tv Trade Supply Chain Officials Discuss COVID-19 Response Medical Supply... CSPAN April 1, 2021 10:01am-11:04am EDT
market by keeping quiet, and it's criminal. host: deb in new freedom, pennsylvania. i am 68 years old and pay for a supplemental insurance plan and subscription plan. 2020 i paid out-of-pocket nearly 88,000 dollars. that is nearly one third of my income for the year. i will leave it there and bring you up next a conversation about covid-19 and the medical supply chain. >> a moment for everyone to load into the zoom room, and we will start momentarily. >> good morning. i am the executive director of the washington international trade association. we are delighted to welcome you to our webinar platform to our
event looking at covid-19 and medical supply chains. this is our 77th panel since march 2020, and we are glad so many of your here today. a few notes about our upcoming programs. next week we kick off the next phase of our series on worker-centric and inclusive trade by going back to the basics and trying to answer the question, why do we trade and who should trade be designed to benefit? we have an all-star panel for that event on april 8. we have an additional event on april 13. u.s. central american trade on april 14. the next event in our series on april 20. information on all those events can be found at www.wita.ort. we are pleased to be joined by our cosponsor women in international trade. thank you for bringing this idea to wita and all you do for the
trade community. welcome to those watching on c-span and youtube. we would like to give a shout out to some of those in our audience today that you cannot see that are in community with, even if they are not visible on zoom, youtube, or c-span. welcome to michael roberts, lindsay meyer, victoria peons , and natalie. for today's event if you are watching on zoom you can ask questions using the q and a tab. if you were watching on zoom you should have received an event program by email with our speakers' biography so we can skip the lengthy introductions. i would like to introduce our moderator, manager of global health at the chamber of
commerce, and from ups, welcome to both of you. meredith, the center for strategic and international studies and a former winner of wita's award. jonathan campbell, vice president for trade and international affairs at the association for festival medicine. welcome. >> getting myself on muted. thank you for helping to make today such a success. to give you more about me i work at the u.s. chamber of commerce's global initiative on health and the economy elevating the importance of investing in health as a strategy for economic growth and development. we strongly believe our
collective focus needs to be on conquering the pandemic today. we also believe it will be vital to strengthen our health system to build resiliency and prepare to meet the challenges ahead. covid has exposed a number of gaps globally. before we dive in, let me tell you more about the other event partner on today's event, the association of women in international trade. it is an organization that promotes the professional development of women in international trade and business and raises awareness of the importance of trade and economic development. we have a number of events coming up. in april we have two on the 22nd. we have an event called what is the role of corporate social responsibility in covid-19 and beyond. on the 27th we have trade and national security. today, the topic of today's conversation is an important
one. covid has demonstrated how important distribution networks are ensuring delivery of goods. over the past year we have experienced shortages in some medical products like ppe, which led for calls my call america and -- like buy america. some ideas on how we can enhance the resiliency of our supply chain going forward. if you could briefly introduce yourself and provide a few opening remarks. starting with meredith, then jonathan. meredith? meredith: it is fun to be here. i appreciate the invitation. i started at the ways and means subcommittee. i would like to recognize what
he did for the field. we will miss him. i worked at ways and means for about 20 years and then ran the industry office during the bush administration and administer the generalized system of preference program there. then went on to serve on the international trade commission as commissioner and chairman. along background -- a long background in the trenches of trade policy. i look forward to talking to you guys. do you want me to start presenting the paper now, madison? or should we go to everyone else in the introduction? i can't hear you. madison, you are muted. madison: i hate when that happens. let's go to jonathan, catherine, and come back to you, meredith.
jonathan: i am the vice president for trade and international affairs trade and international medicine. first, thank you for the invitation. i appreciate the opportunity to discuss critical issues on how we ensure the u.s. has a vibrant and secure functional supply chain and how to work with our allies going forward to make that happen. our industry, global diversity is important to functioning redundant supply chain. no one country can manufacture all medicines to make sure their patients have access to affordable and assessable treatments when they need them. since it is difficult for the u.s. generic manufacturers to compete against low-priced imported products, a sustainable market must be created that creates predictable volumes and prices. how do you design that system is
not easy, but crucial to provide incentives necessary to encourage that investment, especially the pharmaceutical sector where price is often the driving force for market segmentation. and develop perspectives included in our blueprint for enhancing security of the supply chain in the united states. that gets to some of those requirements that our members believe is important to expand their investments in the united states. for our segment, market forces are central to the makeup of the supply chain. i am sure all on the innovative medicine side, but they have much larger margin scanned can absorb some higher -- larger margins and can absorb higher costs. that is why countries who have subsidized the production of key starting materials have been so successful. they have been able to out prefer costs for lower-priced products and have attracted the majority of investment over the last number of decades.
