Europe’s dangerous medicine dependency is the Achilles heel of its defence strategy

With geopolitical tensions rising, globalisation can have threatening side effects. Especially when it comes to essential goods.

Imagine, for example, that the supply chain of antibiotics is interrupted in the midst of an escalating conflict. This is not a far-fetched scenario. 80-90% of the world's antibiotics are made in Asia - mostly China.

Without these essential medicines, routine surgeries become high-risk procedures, and easily treatable infections could turn fatal. It is easy for foreign actors to turn this dependency into a critical vulnerability — one that could severely undermine Europe’s security and defense capabilities.

Without antibiotics, our health systems would simply collapse.

Once a leader in medicine production, Europe now depends on Asia for 60–80% of its pharmaceutical supply. Price pressure on cheap generics, along with higher labour and environmental costs, are the main drivers of this shift.

However, this relocation has left Europe exposed. The COVID-19 pandemic underscored the risks, with hospitals across Europe facing critical shortages of essential medicines, including muscle relaxants needed for emergency intubation.

Even today, all European countries struggle with medicine shortages, largely due to fragile supply chains that rely on long, complex value chains and just-in-time deliveries.

Why is the Critical Medicines Act so important?

In response to persistent medicine shortages, EU member states called for a Critical Medicines Act in May 2023.

The goal of the act is to map vulnerabilities in the supply chains of critical medicines, support European production and diversify supply chains. The act should also improve the overall sustainability of the (generic) medicine market, with procurement criteria that reward the sustainability of production and security of supply.

The Critical Medicines Act is set for release this week. However, since our call in May 2023, geopolitical realities have shifted fast: security has now become the main priority for European leaders.

This security paradigm should encompass health care systems and pharmaceuticals. Several medicines, including antibiotics, anesthetics, and thrombolytics, are not only vital for civilian healthcare but also for military and emergency scenarios.

It is therefore imperative that the EU integrates the act into Europe’s broader security framework, similar to how the United States’ Defence Production Act designates pharmaceutical supply chains as a national security issue.

The DPA enables the US government to map critical pharmaceutical supply chains, identify vulnerabilities, and direct investments to strengthen domestic production. It also allows authorities to issue priority-rated contracts, which require suppliers to prioritise government orders, ensuring that essential medicines are delivered without delay during crises.

In a similar vein, the European Commission must accelerate efforts to map and assess vulnerabilities within the supply chains of these strategic critical medicines. If weaknesses are identified, Europe must be able to act decisively and ramp up domestic production where possible.

Health can't be treated as a secondary issue

The Critical Medicines Act must act as a robust instrument. Part of its funding should be embedded in broader EU defense spending plans, including the financial mechanisms in the new defence package. After all, without essential medicines, Europe’s defense capabilities are compromised.

Moreover, the Act must address Europe’s fragmented approach to the stockpiling of critical medicines.

A coordinated European approach — based on transparency, cooperation, and solidarity — is needed to ensure that essential medicines are available when and where they are needed.

Europe can no longer afford to treat medicine security as a secondary issue. The Critical Medicines Act must be expanded into an effective, full-scale strategic programme, backed by EU defence funding, to secure the continent’s strategic autonomy.

Anything less would be a grave miscalculation — one that could turn our dependence on critical medicines into the Achilles heel of Europe’s security.

Frank Vandenbroucke is Deputy Prime Minister and Minister of Health and Social Affairs of Belgium; Vlastimil Valek is Deputy Prime Minister and Minister of Health of Czechia; Spyridon-Adonis Georgiadis is Minister of Health of Greece; Hosam Abu Meri is Minister of Health of Latvia; Mónica García Gómez is Minister of Health of Spain; Karl Lauterbach is Minister of Health of Germany; Ana Paula Martins is Minister of Health of Portugal; Riina Sikkut is Minister of Health of Estonia; Marija Jakubauskienė is Minister of Health of Lithuania; Valentina Prevolnik Rupel is Minister of Health of Slovenia; and Michael Damianos is Minister of Health of Cyprus.