We are so dependent on Asia for medicines: 'If something goes wrong there, we will be without paracetamol'

Our "medicine supply" has changed significantly in recent years. While we used to produce many medicines in Europe, we've now become heavily dependent on Asian countries. This entails risks, especially in times of geopolitical tensions.

A shortage of medicines could have major consequences for healthcare and patients in the Netherlands. Chemotherapy, antidepressants, antibiotics—almost every medicine starts in a Chinese factory. This makes us more vulnerable than you might think. Should we be worried?

Not only are cheap products, such as clothing , much cheaper in China than here in Europe, but medicines are also produced there at a lower cost. EenVandaag investigated why we are so dependent on these suppliers. "Asia is now the largest supplier of our medicines. Many of the medicines we consider essential or critical are no longer produced in Europe. Moreover, we hardly maintain any stocks, making us vulnerable in the short term to threats that certain medicines will no longer come our way," says health economist Xander Koolman.

Price plays a major role here. Dutch pharmaceutical manufacturers often lose out to producers from China and India by a few cents per package. This results in increasingly less competition globally, as the largest and most efficient manufacturers—who can produce at a fraction of the cost—capture the entire market.

This dependency can become problematic, especially if it's used as leverage during geopolitical tensions. Koolman emphasizes: "Although this is being discussed in Europe, in countries like the Netherlands, it doesn't lead to different procurement policies or a greater willingness to make financial sacrifices for guarantees." According to the health economist, less dependency could be achieved through subsidies or import tariffs, but both cost the Dutch extra money.

Toine Peters, professor of pharmaceutical sciences at Utrecht University, also expressed his concerns to NU.nl : "If Xi decides tomorrow to stop supplying raw materials for antibiotics for strategic reasons, we'll all have a problem. This dependence on India and China is enormous." With ibuprofen and paracetamol, we're talking about a dependency of, for example, 80 to 90 percent.

But it also applies to life-saving medications. Take cytarabine, a chemotherapy drug for leukemia. For that, we are 100 percent dependent on China.

Metro previously reported on concerns that certain medications might become unavailable in the worst-case scenario. The Amsterdam-based Antoni van Leeuwenhoek Institute, known as the Netherlands Cancer Institute, has already found several times that some chemotherapy treatments are becoming less available. "It's something we're concerned about. Classical chemotherapy is still the most effective treatment for many cancer patients. But it's no longer produced in the Netherlands or the European Union," a spokesperson said.

"For the production of generic medicines like paracetamol, antibiotics, and some chemotherapy treatments, we are 80 percent dependent on raw materials and medicines from China and India. Because of this dependence, we assume that shortages will occur more often and that this won't be resolved overnight," says the institute spokesperson.

Peters mentions scenarios in which the Netherlands would run out of medicines. "Every year, there are significant shortages of hundreds of medicines due to production and delivery problems. During the COVID epidemic, but also, for example, the ship that got stuck in the Suez Canal, and then you immediately see problems arise," Peters emphasizes.

This is a headache, because if something goes wrong in China, like a lockdown or a factory fire, we'll be without paracetamol. Or what about a trade war or conflict? Entire treatments would come to a standstill.

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