“In three years, it should be possible to lay the solid foundations of a pharmaceutical industrial plan”

Ln December 22, the People’s Republic of China announced that it was suspending the export of certain drugs, such as ibuprofen. It thus intends to meet the needs of its population, 1.4 billion inhabitants facing a rebound in the Covid-19 pandemic. “It’s a desperate situation and it’s every man for himself”explained an official of the city of Nanjing.

Eighty percent of the production of active pharmaceutical ingredients needed for the medicines we consume are produced in China and India. Yet we know what such dependence entails. In December 2019, because of Covid-19, Chinese factories had to temporarily close. In March 2020, India had closed its borders to exports for certain medicines. The combination of these two phenomena, to which was added the explosion of world demand, had caused shortages in Parisian hospitals. The Chinese announcement of December 22 therefore looks like a repetition of the same bad scenario. Are we better prepared than three years ago? This is doubtful as public action does not seem to have taken into account this dependence and the evolution of the international context.

With each new drug shortage, we recall the structural causes, the ultra-concentration of manufacturing and the inclusion of health products in commercial and financial logics. We show the need for local production of drugs, at least in part public, in different production sites, and the use of hospital production, as well as coordination of this production with other European countries. While it is certainly not possible to improvise a pharmaceutical industrial plan in three years, it is nevertheless possible to lay a solid foundation. Other countries do it, why not France?

Basic works

Each time we put forward these pragmatic structural reforms, we are confronted with the urgency of the situation which would exhaust most of the resources and possible actions. However, competent authorities should be able to put in place appropriate short-term responses, and launch substantive projects that make it possible to prevent, reduce and better anticipate shortages. From 132 ruptures or tensions reported in 2011, we have increased to 2,446 in 2021. Do we think that the only emergency management measures, without fundamental work to stem this explosion, are effective and tenable, even in the very short term? And do we realize how dangerous it is to postpone measures essential to our health security on the grounds that they would take a long time to be put in place?

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