all of that said, it is not that the generic industries not invested in the united states. our membership alone, 21 companies, produces 60 million doses of generic medicine every year in the u.s. and employs 52,000 workers. to the point of the paper that meredith will be presenting, and i strongly support the idea that the united states must work closely with its allies, trusted partners, and promote an agreement to encourage cooperation and coordination to strengthen the security of the supply chain. we can't do this alone as the united states and we must work together with our allies, who, as you know, are facing the same challenges and having the same debate as we are. thank you. i look forward to the discussion. madison: thanks. we will come back to you to hear more about the blueprint. catherine, do you want to give a few opening remarks? catherine: thank you for
inviting me to this program. dumping on jonathan's comments with two points i would like to make opening. from our vantage point in the global express industry we shared the general consensus and thesis of meredith's paper that concentration of sourcing increases supply chain risk. which is true domestically and internationally. covid put a very intense spotlight on that last year. different supply and demand. generally our ups imported and exported were attuned to that reality already, certainly most recently in the context of trade tensions with china and also experiencing disruptions from natural disasters over the past decade. the thesis point where we certainly align ourselves with what meredith has captured in
the paper. the second point i would like to make is specific to medical supply chains, again from the perspective on a health-care logistics provider, we've learned a lot in the past year. about health care distribution, emergency response, vaccines, appointments. as you go forward in understanding the best balance of efficiency and resiliency in supply chains, we want to be included in discussions, like today, and we want to make sure we are not drawing straight lines where they don't necessarily exist. a complex supply chain equals a barrier to access. it is so important that we evaluate case studies, and we look for vulnerabilities and include multiple variety of views and stakeholders, and we come to solutions that
stakeholders, patients, are looking for. madison: both catherine and jonathan have alluded to the paper. let's wait no longer, meredith. give an overview of the paper released in december. for those of you who don't know, covid-19 demand shock and preparedness response securing medical supply chains with aut -- was authored by meredith. it is a strong paper. if you could walk us through some of the key recommendations you put forward and we will use that as the base of our conversation today. meredith: i'm excited to talk about the research we did through this paper. csis began the project in august by convening a group of interested thought leaders and industry representatives to assess how the u.s. medical industrial base was responding to the emergency caused by the
pandemic-related spikes in demand. at the time there was widespread dire concern in congress and the general public about shortages of pharmaceutical and medical devices and personal protective equipment and general angst that u.s. supply chains were failing in the u.s. industry lacked the ability to produce the scale necessary to meet u.s. demand caused by covid. at the time, 50 or 60 bills on the topic had been introduced in congress. our topline conclusion is that our government mandate that manufacturing production returned to the united states will only induce higher prices and more shortages. instead, we propose a trusted supplier network of chosen countries with whom the united states would develop enhanced supply relationships. overall, we expect threats to supply chain resiliency to only increase in the future. the frequent -- the
frequency will continue for many reasons, such as pandemics, but will include the weather, shipping, as we've seen in the suez canal, labor disruptions. mckinsey estimates that on average companies can now expect supply chain disruptions lasting one month or longer to occur at least every 3.7 years. mckenzie survey in may 2020 found that 93% of supply chain executives plan to take measures to make their supply chains more resilient, increasing redundancy, near shoring, and regional lysing their supply chains. mckenzie estimates 30 percent to 60% of the pharmaceutical value chain could regionalized in the coming years. overall we observed companies are moving production and adjusting to new threats for possible disruption, although we don't have a measure of this yet. for csis recommendations, we recommend congress and the biden administration work together to
enact a policy on medical supply chain security centered around diversification within a network of trusted supplier countries that cooperate with the u.s. in order to bolster and guarantee a steady supply of essential medical products in future public health crises. eligibility criteria for trusted partners status could include commitment to safety and efficacy of medical products, ip protection, and free data flow. all partners would commit to enhanced supply chain visibility, work towards a new plural lateral trade agreement for the medical sector. trust, reliability, and commit to cyclical support for supply chain security by prioritizing the flow of goods and information sharing during crises. we suggest several possible trust doctors for the trusted partner network, including, perhaps, reciprocal negotiations with trading partner countries,
