Coronavirus: U.S. relies on China for medical supplies
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.
Laurie Kuypers, a registered nurse, reaches into a car to take a swab at a drive-through testing station.