We must break our dangerous dependency on medication from China
In the last month, China moved to limit exports of two key minerals, gallium and germanium, which industry experts view as retaliation against U.S. export controls.
These minerals are key raw materials for the semiconductor industry — and this is just the canary in the coal mine. It shows how China is willing to engage in economic coercion and weaponize its control over key supply chains.
For too long, U.S. policy has failed to recognize the economic threat China poses to domestic industries or how its domination of particular markets and supply chains creates a national security challenge. We cannot afford to continue this blindness. We are at a point where we cannot even produce the rare earth minerals we need for the military or the pharmaceutical ingredients we need for medicines.
We are dependent on China's medicine.
Many of the name brand and generic medications that millions of Americans rely on every day, from antibiotics and blood pressure medicines, to cancer drugs and blood thinners, are being manufactured in China, or rely on materials that come from China.
It is estimated that if China stopped producing the active ingredients for our medicines, or simply stopped exporting them, the United States would have just two months until we run out of the drugs our patients rely on, according to Rosemary Gibson and Janaradan Prasad Singh, the authors of "China RX: Exposing the Risks of America's Dependence on China for Medicine (Prometheus Books)."
The weakness of our supply chain is contributing to the worrisome drug shortages we are currently experiencing.If you had told me when I was a surgeon serving in Iraq that the personal protective equipment (PPE) I relied on to protect me, and the medications needed to serve our troops, had been manufactured in China, I would have asked, “How did we allow ourselves to get here as a country, especially our military?”
We import everything from tongue depressors to hip and knee replacements, speculums, surgical gowns and exam gloves, wheelchairs, pacemakers, pulse oximeters, dental implants, surgical screws, and diagnostic imaging equipment like MRIs and CT scanners from China.
During the Coronavirus pandemic, the N-95 masks delivered to Congress under House Speaker Nancy Pelosi were manufactured in China.
How did the United States end up in this position?
For decades, China crafted a strategy to push competitors out of the global market through a system of exploiting China’s cheap labor and selling pharmaceuticals below market cost. China could do this because its government controls the market.
In 1990, a plant in Connecticut was producing enough penicillin to supply one-third of America’s needs.
But by 2008, the plant had completely closed. In 2004, the last plant in the U.S. making the raw material for penicillin was closed in East Syracuse, N.Y. Today, pharmacists fill prescriptions for penicillin with essential ingredients sourced from China.
China undercut their competitors by dumping low-cost penicillin on the market.
After China had obtained a substantial share of the global market, they raised prices on penicillin, a strategy China employs over and over again with several different vital pharmaceuticals.
As China continues the push to dominate the global supply chain, it is vital that we work to create a strategic long-term approach of our own.
What are the solutions?
We need to look pragmatically at ways to incentivize domestic manufacturing of everything that goes into the production of the vastly important and complex components of our health: from our pharmaceuticals, to PPE, to medical devices.
These are a vital part of our national security and should be viewed as strategic assets. They are critical to saving lives; and we therefore must rethink how we source them and act accordingly. Privately, some are stepping up efforts to ensure that producers exporting to the U.S. follow strict quality control measures. We also must and can diversify production so that we are not solely reliant on strategic adversaries for products which are key to our national health security.
Last Congress, I introduced the American Made Medicine Act, a bill to help secure our health supply chains.
This legislation would help create manufacturing jobs here in the U.S. by offering tax credits for investments in medical manufacturing. Health care professionals need a reliable source for personal protective equipment (PPE) and pharmaceuticals – not one that can be cut off by an enemy at any moment.
Because our medicines and pharmaceuticals are so vital to our national security, let’s put in place more robust data reporting and oversight requirements for imports of key medical products. We currently lack complete data on the sourcing for our medicines, APIs, drug supply or other critical medical supplies.
As we evaluate the aftermath of the COVID-19 pandemic, this is an oversight that we cannot continue to ignore.