or unilateral designation of countries eligible for the network similar to the gsp program could be considered as a structure. as i said at the outset we conclude wholesale government mandated re-shoring is the wrong approach. we see models indicate that wholesale reassuring would not improve resiliency or efficiency of supply, largely due to the lack of diversification and inability to tap into a global network of suppliers and producers. this was borne out in our case study of gilead, pfizer, ppe, and ventilator production when we saw how the u.s. responded. i will try to highlight case studies, because there's a lot of good information in this study, i think. gilead's experience with ramping up production of remdesivir through its supply chain and global manufacturing network illustrates how a company was able to respond to unanticipated
supply chain disruptions and spikes in demand by adjusting sourcing, improving manufacturing processes, shifting production among global facilities, and repurpose and and ramping up production facilities in the united states. by supplementing domestic manufacturing with multiple international partnerships gilead created a sophisticated network capable of producing huge volumes of remdesivir to meet a large domestic demand, as well as demand in global markets. pfizer's success with the covid-19 vaccine was defined by its ability to mobilize global research, its global manufacturing footprint, and international network, which included an essential scientific and commercial collaborator, biontech in europe. they constructed two parallel
supply chains in europe and the united states to ensure scalability and redundancy. in conclusion, the dire circumstances of the pandemic present a new opportunity for the united states to reinvigorate trade relations with allies, free-trade agreement partners, and trusted supplier countries in the form of a trusted partner network. we have had a bipartisan paradigm shift in thinking on trade, i think. fundamental assumptions about supply chain security and who we can rely on have changed. it is important that the u.s. policy response is developed jointly between the administration and congress to avoid a pendulum of trade and national security policy swinging too far in one direction. the first move will be this interagency team that was established under the president's executive order compiling research, analysis,
and recommendations on supply chain security. they will need a lot input, i think, from the private sector. i would urge the team to be surgical, focused, and above all practical in addressing the stress that has been identified. ted alden hosted a panel yesterday on foreign relations, which made the strong point that we need to take the globalized world as we find it and move from there. we need to fully appreciate that new government mandates will be costly, and therefore must be measured and carefully chosen. thanks. madison: thank you, meredith. that was really helpful. i have a number of questions, number of thoughts. one thing that comes to mind at the top, i think it's important for those listening to understand the value. i think this is often a misunderstood point. perhaps because it is a bit counterintuitive. if we can back up a little bit and go back into the height of
the pandemic, many of us experienced firsthand the effects of supply shortages. the infamous toilet paper scare and a number of other items that we take for granted. at times during the early pandemic they were hard to access. i am wondering, catherine, if you can paint a picture of the supply chain logistics challenges and hammer out a little bit more the point about diversification. again, i think it is a little counterintuitive for people to understand. if you could talk through some of those challenges that we've heard and that you experienced and maybe talk about the value of diversification through it all? catherine: sure. i agree. we should, quickly, though it is well-trodden ground to discuss
what happened last year, just go through it briefly. i think it's a good set up for the discussion about solutions. there were massive shocks in demand, massive shocks in supply, and, separately, there were government interventions and issues creating disruption and chokepoints. on the demand side we had an acute need for certain health care goods. ppe as we all remember. we had a panicked marketplace -- toilet paper as you mentioned and a longer list of other items -- and we had a shift from business-to-business purchasing to business to consumer purchasing in response to lockdown. that was expedited shipping.
that was all an on-demand expectation on the demand side. on the supply side we felt the shock in china in february closing factories. that reverberating to come around the world resulting in delays and additional rolling shutdowns and markets. exasperating all of this was the significant -- significantly reduced air capacity. by april of last year 16,000 passenger jets were grounded. if you didn't know, before covid, we certainly know now that the belly of passenger airplanes carry cargo. in april there were -- there was an 82% reduction in air cargo capacity. the express industry certainly
lacked to fill that demand. there is not nearly enough redundancy in the shipping network to make up for the lossed air capacity. our networks obviously prioritize the central good. ups alone shipped 6 million kilos of ppe to the united states. a lot of other commerce was considered not and was delayed. although we caught up most certainly on that, it was an environment of extreme stress in the shipping world. besides that, there were two other things going on. export restrictions, which i think we're going to talk more about. you can get into what kind of government interventions were happening and how they had a material impact on access to essential good. s.
