February 10, 2021

Hyperglobalization Undermines Response to COVID-19 Crisis

U.S. Trade Deficits in Ventilators, Masks, and Other PPE Increase and Shortages Reemerge, Reflecting U.S. Overreliance on Imported Goods to Battle COVID-19

Trade Data Shows Significant U.S. Dependence on India and China for Key Medicines

U.S. Global Exports of Face Masks Continued to Rise into Summer 2020, after U.S. Exports to China of Medicines, Masks, Disinfectants, and Gloves Spiked between January-April 2020

Decades of hyperglobalization have undermined our resilience against the COVID-19 crisis. Even into fall 2020, the United States still cannot make or get critical goods people need with growing shortages of Personal Protective Equipment (PPE) as infection rates rise again. More than 60,000 U.S. manufacturing facilities have been lost to 26 years of corporate-rigged trade policies that made it easier and less risky to move production overseas to pay workers less and trash the environment.

The infographics below show:

• Updated data showing that the U.S. has grown even more dependent on imports from China and the rest of the world. for key medical goods during the COVID-19 era as the U.S.-China and U.S.-world deficits in COVID-19 related medical goods increased until June and have not returned to pre-pandemic levels through September 2020.
• Data showing from what countries imports into the U.S. of key COVID-19 response goods are sourced over time. (Wherever possible, we include data showing volume, not only value. Volume more accurately represents what is actually being traded, given that the value data often reflects distortions in price caused by corporate tax manipulations and transfer pricing.).
• New information about the countries from which the United States imported medicines in 2019 (the latest full year data available) that show deep U.S. reliance on China and India for many categories of medicines.
• Data showing that U.S. exports of masks to the world continued to spike up until September 2020 after a major increase in U.S. exports of critical medical goods to China when U.S. domestic demand was highest in January-April 2020.

Having the world’s largest trade deficit year after year means the United States is extremely reliant on other countries to provide essential goods. As the COVID-19 crisis emerged in the beginning of 2020, U.S. government officials urged U.S. firms to expand exports to China of the limited U.S. domestic production of key medical goods instead of considering U.S. residents’ needs. Effective implementation of the Defense Production Act (DPA) to purchase and domestically allocate PPE, ventilators and more would have preempted the export frenzy we see in the data. Unfortunately, Americans are still in the dark about the extent to which these critical emergency powers have been used to control exports of critical supplies.

With many critical goods now mainly made in one or two countries, when workers there fall ill or governments prioritize their own peoples’ needs before exporting goods away, a worldwide shortage of masks, gloves, medicine and more quickly develops.

And, it’s hard to quickly increase production elsewhere. Long, thin globalized supply chains make it difficult to source inputs, parts and components needed to scale up domestic production during this crisis. And, monopoly patent protections in many trade agreements expose countries to trade sanctions if they produce medicine, ventilators and more without approval by and payment to pharmaceutical and other firms.

With policymakers and the public distracted, corporate lobbyists are pushing for more of the same trade policies that hatched the unreliable supply chains now failing us all. Instead, we must fundamentally reexamine U.S. trade policy. The goals should be healthy, resilient communities and economic well-being for more people – not the current priority of maximizing corporate profits.

U.S. Exports, Imports and Bilateral Trade Balance with China, January 2019 – September 2020

(USD Inflation-adjusted Million)

U.S. Exports, Imports and Bilateral Trade Balance with the World, January 2019 – September 2020 (USD Inflation-adjusted Million)

Adjusted for Inflation

TOP SOURCES OF KEY COVID-RESPONSE IMPORTS TO THE UNITED STATES

Wherever possible, we include data showing volume, not only value. Volume more accurately represents what is actually being traded. The value data often reflects distortions in price caused by patents and corporate tax manipulations.

