Grandstand. France and the entire planet depend, for the production of pharmaceutical raw materials, on active ingredients produced in South and East Asia. The uncertainties linked to the international situation force us to raise again the vital question of pharmaceutical production in Europe. It is urgent and essential to finally lay the foundations for French and European production, at least in part public, through an industrial tool that allows diversification of supply sources and better responsiveness during global crises.
In the spring of 2020, French and European hospitals, saturated by the first wave of the Covid-19 epidemic, experienced strong tensions in the supply of essential drugs for resuscitation. The standards of care and end-of-life management were then affected. This dramatic situation has made visible the central question of dependence on France.
Because if the “shaping” and packaging stages are sometimes carried out in Europe, 80% of the world’s pharmaceutical raw materials are produced in China and India. These two countries produce a large part of the active ingredients, or APIs (active pharmaceutical ingredient), the first capital manufacturing step of a synthetic chemical drug. This step, which is very restrictive because it is very polluting, is carried out in specific production parks, under conditions that raise ethical issues. Edifying example, the pharmacologist Andrew Hill, of the University of Liverpool, had indicated at the end of March 2020 that for midazolam, a powerful hypnotic used in intensive care units, there were only eight producers of active ingredients worldwide, all located in India.
For a partially public production
The private or public “relocation” of part of the pharmaceutical production in Europe and in particular in France was mentioned for a time in the media and by political decision-makers. A production, at least partly public, would already make it possible to respond to the ever-increasing structural shortages. In 2016, 405 tensions or shortages in the supply of essential medicines were reported to the National Medicines Safety Agency (ANSM) in France. This number rose to 871 in 2018, 1,504 in 2019, 2,446 in 2020. For this last year, 37% of these tensions or shortages were caused by a problem with the supply of active ingredients. These figures show the need to diversify sources of supply and relaunch local production of APIs in Europe.
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