The US is quickly approaching the mid-May deadline for tariffs on pharmaceutical imports. For now, no one knows exactly what these tariffs will entail or how broad their scope will be. But it appears increasingly likely they will move forward: just this week, Trump issued a new executive order directing the Food and Drug Administration to streamline the process for pharmaceutical companies to build new production sites domestically.

There’s no question that America’s pharmaceutical supply chains are vulnerable. Trump recognises that bringing them back onshore is key to US strategic autonomy and this executive order is a step in the right direction. However, between the DOGE-style deregulatory impulse and Trump’s tariff offensive, what’s missing is a carefully considered industrial policy — one that includes access to preferential loans, tax incentives, and programmes to educate a workforce equipped to actually rebuild the industry.

Five years after the Covid-19 pandemic revealed the US’s heavy reliance on Chinese supply chains, the US healthcare sector remains acutely vulnerable. Although 70% of Americans are on at least one prescription drug over the course of a year, the US has minimal capacity to produce antibiotics for basic infections. Most are made offshore, using raw materials sourced from China.

After the pandemic, the problem only worsened. Since 2020, US pharmaceutical imports from China have surged by 485%. In 2019, China did not produce any of the externally sourced molecules used in US pharmaceuticals; today, it produces a third. On top of that, nearly 90% of active pharmaceutical ingredient (API) plants serving the US market are now based in China.

This growing dependency is a national security concern. In early 2024, drug shortages in the US reached a record high: 323 essential drugs were in short supply. This shouldn’t be surprising, considering that nearly 80% of the producers of drugs on the WHO Essential Medicines List — such as anaesthetics, antibiotics, and cardiovascular drugs — are located outside the United States.

Even the military is exposed. One in four drugs used in military hospitals contains Chinese ingredients. In 2023, the Department of Defense assessed 54% of its pharmaceutical supply chain as high-risk. A confrontation with China wouldn’t just affect access to cutting-edge chips. It could endanger access to life-saving drugs for American troops.

Chinese domination in biopharma is more alarming than in rare earths. And the situation is dramatically worse than in the semiconductor sector, where many supply chains remain in the hands of allies. The US has no ally capable of meeting its manufacturers’ needs for active ingredients. And in times of crisis, it can only rely on itself: during the pandemic, both the UK and India banned drug exports to prioritise their own populations.

America Firsters are right to be concerned: China is rapidly becoming a biopharma superpower. But its rise wasn’t built on trade restrictions and a few deregulatory tweaks alone. Raising costs on Chinese imports or removing a handful of regulatory hurdles won’t restore America’s lost capabilities. What’s needed is a long-term, coordinated industrial policy — one that combines targeted public investment, low-interest loans, regulatory reform, robust incentives for domestic manufacturing, FDA modernisation, and workforce development. Expanding STEM education, supporting vocational training, and attracting the next generation of biotech talent are indispensable. On the path to independence, there are no shortcuts.

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Krzysztof Tyszka-Drozdowski is a writer from Poland.

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