U.S. policymakers worry that China, which exports massive amounts of everyday medicines that American depend on, will weaponize drug exports if tensions increase over Taiwan.
The U.S. is woefully unprepared to address even minor disruptions in the supply of antibiotics, over-the-counter pain meds and the stuff that stops itching and swelling, Politico reported.
China sees self-ruled Taiwan as a breakaway province that will eventually be under China’s control. President Joe Biden has said the U.S. would defend Taiwan militarily.
“Medicines can be used as a weapon of war against the United States,” said Rosemary Gibson, a senior adviser on healthcare issues at the bioethics-focused Hastings Center, in congressional testimony in 2019.
“Supplies can be withheld. Medicines can be made with lethal contaminants or sold without any real medicine in them, rendering them ineffective.” Gibson is the co-author of the book, “China Rx: Exposing the Risks of America’s Dependence on China for Medicine.”
How dependent is the U.S. on China for its drugs? The fact is, the FDA doesn’t know, Eric Palmer wrote for Fierce Pharma in 2020.
Twitter user Data Fox, whose bio says he works in data science, recently claimed in a tweet that U.S. reliance on Chinese biopharmaceutical exports represents a threat to national security. “Something like 90% of pharma products manufactured in China. Jobs we lost by elites moving chemistry jobs in 2000s overseas and damn near 100%, which is a threat to National security. I remember as I was a causality of these jobs going overseas. Cost myself & others millions.”
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A watchdog report in Nov. 2019 by the U.S.-China Economic and Security Review Commission and a congressional hearing warned that China hopes to surpass the U.S. as the world’s biggest producer of pharmaceutical products.
In 2018, China accounted for 95 percent of U.S. imports of ibuprofen, 91 percent of U.S. imports of hydrocortisone, 70 percent of U.S. imports of acetaminophen, 40 to 45 percent of U.S. imports of penicillin and 40 percent of U.S. imports of heparin, according to data from the Commerce Department Politico reported.
Lawmakers say they are concerned about a growing dependence on China for imports of active pharmaceutical ingredients (APIs) — the actual medicine contained in a pill, capsule, or shot.
The FDA estimates that 13 percent of the world’s API production facilities are in China, compared with 28 percent in the U.S. About 26 percent are in the European Union and 18 percent in India.
Those statistics don’t mean much, according to Janet Woodcock, FDA director of the Center for Drug Evaluation and Research, in congressional testimony in October 2019.
“The FDA doesn’t know whether Chinese facilities are actually producing APIs, how much they are producing, or where the APIs they are producing are being distributed worldwide, including in the United States,” Woodcock reported. “… Similarly, we do not have information that would enable us to assess the resilience of the U.S. manufacturing base, should it be tested by China’s withdrawal from supplying the U.S. market.”
Statistics on Chinese APIs are misleading, according to the US-China Business Council (USCBC) — a private, nonpartisan, nonprofit organization of more than 270 American companies that do business with China.
“Congressional testimonies and publications often cite that ’80 percent of APIs used in US drugs are sourced from China. However, this statistic misrepresents findings from (FDA) reports on the location of API manufacturing facilities, not their production,” USCBC reported. “The FDA has since acknowledged it “[does] not know whether Chinese facilities are actually producing APIs, how much they are producing, or where the APIs [are] distributed.”
The US-China Business Council cited a study by Avalere, a New York-based healthcare consulting firm with private equity clients that is part of Fishawack Health: “U.S. pharmaceutical production estimates that 54 percent of APIs used to manufacture finished pharmaceutical goods consumed in the U.S. are produced here; only 6 percent are sourced from China. Only 7 percent of total US API imports come from China. After accounting for indirect imports, like finished pharmaceutical products from India that are made using APIs from China, China is responsible for 12 percent of foreign-sourced APIs.”
The U.S. was the No. 1 importer of drugs and medicines in 2021 to the tune of $85.3 billion representing 18.6 percent of total prescription drugs/medicines imports, according to World’s Top Imports, an independent educational website that claims to showcase global trade metrics, trends and opportunities. By comparison, China was the fifth biggest importer at $23.9 billion (5.2 percent) in 2021.
In a July-August 2022 survey by the American Chamber of Commerce in Shanghai, the vast majority of 307 respondents in the chemicals, pharmaceutical, medical devices and life sciences industries said they planned to keep operations in China, CNBC reported.
Images: Pharmaceuticals in North Andover, Mass. (AP /Elise Amendola) / A worker at SMC, a Japanese pneumatic engineering company factory in Beijing, May 13, 2020. (AP/Ng Han Guan)