The many threats from China have been well documented, including the growth and power of its military, its growth as a manufacturing and economic power, and its theft of intellectual property.
However, China presents another threat to our national security, one that looms large and, for the most part, has flown under the radar with little attention: the Chinese manufacture of prescription drugs and its status as a supplier of active ingredients used in drug manufacture. Despite warnings, it’s a problem that our political leadership has not acted upon and the media largely have ignored. The problem likely is compounded by the power of the pharmaceutical lobby.
The Military Officers Association of America (MOAA) is among organizations that have taken a position on this issue, urging the Department of Defense (DOD) and Veterans Affairs (VA) to ensure that our national industrial base is not impacted by the state of the pharmaceutical sector. One recommendation includes the domestic manufacture of medicines such as antibiotics that are now procured from strategic adversaries, which is consistent with a 2018 report that analyzed sectors where the U.S. depends on strategic competitors for military equipment and components.
That recommendation is included in a House bill introduced Oct. 17. The Pharmaceutical Independence Reform Act (H.R. 4710) would require DOD to purchase only American-made medicines and vaccines, including only U.S.-produced raw materials, for use by our military. The bill also would require DOD to identify the national security vulnerabilities caused by our current dependence on pharmaceuticals from China.
The seriousness of the problem is documented by Rosemary Gibson and Janardan Prasad Singh in their book, “China Rx: Exposing the Risks of America’s Dependence on China for Medicine.” The authors provide a chilling insight into China’s role in the prescription and over-the-counter drug market. Their book should serve as a wake-up call. Though California Democratic Reps. Anna Eshoo and Adam Schiff last month said they plan to hold hearings to highlight the problem, until Congress acts to address the problem the potential for catastrophic harm to our nation is real.
Gibson and Singh provide numerous examples of how the Chinese control the generic prescription drug market. Their examples don’t simply evoke an “Oh my, this is quite interesting” type of response. Instead, the reaction is: “My God, how have we let this happen? The health of our entire citizenry could be at risk.”
One example concerns the blood-thinner heparin, commonly given to patients in hospitals to avoid the formation of blood clots. In 2007-2008, several hundred children and adults in hospitals across the country suffered mysterious reactions to drugs they were provided in dialysis clinics and operating rooms. The Centers for Disease Control and Prevention (CDC) traced the problem to certain batches of heparin made with an active ingredient manufactured in China.
The manufacture of heparin begins at slaughterhouses, which sell piles of pig intestines to factories. Workers in bloodstained aprons and boots scoop material from the intestines and boil it in large vats, processing it into crude heparin. In this case, the crude heparin was sold to the Chinese company Changzhou-SPL, which refined it into the active ingredient. A U.S. drug firm bought the active ingredient from Changzhou-SPL and used it for a product that was sold to hospitals and dialysis centers. Ultimately, the Food and Drug Administration (FDA) received reports of 246 deaths associated with the contaminated heparin.
Gibson and Singh also offer the example of penicillin, which was originally mass-produced in the U.S. for the D-Day invasion in 1944. Today, pharmacists fill prescriptions for penicillin with ingredients not from U.S. drug companies but from China. Think of the implications if U.S. forces were to enter a conflict with China — which some day could be a reality. Would our adversary provide us the medicines that our armed forces might require? It’s not a difficult question to answer.
As recently as the 1990s, the U.S., Europe and Japan manufactured 90 percent of the global supply of key ingredients for the world’s medicines and vitamins. China now has become the largest global supplier of active ingredients and chemical building blocks needed to make many prescription drugs and over-the-counter products.
Millions of Americans ingest drugs made in China — and they likely don’t know it. Hundreds of thousands of physicians prescribe them; the medicines may be packaged to look like all-American products, but they are not.
MOAA is concerned about any issue associated with the safety of medications. Our awareness was heightened several months ago when the Food and Drug Administration (FDA) recalled valsartan, a blood pressure medication, after a probable cancer-causing chemical was identified in the active pharmaceutical ingredient and traced to a manufacturer in China.
While there are many macro forces impacting our national industrial base, the risks to the pharmaceutical sector should come under closer examination. We must ensure that active duty, retired military and civilians have an uninterrupted supply of quality medicines. The U.S. should diversify its procurement away from countries who may cut off access or compromise quality, and incentivize the domestic manufacture of strategically valuable medicines.
China has added “global pharmaceutical power” to its resume. It’s time for Congress to map out a course of action to remedy this addiction.
Tom Jurkowsky is a retired Navy rear admiral and a board member of the nonprofit Military Officers Association of America, which advocates for a strong national defense and for military service members.