Coron­avirus: U.S. re­lies on China for med­i­cal sup­plies

The Kansas City Star - - Stay Connected - BY BRYAN LOWRY [email protected]­clatchydc.com McClatchy’s Michael Wil­ner con­tributed to this re­port. Bryan Lowry: 202-383-6167, @BryanLowry­3

The COVID-19 out­break has brought in­creased at­ten­tion to U.S. re­liance on China, where the virus orig­i­nated, for es­sen­tial med­i­cal sup­plies from pro­tec­tive masks to medicine.

Law­mak­ers of both par­ties are scram­bling to pass leg­is­la­tion us­ing the pur­chas­ing power of the fed­eral gov­ern­ment to di­min­ish that de­pen­dency and in­crease do­mes­tic pro­duc­tion of crit­i­cal ma­te­ri­als.

The U.S.-China Com­mis­sion warned in its 2019 re­port to Congress that the “United States’ grow­ing re­liance on Chi­nese phar­ma­ceu­ti­cal prod­ucts puts U.S. con­sumers — in­clud­ing ac­tive ser­vice mem­bers and vet­er­ans — at risk if China cuts off drug sup­plies or hikes the cost of a given medicine dur­ing height­ened geopo­lit­i­cal ten­sions.”

This prob­lem was demon­strated this week when Vice Pres­i­dent Mike Pence pleaded with con­struc­tion com­pa­nies to do­nate pro­tec­tive masks to hos­pi­tals amid a global short­age of the prod­uct made in China and other Asian coun­tries.

“This is a wake-up call and I hope we heed it be­cause we have to fix this,” said Rose­mary Gib­son, the au­thor of “China Rx,” a book out­lin­ing the risks of U.S. de­pen­dence on China for medicine.

“The world would not al­low a sin­gle coun­try to have con­trol over 80 per­cent of the world’s oil sup­ply or re­fin­ing ca­pac­ity be­cause it’s ob­vi­ous why that’s a prob­lem and we shouldn’t al­low that for our es­sen­tial crit­i­cal drugs,” said Gib­son, who serves a se­nior ad­viser at the Hast­ings Cen­ter, a non­par­ti­san bioethics cen­ter in New York.

Trump down­played the risk posed by sup­ply chain dis­rup­tions on Tues­day, telling re­porters that “China has every in­cen­tive to make sure that things work well. China wants to make sure that things work very well.”

But then on Wed­nes­day, he an­nounced he was in­vok­ing the De­fense Pro­duc­tion Act, a law that dates back to the Korean War and en­ables the pres­i­dent to com­pel the pri­vate sec­tor to ramp up pro­duc­tion of emer­gency sup­plies.

“We’ve never been in a sit­u­a­tion like this, where no mat­ter what you have, it’s not enough.” Trump said. “We have tar­gets for cer­tain pieces of equip­ment.”

China has re­port­edly been hoard­ing masks. Other coun­tries are also lim­it­ing med­i­cal ex­ports. Bloomberg re­ported Wed­nes­day that In­done­sia would ban ex­ports of pro­tec­tive masks, hand san­i­tizer and some med­i­cal equip­ment un­til the end of June to shore up its do­mes­tic sup­ply.

Trump’s de­ci­sion comes five days af­ter 56 Demo­cratic law­mak­ers, in­clud­ing Kansas City area Reps. Emanuel Cleaver and Sharice Davids, signed a let­ter urg­ing him in­voke the act to ramp up pro­duc­tion of res­pi­ra­tors and face masks.

But there’s also the longer-term ques­tion about China’s role in the man­u­fac­tur­ing of medicine.

A day be­fore Trump an­nounced in­vo­ca­tion of the De­fense Pro­duc­tion Act, Gib­son said he should use his ex­ec­u­tive power to ac­cel­er­ate U.S. pro­duc­tion of med­i­cal sup­plies rather than wait­ing on Congress to pass leg­is­la­tion.

“I think it’s very likely and would be pru­dent for China to stop the ex­port of generic medicines made there and keep them for their own peo­ple. We know they’ve done it for masks,” Gib­son told The Star. “And as the num­ber of cases in­creases glob­ally de­mand will in­crease. We’ll all be com­pet­ing for a lim­ited sup­ply… That’s why there’s ur­gency to in­vest in do­mes­tic man­u­fac­ture.”

The U.S.-China Com­mis­sion re­port notes that In­dia, the largest man­u­fac­turer of generic drugs, ob­tains 80 per­cent of its ac­tive phar­ma­ceu­ti­cal in­gre­di­ents from China. The U.S. re­ceives 80 per­cent of its ac­tive phar­ma­ceu­ti­cal in­gre­di­ents from over­seas with a large share com­ing from China and In­dia.

Gib­son warned that the U.S. has “vir­tu­ally no ca­pac­ity to make the ‘bread and but­ter’ an­tibi­otics. We can no longer make peni­cillin.”

