Why Europe’s vulnerability in the face of China also extends to medicines. A removed appeal

The health of European citizens cannot be decided in Beijing. When it comes to strategic autonomy, the European debate focuses on semiconductors and rare earths. Yet the most insidious vulnerability concerns active pharmaceutical ingredients. Eleven health ministers wrote this in an open letter that went largely unheeded: dependence on Chinese active pharmaceutical ingredients is the weak point in Europe’s defences. In Europe, medicines are formulated and packaged: the factories are here. But further up the supply chain, it is Chinese. A stress test on 56 essential active pharmaceutical ingredients (APIs) shows that only 26 are low-risk, whilst for 20, a disruption would have serious consequences, particularly for essential antibiotics, many of which form the basis of widely used medicines. For metformin, the risk associated with its precursors rises to 83 per cent; for amoxicillin, to 71 per cent; and for cefpodoxime, to 94 per cent. The limits of European pharmaceutical autonomy are more constrained than we realise.

It is no coincidence; it is a strategy. For decades, Beijing has been building a protected industrial base: over three million euros a year in subsidies per company, tax incentives of up to 175 per cent, and 96 per cent of public tenders awarded to local manufacturers. Now it is focusing on innovation: patents have risen by 440 per cent since 2013, whilst licensing agreements have surged from 52 to 157 billion dollars in a single year. So far, China has not used this leverage as a weapon, but it may decide to do so. Europe must treat pharmaceutical security as a key aspect of European defence. The Critical Medicines Act is a step, not a plan. The top priority is to safeguard the remaining production capacity, with procurement contracts that reward resilience. Next, we must diversify through joint investments and partnerships with third countries. Finally, we must support innovation, without cutting off cooperation with China but without leaving it to chance.