former vice president joe biden holds a town hall today ahead of missouri's presidential primary. that event is starting at 1:00 p.m. eastern and you can watch online at c-span, c-span.org, or listen live on the free c-span radio app. on sunday, bernie sanders held a rally in grand rapids michigan ahead of the presidential primary. watch live at 12:30 p.m. eastern c-span.org,nline at or on the c-span radio app. we are back in joining me now is rosemary gibson, the author of china, exposing the risk of american independence on china for medicine. first of all, thank you for being with me again. >> is great to see you again. >> tell us about your medical

background. >> i am not a physician but i happened to spend three years researching and figuring out where our medicines are made and it is a shocker about how dependent we are on china for so many of our drugs. >> you are also an advisor at the hastings center. tell us about what the hastings center is any the type of research you do. >> the hastings center is a think tank and we do a lot of and on ethical issues availability of good medicine is one of those. -- let's talkut about coronavirus. >> everybody is talking about coronavirus. >> tell us your assessment of the coronavirus right now. do have an issue with coronavirus cases popping up around the country and we have to be careful, do all the things we should do, wash our hands, not go out if we are sick, let's

hope that it passes quicker and we can get back to normal life again. >> the subject of your book is china makesct that a lot of the medicine. >> wesley the ingredients to make them. they have a global chokehold. we have a global pandemic, and now -- >> with china making a lot of the ingredients or our medicines in the united states, are we numbera down take in the in the amount of medicines coming out of china to the united states right now or is it too early to tell? >> look at it this way. production is shut down in china, particularly in areas where the coronavirus has hit badly, like in wuhan, that is a hub for making a lot of chemicals for antibiotics. that is a problem.

then you have a lot of transportation routes being blocked. this is serious business. we predicted this in china rx. in the event of a natural disaster or global health emergency, if the doors were shut on china exports, we could be having problems -- and these are the basic medicines, the ones that 90% of our netizens are generic, this is what makes hospitals one every day. >> on wednesday, a doctor was asked about concerns over drug shortages in the united states and china's role in manufacturing these drugs. here is what he said. factam concerned about the as we have had the conversation previously about this, be number of drugs made, active --redients made, i would add >> we will get back to that tape in a minute.

ingredients do we depend on from china right now? are we seeing those ingredients vanish? chinat we are seeing is has a dominant global market share on antibiotic components. these are antibiotics that treat infectious diseases caused by bacteria. they would not help the coronavirus because they are bacterial infections. the fda did announce the first shortage of a medicine directly because of coronavirus and i'm told by those who work in hospitals that it be an antibiotic. we are seeing the affects of it right now. we have had drug shortages for 20 years. now we add coronavirus on top of that, where the need is greater for ushering we have medicines. i can better china is withholding supply of exports

because they need is medicines for their own people. , one ofve a question our viewers who wants to know -- let me see if i can pull this up. why are we dependent on china for making the ingredients for pharmaceuticals? why can't we make our own? labor costs, availability of resources? >> that is a great question. we started becoming dependent on china for the court chemicals in the 1990's and it ramped up in the early 2000s where the u.s. opened free-trade with china, tariffs came down. that is when we lost our last penicillin plan. we cannot make penicillin anymore and generic antibiotic router not made. cannot make vitamin c anymore. who knew our trade laws would have such an impact? that is where we are now. we can make them here, but china has cheated on trade, fixed

prices, troll -- control supply. plus the chinese government is subsidizing chinese companies. you have american companies competing not with tiny companies, but with the chinese government. youcan we -- we can make medicines here and that is what i have been working on the last couple of months. the number of people who reached out to me who are smart people who know how to make medicine, they want to start small companies and we can do this. we can do it, and with new technology, advanced manufacturing technology, we can make them cheaper here in the united states. labor costs are lower. we have been making medicines the same way for a hundred years. the way we make potato chips is more advanced than how we make our medicine.