COVID-19 RELATED MEDICAL DEVICES Top Sources of U.S. Imports of Medical Devices by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Mexico	8,206,754,770	27%		Mexico	3,881,982,719	26%		Mexico	1,323,268,397	21%
Germany	3,265,161,773	11%		Germany	2,032,245,572	14%		Japan	987,700,579	16%
China	2,269,586,172	7%		Japan	1,366,309,778	9%		Germany	857,000,470	13%
Ireland	2,201,134,608	7%		China	1,088,679,998	7%		Dominican Rep	348,912,546	5%
Japan	2,084,490,902	7%		Ireland	966,863,757	7%		Israel	334,790,641	5%
Costa Rica	1,728,075,021	6%		Costa Rica	620,810,194	4%		Ireland	327,237,977	5%
Singapore	1,274,502,458	4%		Dominican Rep	506,420,583	3%		United Kingdom	268,411,776	4%
Switzerland	1,260,918,781	4%		Switzerland	486,686,915	3%		Netherlands	223,981,235	4%
Israel	981,734,772	3%		Australia	391,730,743	3%		Singapore	223,661,066	4%
Dominican Rep	805,123,270	3%		Netherlands	377,391,378	3%		Canada	193,381,083	3%
Rest of World	6,368,372,062	21%		Rest of World	3,143,282,330	21%		Rest of World	1,281,333,928	20%
Total	30,445,854,589	100%		Total	14,862,403,967	100%		Total	6,369,679,698	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Electrocardiographs (9018.11.3000) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Switzerland	312,242,442	92%		India	4,040,784	32%		China	9,435,659	53%
Mexico	13,733,208	4%		Switzerland	2,022,518	16%		Switzerland	3,689,378	21%
India	4,595,142	1%		China	1,618,821	13%		Germany	1,857,834	10%
China	3,182,740	1%		Germany	1,553,654	12%		Japan	1,517,245	8%
Singapore	1,333,572	0%		Japan	1,058,598	8%		Israel	467,834	3%
Germany	1,233,669	0%		Israel	599,964	5%		Italy	360,209	2%
Slovakia	433,524	0%		United Kingdom	387,796	3%		Australia	272,593	2%
Israel	398,477	0%		France	210,380	2%		United Kingdom	153,495	1%
United Kingdom	296,941	0%		Austria	209,295	2%		Sweden	45,726	0%
South Korea	250,476	0%		Netherlands	148,904	1%		Brazil	36,650	0%
Rest of the World	857366	0%		Rest of the World	866915	7%		Rest of the World	85432	0%
Total	338,557,557	100%		Total	12,717,629	100%		Total	17,922,055	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Electrocardiographs (9018.11.3000) by Volume (Unit)
2019				2009				1999
Sources	Volume	Participation		Sources	Volume	Participation		Sources	Volume	Participation
Switzerland	122,337	80%		Germany	3,867	24%		China	3,531	29%
Mexico	7,993	5%		India	3,012	19%		Japan	2,871	23%
India	5,915	4%		China	2,550	16%		Switzerland	2,427	20%
China	5,504	4%		Switzerland	1,903	12%		Israel	1,484	12%
Germany	4,858	3%		Japan	1,110	7%		Germany	1,226	10%
Slovakia	2,724	2%		Austria	1,000	6%		Italy	365	3%
Israel	723	0%		United Kingdom	608	4%		United Kingdom	169	1%
Singapore	636	0%		Israel	482	3%		Australia	58	0%
South Korea	607	0%		Netherlands	258	2%		Brazil	50	0%
Japan	383	0%		Italy	207	1%		Hungary	29	0%
Rest of the World	1,103	1%		Rest of the World	1,080	7%		Rest of the World	45	0%
Total	152,783	100%		Total	16,077	100%		Total	12,255	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Ultrasound Machines (9018.12.0000) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
South Korea	111,743,432	28%		South Korea	41,726,463	21%		Japan	38,985,176	35%
China	78,437,997	20%		Japan	32,735,680	17%		South Korea	26,831,897	24%
Japan	48,046,656	12%		Singapore	18,540,143	10%		Norway	14,541,819	13%
Malaysia	33,730,387	9%		Canada	18,175,102	9%		Denmark	10,031,801	9%
France	21,931,382	6%		China	16,993,907	9%		Mexico	4,021,229	4%
Norway	21,834,486	6%		Austria	13,242,438	7%		Austria	3,693,976	3%
Mexico	21,258,031	5%		Italy	8,003,638	4%		Netherlands	2,696,723	2%
Canada	12,903,283	3%		France	7,519,686	4%		Germany	2,395,929	2%
Austria	11,242,916	3%		Norway	7,480,253	4%		Canada	1,843,560	2%
Israel	10,805,965	3%		Netherlands	4,926,542	3%		United Kingdom	1,610,859	1%
Rest of the World	23,712,431	6%		Rest of the World	25,099,268	13%		Rest of the World	4,311,522	4%
Total	395,646,966	100%		Total	194,443,120	100%		Total	110,964,491	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Ultrasound Machines (9018.12.0000) by Volume (Unit)
