Globalism can kill us! An April 2023 on-line Supply Management article makes some startling remarks about drug shortages in the US. Nine in 10 (90-95%) of generic sterile injectable drugs for critical acute care in the US rely on key starting materials from China and India. India possessed 62% of the global manufacturing capacity of active pharmaceutical ingredients, API, in 2021, while China stood at 23%, and the US just 4%, and doctors were rationing lifesaving treatments. The article concludes with this dire warning, Drug shortages are increasing, lasting longer, and having a greater impact on patient care.
A May 2023 on-line article reviewed a Senate report that cited an overreliance on foreign sources as a concern. Factories in China and India supply most of the raw materials used in American medicines. Early in the COVID-19 pandemic, India restricted exports of API’s and finished drugs made from those chemicals to protect its domestic drug supply. BIG PHARMA further complicates supply shortages because medications like Adderall and amoxicillin generate thin profits so companies don’t have an incentive to make and store large amounts in case a shortage develops, University of Utah Health researcher Erin Fox observed. In addition, when demand spikes. Federal regulators limit supplies of Adderall each year because it is a controlled substance. Once shortages develop, they can last for years; and it can be tough for patients to get reliable information. Fox said there is no legal requirement for drugmakers to update the public. Companies have said they aren’t getting enough raw materials to make the drugs, and the federal government says companies aren’t using what they have. Fox said, There’s been a lot of finger pointing back and forth.
The finger pointing is amplified by a February 2023 CNN on-line article, McKinney, the FDA spokesman, clarified that although the FDA is working with manufacturers, the agency does not make drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug. The lack of transparency about these production issues “ how big the shortage is and how much drug each company is making “ is hindering solutions. Additionally, pharmaceutical manufacturers are not required to disclose the reason for disrupted supply. Knowing the exact reason for a given shortage is needed to anticipate shortages and find solutions. Without solutions, globalism can kill us.
The Administration for Strategic Preparedness and Response told the committee staff that 90 to 95% of injectable drugs used for critical acute care rely on key substances from China and India. In other words, a severe breakdown in the supply chain could leave emergency rooms scrambling. The report also found that the federal government and industry regulators lack visibility into the supply chain for such drugs, making it harder to predict shortages. The Food and Drug Administration doesn’t know, for example, the amount of starting material a manufacturer has available, or, in some instances, how many manufacturers are involved in producing the final drug.
Nikkei Asia headlines and summaries note that China’s pharmaceutical market is already the second biggest in the world, after the U.S., thanks in large part to domestic demand from hospitals. Now Beijing wants to take the final step and surpass the U.S. Many pharmaceutical companies faced supply chain disruptions, especially since Covid-19. Often, chemicals used to produce the key ingredients in drugs were sourced from only a few suppliers in China — or sometimes just one. The pandemic has brought to light just how much the global pharmaceutical supply chain depends on China, even for the most basic ingredients. Consequently, globalism can kill us.
According to an August 2021 Harvard Business Review on-line article, most finished pharmaceuticals, whether made abroad or in U.S. factories, depend almost entirely on the availability of API’s, the primary functional components of the drugs we take. These ingredients include everything from the active substances in over-the-counter pain medications to life-saving IV solutions. Without APIs, pharmaceutical manufacturing grinds to a halt and shortages quickly follow. There is a very limited domestic capacity to make these essential medicine ingredients. The U.S. manufacturing base to make APIs has drastically eroded over the last several decades. Most of the supply now comes from abroad. For many materials, there is a single, foreign source of supply. The global over-reliance on China and India for APIs required to produce them, and essential medicines is especially worrisome. An estimated 80% of the world’s APIs come from China, India, and a handful of other foreign countries.
For several decades globalists in our national government, pharmaceutical industry, and many of our other domestic manufacturing conglomerates have moved manufacturing overseas. The result is a progressive globalism contradiction. They do this to save money on land, labor, facility construction due to lower environmental protection laws, and fewer occupational safety regulations. Consequently, the United States no longer controls our supply chains for many products needed to maintain our dominance in several global markets, including pharmaceuticals. Where the pharmaceutical industry is concerned, globalism can kill us.
The fact that the US only produces 4% of the globes API needed to manufacture critical pharmaceuticals must be solved. This is a national security problem and a national health problem. The fact that most of our pharmaceutical companies are now international conglomerates run by globalists makes solutions to this problem difficult. The multinational corporations must first answer the question of allegiance. Do they owe their allegiance to their shareholders; or to the nation and people where they gained their stature and competitive position on the world market? This is the most critical and contradictory question that progressive corporate globalists must answer. If corporate leaders and boards of directors cannot convince pharmaceutical shareholders that they should put the United States and We the People ahead of profits, then globalism can kill us. If the majority of the pharmaceutical supply chains, API sourcing and production, and final product manufacturing cannot be either greatly diversified or moved to US facilities, globalism can kill us.
Solving these critical issues will require cooperation between our local, state, and national governments and the entire pharmaceutical industry. At the national level, many of the more restrictive environmental assessment requirements could be waived to facilitate timely plant construction. State and local zoning regulations could be reduced and programs to train the workforce for these plants could be implemented and timed to meet plant openings. Government and the pharmaceutical industry must work together to ensure that We the People have the medications to live healthy, productive lives without the danger of medication shortages. If this cannot be done, shame on you in government and the pharmaceutical industry, globalism can kill us; it has and it will.
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