Policymakers have been aware of U.S. vulnerability to Chinas supply chain dominance for decades, and have contemplated the possibility of Beijing weaponizing its control by throttling exports to the United States. Last summer, Chinese President did. Relying on an adversarys good graces on matters of national health and security invites disaster. But critical minerals are only one weakness. Washington also relies on Beijing for the nations pharmaceuticals. It should be intolerable.Â
In 2000, America imported roughly 100,000 metric tons of pharmaceuticals. By 2024, that figure had jumped above 800,000 metric tons. Last year, the United States imported roughly 90% of inputs for prescription drugs. About half of these medicines come from India, but India sources 70% to 80% of active pharmaceutical ingredients (APIs) from China.Â
Americas medical dependency on the Chinese Communist Party (CCP) does not end there. Chinese companies are now beginning to outpace U.S. competitors in drug discovery, not merely drug production. Consider this warning from the National Security Commission on Emerging Biotechnology: “In just three years, rose from near irrelevance to dominance.”
What does that mean practically? Per the commissions findings: “This overall innovation trend is set to accelerate, with Chinese drugs projected to account for 35%” of new drug approvals by 2040.
Americans are witnessing the offshoring of our medicine supply chains to a foreign adversary that has already exploited its control over critical minerals. The CCP has threatened to do the same with drugs. During the early days of the COVID-19 pandemic in March 2020, Chinese state media wire service Xinhua  that threatened to impose export controls on pharmaceuticals to the United States, and thus plunge America in a “sea of coronavirus.”
Americas health infrastructure is dependent on a country with a history of weak intellectual property enforcement, state-backed chemical exports, and adversarial trade behavior. The next pandemic or health crisis could be weaponized purposefully through our own medicine cabinets. The threat is concerning, but the risks are not hypothetical. Beijings lack of quality health standards has materially harmed Americans over the past three decades.Â
In 1996, an internal memo issued a stark warning: “We literally have no control over bulk drugs that enter the US.” The next year, Congress took steps to address this threat by requiring foreign pharmaceutical companies to register with the FDA. Ten years later, however, the government had not enforced this requirement. The results were deadly. In 2008, hundreds of Americans were injured or killed by contaminated Heparin, a blood thinner used in dialysis, surgery, and care to prevent blood clots.
Again, Congress acted and gave the FDA authorities and funding for foreign inspections by passing the Food and Drug Administration Safety and Innovation Act of 2012. What has often transpired, however, is a cat-and-mouse game with Chinese producers delaying inspections and hiding potentially concerning products, while Beijing delays granting visas for FDA inspectors.Â
This history underscores the double-crisis of Chinas dominance over Americas pharmaceuticals. On one hand, poor regulation, cost-cutting measures and evasive behavior have endangered, harmed and in some cases killed Americans who rely on .
On the other hand, the United States does not have alternative suppliers to tap. At present, we are stuck in the unacceptable position of hoping the CCP does not exploit this vulnerability, as they did with critical minerals. In their 2021 book “China Rx,” authors Rosemary Gibson and Janardan Prasad Singh underscore this threat: “A poorly made drug could be the difference between life and death for those who take it. With medicine, there is no room for error. And it better be available when we need it.” For these reasons, they warn that “worldw