2019				2009				1999
Sources	Volume	Participation		Sources	Volume	Participation		Sources	Volume	Participation
South Korea	208,050	37%		Singapore	79,922	42%		Japan	3,683	22%
Malaysia	117,261	21%		South Korea	29,051	15%		South Korea	3,081	19%
France	73,227	13%		China	20,933	11%		Mexico	2,322	14%
China	66,709	12%		United Kingdom	16,780	9%		Denmark	2,120	13%
Japan	19,432	3%		Malaysia	13,643	7%		Netherlands	1,842	11%
Taiwan	18,277	3%		Japan	12,102	6%		Canada	1,146	7%
Mexico	12,273	2%		France	4,491	2%		Norway	666	4%
Denmark	9,307	2%		Mexico	2,781	1%		Germany	318	2%
United Kingdom	7,366	1%		Canada	2,669	1%		United Kingdom	296	2%
India	6,069	1%		Taiwan	1,651	1%		India	243	1%
Rest of the World	17,685	3%		Rest of the World	6,937	4%		Rest of the World	717	4%
Total	555,656	100%		Total	190,960	100%		Total	16,434	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Endoscopes (9018.19.4000) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Japan	687,143,667	71%		Japan	408,792,075	78%		Japan	244,710,990	84%
Germany	76,690,789	8%		Germany	38,660,822	7%		Germany	25,004,010	9%
Israel	51,960,605	5%		Ireland	25,830,648	5%		United Kingdom	7,386,738	3%
China	28,627,553	3%		China	7,540,606	1%		Sweden	6,943,932	2%
Canada	28,424,647	3%		United Kingdom	5,867,348	1%		Norway	2,470,677	1%
Mexico	13,801,026	1%		Israel	5,864,410	1%		Switzerland	859,137	0%
United Kingdom	13,656,834	1%		Mexico	5,686,110	1%		Israel	840,950	0%
Vietnam	11,648,290	1%		South Korea	2,822,135	1%		Canada	815,366	0%
Thailand	10,273,208	1%		Finland	2,718,856	1%		Ireland	760,098	0%
Czech Republic	9,050,237	1%		Thailand	2,550,000	0%		Spain	569,685	0%
Rest of the World	36,410,590	4%		Rest of the World	16,333,604	3%		Rest of the World	1,866,247	1%
Total	967,687,446	100%		Total	522,666,614	100%		Total	292,227,830	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Patient Monitoring Systems (9018.19.5500) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Japan	687,143,667	71%		Japan	408,792,075	78%		Japan	244,710,990	84%
Germany	76,690,789	8%		Germany	38,660,822	7%		Germany	25,004,010	9%
Israel	51,960,605	5%		Ireland	25,830,648	5%		United Kingdom	7,386,738	3%
China	28,627,553	3%		China	7,540,606	1%		Sweden	6,943,932	2%
Canada	28,424,647	3%		United Kingdom	5,867,348	1%		Norway	2,470,677	1%
Mexico	13,801,026	1%		Israel	5,864,410	1%		Switzerland	859,137	0%
United Kingdom	13,656,834	1%		Mexico	5,686,110	1%		Israel	840,950	0%
Vietnam	11,648,290	1%		South Korea	2,822,135	1%		Canada	815,366	0%
Thailand	10,273,208	1%		Finland	2,718,856	1%		Ireland	760,098	0%
Czech Republic	9,050,237	1%		Thailand	2,550,000	0%		Spain	569,685	0%
Rest of the World	36,410,590	4%		Rest of the World	16,333,604	3%		Rest of the World	1,866,247	1%
Total	967,687,446	100%		Total	522,666,614	100%		Total	292,227,830	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Ventilators and Other Oxygen Therapy Equipment (9019.20.0000) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Singapore	919,514,568	34%		Australia	373,175,399	29%		Mexico	105,160,948	31%
China	449,464,657	17%		Mexico	305,683,459	23%		Ireland	63,011,992	18%
Mexico	413,691,914	15%		China	204,273,285	16%		Australia	36,344,533	11%
Australia	256,030,776	9%		New Zealand	99,741,082	8%		Sweden	28,780,950	8%
New Zealand	117,354,100	4%		Singapore	57,072,576	4%		New Zealand	17,581,910	5%
Sweden	90,193,501	3%		Ireland	42,710,580	3%		Germany	17,360,441	5%
Ireland	79,207,770	3%		Germany	34,968,403	3%		Italy	10,851,326	3%
Germany	62,829,431	2%		United Kingdom	32,703,362	2%		Malaysia	10,739,064	3%
Switzerland	58,287,916	2%		Canada	25,116,165	2%		China	10,398,954	3%
Malaysia	57,848,627	2%		Taiwan	24,773,861	2%		Canada	7,986,373	2%
Rest of the World	192,658,895	7%		Rest of the World	108,837,344	8%		Rest of the World	34,624,541	10%
Total	2,697,082,155	100%		Total	1,309,055,516	100%		Total	342,841,032	100%

