Pharmaceutical Blackout: The Hidden Threat to U.S. Security

Imagine a crisis where U.S. citizens are abruptly cut off from lifesaving medications. Pharmacy shelves are empty. And medicine cabinets lay bare. This isn’t a far-fetched dystopia. It’s a real and growing threat. Generic drugs, which make up nearly 90% of U.S. prescriptions, depend on Chinese and Indian manufacturing for active pharmaceutical ingredients (API), finished dosage forms, or both. In the event of a possible – if not probable – trade war or geopolitical rupture, these supply chains could be severed; leaving Americans vulnerable to “pharmacological blackouts.”

Market forces have created unsustainable economics and a reliance on offshore manufacturing. These market forces will not solve the very problem that they created. An active, strategic federal response is required to restore domestic manufacturing capacity and protect the public.

We need look no further than the semiconductor industry for inspiration. After years of dependence on Taiwan and South Korea, the U.S. government deployed $53 billion under the 2022 CHIPS Act to revive domestic chip production when it became clear that market forces alone wouldn’t protect national security. While chips represent a concentrated, high-value sector, the generic pharmaceutical supply chain is sprawling, fragmented, and far less valuable. Yet it is no less critical. In a geopolitical crisis, these dependencies could quickly become choke points. Pharmaceutical supply chains are as critical to national security as semiconductor supply chains; therefore, the government must treat them with similar urgency.

As a prerequisite, it is critical to identify which medicines are truly mission critical. This begins with establishing a consolidated national list of essential drugs to guide strategic investment. The U.S. must also consider which disease areas are likely to shift from chemically synthesized drugs to biologics in the near future, to avoid investing in capabilities that may soon be obsolete. Once the essential drug list is in place, the federal government must take decisive steps to onshore production and build a resilient, secure supply chain. To address this urgent need, the U.S. government must take the following action:

The stakes are clear: Americans’ health hangs on economically unstable supply chains that are concentrated overseas. Rebuilding domestic pharmaceutical manufacturing is not just an economic issue but a national security imperative. By guaranteeing fair prices for U.S. generics, prioritizing U.S. manufacturing, investing in factories, and reducing regulatory approval time, we ensure that if global politics turn hostile, Americans will still have their medications. The policy roadmap is available; the crisis is real. We must act now.

Gen. Tim Ray (U.S. Air Force, ret.) is president and CEO of Business Executives for National Security. He previously served as Commander of Air Force Global Strike Command. Stuart Glickman, a leading pharmaceutical operations and supply chain executive, most recently headed Supply Chain and Manufacturing Services at Emergent BioSolutions.