Geopolitical Impacts on US Drug Shortages and Supply Chain Mitigation Strategies

The stability of the United States' pharmaceutical supply chain is increasingly threatened by evolving geopolitical dynamics, with significant consequences for public health. As the majority of raw materials and finished pharmaceutical products are sourced from foreign suppliers, global disruptions, including trade disputes, export restrictions, and regional conflicts, have created a fragile and often unpredictable landscape for drug availability in the U.S. market. Events such as the U.S.-China trade tensions, the COVID-19-induced export bans in India, and shipping disruptions in the Middle East have repeatedly illustrated the extent to which geopolitical volatility can undermine pharmaceutical supply continuity. These disruptions result not only in shortages of essential medications but also in heightened financial burdens on healthcare providers and increased risks to patient safety due to delayed treatments or the use of suboptimal therapeutic alternatives. Against this backdrop, the imperative to mitigate the effects of geopolitical shocks has gained prominence across policy, industry, and regulatory domains. This paper examines the intersection of geopolitics and drug supply chain management through a systematic analysis of disruption patterns, causative geopolitical factors, and the effectiveness of existing and emerging mitigation strategies. Employing a mixed-methods approach, the research integrates quantitative analysis of drug shortage data with qualitative insights derived from stakeholder interviews, policy reviews, and case study evaluations. It identifies how supply concentration, reliance on limited geographic manufacturing hubs, and lack of real-time transparency contribute to systemic vulnerabilities. Furthermore, the study presents and analyzes four core mitigation strategies: diversification of suppliers and production sites, expansion of domestic manufacturing capacity, the development of national strategic drug stockpiles, and the deployment of real-time visibility tools for proactive risk detection and management.