When the covid-19 pandemic broke out, the world discovered that the production of essential medicines was concentrated in very few hands. Three years later, that dependence remains a headache for many governments, but it has also sparked a race to reshape the global pharmaceutical map. The production of active ingredients — the components that make a drug work — is still dominated by a handful of countries, and that has led to a new wave of public policies aimed at diversifying suppliers.
More than 60% of the active ingredients consumed worldwide are manufactured in just two countries: India and China. This concentration is now seen as a strategic risk.
The dependence no one wanted to see
For years, pharmaceutical globalization was based on efficiency: produce where it is cheapest and distribute to the whole world. That allowed accessible prices, but it also created vulnerabilities. When factories shut down during the pandemic, wealthy countries realized they couldn't manufacture even the most basic drugs, like paracetamol or antibiotics. Since then, the European Union, the United States, and several Latin American countries have launched programs to relocate part of the production, although the process is slow and costly.
The role of artificial intelligence in the new pharma
Artificial intelligence is entering the pharmaceutical industry not only to discover new molecules, but also to optimize manufacturing. Machine learning systems can predict failures in production lines, adjust parameters in real time, and reduce waste. Additionally, some companies are using algorithms to design more efficient synthesis processes, which could shorten the supply chain and allow complex drugs to be produced locally. Although it is still an emerging trend, governments see it as a tool to strengthen their health autonomy.
What is an active ingredient?
It is the component of a medicine that produces the therapeutic effect. Without it, there is no drug. Its manufacturing requires high technology and strict quality controls, which is why it is highly concentrated.
Latin America: between opportunity and urgency
In Latin America, the pandemic left a bitter lesson: when the world closed borders, the region depended on imports for 80% of its medicines. Today, some countries are promoting regional agreements to produce vaccines and generics, taking advantage of installed capacity in Brazil and Argentina. However, the lack of investment in research and development remains an obstacle. Experts point out that regional cooperation is key to avoid repeating past mistakes.
The risk of a new inequality
While wealthy countries can afford to relocate production, low- and middle-income nations risk being left behind. The World Health Organization has warned that the concentration of manufacturing capacity in a few countries could exacerbate inequalities in access to essential medicines. Therefore, international bodies and NGOs are pushing for the new health autonomy policies not to become a luxury exclusive to advanced economies.
What does this mean for the world?
The reshaping of pharmaceutical production is not a passing trend: it is a structural response to a more fragmented world. In the coming years, we will see countries seeking a balance between efficiency and security, and how technology, including AI, can help make manufacturing more agile and decentralized. The challenge will be to ensure that this new geography of medicines leaves no one behind, because global health is a common good that cannot depend on just a few nodes.