it later role in slowing down the allocation of essential goods we needed. the second issue, which is one, is we are still getting the health protocols related to essential workers moving across borders to facilitate air cargo. for us, our pilot network. the timing and conditions for rest between long-haul flights is precise, rooted in safety, and we are operating in environment today of challenges and unpredictability because we don't have a common global standard. when we think about what in that landscape of last year we can change it what we can't change, i think from our perspective certainly the concentration of -- was a major, had a major
impact on the success of the supply chain. that can be changed. export control were a major impact, which can be addressed internationally. and protocols and essential services and essential goods for the world in events like the global pandemic, it should be fixed and can be fixed through some of what meredith is proposing. i think that is how we look at last year. we look at static problems in sourcing and in the supply chain. we look at the impact of the pandemic from a health perspective, and the limitations we had in the logistics industry . i will be happy to talk solutions when we are ready to get to that part, madison. madison: thanks, catherine.
i think some of the export restrictions and export control we all witnessed firsthand. it is something i was thinking about when i was reading the paper, meredith. we have trading partners already in the form of nato and countries we have signed free-trade agreements with. i wonder in the solutions that you put forward in the paper, what would stop countries from resurrecting restrictions, even if they were in our trusted trading network to protect their own citizens during the next health crisis? can you talk a little bit about what is different here between what we already have? meredith: it is a really good question. for example, there is a global trade and health initiative put forward in the wto at this point by the ottowa group thinking
about how do we make a trade agreement that will increase security in this area? i don't think anyone in that group is saying they will have a guarantee of no export restrictions ever being supplied. the benefit and improvement will be inability to -- will be in ability to set forth principles you will only resort to export restrictions in the most dire situations, and in a manner that is targeted, transparent, and time-limited. it sets up a lot of good governance discipline on how if a country were to have to resort to export restrictions how it would happen and different elements to be considered. in the paper we did a case study with canada. early on there were export restrictions put on by the united states. we were able to work off by coordinating on where supply was in the hemisphere and thinking
where we could back each other up. a lot of this is just communication and thinking through what responses are in trying to limit the panic, buying the panic export restrictions, which is always political pressure for that, but you try to moderate that and keep it around good governance, i think. maddison: thanks, meredith. i want to talk also about the role of pharmaceuticals. one thing that also surprised me about the conversations were having today is while we of course, observed a lot of shortfalls in supply through the pandemic, we didn't have these shortfalls in the pharmaceuticals -- in pharmaceuticals or medicines. i also know, come to find out, 70% of the value of our
pharmaceuticals comes from the u.s. already. jonathan, i wonder if you could talk a little bit about the genesis of buy america and the on shoring of pharmaceutical supply chains. jonathan:jonathan: thank you foe question. the debate around pharmaceuticals began prior to the covid crisis. you saw in the summer of 2019 increased attention in congress and within the trump administration about the role of china and the perception that it was playing too large a role in the pharmaceutical supply chain so there was a number of members of congress who expressed concern and had written to the administration asking for details of china's role specifically in the department of defense. that debate was already ongoing when the pandemic hit.