technologybring this to making medicine and the united states, medicines that are important for our health and national security. host: how long would it take to for thesee production medicines in the united states as opposed to depending on the ingredients coming from other countries? and another question, why china? why is tyler the hub and not india, not england, not nigeria, why china? goal that weset a will become a pharmacy to the world and they have a whole plan or how to do that. to their credit, they are executing it and have ramped up quickly. if you are a country of more than a billion people, you need edison. quicklyare accelerating to become that global pharmacy

to the world to the point where genericia, the biggest maker in the world, and yet depends on china for the core components. wen china shuts down, as have seen with coronavirus, it affects everybody. host: our viewers can take place in this conversation. lights,open up regular that means democrats, your number will be (202) 748-8000, republicans will be (202) 748-8001, independents can call in at (202) 748-8002, and we will open up a special light for medical professionals. i want to hear what you are seeing in pharmacies, hospitals, doctors offices. are you not being able to fight medicines? we want to hear from you specifically, medical professionals, your number will be (202) 748-8003. you can text us your questions

and comments at that same number, (202) 748-8003. we are also reading on social facebook.witter and you have said this line specifically earlier. i remember this live from our last show. you said it is nobody's job and the federal government to know who controls our drug supply. we had this conversation eight months ago. is that still true? fda is working as fast as i can to figure out where these court chemicals are coming from, where they are made, and we have alternative sites? this should have been done years ago. we have not been prepared. now we are trying to play catch-up. we can makeis that

medicines in the united states so we don't have to worry about this next time we have a coronavirus or whatever the next thing will be. we can fix this at there will be hearings next week and congress and i hope that we can talk about the kinds of solutions that we can implement. if there was money, we could implement solutions to bring back medicine making for those essential medicines needed to care for people. here is an interesting data point. let's take people who are hospitalized with coronavirus, and that is a small percentage. they had to be cared for. you need sedatives, you need pressers, you need antibiotics in case they get a secondary infection. i asked a group of people making medicine, these are the men and women in the manufacturing plant, how dependent are we? what percentage of those

ingredients to make those medicines to care for people, how much of them come from china? we went around the room and everybody said 90%. 90% of the ingredients to make the essential medicine to treat people with coronavirus. not cure them, just care for them. we depend on china. we have a strategic decision to make as a country. continue down the same path, which will worsen, we will get more dependent, or we can began to bring some of that manufacturing back home and do it cheaper. we can sell medicines cheaper than we do now with advanced manufacturing technology. the doctor see what sat in front of congress this week about drug shortages in the united states and china's role in manufacturing those drugs. [video clip] >> i am concerned about the fact that as we have had the

conversation previously about this, the number of drugs made, active ingredients made, i would add medical devices, in places like china, do we really know what that you play chain is with various companies? we did a letter this morning to the top 20 prescription drug companies asking this question. do we keep track of this anywhere to know how many of the drugs are made in places like china and where we could be for potential shortages in a case like this? >> i believe the fda does and the fact you are concerned is one we had been talking about as part of pandemic preparedness for years when we put together 2005, we said one of the problems is supply chain. impressed/shocked that something like 90% of the fundamental ingredients that go into many of the drugs -- not

the actual drug itself -- comes from china. that is a problem. i don't have an answer. it is not anything we do, but something that impacts us. be tracking active ingredients and medical devices as well? >> i would imagine yes. that is out of our purview. thank you. host: go ahead and respond to the doctor and what he said. guest: we should have been prepared a long time ago but one good news is it is china rx that broke the story and it took three years to figure it out because it was so hidden. finally, it is out of there about how dependent we are at we are trying to scramble in the moment, but i hope this is the moment when we decide we have to bring some of this medicine making back home so we are not dependent on any country. any country that has a public health emergency or natural disaster, people keep their medicines at home. whether it is europe or canada.

we have to realize that and make sure we could take care of our own people. host: let's get our phone lines and let our viewers join in. from start with jody michigan on the democratic line. good morning. caller: good morning. my question was, what is needed to get the funding for the pharmaceutical companies to get started? need?a legislation an executive order? the second part of that, what would be the timeframe echo our pharmacy companies geared up on the manufacturer and to provide these ingredients that are needed for us? that wea silver lining are aware of this? of all the things that have come out of this, this is something that might promote the united states to become the center at

have a positive impact out of all of this devastation that has cause for many families. guest: i think you are so right about this being a silver lining that we have an opportunity to know where we are vulnerable. it is no secret anymore. what it will take is some funding for rebuilding some of our manufacturing base. it collapsed over the past 25 years. dobbs have shut down, have moved to china and other countries. we have to rebuild some of those plants and the ones that are still standing, we have to refurbish them. if we can use advanced technology, it takes a smaller physical space, smaller environmental footprint, we can make them more efficiently. it will take some funding on the infrastructure side.

