Senators urge DoD to address risk from overreliance on foreign pharmaceuticals

U.S. Sens. Marco Rubio (R-FL) and Elizabeth Warren (D-MA) urged the U.S. Department of Defense to address the DOD’s overreliance on pharmaceuticals produced abroad in a letter on Friday.

The letter, to Gregory Kausner, acting Under Secretary of Defense for Acquisition and Sustainment, said the DoD’s reliance on drugs from overseas, particularly from China, pose a serious risk to national security and the health of servicemembers.

“DoD’s medical and pharmaceutical supply chain has a unique set of concerns and vulnerabilities that, if left unaddressed, represent a serious risk to national security,” the Senators wrote. “As our nation continues to confront challenges to our supply chains, we urge you to prioritize the challenges to the Department and the national security risks posed by overreliance on pharmaceuticals produced abroad.”

The letter comes after a DoD inspector General report found that the DoD has not assessed or mitigated risks to its pharmaceutical supply chains. In 2020, Rubio introduced legislation that required the Secretary of Defense to conduct a study on the DoD’s dependence on foreign-made pharmaceuticals.

“The Department must consider pharmaceuticals in its work to shore up vulnerable supply chains important to national security just as it does for semiconductors, microelectronics, and rare earth minerals,” the senators wrote. “We urge you to focus on this important and consequential aspect of supply chain risk management.”

Rubio also included in the CARES Act language that would require pharmaceutical companies to provide the Food and Drug Administration (FDA) with information on the volume of active pharmaceutical ingredients (API) used on pharmaceuticals.

Reports have shown that only a third of the facilities that manufacture APIs in prescription drugs consumed by Americans are in the U.S. During a U.S.-China Economic and Security Review Commission in 2019, a witness testified the U.S. has virtually no domestic capability to manufacture generic antibiotics, a class of drugs commonly prescribed to active-duty servicemembers, and that most of the manufacturers of those drugs are located abroad. Since APIs are the components of pharmaceuticals that provide a drug’s effectiveness, they are necessary to manufacture generic drugs and vaccines. But only 28 percent of facilities manufacturing APIs used in drugs and 47 percent of facilities manufacturing fined dosage forms of drugs for the U.S. market are located in the U.S.

“The risk of this overreliance on foreign API manufacturing –particularly from China — are serious, and the COVID-19 pandemic brought many of these vulnerabilities to light,” the senators wrote. “Shortages in crucial medical supplies such as syringes, ventilators, personal protective equipment, and pharmaceuticals hampered the nation’s response to the pandemic in the early months. Any interruption to the supply of APIs or other pharmaceuticals from foreign manufacturers, either accidental or by design, would have similarly devastating consequences.”