December 09, 2019

In Bipartisan Letter, Warren, Cotton, Kaine, & Romney Warn of National Security and Public Health Risks Posed by China's Influence Over Drug Supply Chain

Foreign Imports Account for 80% of U.S. Active Pharmaceutical Ingredients

Washington, D.C. - United States Senator Elizabeth Warren (D-Mass.), along with Senators Tom Cotton (R-Ark.), Mitt Romney (R-Utah), and Tim Kaine (D-Va.), sent a letter to Secretary of Defense Mark Esper raising concerns about the national security risks posed by U.S. reliance on foreign-manufactured pharmaceutical products. The senators' letter follows the publication of the U.S.-China Economic and Security Review Commission's 2019 Annual Report that highlights the nation's "growing reliance" on products critical to the manufacturing of drugs, which are primarily made in China.

In recent years, China has come to dominate the global market for pharmaceutical products, particularly active pharmaceutical ingredients (APIs), which are necessary to manufacture pharmaceutical products such as generic drugs and vaccines. Despite the critical role of APIs in drug production, the United States only makes about 20% of the APIs used in domestic pharmaceutical production, with the remaining 80% coming from foreign sources.

"Millions of Americans, including servicemembers, rely on drugs to stay healthy-yet the United States imports a significant portion of these drug components from China," the senators wrote. "It is critical that DoD, along with other key federal agencies, address the dangers posed by this reliance on foreign drug makers."

In their letter, the senators warned that an interruption in the delivery of APIs would impact the production of medicines and ultimately military readiness, noting that DoD provides servicemembers and their families with drugs that can contain ingredients from China. The senators also observed that the Food and Drug Administration (FDA) does not consistently conduct tests to verify the contents of APIs or drugs that enter the United States, nor does it measure their quality, even after APIs that have been traced back to China have caused numerous public health crises in the United States and across the world.

"...overreliance on Chinese API exports raises the possibility that China could terminate or raise the cost of prescription drugs that millions of Americans, including servicemembers, rely on every day in the event of escalating geopolitical tensions," the senators continued. "It is essential the United States develop strategies to avoid over- or sole-reliance on China for its critical drugs and drug ingredients."

To address their concerns, the senators asked Secretary Esper to answer a series of questions about the potential national security risks posed by U.S. reliance on Chinese pharmaceutical products and DoD's role in addressing these risks, and requested a briefing on the matter. They requested a response to their letter by December 20, 2019.

Senators Warren, Cotton and Kaine are all members of the Senate Armed Services Committee. Senators Romney and Kaine serve on the Senate Foreign Relations Committee.