Rep. Vicky Hart­zler, a Mis­souri Repub­li­can, and Rep. John Gara­mendi, a Cal­i­for­nia Demo­crat, in­tro­duced leg­is­la­tion in Novem­ber to lever­age the pur­chas­ing power of the mil­i­tary to boost U.S. pro­duc­tion.

Their bill in­structs the Depart­ment of De­fense to study and en­act poli­cies that would re­duce the mil­i­tary’s de­pen­dence on other coun­tries for medicine, by us­ing the De­fense Pro­duc­tion Act “to ac­quire and pur­chase such raw ma­te­ri­als, medicines, and vac­cines, rec­og­niz­ing the na­tional se­cu­rity vul­ner­a­bil­i­ties of a de­pen­dency on a for­eign med­i­cal sup­ply chain.”

Hart­zler said the De­fense Pro­duc­tion Act of­fers in­cen­tives to U.S. busi­nesses to com­ply. “They should wel­come the ad­di­tional pro­duc­tion here,” Hart­zler told The Star.

Hart­zler and Gara­mendi, mem­bers of the House Armed Ser­vices Com­mit­tee, plan on in­clud­ing the leg­is­la­tion as part of the larger Na­tional De­fense Au­tho­riza­tion Act, which Congress passes an­nu­ally to au­tho­rize mil­i­tary spend­ing.

The Mis­souri Repub­li­can said the risk of re­liance on Chi­nese pro­duc­tion ex­tends be­yond the cur­rent cri­sis and poses strate­gic vul­ner­a­bil­i­ties.

“In a time of con­flict with them, they could quit sup­ply­ing us or they could do some­thing like putting in­ert in­gre­di­ents in (phar­ma­ceu­ti­cal prod­ucts),” she said.

Other Mis­souri law­mak­ers are also look­ing at the is­sue more se­ri­ously in the wake of the coron­avirus pan­demic.

Sen. Roy Blunt, a Mis­souri Repub­li­can, said he’s hope­ful that Congress will in­clude med­i­cal sup­ply chain leg­is­la­tion in one of its up­com­ing coron­avirus re­lief bills.

“I think over time this has grad­u­ally be­come a big­ger prob­lem—as the global sup­ply chain ex­panded and got more and more com­mit­ted to who could pro­duce a qual­ity prod­uct at the low­est price,” said Blunt, who chairs Se­nate Ap­pro­pri­a­tions sub­com­mit­tee that over­sees health fund­ing.

Blunt co-spon­sored leg­is­la­tion last week with Ten­nessee Repub­li­can Sen. La­mar Alexan­der and Illi­nois Demo­cratic Sen. Dick Durbin that would di­rect the Na­tional Acad­e­mies of Sciences, En­gi­neer­ing, and Medicine to as­sess vul­ner­a­bil­i­ties in the med­i­cal sup­ply chain and pro­vide rec­om­men­da­tions for in­creas­ing do­mes­tic man­u­fac­tur­ing and stock­piles.

Mis­souri’s other Repub­li­can se­na­tor, Josh Haw­ley, in­tro­duced his own mea­sure ear­lier this month that would re­quire man­u­fac­tur­ers to re­port fore­casted short­ages of med­i­cal de­vices and en­able the Food and Drug Ad­min­is­tra­tion to ex­pe­dite the re­view process for these de­vices.

Haw­ley’s bill would also en­able the FDA to re­quest in­for­ma­tion from man­u­fac­tur­ers on the ori­gin of com­po­nent parts, in­clud­ing ac­tive phar­ma­ceu­ti­cal in­gre­di­ents in drugs.

“I think it’s been clear for a while now that we are far too re­liant on China for our do­mes­tic pro­duc­tion es­pe­cially for es­sen­tial prod­ucts that we rely on and of course our med­i­cal sup­ply chain is at the very top of the list as we’re sadly find­ing out,” Haw­ley said last week at a hear­ing of the Se­nate Small Busi­ness Com­mit­tee that fo­cused on coron­avirus and the U.S. sup­ply chain.

At the hear­ing, Haw­ley asked Gib­son, a witness, about the num­ber of drugs in the U.S. that in­volve China in some stage of their pro­duc­tion.

“Thou­sands. Thou­sands of our generic drugs and even some of the brand name prod­ucts and per­haps even some new ther­a­pies for coron­avirus may de­pend pri­mar­ily on the chem­i­cals that are sourced in China,” she replied.

Gib­son told The Star that both Mis­souri sen­a­tors’ bills fall short of solv­ing the prob­lem. She said the time for law­mak­ers to study the is­sue has passed and ques­tioned the ef­fec­tive­ness of Haw­ley’s pro­posal.

“Are we ex­pect­ing that the Chi­nese gov­ern­ment will help us out and tell us where they get their chem­i­cals from?” she said.

ELAINE THOMP­SON AP

Lau­rie Kuypers, a reg­is­tered nurse, reaches into a car to take a swab at a drive-through test­ing sta­tion.

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