America's Antibiotic Weakness Is a National Security Blindspot

"OPINION - Offshoring and outsourcing antibiotic production to China and India is putting America's access to lifesaving medicines at risk. It's time to implement antibiotic security measures before a supply crisis occurs. The first step is rebuilding onshore fermentation manufacturing capacity. Antibiotics have significantly improved life expectancy and overall public health for over 80 years. Penicillin alone has saved approximately million lives. Its discovery paved the way for further advancements in antibiotics that have saved hundreds of millions more."

"From the 1940s to the late 1980s, the United States led global antibiotic manufacturing. The volume of fermentation capacity required to produce antibiotics in the U.S. was a key measure of this. However, over time, pharmaceutical companies steadily outsourced and shifted antibiotic manufacturing to other countries, largely driven by opportunities to reduce costs and avoid capital investment. Today, the production of antibiotic active pharmaceutical ingredients (APIs) is concentrated in a handful of countries;"

"More concerning, the United States no longer has any significant fermentation manufacturing capabilities to produce antibiotic APIs onshore (see Table 1). Fermentation capacity for manufacture of antibiotics in USA This reality creates risks to health security and equitable access to key medicines, especially since antibiotics are such an essential tool for combating infections. In 2024, there were million prescriptions for antibiotics distributed in the U.S. alone."

Offshoring and outsourcing antibiotic production to China and India has reduced U.S. onshore fermentation manufacturing capacity and placed access to lifesaving medicines at risk. Antibiotics have improved life expectancy and public health for over 80 years, with penicillin and subsequent drugs saving millions of lives. From the 1940s through the late 1980s, the United States led global antibiotic manufacturing, but production was progressively outsourced to reduce costs and avoid capital investment. Production of antibiotic active pharmaceutical ingredients is now concentrated in a handful of countries, primarily India and China. The United States lacks significant onshore fermentation capabilities, creating health security, equitable access, and shortage vulnerabilities. Rebuilding domestic fermentation capacity and implementing antibiotic security measures are identified as urgent priorities to prevent a supply crisis.

Read at The Cipher Brief