The United States relies heavily on China for pharmaceutical ingredients, with China producing roughly 45% of global active pharmaceutical ingredients and more than 60% of essential components for antibiotics, creating a national security risk.

Historically, US production of pharmaceutical ingredients has declined from about a quarter of world supply in 1981 to current heavy reliance on China, a trend driven by decades of offshoring and outsourcing.

This dependence is framed as a loss of sovereignty that could allow adversaries to disrupt or weaponize access to medicines, impacting military, government, and civilian health.

Analysts point to links between Chinese chemical networks and illicit drug supply chains, underscoring systemic vulnerability and the risk of supply-chain weaponization.

A strategic goal is to build a national program to incentivize American pharmaceutical production, ensuring medicine security for the United States.

A practical path forward is to expand domestic manufacturing capacity, using Ohio as a model for regional pharmaceutical production through coordinated investment, infrastructure, and a skilled workforce to create secure jobs and reduce dependence.

Policy responses include the BIOSECURE Act and tariff actions on synthetic opioids, but they are viewed as insufficient without expanding domestic manufacturing capacity.