America is facing a growing crisis in its medical system — not from a lack of talent or innovation, but from a breakdown in the control, safety and supply of essential medicines. Our growing reliance on imports is now driving serious drug shortages, destabilizing supply chains and increasingly making medications unsafe.
At the root of it is a hard truth: We no longer have control of the medicines we depend on every day.
In 2002, America manufactured 83.7 percent of the pharmaceuticals it consumed. By 2024, that number had dropped to just 37.1 percent. Meanwhile, the U.S. pharmaceutical trade deficit has soared, reaching a record $118.3 billion in 2024. We didn’t just outsource manufacturing — we outsourced the sovereignty and safety of our health care system.
This means that nearly two-thirds of America’s pharmaceutical supplies are now imported. Most critical medications, such as generic drugs, now come from China and India.
China controls 80 to 90 percent of the global supply of active pharmaceutical ingredients — the chemical building blocks of modern medicine. Even drugs labeled “Made in the USA” often chemically originate in China. And India, which produces about half of America’s finished generic drugs, relies on China for up to 80 percent of its active pharmaceutical ingredients.
That’s not a supply chain — it’s a ticking time bomb.
When something goes wrong, American patients suffer. In 2023, the Food and Drug Administration shut down a single Indian plant responsible for 50 percent of the U.S. supply of cisplatin, a critical chemotherapy drug, after uncovering a “cascade of failure” in safety practices and shredded documents soaked in acid. With no domestic backup, patients nationwide had their treatments delayed.
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