The unfulfilled dream of drug reshoring

This month, the Joe Biden administration awarded $14 million to the API Innovation Center, a Saint Louis–based nonprofit that aims to remedy supply chain problems for active pharmaceutical ingredients (APIs). The organization will use the funds to produce APIs used in medications for asthma, anxiety, and diabetes—molecules that have been imported from China and India for years. The center is hardly the first group to be concerned about overdependence on APIs from these countries. In October 2019, Janet Woodcock, then the director of the US Food and Drug Administration’s Center for Drug Evaluation and Research, warned a House of Representatives subcommittee on health that the number of API facilities in China had more than doubled since 2010. Months later, when the COVID-19 pandemic put the world under lockdown, the repercussions of reliance on China became evident. When that country halted production and paused shipments, US citizens faced drug shortages. No