Source: U.S. International Trade Commission

PERSONAL PROTECTIVE EQUIPMENT Top Sources of U.S. Imports of Personal Protective Equipment by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
China	4,789,919,170	47%		China	2,573,442,752	51%		China	287,166,310	30%
Malaysia	1,650,146,772	16%		Malaysia	766,280,823	15%		Mexico	235,726,306	25%
Mexico	839,339,263	8%		Thailand	444,628,937	9%		Taiwan	115,319,905	12%
Thailand	718,162,744	7%		Mexico	339,641,507	7%		Malaysia	88,458,679	9%
Canada	381,046,610	4%		Canada	182,692,449	4%		Honduras	39,024,211	4%
Vietnam	249,745,714	2%		Taiwan	124,523,426	2%		Canada	29,982,771	3%
Taiwan	234,608,334	2%		Indonesia	97,156,765	2%		France	26,101,202	3%
India	158,015,459	2%		Honduras	79,030,904	2%		Thailand	15,607,020	2%
Indonesia	152,155,098	1%		Germany	73,261,590	1%		United Kingdom	15,465,478	2%
Germany	93,837,033	1%		India	39,437,272	1%		Indonesia	12,059,194	1%
Rest of the World	890,445,604	9%		Rest of the World	303,205,172	6%		Rest of the World	92,979,365	10%
Total	10,157,421,801	100%		Total	5,023,301,597	100%		Total	957,890,441	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Aprons and Gowns by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
China	394,217,278	45%		China	199,947,785	75%		China	72,656,172	75%
Canada	146,455,529	17%		Canada	39,026,866	15%		Taiwan	4,323,011	4%
India	68,081,499	8%		Mexico	4,060,177	2%		Mexico	3,983,834	4%
Vietnam	64,258,956	7%		Hong Kong	3,630,402	1%		Hong Kong	2,899,286	3%
Pakistan	40,116,024	5%		Taiwan	3,181,853	1%		Canada	2,216,622	2%
Mexico	37,643,170	4%		Thailand	2,891,590	1%		South Korea	2,134,193	2%
Cambodia	22,696,136	3%		Italy	2,890,597	1%		Italy	1,211,157	1%
Taiwan	14,609,752	2%		Vietnam	1,985,498	1%		Philippines	784,579	1%
Indonesia	13,603,980	2%		Lithuania	1,351,282	1%		France	767,985	1%
Guatemala	8,618,654	1%		France	1,150,550	0%		Sweden	750,569	1%
Rest of World	73,399,683	8%		Rest of World	6,182,272	2%		Rest of World	5,002,290	5%
Total	883,700,661	100%		Total	266,298,872	100%		Total	96,729,698	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Aprons and Gowns by Volume (Dozens)
2019				2009				1999
Sources	Volume	Participation		Sources	Volume	Participation		Sources	Volume	Participation
China	106,501,885	89%		China	64,381,058	95%		China	25,474,017	85%
Vietnam	2,830,336	2%		Thailand	1,221,750	2%		Hong Kong	2,058,656	7%
India	2,517,973	2%		Hong Kong	996,082	1%		Taiwan	492,922	2%
Cambodia	2,042,470	2%		Taiwan	584,575	1%		Mexico	447,509	1%
Pakistan	1,683,581	1%		Mexico	132,656	0%		South Korea	431,400	1%
Mexico	516,897	0%		Vietnam	117,630	0%		Italy	293,364	1%
Taiwan	475,952	0%		Italy	67,808	0%		Switzerland	168,466	1%
Burma	427,490	0%		South Korea	39,128	0%		Thailand	146,509	0%
Thailand	364,919	0%		Egypt	36,335	0%		Honduras	128,522	0%
Canada	273,010	0%		Indonesia	34,471	0%		Philippines	113,294	0%
Rest of the World	1,667,121	1%		Rest of the World	209,947	0%		Rest of the World	389,832	1%
