China’s Potential for Pharmacological Warfare

Editor’s note: This article first appeared at The American Spectator.

It’s the middle of the night. Your child is tugging on their ear and crying inconsolably. It’s an ear infection. If you’ve ever had to deal with that situation, you’re thankful for the antibiotic amoxicillin. According to the U.S. Centers for Disease Control and Prevention (CDC), amoxicillin is the most widely prescribed antibiotic in the United States, and one of the most prescribed drugs in the world.

It is used to treat a variety of bacterial infections in adults and children, and in its generic form is an inexpensive yet effective option for millions of patients.

Unfortunately, amoxicillin also has the potential to become a weapon for America’s main geo-political foe, China. Data from the International Trade Center (ITC) show that the majority of global exports of antibiotics originate in China. This isn’t biological warfare in the traditional sense, but a new way for China to pressure and possibly harm the United States. It is pharmacological warfare.

A recent Wall Street Journal article decried the lack of American generic drugmakers and highlighted the production of amoxicillin as a prime example. USAntibiotics is the only generic manufacturer in the United States currently producing amoxicillin and the company is in dire financial straits.

USAntibiotics can’t make enough money to cover its costs because overseas competitors produce and sell their products at rock-bottom prices. Reducing the cost of prescription drugs is a key effort in helping to control healthcare costs. But the supply problem is exacerbated when hospital buying groups and drug wholesalers consider price alone when making buying decisions.

While this is an example of the free market at work, it is also a dangerous symptom of a bigger problem.

China plays a significant role in the supply chains of many American companies due to its low-cost structure and cheap labor. It may not be a significant issue for the manufacture of iPhones or consumer goods because these items are ultimately owned by U.S. companies. But when it comes to supplying a critical drug like amoxicillin, it becomes more problematic.

The American public is already aware of the threat posed by fentanyl made in China and entering the country through Mexico. While fentanyl represents a threat, what would happen if China decided to constrain the supply of amoxicillin or increase its price dramatically because of trade disagreements or as a geo-political tactic?

This type of “warfare” would open a new front in how a country such as China could impact America and its citizens. Using a widely prescribed drug compound like amoxicillin as a “weapon” against the United States and its people would represent pharmacological warfare and an issue of national security.

When considering how to defend against a situation like the one described above, prevention — or prophylaxis, to keep with the pharmaceutical analogy — represents the best approach. Providing financial incentives for generic drug manufacturers based in the United States, reducing the Food and Drug Administration (FDA) regulatory burden for approval of generic drug production, and sourcing alternative international suppliers are appropriate tactics.

Unless proactive steps are taken to prevent critical medicines from becoming weaponized by adversaries of the United States, patients like the toddler suffering from an ear infection will literally feel the pain.