The U.S. prides itself in having some of the most advanced health care facilities and systems in the world. While that is commendable, the undeniable truth is that the nation's healthcare capabilities rest precariously on the global pharmaceutical supply chain.
Even before the pandemic, the skewed situation had raised concerns among those in the profession and the administration. Covid-19 exacerbated the problem. As the virus brought global supply chains to a standstill, Americans were confronted with shortages of essential medicines, like some prescribed to control blood sugar, pain relievers, and a few antibiotics. According to the American Medical Association (AMA) data, cardiovascular and central nervous system medications, antimicrobials, ophthalmic, and chemotherapy agents were also in short supply.
The FDA had more than a hundred drugs on its shortage list during the pandemic. Acute shortages of essential drugs, antibiotics, and saline solutions, as experienced during the initial months of the pandemic, could have threatened patient care and compromised Americans' health.
The pharmaceutical industry, like any other sector, operates for profit. While profit motive is not a cause for concern, monetary and price concerns alone cannot define and drive the pharmaceutical industry. The problem lies in how American drug manufacturers have succumbed to market forces over the past couple of decades.
Factors At Play
Active pharmaceutical ingredients (APIs), the basic building blocks of a pharmaceutical drug, are rarely manufactured in the United States. Most of these vital substances are imported from China and India. The American drug industry relies on a single foreign supplier for some of these essential substances!
Over the past couple of years, supply chain disruptions have called into question the wisdom of relying on imports for goods as essential as medicines. Export bans, shipping disruptions, or shutdowns in another part of the world could adversely impact the American health industry. If the U.S. doesn't improve its manufacturing capabilities now, it would be a mistake for which innocent people might have to pay dearly.
Secondly, relying on foreign drug manufacturers makes it challenging to impose stringent manufacturing practices. According to the FDA, over half of the drug shortages between the years 2014 and 2017 resulted from quality issues. When it comes to life-saving drugs, cutting costs and corners could lead to life-threatening situations.
It is time to recognize that medicine and critical medical supplies are 'strategic assets.' The industry must be incentivized to think beyond immediate profits and boost production in the United States. Manufacturing quantities that fully meet the nation's needs for commonly used and vital medicines should be the long-term goal.
Further, the U.S. must diversify supply chains and not rely on a single source for critical APIs. The government's initiative to extend the strategic national stockpile to include key pharmaceutical ingredients necessary to produce essential medicines within the country will address the shortages to a considerable extent. Innovations, up-to-date manufacturing techniques, and faster production must be encouraged and made viable.
Though the country is divided on many issues, almost all Americans agree on the need to update, upgrade, and augment domestic pharmaceutical production. In a recent TIPP poll, 1,318 American adults were asked how important they considered a strong manufacturing base of medical drugs for national security.
A whopping 82% felt it was important. While 10% did not give an opinion, only 7% did not consider the sector significant regarding national security.
A closer look at the data reveals—
- More than half, 55%, of the survey respondents consider medicine manufacturing abilities "very important" to the country's interests.
- 92% of senior citizens and 85% of those in the 45-64 age group consider the American pharmaceutical industry's manufacturing capabilities important.
- 89% with a college education see the importance of the sector.
Interestingly, political affiliations and party ideologies did not cause any divergence on the topic.
- 86% of Democrats and Republicans consider it important
- 79% of Independents concur
- 89% of conservatives, 80% of moderates, and 85% of liberals agree.
The federal government and policymakers will have to play a crucial role in redeeming the situation, leveraging their purchasing power and ensuring transparency where imports are necessary. As the past couple of years have shown, the pharmaceutical sector is critical to the nation's interest, and augmenting its manufacturing capabilities is the need of the hour.
Data Pack - Cross-tabs
Medical drugs manufacturing in the U.S., March 2022
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