U.S. Drug Dependence on China Is a Security Risk
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- Council on Foreign Relations authors Prashant Yadav, Thomas Bollyky, Rush Doshi, Paul Friedrichs and Victor Suarez rebut a STAT op-ed by Pooja Yerramilli that argued U.S. dependence on Chinese pharmaceutical manufacturing is overstated as a national security risk.
- Made in China 2025 designated biopharmaceuticals a strategic sector, with Beijing providing tax holidays, low-interest loans, land discounts, dedicated biotech hubs, joint venture requirements, and forced technology transfer to build industry dominance.
- A 2025 IMF paper estimated 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.
- A 2023 U.S. Department of Defense official testified that risks from Chinese dominance of active pharmaceutical ingredients "cannot be overstated" for both domestic and military uses.
- Beijing has previously weaponized pharmaceutical supply chains: imposing export controls on dual-use products shipped to Japan after the Japanese prime minister's Taiwan Strait remarks, and flooding markets with below-cost exports to undercut India's domestic ingredient suppliers.
- U.S. drug shortages last an average of three years, the authors note, because new manufacturing facilities require FDA approval and are expensive and time-consuming to establish, forcing reliance on substitutes that can cause adverse reactions.
- The authors call for coordinated U.S. industrial policy: long-term purchase commitments for U.S.-made essential medicine inputs, grants and low-cost financing for local production, accelerated FDA oversight for advanced manufacturing, and allied sourcing partnerships.
Why it matters: The piece reframes the drug-shortage debate from "fix U.S. regulation" to "match China's industrial scale." Patients face shortages lasting three years on average while China has already weaponized drug supplies against Japan, the authors note. Their prescription—sustained U.S. investment in domestic manufacturing and allied sourcing—directly rejects tariff-only approaches as inadequate.
