The west has given China the keys to the medicine cabinet. A 2026 Council on Foreign Relations report found that China supplies roughly 94 per cent of the key raw materials for amoxicillin, the world's most common antibiotic, and nearly half of global antibiotic ingredient exports. Almost 700 medicines approved in the US rely on at least one chemical made only in China.

The 2022-23 amoxicillin shortage in the US and Europe exposed the fragility of a supply chain optimised for the lowest price. The market left antibiotic research because these drugs are rare products whose value rises the less they is used, with Novartis, Astra Zeneca and Sanofi exiting antibiotic research while capital went to oncology and obesity drugs.

The West could still out-innovate China, but Britain has already begun paying for antibiotics through a subscription model, and America's proposed Pasteur Act would do the same. A second, cheaper lever is reforming how we pay for diagnostics to cut wasteful use and reduce demand.

China dominates manufacturing and accounts for roughly a third of the world's new drug pipeline. Antibiotics are critical infrastructure that should be treated as strategic rather than commodities to be sourced at the cheapest price.