There are two sets of data on exports of medicines. One set measures the amount of medicine sent to the United States, while the other measures the value of the medicines imported. The value data set reflects the high prices of some medicines, as well as the tax avoidance strategies adopted by pharmaceutical corporations. Some firms move their legal homes to countries with low taxes, and then charge their old base countries patent licensing fees, which can be deducted as a business expense. These two sets of data are used to create an infographic showing the top ten import sources.

India

One of the largest exporters of medicines in India. The country is one of the top producers of antiretrovirals. It supplies 80% of the anti-retrovirals used globally. China has been shutting down many of its factories due to a coronavirus outbreak, which has caused a shortage of essential ingredients. Besides, Indian pharmaceutical firms had already stockpiled ingredients to meet demand during the lunar new year, but the shortages have already started.

While most of the factories are covered until the end of March, the shortages may have long-term impacts on the global availability of some of the most widely used medicines.

India’s pharmaceutical industry started in the late 50s and early 60s, out of a need to meet local shortages of medicine and reduce costs.

Then, many large multinational companies (MNCs) began manufacturing medicines in India. In the late eighties, India began to expand its market internationally and has since enjoyed steady growth. At present, India is the third largest exporter of medicine in the world. In terms of volume, India produces around 40 percent of the world’s generic medicines and 20 percent of its vaccines.

The Indian pharmaceutical industry has enjoyed a strong growth trajectory in recent years, despite a decline in the economy. The industry has seen a 13 to 14 percent increase in the last five years, compared to 9 percent between 2000 and 2005. However, most growth drivers are keeping up with the projected growth rate. There have also been recent launches that have shown the true potential of patented products. The recent decline in GDP growth has hampered the industry’s progress in the global arena.

China

The largest market for Chinese medicines is Africa, which has over 900 million people and accounts for 12 percent of the world’s population. The region has traditionally had little access to medical care, but Chinese medical producers are changing this situation. Exports of medicine from China to Africa are growing faster than those to Mexico, Southeast Asia, and other countries. The country has a growing demand for prescription medicines. For this reason, African countries have turned to Chinese medicines to meet their medical needs.

The growth of Chinese medicine exports is mainly due to its low cost of production and high quality.

As a result, they have to slash prices to gain market share. Despite this, Chinese exports to the world have consistently increased. In fact, China’s share of medicine exports has increased by almost half in just over four years.

Although China is the largest exporter of medicine, its terms of trade do not reflect its position as the world’s largest manufacturer of medical products. Although China is not explicitly blocking the export of pharmaceuticals, the country has halted exports of face masks due to a government order. Because of this, Chinese manufacturers have no face masks to sell. Meanwhile, transportation restrictions and factory closures have disrupted medicine supply chains. During a pandemic, China’s production is vital. If the epidemic of COVID-19 continues to spread, the world could face a drug shortage.

United States

That scale is the key to China’s success in the world market. Recently, a group of senators called on the Defense Department to evaluate the national security implications of dependence on Chinese medicines. The senators asked the Defense Department to protect the health of millions of Americans by increasing domestic pharmaceutical production.

Medical equipment is a key source of imported goods for the U.S., with imports accounting for 30% of the country’s total demand of medicine.

Medical equipment exports represent approximately 20% of gross domestic product. Over time, the U.S. has become increasingly dependent on foreign suppliers of medical equipment, with a 7% deficit in 2012 and a 14% deficit in 2018.

Medicine imports from the Netherlands and Germany represent the largest proportion of total global exports.

While the Netherlands and Germany were the biggest sources of imported medicine in the past decade, they are not the only countries that export medicine to the United States. China (mainland) and the Netherlands ranked second and third, respectively. In terms of value, the Netherlands, Japan, and China (mainland) were among the top five nations for medical equipment imports.

Despite these risks, the United States is still the world’s biggest exporter of medicine. Its trade relationship with China is adversarial, but it is unlikely to stop any major disruptions. Moreover, it is not prepared to address any minor disruptions in medicine supply from China. And China is a major source of antibiotics, including penicillin and heparin. This is because its domestic manufacturing capacity is far smaller than China’s.

Germany – Medicine

Since 2011, the U.S. has been the biggest supplier of German pharmaceuticals and medical technologies. Last year, German exports of medical supplies and pharmaceuticals totaled $2.2 billion. Increasing demand has resulted in greater regulatory hurdles, but the U.S. continues to be the world’s leading supplier of medical technology and medicines. Germany’s exports of medical technology and medicines have increased by 18 percent since 2010.

In 2018,

the German pharmaceutical market was worth USD 76 billion, accounting for 15.6% of the total health expenditures of the country and 2 percent of its GDP. Over eighty percent of this total was prescription medicines, and 69 percent of that was attributed to patented drugs. In the next few years, the market is forecast to grow at a CAGR of 4.1 percent in both euro and USD terms, with chronic disease and an aging population serving as the primary drivers of growth.

In addition to pharmaceutical products, Germany is the biggest exporter of medical equipment. Its trade in medical equipment reached EUR 50.2 billion USD in 2018. This represented twenty-one percent of the entire market. Despite this, Germany’s trade deficit with the US fell from EUR 46 billion in 2018 to EUR 49 billion in 2021. The Netherlands and Belgium had the largest trade surpluses of pharmaceutical products, while Germany’s trade deficit with the United States was less than half that amount in 2021.

The German market is also a large one, with robust medical equipment production & medicine.

Companies like Siemens, Carl Zeiss, and Dragerwerk are prominent in this sector, focusing on optical technologies and precision medical instruments. Today, Germany is the world’s third-largest market in the area. Its market for medical technology is three times bigger than that of the United Kingdom. The government also funds many research and development projects, and its annual Healthcare Technologies Resource Guide is a useful reference for businesses interested in selling medical products in Germany.

Africa – Medicine

African economies are becoming the largest exporters of medicine, and global pharmaceutical companies have to take note. The continent is home to many small pharmaceutical companies and an estimated 4.5 million people. The region is one of the fastest-growing, and pharmaceutical companies are looking for local business partners to help them navigate its complexities and diverse markets. Local partners understand consumer preferences, manufacturing and distribution infrastructure, and regulatory environments. In addition, partnerships with governments play a significant role in the development of medicine in Africa, including guiding research priorities, securing funding, and providing equipment and training to hospitals.

In 2012, China was the largest exporter of medicine to Africa, while the US ranked far behind 2012.

Since then, however, the volume of trade has never surpassed the 2012 level. In addition to medicine, Africa also exports protective equipment such as sterile containers and has developed advanced manufacturing and regulatory infrastructure.

With so much soaring demand for medicine, the continent should increase its investment in public health. Public-private partnerships could provide a broader range of medicines to developing countries. Currently, most African countries are far from the 15 percent target set in the Abuja Declaration, with only Tanzania surpassing it last year. Afreximbank, a pan-African tech company, and the African Centres of Disease Control and Prevention have partnered to develop a platform to facilitate the export of medicine to Africa. Afreximbank will handle payments and logistics partners will ensure timely delivery.

In the aftermath of the COVID-19 pandemic medicine,

African pharmaceutical companies stepped up production of critical supplies, despite the continent’s reliance on external suppliers. With global shortages, disruption of supply chains, and export bans, African pharmaceutical companies are increasingly stepping up their game to meet the continent’s need for vital medicine. Leaders of African countries can decide which production capabilities are essential for the continent and which industries to support. Investments in regulatory capacity development and convergence and harmonization of medical products regulation should be prioritized.