OUTSOURCING CAN BE DEADLY
It May Not Be the Virus That Kills Me
Many lives depend on the medical supply chain, which Covid-19 will severely test.
March 12, 2020
With each passing day, the coronavirus pandemic reveals that many of our lives hang by a thin fiber-optic thread that can snap at any time. As more people are quarantined and businesses grind to a halt, supply chains will break down. While this will have negative economic consequences for all, for many of us it will be a matter of life and death.
My life depends on an artificial pancreas I wear on my belt. Without the insulin it delivers 24/7, I would die within a few days. I’m not sure where the insulin and components for my pump and the related sensors, transmitter and continuous glucose monitor are produced. The supply chain of the world’s largest insulin producer, Novo Nordisk, runs through the U.S., Brazil, Denmark, France, China, Russia, Algeria and Japan.
When I started a different insulin pump two years ago, the company could send me only three sensors at a time, each of which lasted a week, because its factory in Puerto Rico had been damaged by Hurricane Maria. Today Beijing is the problem. If insulin or anything related to my pump comes from China, I am in trouble.
But if it hadn’t been Covid-19, it would have been something else. The advent of the internet made it much easier for companies to outsource production to foreign countries where labor costs are lower. Combine this with the popularity of just-in-time production, which minimizes excess inventory, and you have long, vulnerable supply chains. Like many other corporations, large drugmakers have engaged in extensive outsourcing. Though this system may be economically efficient, it is perilous for people whose lives depend on reliable delivery of medical materials. In a crisis, timely deliveries are all the more important, while the supply chain is under all the more strain.
The coronavirus crisis will likely highlight this problem for many, but the issue is more complex than fragile supply chains. Even if drugs and medical supplies are available, patients can’t always accumulate a backup supply because of limitations imposed by insurance companies, pharmacies and government regulators. My provider, for instance, allows prescriptions to be refilled only every 30 days.
I have a one-month supply of insulin and other materials for my pump. It will be 3½ weeks before my insurance company will pay for more. Even if I could order backups, I don’t know if the drug company and pump manufacturer have what I need. If the supply chain has snapped, I’ll have only a few days after my insulin runs out before I could die.
My situation isn’t unique. In coming weeks, it won’t just be Covid-19 that kills people but the havoc it has wreaked on the global medical supply chain.
Mr. Taylor is a professor of religion at Columbia and author of the forthcoming “Intervolution: Smart Bodies, Smart Things.”
