The US can use the Abraham Accords to nearshore vital medications

At the height of the COVID-19 pandemic, as hospital emergency rooms eclipsed capacity and states engaged in bidding wars over disposable N-95s, the American people confronted another medical crisis: they could no longer depend on access to their essential medications. 

The Food and Drug Administration reported shortages of more than 150 common medications, including famotidine, a popular ulcer medication, and hydrocortisone, a common steroid for treating severe allergies. Congress even passed legislation requiring the FDA to publish a medical device shortage list, which, today, includes chest drains, ventilators and defibrillators. 

Although there have been drug and medical device shortages in the past, since the U.S. began tracking the issue in 2001, COVID-19 laid bare the alarming vulnerability to America’s pharmaceutical supply chain and its overdependence on China. The good news is that the global pandemic, combined with diplomatic breakthroughs in the Middle East, presents a unique opportunity for the United States to “nearshore” some of its pharmaceutical operations to Abraham Accords nations — specifically Israel, the United Arab Emirates, Bahrain, and Morocco. 

Nearshoring — moving the operations to a country that is geographically close and more cost-effective — our drug manufacturing, clinical trials and development will not solve all our supply chain challenges, but it will make America safer.

In recent decades, America has experienced a decline in the percentage of domestically produced pharmaceuticals. One study found that 70 percent of the top 40 brand-name drugs sold in America were imported. Indeed, more than 95 percent of our imports of ibuprofen and 70 percent of acetaminophen — Tylenol— come from China.

This is not merely an issue of commercial competition; this is a critical matter of national security. In her 2019 testimony before the U.S.-China Economic and Security Review Commission, Rosemary Gibson, author of “China Rx: Exposing the Risks of America’s Dependence on China for Medicine,” testified that if China ceased exporting its pharmaceutical ingredients, “military hospitals and clinics would cease to function within months, if not days.”

Nearshoring can also save money for pharmaceutical companies and, ultimately, the American consumer. Although the cost of producing pharmaceuticals in China keeps some manufacturing expenses down, we have seen over the past 30 months the devastating economic impact — and human toll — that supply chain gaps can cause. Moreover, moving drug production sites out of China could prevent intellectual property theft, which costs multinational companies trillions of dollars. 

In examining the Abraham Accords countries, the UAE has considerable pharmaceutical production capabilities, including vaccines with proven scale-up potential. Recently, G42 Healthcare, an Abu Dhabi-based company, signed a letter of intent with AstraZeneca, a leading global pharmaceutical company, to expand their collaboration into the domains of diagnostics and clinical research. Morocco is quickly becoming a pharmaceutical manufacturing hub for the African continent, and many leading American pharmaceutical companies already maintain offices in Bahrain. Israel, of course, is renowned for its startup culture and game-changing life sciences breakthroughs. When Pfizer’s COVID-19 vaccine rolled out, clinical trials on the Israeli population delivered the most comprehensive data to American policymakers. It became the largest real-world study of COVID-19 and helped much of the world chart safety policies. 

The path forward is clear. The United States should first open an FDA field office in an Abraham Accords partner nation. The office could focus initially on technical assistance that would benefit the local healthcare ecosystems and serve as a fulcrum to drive new cooperative arrangements. Next, there must be a program to incentivize investments into local product development that can help fill market gaps in America. The FDA can then identify opportunities for greater American private sector investment into local research and development while accelerating our ability to lessen the Chinese stranglehold on the American medicine cabinet.

Pivoting our pharmaceutical supply chain away from China affords the United States the ability to reclaim control of its own drug industry and develop new technologies. The cost of production at home remains prohibitively expensive for many domestic companies and could disincentivize new drug discoveries. Bringing drug production closer to home — to the Abraham Accords countries — will strengthen America’s allies, reduce costs for medicine, and save American lives. 

Heather Johnston is the founder and chief executive officer of the U.S. Israel Education Association.