and, that ground was fertile for that kind of conversation. what we saw early on, you saw powerless he makers -- policymakers and leaders across the spectrum concerned about the impact and the way that china shut down manufacturing would have on this medicine for the united states. like, for the pharmaceutical industry, this was not the first supply chain challenge. you saw china shut down manufacturing as well for pollution control issues. you saw korea had they -- have a significant impact in pharmaceutical import in puerto rico. all of that led to a robust and significant sort of regime of contingency plans that the industry had in place and was able to act upon early in 2020 when the crisis was ramping up. so, the expression of concern that we saw from policymakers and others about the
potentialities for supply chain for medicines in the united states, one of the reasons and one of the main reasons it did not come to fruition is because the industry was ready and had backup supplies on hand. more so than when we were beginning to look at this based on the political movement happening. we were surprised the amount of stock that the industry kept on hand, especially api. they were ready for they supply disruption. we saw that while the transportation crisis that catherine had mentioned had a significant impact in march and april, data that we analyzed actually showed that by early may, the amount of pharmaceuticals flowing back into the united states had reached the same level that they had prior to covid, and that was based on a lot of preparation that the industry had put into place. now, i think the genesis of why
latin america is still focused on the pharmaceutical industry is because it does make sense to increase the role and ensure that the u.s. has a strong, secure supply chain. we are seeing a lot of members of congress and the biden administration looking at this issue. where i think it has evolved and it is the right conversation is that it has gone on the u.s. should produce everything to exactly the idea that mary was promoting, that the u.s. cannot do this alone and we have to work with our allies and find trusted partners who can help us with our supply chain as we are working to help secure the global supply chain. having that diversity, resilience, and redundancy is really valuable to the u.s. and that global network. this is actually an idea that we are actually emoting this. but -- promoting this.
but there could be differences where the congress might scale in the markets, and it might not make sense for the united stands -- united states to manufacture all of its own api, with partners they can focus on where they have the competitive advantage and they have the competitive -- and we have the competitive advantage and it is through communication and transparency that goes around that we can lead to a place where the u.s. is a more secure supply chain and partnership. >> i am wondering if you can go ahead and get a little more into the blueprint for the supply chains, because i think that is another valuable area that contributes to this conversation, i am also wondering, say you did wants to or decides to move forward or getting the pharmaceutical industry to expand investments
in the united states, or expand their economic footprint at home. what would be some policy challenges or changes that needed to happen to kind of enable that investment here at home? so, if you could hit on both points. jonathan: one of the big concerns for the generic industry is how do you have a sustainable marketplace? as i mentioned in my comments, the supply chain has evolved in the generic space in response to the market conditions that exist. in the united states we have very rogue generic medicine because of market-based pressures where health care purchasers do not want to pay much, and because we are commodity-based, competition helps lower the price, therefore, you have seen manufacturing take lace. -- take place.
if you are bringing that manufacturing back or starting it in the united states you need to ensure that there is predictability. so that manufacturing does not lose out to imports coming in. our blueprint lays out what we think is necessary to build out that marketplace. it starts with a list of essential medicines, the way the fda has defined them. we might do it a little differently, but it is getting a subset of all the 6000 plus medicines in the u.s. market to replace and to focus on what are the most critical medicines and where does the u.s. need to have greater manufacturing. that can be accomplished with the central medicine blitz that came out on october 30. that is a good place to start. based on that list, we believe that grants and the biden administration and congress has just approved a large number of
available funding for whether it is the dta and other sources to build up u.s. manufacturing, access to help equalize the marginal cost of production for overpriced markets, and a predictable market. where the u.s. is the direct bircher of dutch purchasers -- purchaser of medicines, and it is not large. the department of defense and the department of veteran affairs are the largest purchasers. there should be contracts for the prices guaranteed and the volume is guaranteed over a set period of time so companies no -- know that they are expanding or building a new plant that they can fend off the low price competition for a set period of time. we need regulatory informers to make sure that these facilities are improved quickly, and this
aligns closely with what meredith was talking about. we believe that there should be the conclusion of the international supply chain agreement which is the idea that the u.s. partnering with allied countries. and one thing i forgot is the strategic national stockpile should be expanded to include the medicines on the essential medicine list to help ensure that a predictable marketplace for the medicines that are deemed most important. maddison: thank you. i am seeing a number of questions come through in reaction to some of the ideas that you just put forward. i will leave it to the audience to kind of hammer out some of those questions. and for those of you who have not had a chance to direct questions, please go ahead on the lower half of your screen and hit the q&a question and type it into us.
catherine, one more question for you with each -- which has to do with where we are now. on the top of many of our minds is the vaccine rollout. last week president biden marked a milestone of 100 million shots administered during his presidency. i am wondering if you could just talk a little bit about the logistical challenges that we will be facing in distributing the vaccine in the u.s., and then what are the additional hurdles as we move towards the rest of the world? and, feel free to kind of bad any last comments on -- add any last comments on the proposals. i think that is a good way to rounded out. catherine: yes, and thank you. i think one of the -- one observation for us with the u.s.
