The Tenderloin Voice publishes opinion pieces by community members.
There are no pharmacies in the Tenderloin. The high demand for them means that lines at nearby locations are discouragingly long. At the one closest to me, the Walgreens at Market and 9th streets, picking up medications requires a minimum half-hour wait regardless of the time of day.
To some degree, the Tenderloin is suffering from a larger trend of pharmacy closures throughout San Francisco — in my opinion, this is a mounting public health crisis that’s turning neighborhoods into pharmacy deserts. The exodus is staggering: At least 64 pharmacies have closed in the past decade, according to June reporting by SF Gate. Walgreens is down from approximately 53 stores in 2021 to just 29, and CVS locations have halved to 11. Rite Aid shuttered all of its San Francisco stores.
This trend appears driven by corporate decisions prioritizing bottom lines over community health care needs. Over the decades, big chain pharmacies have undercut and driven out small neighborhood pharmacies. These days chains face greater difficulties maintaining their own locations, as they pay out court settlements for their over-prescription of opioids. And because insurance middlemen often reimburse pharmacies less than the cost of the medications they distribute, the pharmacies cover the difference, which also hurts their finances.
The human toll is steepest for vulnerable residents. This includes seniors, the ill, those struggling to live on low fixed incomes, and people with mobility challenges or disabilities. Things like apps or online ordering are not solutions for many. For them, pharmacy accessis essential for stable health and wellness, which is a foundation for maintaining independence in life.
Michael Lyon, founder of the San Francisco Gray Panthers, a senior advocacy group, confirmed in a conversation with me that these closures are harming seniors. Teresa Palmer, M.D., a specialist in family medicine and geriatrics, told me that seniors and medically fragile patients struggle in lines that can require them to stand for an hour or longer. While exercise is generally a benefit to older people, standing in place is not.
With fewer pharmacies nearby, the burden of seeking care weighs down the people least able to bear it all. Seniors, including those who have trouble moving around, must now take multiple buses, rather than just one, to get to their meds — or pay for expensive rideshares. For low-income families, long travel times mean lost wages, forcing transportation expenditures to compete with other necessities. The remaining locations become pharmacies of last resort, like those in the Mission District, plagued by predictably long lines.
People who struggle to surmount these barriers can run out of medications and miss doses. And they lose the vital patient-pharmacist relationship and consultations necessary to understand drug interactions and side effects, and to manage chronic conditions. This can lead to worsening health or even hospitalization.
We urgently need to fix our pharmacy deserts. San Francisco must treat pharmacy access as an essential public service, moving beyond market dependency to safeguard its most vulnerable residents. Until then, the human toll of corporate disinvestment continues.
David Elliott Lewis is a 40-year SF resident, 20-year TL resident, photographer, community organizer, activist, and co-chair of the Tenderloin People’s Congress.
