CFR: U.S. Pharma Dependence on China Is a Security Risk
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- Council on Foreign Relations authors Yadav, Bollyky, Doshi, Friedrichs, and Suarez push back against Pooja Yerramilli's STAT op-ed, arguing U.S. dependence on Chinese pharmaceuticals stems from decades of coordinated Chinese state industrial policy — not solely market forces and weak U.S. regulation.
- Made in China 2025 designated biopharmaceuticals a strategic sector, backed by tax holidays, low-interest loans, land discounts, dedicated biotech hubs, joint venture requirements, and forced technology transfer.
- A 2025 IMF paper estimates China's industrial-policy support across industries at roughly 4.4% of GDP — close to $700 billion annually — with chemical and pharmaceutical manufacturing among the largest beneficiaries.
- Beijing has previously weaponized pharmaceutical supply chains: it imposed export controls on dual-use products shipped to Japan after remarks on Taiwan, flooded India's market with below-cost exports to undercut domestic resilience efforts, and in 2020, Beijing-amplified voices warned that '90% of drugs imported by the United States are related to China.'
- U.S. drug shortages last an average of three years, partly because drugmakers must secure FDA approval for new manufacturing facilities — a process the authors describe as expensive and time-consuming, with FDA's temporary importation authority typically taking months to invoke.
- A 2023 U.S. Department of Defense official testified that Chinese dominance of active pharmaceutical ingredients 'cannot be overstated' for both 'domestic and military uses.'
- The CFR authors recommend a coordinated industrial policy response: robust investment in U.S. clinical research, long-term purchase commitments for U.S.-made essential medicines, grants and low-cost financing for local production, accelerated FDA oversight for advanced manufacturing, functional emergency stockpiles, and allied sourcing partnerships.
Why it matters: U.S. drug shortages already last three years on average, and the authors argue that Beijing has both the leverage and the demonstrated willingness to exploit that persistent chokepoint — having already weaponized drug and dual-use supply chains against Japan and India, and with an IMF-estimated $700 billion a year in Chinese industrial subsidies tilting the playing field.
