There is one thing the Coronavirus Pandemic has brought to everyone's attention. The United States is far too dependent upon China and other Asian countries for our drugs and medical equipment.

I am calling upon the President and Congress to create a Strategic Medical Stockpile, (SMS). This is a matter of National Security, to protect the health and lives of Americans. The SMS would be like our Strategic Petroleum Reserve, it would be drawn down for use in the United States when there is a disruption in the supply chain of critical medical supplies. Generally, the SMS would provide a supply of our most necessary prescription drugs, Active Prescription Ingredients, (API) and medical devises, for a period of time until U.S. manufactures could obtain the necessary materials to provide our supplies.

Since the 1990s, U.S. companies have increasingly imported pharmaceutical products from China and India. The ingredients and labor are cheaper, and regulations are fewer in those countries. Result, we are now heavily dependent upon these countries for our drug and medical supplies.

The basic facts about our supply chain of drugs in the county is:

1. China is a large exporter of drugs, biologicals, (drugs from natural sources) to the U.S.
2. China is the largest supplier of medical devises.
   1. Class 1: Bandages and Gloves
   2. Class 2: Scissors, forceps and other surgical supplies
   3. Class 3: Pacemakers and ventilators
   4. Class 4: Imaging Devices
3. About 80 percent of Active Pharmaceutical Ingredients come from China and India
4. The U.S. relies upon China for 90 percent of our generic prescription medicine
5. India provides over 40 percent of the over-the-county drugs to the U.S.
6. India depends heavily upon China for the ingredients in their drug production

From a supply chain perspective, India is dependent upon China. Factories in China have been closed to deal with the coronavirus, so India has been forced to slow production of its products coming to the U.S. Further, the Indian government has stopped the export of twenty-six pharmaceutical products, mostly antibiotics to ensure adequate supplies remain in their own country. This decision makes drug shortages a potential here in the U.S. particularly, antibiotics.

We know the Federal Drug Administration, (FDA) has asked drug companies to evaluate their supply chains with China and India and take steps to mitigate potential shortages. The question is, are U.S. manufacturers gearing up to compensate for the foreign shortfalls. Do we know the time required to start up production and to make an impact on the U.S supply for prescription and OTC drugs?

The dependence upon foreign countries for drugs in not the only medical supply item impacted. There are major medical devices that are manufactured in China. Firms in the medical devise manufacturing industry produce diagnostic, medical monitoring, and treatment equipment. Surgical masks are also predominately made in China, and testing kits are made in Europe. Finally, the Center for Disease Control warns that we are in short supply of masks and testing kits.

The United States needs to ensure that the American people are provided for in times national health emergencies or other national impactful health events. The Department of Health and Human Services, (HHS) should seek Congressional approval and funding to create a Strategic Medical Stockpile, which is constantly replenished and kept separate from the Strategic National Stockpile. I have listed six steps to set up the Strategic Medical Stockpile, and I encourage you to evaluate my solutions. https://www.realsolutionsfortn.com/strategicnationalmedicalsupply

George S. Flinn, Jr., MD

Republican Candidate U.S. Senate