Total	119,301,634	100%		Total	67,821,440	100%		Total	30,144,491	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Gloves by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
Malaysia	1,636,351,961	48%		Malaysia	757,294,454	36%		China	125,203,731	38%
China	968,699,496	28%		China	727,530,388	35%		Malaysia	86,424,307	26%
Thailand	554,709,370	16%		Thailand	414,378,024	20%		Taiwan	51,891,839	16%
Indonesia	133,839,928	4%		Indonesia	90,115,567	4%		Canada	14,562,730	4%
Sri Lanka	48,856,514	1%		Sri Lanka	34,301,383	2%		Thailand	12,703,424	4%
Vietnam	39,983,252	1%		Pakistan	9,067,088	0%		Indonesia	11,511,608	3%
Pakistan	17,887,281	1%		Taiwan	8,839,995	0%		United Arab Em	5,240,846	2%
South Korea	5,474,283	0%		Vietnam	7,387,623	0%		Belgium	4,834,392	1%
Taiwan	5,233,797	0%		Mexico	6,714,319	0%		Sri Lanka	4,158,679	1%
Guatemala	2,353,410	0%		Colombia	4,584,149	0%		Mexico	3,271,499	1%
Rest of World	17,513,772	1%		Rest of World	14,796,549	1%		Rest of World	12,530,172	4%
Total	3,430,903,064	100%		Total	2,075,009,539	100%		Total	332,333,227	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Gloves by Volume (Dozen Pairs)
2019				2009				1999
Sources	Volume	Participation		Sources	Volume	Participation		Sources	Volume	Participation
China	2,691,291,220	43%		China	1,613,588,100	50%		China	275,436,206	51%
Malaysia	2,577,501,552	42%		Malaysia	943,014,505	29%		Taiwan	97,770,844	18%
Thailand	613,777,726	10%		Thailand	472,690,951	15%		Malaysia	71,805,469	13%
Indonesia	213,290,574	3%		Indonesia	160,765,621	5%		Thailand	25,327,097	5%
Vietnam	66,178,365	1%		Taiwan	18,276,211	1%		Indonesia	24,337,404	5%
Sri Lanka	17,809,904	0%		Vietnam	14,389,649	0%		Canada	20,394,716	4%
Taiwan	4,276,701	0%		Sri Lanka	12,112,853	0%		Belgium	7,429,906	1%
Hong Kong	2,410,565	0%		Colombia	10,331,921	0%		Hong Kong	3,747,009	1%
India	1,754,830	0%		Hong Kong	4,648,481	0%		India	3,520,619	1%
South Korea	1,547,515	0%		South Korea	1,838,962	0%		South Korea	1,079,785	0%
Rest of the World	7,665,792	0%		Rest of the World	4,466,608	0%		Rest of the World	4,020,324	1%
Total	6,197,504,744	100%		Total	3,256,123,862	100%		Total	534,869,379	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Face Masks (6307.90.9889) by Value (USD)
2019				2009				1999
Sources	Value	Participation		Sources	Value	Participation		Sources	Value	Participation
China	2,319,451,193	72%		China	1,046,568,422	71%		N/A	N/A	N/A
Mexico	293,579,032	9%		Mexico	161,682,578	11%		N/A	N/A	N/A
Canada	109,980,688	3%		Canada	44,710,166	3%		N/A	N/A	N/A
Vietnam	83,285,631	3%		India	36,156,852	2%		N/A	N/A	N/A
India	83,215,737	3%		Taiwan	33,807,590	2%		N/A	N/A	N/A
Taiwan	56,208,998	2%		Thailand	15,180,224	1%		N/A	N/A	N/A
Pakistan	26,037,908	1%		Vietnam	14,190,569	1%		N/A	N/A	N/A
Thailand	21,079,299	1%		United Kingdom	12,822,696	1%		N/A	N/A	N/A
Japan	19,046,809	1%		Pakistan	12,054,734	1%		N/A	N/A	N/A
Germany	18,898,225	1%		Germany	9,043,868	1%		N/A	N/A	N/A
Rest of World	185,022,065	6%		Rest of World	80,519,706	5%		Rest of World	N/A	N/A
Total	3,215,805,585	100%		Total	1,466,737,405	100%		Total	N/A	N/A

