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OPINION:
During the Opium Wars of the 19th century, Britain and other Western nations humiliated a weakened China by forcing the import of harmful drugs on its population to make a fast buck. We are not proud of that chapter in our history and would not today repeat it.
The Chinese seem to have taken a different lesson from that history. Xi Jinping, the communist Chinese leader for life, has embarked on his own 21st-century opium war against the United States.
The flow of opioids and counterfeit drugs into the United States is perhaps retribution for a long-ago defeat. More ominously, it is an asymmetric assault on a strategic American vulnerability: our medical supply chain.
China understands that dominating or corrupting that supply chain gives it strategic leverage for its hegemonic ambitions.
The downstream effects are visible on the streets, where fentanyl kills twice as many Americans in one year as the number who perished in a decade in Vietnam. Americans are now dying from illicit and unverified drug compounds that have made their way into the supply chain, placed there with counterfeit corporate and chemical makers that China has slipped into our system, often through drug cartels. So pervasive is this infiltration of the American medical market that Novo Nordisk reports numerous deaths and hundreds of hospitalizations from the use of compound copies of everyday weight loss and diabetes drugs.
The Partnership for Safe Medicines notes: “Consumers remain largely unaware that, unlike prescription medicines, these knockoffs are not Food and Drug Administration-approved and they’re not generics. Our report reveals these knockoff GLP-1s (compounds used to lower blood sugar levels and promote weight loss) may contain active ingredients from unregulated, overseas manufacturers that are not … suitable for human use.”
There is no medical rationale to still be buying these products from China; the Trump administration says there is no longer a shortage of the compounds. FDA-approved drugs are now being manufactured in the U.S. in record numbers.
China is using social media platforms to market knockoff drugs that resemble legitimate products to lure potential patients and circumvent conventional commercial processes.
Veterans, whom I was proud to serve as secretary of veterans affairs, are a population vulnerable to online offers of GLP-1 knockoffs. Men and women who have served in the military, where physical fitness was encouraged and supported, often find some of those positive habits more difficult to maintain once they are out of the service. Legitimate FDA drugs, under the supervision of a doctor, can be effective, but access restrictions in the Department of Veterans Affairs medical system and wait lists for veterans, even those who are eligible, make turning to the low-cost knockoff market tempting. Reference to veteran status — such as thanks for military service and offers of a “veterans discount” — are often explicit in the advertising.
China subsidizes the manufacture of these knockoff products and actively thwarts investigations into its activities. It is adept at playing the regulatory cat-and-mouse game with sclerotic federal enforcement agencies. Once an alarm is sounded, the Chinese rename the suspect company, change drug transshipment routes and clog the system with paperwork. Only 25% of Chinese drug firms are subject to FDA inspection, and those are the ones with some legal status. The rest are outside FDA controls.
President Trump has moved to shut the door at the border, but he must now expand import alerts and automatic detention for drugs from unregistered or un-inspected facilities.
To protect America, rebuild our biotech edge and end dependence on foreign inputs, particularly from China, Mr. Trump can drive a full-spectrum “America First” agenda that brings discovery, clinical trials, API manufacturing and fill-finish back to our country. We still have time before someone utters the most lamentable words in the language: “Too late.”
• The Honorable Robert Wilkie served as the 10th secretary of veterans affairs and undersecretary of defense for personnel and readiness in the first Trump administration.
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