i think the real innovation will come from the smaller companies. one of the interesting things to think about, who are the western generic drug makers now? largest u.s.-based drug maker generics and they merged with pfizer, so they are based int -- they were west virginia. ,hen we have european companies we are seeing that they have been discontinuing products in recent months because they cannot compete with china because their companies are being subsidized by the chinese government. when we talk about pharmaceutical companies, generic drugs are the new orphan drugs. the big pharma companies are not interested in these products, making them, because there is not that much margin.

they can make more margin in the innovator products, brand-name products. if the good news is there are smaller companies that are innovative, don't have legacy looking at this, and say, let's bring this new technology and make our medicines here. how soon can we get going? companies i talked looking at td start within days to begin to make the active ingredients here and make all those active ingredients totally in the united states shortly thereafter. it takes some money to good people that want to do it right, but it cannot be tax credits and hope something happens. we have to be targeted and specific that whatever we fund, companies have to produce products cannot make generic drugs in the united states to help us meet our national security needs. host: i want to read from a story that came out from cbs earlier.

the fda on thursday said that for the first time since the outbreak, it drugmaker reported a coronavirus-related shortage right undisclosed drug because they cannot access enough raw components which are made in china. ,he fda did not name the drug the condition it treats, or manufacturer. the tort it is due to an issue with manufacturing of an active pharmaceutical ingredient used in the drug. the agency said, while noting there are substitutes for u.s. consumers. do we know what club this was? do we know the manufacturer, what ingredient? do we know anything more than that statement? guest: the fda did not name the drug and i think that could be for good reason. go onnot want hoarding to by hospitals if they buy all the supply. what we should be doing is whatever supply exits, it is distributed to those patients

that needed and we don't want to panic about a particular product. i can understand why the fda did it, but the reality is we have a lot of medicines now that irrespective of coronavirus, are rationed. the official term is allocating. it is under allocation. the reality is, we are rationing a central medicine, including antibiotics. let me tell you a story from the field. i was visiting a hospital and i met at ems worker, who works on ambulances to bring people to the hospital. i said, tell me what you are seeing. she said, we don't even have epinephrine, an important medicine to revive people. i said, what do you do? she said, we try to drive faster to the hospital. that is not an answer and the

american people should not be satisfied with that. that is probably not because of coronavirus, that was probably going on before this. the coronavirus is highlighted just how dependent we are on china, but how we had these shortages and allowed them to happen for 20 years. 100 plus drugs and shortage before coronavirus. how do we tolerate that? the fda does not tell us the real reason. we should know exactly why a certain drug is and shortage, who is making it, where it was being made, and the real reasons. that has been obvious stated. we need transparency from the federal government why we are not seeing these medicines at what we are doing about it. there is one entity that has started to work in dealing with drug shortages called civic rx, a nonprofit. hospitals,d by 1300 mayo clinic was one of the

leaders. they said, it is crazy to have drug shortages. how do they fix a shorter? they do what anybody else would do if they had a shortage of say tomatoes and you could not make pizza. they went out and identified trustworthy manufacturers and trustworthy countries, they paid them a fair price, not a race to the bottom price, and give them long-term contracts so they can invest in manufacturing facilities and total transparency, country of origin and cause. within a year, they were delivering injectable they come injectable vancomycin. they delivered 18 other drugs just in a year. they have 20 more lined up. shortages are not inevitable. they have been allowed to persist and it is unacceptable. host: left go back to our phone lines. on therom maryland

republican line. good morning. caller: good morning. there has been political talk around pharmaceutical companies at a preoccupation with reorganizing our health care services has treated havoc. -- which has created havoc. is there a chinese lobby to keep our american production in disruption? the other question i have, do you think universities can help in the production of needed pharmaceuticals and other things? thank you. guest: thank you for those questions. , as it ischina becoming a pharmacy to the world, sees this as a tool of great leverage. economically, politically. if you are sitting in the white house and get a call from a

chinese official say, we want you to do x, y, z, if you go to, we could withhold supply of medicine, that is an example of the kind of leverage china could use and china has threatened the u.s. government in the past in a different situation with drug shortages if the u.s. government did not do what it wanted. china is using its control of the global supply of ingredients for medicines for geopolitical purposes. that is without doubt. insofar as universities, we have to find universities that have unique capabilities in chemistry and pharmaceutical engineering. the people who cap put it together. that had the experience in manufacturing product. a talk -- it takes a lot of different skill sets. writing china rx, i developed

a healthy respect for what it takes to make high-quality medicines. some of them, with the right combination of skills, they can be part of the solution. host: let's talk to one from new jersey on the democratic line. good morning. caller: good morning. i worked for a company in new jersey, the largest pharmaceutical company in the merck they were bought by ad bankrupted. .ne of the problems is greed if you make generics, somebody will buy you out and put you out of business. i watched in my lifetime. i think what the caller is saying is a clear reality of what happens in our medicine market.

