The United States produces roughly 3% of the active pharmaceutical ingredients in the world. Meanwhile, China produces a whopping 45%. A Johns Hopkins study found that China supplies more than 60% of the essential components American manufacturers need for antibiotics.
That’s not just a trade imbalance, it is surrendering sovereignty.
The health of our military, our leaders, our children and our neighbors is beholden to an adversary who could weaponize not just the availability of and access to essential medications but the safety of those very products.
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We didn’t get here by accident. Decades of offshoring gutted the American industrial base and shipped critical manufacturing jobs overseas. As recently as 1981, the United States produced 25% of the world’s pharmaceutical ingredients. Today, China controls nearly half the global market. A nation that cannot make its own antibiotics and cannot stop adversary-sourced chemicals from crossing its border does not fully govern itself.
The Council on Foreign Relations called this what it is: a pharma choke point. The dependence is structural, deep and spreading from generics into advanced biologics.
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Beijing has already shown it will weaponize supply chains. It did so with rare earths, semiconductor inputs and defense-critical metals. Why would we believe the Chinese Communist Party (CCP) would treat medicine any differently in a crisis when it has the capacity to poison an entire people?
The same chemical networks that feed Chinese precursors into American pharmacies also feed the fentanyl pipeline through Mexico. Research from the University of Virginia’s National Security Data and Policy Institute describes Chinese suppliers and Mexican cartels as a singular adaptive supply chain: precursors bought cheaply online, air-shipped in bulk, converted into pills, and pushed across the border.
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A few thousand dollars of chemicals can buy millions of doses. The wreckage in Midwestern towns is not a mystery. It is the real-life effect of a Chinese chemical distribution system operating behind a cartel front.
Congress has rightly begun to respond. The BIOSECURE Act, signed into law in December 2025, restricts federal procurement involving biotechnology products from designated companies tied to foreign adversaries. President Donald Trump also took executive action on tariffs targeting the synthetic opioid supply chain. Those steps matter. But they don’t build manufacturing plants.
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Legislation alone does not build a factory, bring jobs back and secure our nation. To effectively pry China’s grip off our supply chain, we must invest heavily in domestic producers. We need to build the manufacturing facilities here at home.
Take my home state of Ohio: the Buckeye State shows this model works. The state is already becoming a center of American semiconductor manufacturing by combining investment, infrastructure and a skilled workforce. It has the same heritage to become a national hub for pharmaceutical production. CNBC recently ranked Ohio No. 1 in the country for both business and infrastructure. Incentivize American companies to build advanced manufacturing in the Midwest and you do two things at once: create secure work and close a defense vulnerability.
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The choice is not complicated. Invest now in American pharmaceutical capacity or pay an unimaginable price later when Beijing turns the American medicine supply into a weapon.
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The border is not secure as long as Chinese chemical suppliers are arming cartels. The military is not ready as long as battlefield antibiotics are manufactured in a country we may one day fight. And the American people are not safe as long as their medicine cabinet depends on the goodwill of an adversary.
Build the plants. Bring the work home. Make medical independence a national priority.