experience in delivering the vaccine, and i know this might not be everybody's personal experience in getting access to it, but from an operational perspective it has gone well. and, we speak to that from the perspective of the public-private partnership in place under operation warp speed and a couple of the elements that have really driven efficiency and effectiveness including transparency, collaboration the allocation of resources and that has allowed it to be a very productive environment of taking lessons week by week on where there have been successes in distribution and make operational changes in other areas to apply those, and we consider it to be an enormous achievement to have gotten to where we are today knowing that
we have a long way to go, but it is something we would like to see replicated around the world. and, i just want to give ups credit and humble marveling at the innovation that brought us these vaccines. we played but only the second phase which is getting it to folks. and, what is really at the top of our minds is the 2,000,000,002 target around the world. and the pressure of 2021 are going to be on managing supply, scaling supply, and in managing preparedness. we do not have a real supply chain problem right now with the vaccines. we are a fraction of the single percentage point away from 100% on-time delivery. there are -- there is a lot of
government support behind that and we need to deliver vaccine and it is sometimes met by the head of state and some -- and ushered through procedures that are sometimes accelerated. there is a lot of support in the supply chain right now to move the vaccine and not just -- and to be successful in preventing the roadblocks that we are anticipating. the most difficult challenge is still ahead of us, and that is reaching a majority of the world's population with a distribution plan that is not yet in place. what we are looking for and what we would like to see is more collaboration, more public private partnerships between governments, helping spread the expertise that we have as already delivering and we have seen countries through the
companies, and managing supply on a just-in-time distribution effort that really promotes equity among the most vulnerable countries. now, in ways that are going to prioritize that access. so, i think it is a tribute to the productivity of the pharmaceutical networks that we are today in terms of manufacturing and to watch one of these vaccines get created is balancing across several regions getting inputs in country a, and moving to country beaver finishing and going to country see -- country c before being delivered and it is done with an incredible amounts of sophistication that is enabling real speed, production and scaling. there is something to be learned from what we are seeing in the
vaccine environment right now that could be applied to understanding other ways to protag vulnerabilities in the industry. but, i say that with the reminder that we are very much in the beginning of the vaccine rollout globally. maddison: thank you catherine, and thank you to all of our panelists today for your thoughts and comments. i think ken is about to pop back onto to get us started. ken: thank you, i really appreciate the conversation. you know, we like to look at the big picture issues, we like to drill down into some of these topics, and this has been insightful and informative, thank you. we have interesting questions from the audience. one, i just want to say a big
picture question and maybe that can be directed at all of you. you know, just read the question verbatim. now that we have a better understanding of -- pandemic preparedness, how do you think the biter administration -- biden administration can reshape their supply chain compared to president trump's by america executive order that remains in effect, and has impacts on some of our wto commitments? anyone want to grab that one. meredith, i see you reaching for the mute. meredith: i think they need to take a look. they do not need to iterate another by america executive order on top of what the last administration did, because we are at a place where we need a more cohesive policy that takes into account what is going on in the government. and our national champion
companies in the pharmaceutical and medical device area are actually very successful in foreign markets under the government and the wto has protected those sales for us and so many other governments are structured where there medical sector is much more government procurement than the u.s. medical sector, which is less. i think it was mentioned -- mentioned that the veterans administration and the dod are doing most of the procurement for medical products. i think if we get into discussions with other countries that we might deem to be trusted partners, they may want to work with us in a better, cooperative relationship under the government procurement code that will only be clear when we start talking to some of these countries. i think it is something that needs to be look at -- looked at holistically in terms of the secure supply chain medical policy. ken: does anyone else want to
jump in? i am not seeing any hands. i will ask a two part -- there is a two part question that has come in, and it plays -- one, we have all been focused in the last week about the crisis at the suez with the superjumbo container ship that got wedged in the canal and locked maritime traffic between the red sea and the mediterranean. huge problems there. diverting ships all around the world. what does that mean for the just in time that you were talking about when you have those kinds of supply chain disruptions? what are some of the ways that we could build in resiliency? i will get to the second
question after we do this one. catherine: that is a good point, and jonathan raised this too. supply chain disruptions are common, and the suez canal was an unfortunate but very impactful example of what can go wrong in human error. jonathan mentioned hurricanes, pandemics, trade tensions, the list goes on and on, and these are reasons for diversification. if you talk to the smallest customer of ups, they yell that very acutely. they are importing from a single market and something like that impacts and it is a primary product that they are building a business around, and it is impacted or delayed it can be devastating. even the smallest of importers in the u.s. very closely