if we are going to bring manufacturing home, we have to treat it as a strategic asset, not as entities that can be bought and sold for financial purposes. we would not do this with oil, not with food supplies. we need to treat our medicines as something valuable. it is essential to the survivability of our country. that is why if there is any federal support, which i hope there is, to rebuild our infrastructure, there be contracts so manufacturers will know what is expected of them and provisions that five years from now, if china or somebody wants to buy it for a billion dollars, you cannot sell it. security national asset for our nation. we need to make medicines for our military. and for seniors and all of us. we need to treated in a way that is immune from a lot of the

market ups and downs that have contributed to our infrastructure bullies he decimated. host: -- infrastructure base being decimated. someone must know, if it is popular to make drugs and new technology, why isn't big pharma doing it? guest: here is why. if they had a brand-name drug, most of the funding that goes into that is for the rmd. for them, it is not been worth it -- it has not been worth it to invest in this technology. it is also havoc. they had been slow to the game. where there is urgency around generic drugs, there is nobody here -- we are talking about generic drugs. arelower cost products that off patent. they don't have much margin as

brand-name products do. generics are 90% of what it is we take. there is not that much margin. that is why we need new entrants who need arketplace, leg up so they can start making medicine for all of us. host: one of the things i keep hearing when you talk about medicines as a strategic asset is government. government control of medicine. is that something that we should have? should the government get theseed in controlling necessary medicines? guest: i think the government's role is to know who controls our for supply, be prepared events like we are seeing with coronavirus, and have the resources to take the action steps necessary. here is what government could and should do. core can make the ingredients in our medicines in

the united states, which we can do with chemistry and technology, make them here, from soup to nuts, then stockpile we have stockpiles, these will last longer. if we have a coronavirus outbreak or whatever the next issue that comes up, all we have have finished facilities next door, get them up and running, and within a month, you can start producing product. so we don't have shortages. that is the type of planning and preparation we need and i hope this time, there is government support to do that. we should never be caught off guard like we are now. but we are getting smarter, now we have to invest in that infrastructure and production facilities so we are ready to go. host: let's go back to our phone lines. valerie from florida on the

independent line. good morning. caller: hello. know how our government could get us in this predicament, that we have to depend on china for our medicine. this is america. we are a great country. why should we have to depend on , more than we have to depend on iran for oil? dependent off the oil, but we have to be self independent and stop and think about it. china, we do a lot of trading, i understand that. but if china -- china wanted to be the greatest and they are not. they are trying to be.

what are they putting in our medicines that could demean us so they could take over one day? caller is on point with why are we doing this? if you talk to the average person on the street, we start talking about this, people will be apoplectic. how could this be? they are right. that is the voice of the commonsense norms that need to come to washington and say we need to fix this. china andd to quality, what i am concerned , they recallfda their inspectors from china because they don't want them to get sick from coronavirus. that means there is nobody over there inspecting the manufacturing facilities that are making medicines, producing food for the united states. i think it will be a long time before the fda gets over there.

something i learned recently is that those who do inspections in china, these are highly technical people and go in these plants and they look to see if the way they are being made meets u.s. standards. highest in the world. to do that work, you volunteer. you have to go to china next week and inspect that plant. they can say, i don't want to do that. they have to volunteer. who will want to volunteer for the remainder of the year? even in the future? i also heard from thoughtful -- you are an inspector over there and this is a planned producing huge volume's of products for the united states. you are going to be the inspector that says, this product does not meet standards, so we are going to -- the fda will block it, company cannot sell it to the united states because of quality problems.

