Dependence on China and India for Medicine Ingredients: A Supply Chain Risk

Most people never think about where the active ingredient in their tablet was made. But that question sits at the heart of today's medicine shortages. A February 2026 House of Lords report found that most active pharmaceutical ingredients used in NHS medicines are sourced from China, India or other single sources.

Why production became concentrated

Over several decades, manufacturing of active ingredients and generic medicines moved to countries with lower costs and large-scale chemical industries. That kept prices low for health systems, including the NHS, but concentrated risk in a few places.

How concentration causes shortages

• A quality problem at one plant can affect supply in dozens of countries.

• Export restrictions or geopolitical tension can cut off supply suddenly.

• Shipping disruption can delay ingredients for weeks.

• Low prices leave little incentive to maintain backup suppliers.

What governments are doing

The UK government has said it is investing more in domestic manufacturing. The EU is pursuing its Critical Medicines Act, and the US is using tariffs to encourage production at home.

What buyers can do

Individual pharmacies and clinics cannot rebuild global manufacturing, but they can reduce their own exposure by using several suppliers and keeping close to the market. Acorn Pharmaceuticals helps customers source alternatives when a supply chain breaks.