OPINION: Expanding the domestic public health supply chain is a matter of national security

Why the U.S. needs to expand its domestic public health supply chain Expanding the domestic supply chain for public health materials will strengthen national security and improve the U.S. economy. Patrick Skerrett STAT

One of the many hard lessons learned from Covid-19 has been that a robust and resilient domestic public health industrial base is essential to the health and security of the United States.

Early in 2020, as the pandemic emerged in the U.S., hospital executives; nursing home directors; clinicians; federal, state, and local officials; and so many others scrambled to get shipments of masks, gowns, and other personal protection supplies from around the world. Companies racing to develop diagnostic tests, therapeutics, and vaccines competed against each other for raw materials and supplies necessary for manufacturing.

The U.S. has come a long way since then, in part due to improvements in American production capacity and capability. Yet both remain far short of what the country needs for pharmaceuticals and medical supplies.

Take the drug manufacturing supply chain as an example. It generally starts with suppliers of raw materials such as the solvents, reagents, and other chemicals used to manufacture intermediate chemical compounds, key starting materials, and active pharmaceutical ingredients that become vaccines or therapeutics.

As of March 2021, 73% of the FDA-registered facilities that manufacture raw materials into active pharmaceutical ingredients were outside the U.S. And that percentage does not reflect that many of those facilities are themselves dependent on intermediate compounds imported from other countries. The vast majority of other essential public health supplies, such as N95 respirators, are also manufactured overseas. ...