we think the chinese government will want to give you a visa time you want to do an inspection? you will not be well received. what we are seeing is globalization is a new form of deregulation. the last time we spoke, there was blood pressure medicine. medicine andssure active ingredient was made in china and it had carcinogens in it. 200 times the acceptable limit per pill. the chinese company it had a gets -- it it's medicines did not meet standards but it's old anyway. this cavalier attitude is not going to work for the foreseeable future. what i am seeing now as we learn more about this as we are seeing the beginning of the end of the fda's ability to be effective in

china. to james from connecticut on the republican line. good morning. caller: thank you very much. i want to say to the author, you are preaching to the choir. my question in this would be, do you feel that the environmental , fentanyl, a drug that can help but can kill, or happened is that what i hear is produced in india, do we have to look at the environmental regulations not by lowering them , but allowing companies if they were to open in the united states, do not be as subject to litigation, provided they meet a higher government standard? part of the reason we don't have these companies here anymore, it is easy to sue them for massive

amounts of money into that risk prevents companies from wanting a smallt it even pharmaceutical plant. i will listen to your comments on the air. thank you. guest: that is a great question. one of the reasons china is cheaper is not just because of government subsidies, but labor costs are lower and environmental regulations are not what we have here. by outsourcing, we increased the global pollution that comes from pharmaceutical manufacturing. , i keepeen impressed coming back to this, the new chemical processes we have an advanced manufacturing technology that reduces the environmental footprint. if we can learn to make our medicines differently and adopt those practices more routinely, we can mitigate the environmental impact that comes

from traditional ways of making medicine. , and i want to point out ,he $8.3 billion spending bill a representative pointed out that there is $61 million for medical countermeasures and mitigation of supply-chain interruption. supply-chain interruption, is that what we are talking about? guest: that could mean for masks and personal protective gear. i am sure people heard about the shortages of masks. whether it is home depot or the local pharmacy, they are in short supply. -- $51f that is going million will not take as far if we want to bring our basic manufacturing back to the united states. we don't have to produce all of it, but some basic level. host: what exactly should the

government be doing now and are they doing it? guest: what i would like to see and recommend in testimony this coming week is there be funding for investment in capital and equipment for those companies that want to use new technology making our medicines here at home from soup to nuts, we are not dependent on china or any country, to launch that at a commercial level and those medicines have to be used for strategic purpose, done in the interest of national security. that is what congress should do. host: let's go to our phone lines. moses from new jersey on the independent line. good morning. caller: good morning karen -- good morning. some of the colors have taken my thunder already. smalld to have so many , all thesecal plants

companies, but all these becauses have gone now there are companies overseas, india, getting all of our plants. they are making all the medicine now and we are left in the cold. you are right. that is exactly what has happened. our manufacturing base has collapsed. making the final stages, which is less complex but we havetly, lost it. one thing we have to do is not lose the human capital, the talent. we have to capture that now before it is gone. we can be self-sufficient in the next coronavirus -- and frankly so we don't have these shortages

of life-saving medicine. i am told by doctors, people died because of drug shortages. this was pre-coronavirus. we don't want that to happen. the fda says, there is a shortage of this product and there are alternatives. those alternatives are second-best. they can have impacts that you would not want to have as a patient. we should make sure every patient every time has the right medicine and not have unavailability or a product discontinued. we have to bring a back to the united states. call your member of congress and say this is what we need to do. host: let's take coronavirus out of the discussion. we were are talking about the same drug shortages before the coronavirus hit. the drugs we were talking about previously were drugs like heffron. is there still a shortage right now?

are there other drugs out there that there are shortages of immediately and what drugs do you see coming up because of what is going on in china that there may be a shortage of in the future? guest: two days ago, the indian government announced that it is banning the export of 26 products to the world because they cannot get the core components to make them from china from its generic industry. host: anything big we should know about? the ingredient for important antibiotics and other antibiotics. we know that for a fact. we are talking about countries arefrica, europe, asia that affected by this. this is what happens when you have a centralized global supply chain in a single pedigree -- a single country.

there is another important antibiotic used to treat people with sepsis, which can be deadly. a lot of people die from that. 27,000 people every year. this is an antibiotic and shortage now. if we go back to what happened five or six years ago, there was a plant in china making the chemical for it. it blew up. probably because they were not made with safety in mind. they rebuilt the plant. the fda but an and give it an ok but the european regulators came in and said, this does not meet western standards. but they allowed it to be sold anyway. to prevent a shortage. now we are at a point in the united states where we are making trade-offs between allowing substandard medicines , better to have something than nothing.

if the american people knew that, they would be unhappy about it. host: let's go to our phones and talk to chris from ohio. chris is in the medical profession. what you do in medicine? caller: i am a paramedic and work for public safety. i wanted to add one point of clarification. ms. gibson mentioned there is a shortage of heffron. that is correct, but we have it available. there are different concentrations of the medication. but we do not have available or what there is a shortage on is the preloaded injectable for cardiac arrest. piles, we havehe to draw it up on the scene and makes it to use it. the comment was it is not -- >>