Source: U.S. International Trade Commission

 

Top Sources of U.S. Imports of Face Masks (6307.90.9889) by Volume (Units)
2019				2009				1999
Sources	Volume	Participation		Sources	Volume	Participation		Sources	Volume	Participation
China	4,488,157,255	69%		China	2,598,124,878	64%		N/A	N/A	N/A
Mexico	696,544,156	11%		Mexico	975,892,655	24%		N/A	N/A	N/A
Japan	246,219,460	4%		Thailand	120,392,058	3%		N/A	N/A	N/A
Canada	245,886,564	4%		Taiwan	49,018,724	1%		N/A	N/A	N/A
India	196,749,251	3%		India	42,476,021	1%		N/A	N/A	N/A
Thailand	146,747,975	2%		Canada	37,798,706	1%		N/A	N/A	N/A
Vietnam	105,189,436	2%		Colombia	35,122,968	1%		N/A	N/A	N/A
Israel	72,936,684	1%		Pakistan	25,324,898	1%		N/A	N/A	N/A
Taiwan	52,179,062	1%		Indonesia	19,920,989	0%		N/A	N/A	N/A
Pakistan	48,555,747	1%		South Korea	18,636,706	0%		N/A	N/A	N/A
Rest of the World	172,385,355	3%		Rest of the World	125,634,467	3%		Rest of the World	N/A	N/A
Total	6,471,550,945	100%		Total	4,048,343,070	100%		Total	0	0%

Source: U.S. International Trade Commission

TOP SOURCES OF KEY MEDICAL DRUGS TO THE UNITED STATES, 2019

Top Source of U.S. Medicines by Volume, 2019 (kg)

Sources	Volume	Participation
India	95,125,143	23%
Mexico	77,492,876	19%
China	39,462,531	9%
Canada	39,440,557	9%
Italy	28,756,717	7%
Germany	21,037,695	5%
United Kingdom	13,893,620	3%
Israel	12,485,452	3%
Spain	11,867,480	3%
Ireland	11,109,211	3%
Rest of the World	64,953,243	16%
Total	415,624,525	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Drugs Sold in Measured Doses for Retail by Volume, 2019 (kg)

Sources	Volume	Participation
India	82,430,392	24%
Mexico	77,434,205	22%
China	30,404,432	9%
Canada	29,080,578	8%
Italy	24,221,113	7%
Germany	14,393,453	4%
United Kingdom	11,529,728	3%
Spain	10,488,655	3%
Ireland	9,667,305	3%
Israel	7,882,120	2%
Rest of the World	49,153,437	14%
Total	346,685,418	100%

Source: U.S. International Trade Commission 

 

Top Sources of U.S. Anti-Infective Medicines by Volume, 2019 (kg)

