All it takes is the flap of a butterfly’s wings somewhere in Asia – or the dry cough and fever of a lone worker on an assembly line in Zhejiang province, eastern China – for the global supply chain to grind to a halt. Millions of Europeans will then be deprived of smartphones, suitcases, tuxedos, shoes and underwear, stuffed toys, piggy banks…And, more worrisomely: meds.
Given Europe’s over-reliance on the “factory of the world”, there is little doubt that the safe, sustainable supply of essential medicines is now in jeopardy.
Shortages of generics
Interestingly, it’s not the new, more costly drugs that are the most vulnerable. “Those rarely go out-of-stock”, notes Jean-Paul Vernant, a prominent oncologist at La Pitié-Salpétrière in Paris.
It is the generics — the cheaper equivalents to off-patent originals, which play a critical role in ensuring access to quality healthcare across Europe — that are in trouble.
There are several accepted reasons for this. One is the choice, by European big pharma, racing for profitability over the last 30 years, to massively outsource from China off-patent so-called active pharmaceutical ingredients (APIs) — the chemical building blocks that give drugs their therapeutic effects.
Widely used antibiotics, like amoxicillin; painkillers like aspirin and paracetamol; vaccines against hepatitis B; even life-sustaining drugs to treat cancer, like busulfan and zolendric acid – all been regularly at risk.
In France, 538 medicines of “major therapeutic interest” faced shortages at some point in 2017, according to the National Drug Agency. A twelve-fold increase over 10 years. In the Netherlands there were 2044 reports of impending or actual shortages during the first half of 2019 alone, up from 1390 for the whole previous year. Patients were forced to make do with either no medicine or less effective ones.