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As concern mounts over the global pharmaceutical supply chain, more fingers are being pointed at India and China due to increasing quality-control infractions at manufacturing facilities. Such problems have led to shortages of key medicines — notably, the lower-cost generics that account for 89% of all prescriptions filled in the U.S. But Rosemary Gibson, a health care and patient safety expert at The Hastings Center, a bioethics nonprofit, argues that developments in China pose an even greater risk. As the key supplier of active pharmaceutical ingredients, China ultimately threatens the national security of the U.S., which was the theme in her April 2018 book, “China Rx: Exposing the Risks of America’s Dependence on China for Medicine,” written with Janardan Prasad Singh. Last week, she testified before a House committee on supply chain issues and we subsequently chatted about the problem. This is an edited version of the conversation.

Pharmalot: What is the exact role that China now plays in the global supply chain? And why should we be more concerned about what happens in China than in India?

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