understand this connection. when we work up from that to understand what we need in our health system or what we need in our resiliency, diversification is the answer. diversification with the protection of trust, and meredith explained it so well in her paper. we do not need to view the world -- the word diversification is a risk, but building trust and understanding between partners. that is the only insurance against keeping your business going when there are these kind of disruptions. ken: thank you. so, another question that came in, sort of the part two part. this is a friend of several of ours at the wilson center. the panel is largely focused on vaccines and medications for obvious reasons. any direct did this at meredith
and catherine to speak about the movement of ppe and devices during the pandemic and white -- what might be needed going forward. jonathan, are some of the policies as presented by aam applicable beyond the pandemic? meredith: sure. as we looked at the medical equipment and ppe, and an arsenal -- also pharmaceuticals, there were missed -- where more disruptions and would've gotten into it when i summarized the paper, and ventilators and ppe. there was some early on problems, but the industry was able to ramp up and reconfigure its supply chains and work with some of its international partners to solve this shortage. it may be that ppe lends itself more to a regional latin america hemispheric approach to
security. we noticed that the pharmaceutical industry was so dependent on its international collaborations for the research and development and the sophisticated bioengineering that they are doing. whereas ppe was basic in terms of the production processes and it was a matter of knowing where it was produced and how much was in sight, and how much needed to be stockpiled and so forth. i think there are differences in the characteristics, and it will be my sense that maybe the inter-agency team that is looking at this might have different recommendations for different parts of the sectors. ken: catherine? catherine: yes. i would say from our perspective that i think ppe does support -- provide an example of the problem to be solved. we were overreliance on one country and our covid response.
and although we were able to ship an enormous amount of ppe from china to the u.s., when there were regulatory delays, because it was a single market it had an impact on our ability to move quickly. and, the delays related to ppe, vulnerable to counterfeit because they are manufactured goods. and we did not have as many trusted manufacturers as we needed, so, there were -- we were exposed in the ppe response, no questions, and i think solutions around diversification regionally and bringing that resiliency model to place certainly makes sense from our perspective and our experience of that movement in that covid response. ken: did you want to jump back
in? meredith: i am good. ken: thank you. catherine, playing off of the answer that you were just giving in this last question, a question comes in from peter martin did the surge in e-commerce affect the ability and capacity to deliver critical medical and pharmaceutical products, maybe because it was almost democratized in the way that people can access those materials and individuals and institutions might have been trying to access those was a blessing and a curse at the same time? catherine: yes. a blessing and a curse. i do not think ups looks back on the days of having to establish a watch power to try and bring some prioritization to shipments
, what is most essential to clear capacity in one of our aircraft and get it to a country. i do not think we look back as to something we would like to repeat. it is a difficult position for a company to be in and decide what is most essential. fortunately, when we have good relationships with the governments that we served and we were able to understand what the government man's -- government demands, it is a whole list of categories of other goods, not covid related that are still essential and should still be on site. it was very difficult. the commercial goods that were not health-care related are the ones that were put aside during that time and that is where we experienced a lot of delays with our customers, but there is no doubt that there was a period of confusion and challenges, and i
think there are lessons for the u.s. domestically in the way we handled that and as we look at other countries that are being reviewed. ken: talking about some of the challenges early on, jonathan, a question directed towards you. early on there were shortages of sedatives needed for intubation in several regions where the worst hospital surges were occurring. you know, what was the cause and what were some ways that we were able to get out of that crisis? jonathan: i think the cause was unprecedented levels of demand for those medicines, and there was never a national shortage for these medicines. what we have is a diversified and distribution network in the united states where distributors have warehouses that supply different parts of the u.s. market. what use on places where like
new york was facing the toughest time in their pandemic that you saw a greater number of that being used. those regional shortages, but we did not run into where the u.s. itself was facing shortages so it was much of a distribution issue. what seemed -- what came to pass is that the industry worked closely with distributors to design a system that was more flexible and able to meet the needs as they were emerging, and i think what we saw as time progressed, less instances of regional shortages and greater ability to supply parts of the country when spikes were noticed. ken: thank you, jonathan. we have a last question that has come in so far, and i will use that to be a set up question for all of the panelists to maybe
jump in including madison -- maddison as well. what proactive actions should the u.s. government take to help build trust with our training partners who might be skeptical given the by america announcement? is there more we can be doing to make sure that supply chains remain integrated especially for vaccines and their input? and to give it a broad question, there has been a lot of talk about what steps we should take in advance of the next pandemic. most people believe it is a question of when. what should we be doing now during the coming months and years to prepare on the supply chain side so that the next time it hits we are able to react quickly? we will go around the panel to see who wants to jump in on that. jonathan, i see you ready to jump in. jonathan: i will take it.
