The US Israel Education Association has released a report arguing that Abraham Accords could reduce America’s dependence on China in the pharmaceutical field.
EXCLUSIVE: The threat from China may be closer to home than most Americans realize: It’s in their bathroom cabinets. A new report warns that America’s dependence on Chinese drugs is making the country vulnerable and points to a possible solution: “friendshoring,” or learning to rely on allies instead of adversaries.
The American Israel Education Association (USIEA) recently released a report warning that “foreign countries are holding American medicine cabinets to ransom.” This includes China, which plays a key role in the US medical supply chain, as 41% of Key Sourcing Materials (KSMs) used in US-approved active pharmaceutical ingredients (APIs) come exclusively from China.
Furthermore, the report notes that “China is the only supplier of at least one KSM for 679 APIs, accounting for 37% of all APIs,” which seriously endangers American consumers. USIEA argues that the current U.S. medical supply chain places price over safety and is the equivalent of “playing Russian roulette” with bad actors.
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The American Israel Education Association (USIEA) recently released a report warning that “foreign countries are holding American medicine cabinets to ransom.” (iStock)
“For example, about 90 percent of the pharmaceutical products that we use by volume here in the United States are generic drugs, and they are overwhelmingly produced abroad, largely from China and India. And if China were to one day decide to simply stop sending us pharmaceutical products for political reasons… we would be in a very difficult situation because we really wouldn’t have the pharmaceutical products that we need to save people’s lives,” former FDA Associate Commissioner and USIEA Senior Fellow Peter Pitts told Fox Business.
The USIEA report points to the COVID-19 pandemic as a prime example of the vulnerabilities in the U.S. pharmaceutical supply chain and how dependence on China could become dangerous. During the pandemic, the U.S. has faced a shortage of contrast agents, which medical professionals use to improve the visibility of organs, blood vessels and tissues on X-rays, CT scans and MRIs. The report notes that in 2022, a major contrast agent manufacturing facility near Shanghai closed due to a COVID lockdown, causing chaos in the US.
“Here at home, this resulted in a radical decline in angiograms, perfusion scans and other tests crucial for assessing stroke, cancer diagnosis and other emergency medical care,” the report said. “This one factory in China supplies almost all the contrast agent used in the United States. It is not difficult to imagine similar supply chain crises for diabetes test strips or ADHD drugs, or penicillin driven by geopolitical purposes.”
However, the issue predates the pandemic. The USIEA report points to an example from 2008, when a substandard anticoagulant from China killed 81 people and left 785 seriously injured.
The FDA’s understanding of Chinese manufacturing is also limited and heavily monitored, which the USIEA says is a “recipe for disaster.”
As the report explains, when inspectors are required to notify a factory in advance, “production logs are changed, factory floors are cleaned, expired supplies are moved, and access to many key areas is restricted.”
Torasemid AL high blood pressure tablets leaving a Fette Compacting 2090i machine, manufactured by Fette GmbH, at the Stada Arzneimittel AG pharmaceutical factory in Bad Vilbel, Germany, in 2014. (Krisztian Bocsi/Bloomberg)
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The organization came up with a solution that has already received some attention in Washington: the creation of an FDA Abraham Accords Office. The report describes the agency as a “regional regulatory mission” that would act as “a forward-deployed extension of the FDA” with three key priorities: economic security, public health and diplomatic leadership.
The goal of the FDA’s Abraham Accords Office, according to the report, would be to “institutionalize friendshoring, allowing the U.S. to diversify supply chains for essential medicines through trusted partners while maintaining the FDA’s ‘gold standard’ for oversight.” This would allow the US to shift its dependence from riskier countries, such as China, to friendlier countries, such as Israel, the United Arab Emirates, Bahrain and Morocco.
A bipartisan bill which has already passed in the House of Representatives, includes a provision for the establishment of the FDA Abraham Accords Office. The bill, known as HR1262, or the “Mikaela Naylon Give Kids a Chance Act,” was introduced in February by Rep. Michael McCaul, R-Texas, and has bipartisan cosponsors. Under the legislation, the agency would not approve drugs but would work as a coordinator between the FDA and manufacturers in the Abraham Accords countries.
The USIEA said the Abraham Accord countries “can be trusted partners who share regulatory standards and political alignment.”
“The Abraham Accord countries have made the decision that they’re looking at the 21st century… So it presents an opportunity to expand into a part of the world that, frankly, the United States had largely ignored, especially in this area,” USIEA Director of Policy and Strategic Operations EJ Kimball told Fox Business.
However, the friend-shoring strategy is as practical as it is political, as Kimball, Pitts and the USIEA argue that Abraham Accord countries are ready to meet US pharmaceutical needs.
“[Israel and the United Arab Emirates] They are two very stable entities that are very advanced in a number of different areas, not least pharmaceutical development and manufacturing,” Pitts said. “They punch well above their weight in these areas.”
Workers work on the production line of Xiaoqinglong capsules, a cough medicine, at a factory in 2023 in Shenyang, Liaoning province, China. (VCG via Getty Images)
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The push to expand pharmaceutical cooperation with the Abraham Accords countries is about more than securing the U.S. supply chain; it would also allow the US to stay ahead of Chinese influence. Kimball warns that China has been hard at work deepening its presence in the Middle East. However, he and Pitts believe that by expanding Abraham Accords relations, the US can stop China in its tracks.
“Morocco has been very clear to us that they want to work with the United States, and China is knocking on their door. And they’re doing some work with China, but they understand the threat it poses to them, and so if the United States doesn’t also knock on their door at some point, China will eventually come in, because you can only say ‘no’ for so long when they’re offering you so much,” Kimball said.
Pitts criticized U.S. governments for “giving the cold shoulder” to potential international partners without considering the consequences. However, he believes the US can still attract countries that have turned to China.
Hard capsules containing the drug “Grippostad” are produced at the headquarters of the pharmaceutical manufacturer STADA in Bad Vilbel. (Boris Roessler/Photo Alliance via Getty Images)
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“Once we open our arms and say we want to do business with countries we trust, with countries that embrace high quality, with countries that don’t cheat, with countries that play fair, with countries that recognize the value of technological progress for reasons other than military and geopolitical positions, we win hands down every time, and everyone wins,” Pitts said.
The USIEA argues that moving the supply chain to friendly countries, such as those in the Abraham Accords, is not just a strategic move but an essential act to protect national security. As the report puts it: “In a world where supply disruptions can endanger national stability as much as military threats, ensuring access to essential medicines is an act of sovereignty.”
