The first recorded case of Covid-19 in the United States was reported on January 20, 2020—a person who traveled from Wuhan, China, to Washington State. As the virus spread across the country, global supply chains that are usually invisible suddenly became highly visible. News headlines tracked a surge in demand for personal protective gear for frontline health care workers. At the same time, however, factories had shuttered or were operating at a fraction of capacity, causing shortages and panic.
China’s role in supplying masks, gowns, gloves, and testing kits for the United States and other countries became evident. But the media were strangely silent about China as the top global producer of components to make generic drugs, which represent 90 percent of medicines prescribed in the United States.
Days before Congress shut down, the Senate Committee on Small Business and Entrepreneurship held a hearing on Covid-19. Testimony revealed the extent of U.S. dependence on China for medicines as the country was facing a surge in hospitalizations. China produces 90 percent of the core components for the generics needed to treat people hospitalized with Covid-19. The sedative propofol (which is administered to people on ventilators), antibiotics including azithromycin and vancomycin for secondary bacterial infections, and anti-inflammatories such as hydrocortisone are among the generic medicines in America’s intensive care units that are made with China-sourced materials.
Beyond medicines used to treat Covid-19 and related illnesses, China controls the global supply of raw materials and chemicals, called key starting materials (KSMs), for thousands of generics sold in retail pharmacies and big box stores. Take the case of the antibiotic azithromycin. Ground-zero Wuhan is a global manufacturing hub for the key ingredient in the antibiotic. When the city shut down, production did too.
In the aftermath of Covid-19, supply chains for products used by millions of Americans have been disrupted. Shortages of semiconductors, critical minerals, batteries, household refrigerators, and much more ripple through the economy and drive rising prices. As government and industry reassess global supply chains, actions to strengthen U.S. manufacturing are being debated in Washington and corporate board rooms.
Antibiotics and other life-saving medicines should rank high on the priority list for domestic production. The U.S. supply chain for essential generic drugs is at high risk of catastrophic failure. Mitigation measures are needed now if we are to be prepared for the next pandemic.
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