A blueprint for building a stronger, safer and healthier America

The early days of the COVID-19 pandemic opened the eyes of many to a problem that had slowly snowballed into one of monumental proportions: America’s reliance on foreign supply chains for our basic medical needs.

From personal protective equipment (PPE) to ventilators and even basic generic drugs, healthcare providers, state and local governments, businesses and American families scrambled to secure the necessities as the supply chain became squeezed.

The statistics are staggering: In 2018, China manufactured 95% of the world’s supply of ibuprofen, 70% of acetaminophen, and roughly 45% of penicillin. The Food and Drug Administration estimates that approximately 72% of active pharmaceutical ingredients (APIs)—the building blocks of medicines—are made in foreign countries with nearly a third manufactured in India and China.

From lower costs on inputs like labor, electricity and raw materials to lax environmental regulations and regulatory regimes, these countries have created an attractive atmosphere for many industries.

As a pharmacist, I’ve witnessed this sourcing trend firsthand as more and more of the medications I dispensed to my patients came from abroad. It was not until I was a member of Congress that the national security implications of this shift became clearer.

If China, or any of these countries, chose to retaliate against the U.S., they could halt exports or substantially hike prices. In fact, India went down this road—blocking export of 26 essential medicines in the early days of the pandemic—causing severe shortages worldwide. China, for its part, stockpiled PPE desperately needed by healthcare workers around the world. 

While this is a serious issue that threatens our health, safety and national security, it is neither insurmountable nor does it, as some have suggested, require government subsidies or purchasing mandates to fix. 

In June, I was joined by Sen. Tim Scott (R-S.C.) in introducing the Manufacturing API, Drugs, and Excipients (MADE) in America Act. This is the only bipartisan, bicameral legislation to mitigate drug shortages by incentivizing the domestic manufacturing of drugs, APIs, PPE, durable medical equipment and diagnostics.

We achieve the task in two distinct ways: 

First, we encourage domestic manufacturing of these vital items through a new 30% tax credit that would apply to manufacturers operating in certain Opportunity Zones across the country. U.S. territories, like Puerto Rico, would also be eligible for this credit.

Opportunity Zones have transformed once depressed communities across the country, spurring billions in investment. We aim to build on their success, further uplifting communities while also strengthening our supply chain and national security.

Second, we empower the FDA to better enforce our stringent safety measures abroad and to adapt to new technologies. Our approach bolsters the FDA’s reach overseas and encourages the agency to expand mutual recognition agreements to make it harder for foreign manufacturers to skirt our regulatory oversight. Additionally, we would create a new pathway for the FDA to evaluate advanced manufacturing technologies to promote modern, reliable production strategies.

America has the most innovative minds in the world. That’s why we, through Operation Warp Speed, were able to recraft the regulatory and funding regime for vaccine development to accomplish what many said was impossible: rapidly developing not just one but three safe and highly effective COVID-19 vaccines.

I believe we will continue to lead the world in healthcare innovation, but to fully reap the benefit we must reshore and strengthen our domestic supply chain for everything from the latest technology or treatment to the most tried and true.