to support our members like we do without Direct Relief.”
Ongoing Programs
Among the many ongoing U.S. programs are:
ReplenishRx, a streamlined option for pharmaceutical companies to donate their products, via safety net clinics, to people without health insurance or other means to pay for them. The program reduces administrative burdens and the risk of patients losing access.
Donor-funded innovation awards provide flexible funding to safety net providers for new and expanded programs that best meet community needs. In all, $18 million has been awarded to health centers, free and charitable clinics, and women’s health centers through support from AmerisourceBergen, Baxter, Bayer, BD, Eli Lilly, Pfizer and Teva.
Direct Relief’s Fund for Health Equity, which provides flexible philanthropic funds that enable health centers to focus on high-value efforts that are not easily funded from existing revenue streams. The Fund has awarded $43.7 million in grants.
Power for Health – Without power, critical health services can’t be provided – lifesaving medicines go bad, electronic health records can’t be accessed, essential medical equipment can’t be powered, and vital community health facilities serving the most vulnerable shut down. This initiative brings clean, renewable backup power to community health centers and free clinics to ensure they can deliver critical healthcare services during power outages.
AccessHealth, an FQHC serving two counties west of Houston, uses a mobile clinic the size of a large bus to bring care to its patients. With the mobile clinic, donated by Direct Relief, AccessHealth holds back-to-school health fairs each August serving about 2,000 families, providing the immunizations their children need to attend school, along with health screenings, eye exams and dental screenings.
The AccessHealth with their mobile unit, made possible by Direct Relief, that services surrounding communities creating greater access to affordable health care. (Photo by Donnie Hedden for Direct Relief)
About half the patients it serves lack any form of health insurance. In 2023 through November, Texas kicked 1.4 million people – 64% of all enrollees – off its Medicaid program, the highest number and largest proportion of any state, according to KFF.
“The funding Direct Relief has given us for the mobile health unit allows us to work in rural communities, both on the medical and dental side,” said Mike Dotson, CEO of AccessHealth. “The need for transportation highly affects the folks that we see, so being able to use that resource is a big win for us, and it helps our patients in a really, really positive way.”
Disaster Response
In addition to its decades-long work internationally, Direct Relief has responded to dozens of major natural disasters in the U.S. since ramping up its domestic programs nearly 20 years ago.
Climate change is driving more frequent and far more destructive hurricanes and wildfires, uprooting people from their homes and cutting them off from their healthcare providers and medicine supplies. Research has shown that in disasters like 2017’s Hurricane Maria, which devastated Puerto Rico, more people have died from interrupted access to healthcare than from physical injury. People living with medication-dependent chronic conditions like type 1 diabetes and hypertensive diseases are at particular risk.
Drawing on its long experience responding to natural disasters, Direct Relief assembles, stocks and prepositions caches of the medicines and medical supplies most commonly needed by people in the wake of a disaster, including trauma supplies, antibiotics and wound care supplies, as well as medications for diabetes, hypertension, and respiratory, psychological and gastrointestinal ailments.
Direct Relief provides the supplies both in Emergency Medical Backpacks, which can be quickly flown to disaster scenes and given to medical responders, and in Hurricane Prep Packs (HPPs), which are large caches prepositioned in hurricane-prone areas. Packed into each HPP are 220 types of medicine and medical supplies designed to provide enough medical supplies to care for 100 people for 72 hours. Ahead of the 2023 hurricane season, Direct Relief pre-positioned emergency medical supplies in every southeastern and Gulf Coast U.S. state from Virginia to Texas, as well as throughout the Caribbean and Central America.
As with its ongoing domestic programs, Direct Relief’s U.S. disaster response is delivered primarily through its health center and free clinic partners. Health center and clinic patients tend to be more medically vulnerable due to factors such as longstanding societal barriers, lower incomes, and less wealth, and these factors magnify the impact of emergencies. The health centers’ and clinics’ deep experience and earned trust within communities and among their patients, and their keen familiarity with the particular health risks that existed prior to an emergency, are essential to engage and support when an emergency occurs.
A Domestic Program Born in Crisis Response
From its founding in 1948 until the mid-2000s, Direct Relief worked almost exclusively outside the United States. In 2005, Hurricane Katrina destroyed much of New Orleans, displacing 1 million people and cutting them off from essential medicine supplies. This was a turning point for Direct Relief, spurring the organization to obtain pharmaceutical distribution licenses nationwide. In 2009 it became the first charity with licenses to distribute pharmaceuticals in all 50 states. Today, the vast majority of Direct Relief’s support for community health is provided for ongoing needs that aren’t tied to specific disasters.
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