what can we do in the united states to engender trust among our partners in this space, i think it is greater engagement and transparency. i think we saw during the last administration there was a withdrawal from engaging with partner countries and this time of crisis, so the biden administration has joined the who and support -- and pledged $4 million to distribute vaccines to less-developed countries. you are seeing with the commitments for mexico and canada that are supplying exports of vaccines to these countries. it is re-engaging in this partnership, showing them that the u.s. is not isolated in its response. i think there is going to be significant more of this as the u.s. reaches critical mass in terms of vaccinations, and my assumption is that the u.s. will be a leader in ensuring that other countries get access to the medicine that they need. i think that will be critical in
the medium to long-term is reestablishment of the u.s. as a trusted partner. i was going to take the second question real quick. i think to build out and how do we prepare. it is engaging with allies, more transparency and supply chains around the world in discussions with allies as well putting in place incentives that can help increase the footprint of the manufacturing base in the united states as part of that global diverse supply chain. ken: meredith? meredith: we need to kind of keep the bifocals going and keep up discussions with trading partners so that we can engender some trust. i think there is a free trade commission meeting coming up between mexico and canada, and i think usmca is a good place to start to think through what kind of trusted relationships would work with other countries and
this will depend a lot on what countries like men's -- mexico are interested in doing in terms of supplying us. i think there are lots of opportunities and we need to start sitting down with countries and talking. the other thing i would mention, which is interesting when we talk about the system evolving, a lot of the system will come between the enter lay between the digital trade world and product world in the sense that the supply chain managers are going to be able to drill down and get much more transparency into where their supplies are coming from and where their inputs are coming from and where to anticipate if you have a shortage and how to duplicate it at a different production site. digital trade capabilities will be more and more important. ken: thank you. any last words on this question or other topics? catherine: quickly, i agree that this is an enormous opportunity, and the covid response in 2021,
there are lessons and expertise to be scared, express -- excess vaccines to be spared, and this will help facilitate conversations to commitment to a trusted supplier network. in the sec. on preparedness i agree with meredith on the opportunity to make more permanent some of the public and private sharing and transparency around the surveillance of goods around the world and understanding where there is capacity in need. we have truly learned a lot through this experience and we should keep that in place as a point of preparedness into the next event. ken: maddison. maddison: i would just echo everything said by the panel so far, and i would add that it is important that we will be under a lot of pressure under -- coming out from under the pandemic.
we will be under a lot of financial pressure to make sure that we are investing across the health continuum and investing for pandemics to come. of course, working to address covid and bring this to an end. but also not letting other parts of our health system fall to the wayside. ken: thank you all very much. thank you, thanks to those of you who have been watching. a reminder, next week we are having the next event in our series of events on inclusive trade. we have an all-star panel next week with grant, beth, dan, sarah, and moderated of -- moderated by david lynch on april 8. we hope we will join us for that event. -- you will join us for this event.
thank you for women in international trade for cohosting this event. thank you again to the panelists. for those who are still watching, a reminder to wear a mask and get the shot when you are eligible to do so. thank you very much and take care. stay safe. >> thank you. [captions copyright national cable satellite corp. 2021] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> go to c-span.org/coronavirus for the federal response to the coronavirus pandemic. if you miss our live coverage it is easy to find the latest briefings and the biden administration's response using the interactive gallery of maps to follow cases in the u.s. and worldwide. go to c-span.org/coronavirus. >> middleton high school students competed in the studentcam competition. all month we are featuring the winners. our second prize middle schools winner are dermot