Sources	Volume	Participation
India	3,093,018	43%
Mexico	789,822	11%
Canada	780,679	11%
Singapore	398,201	6%
France	303,670	4%
United Kingdom	293,441	4%
Taiwan	216,549	3%
Croatia	183,488	3%
China	159,638	2%
Germany	157,739	2%
Rest of the World	833,891	12%
Total	7,210,136	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Cardiovascular Medicines by Volume, 2019 (kg)

Sources	Volume	Participation
India	16,402,787	62%
Canada	3,253,518	12%
China	1,017,985	4%
Singapore	784,913	3%
Czech Republic	767,832	3%
Italy	531,616	2%
Israel	461,786	2%
France	419,683	2%
Bangladesh	317,996	1%
Portugal	312,855	1%
Rest of the World	2,333,623	9%
Total	26,604,594	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Anti-Inflammatory Drugs and Painkillers by Volume, 2019 (kg)

Sources	Volume	Participation
China	10,558,922	50%
India	5,588,839	26%
Canada	2,067,920	10%
Japan	786,779	4%
Germany	555,001	3%
Italy	261,707	1%
Israel	256,285	1%
Spain	212,678	1%
Sweden	188,958	1%
Czech Republic	128,347	1%
Rest of the World	673,040	3%
Total	21,278,476	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Sedatives by Volume, 2019 (kg)

Sources	Volume	Participation
India	9,851,067	52%
Austria	2,749,435	15%
Italy	1,782,049	9%
Sweden	1,731,923	9%
Israel	675,319	4%
Norway	482,706	3%
Czech Republic	309,118	2%
China	191,250	1%
Switzerland	161,641	1%
France	157,379	1%
Rest of the World	830,443	4%
Total	18,922,330	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Diuretics by Volume, 2019 (kg)

Sources	Volume	Participation
India	1,480,688	84%
Canada	129,007	7%
Czech Republic	86,315	5%
Croatia	61,784	3%
Italy	5,347	0%
Israel	3,627	0%
N/A	N/A	N/A
N/A	N/A	N/A
N/A	N/A	N/A
N/A	N/A	N/A
Rest of the World	N/A	N/A
Total Imports	1,766,768	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Cough & Cold Medicines by Volume, 2019 (kg)

Sources	Volume	Participation
Canada	20,093,636	37%
China	13,631,559	25%
Switzerland	7,155,109	13%
United Kingdom	6,969,467	13%
Mexico	4,699,574	9%
India	992,727	2%
Spain	504,460	1%
Italy	368,045	1%
Germany	106,705	0%
Pakistan	23,171	0%
Rest of the World	77,802	0%
Total Imports	54,622,255	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Drugs Affecting the Respiratory System, Eyes, and Ears by Volume, 2019 (kg)

Sources	Volume	Participation
Ireland	3,400,505	31%
France	1,380,423	13%
India	1,371,653	13%
Canada	905,788	8%
South Africa	766,990	7%
Belgium	597,824	5%
Germany	484,378	4%
China	476,962	4%
Switzerland	348,894	3%
Israel	302,786	3%
Rest of the World	885,830	8%
Total Imports	10,922,033	100%

Source: U.S. International Trade Commission

 

Top Sources of U.S. Antibiotics by Volume, 2019 (kg)

Sources	Volume	Participation
India	4,559,779	27%
Italy	2,604,267	16%
Jordan	1,858,484	11%
China	1,766,479	11%
Canada	1,076,038	6%
Switzerland	962,067	6%
Germany	760,658	5%
United Kingdom	607,031	4%
Brazil	515,999	3%
Austria	465,984	3%
Rest of the World	1,604,320	10%
Total Imports	16,781,106	100%

Source: U.S. International Trade Commission

U.S. Import Reliance on China & India for Particular Drugs by Volume, 2019

U.S. EXPORTS OF CRITICAL MEDICAL GOODS TO CHINA AND THE WORLD BY MONTH, JAN. 2019 – SEPT. 2020

Data Notes

Data sourced from the U.S. Census Bureau and the U.S. International Trade Commission. The identification of critical medical goods was based on the U.S. International Trade Commission study “COVID-19 Related Goods: U.S. Imports and Tariffs (Updated)”, which used the World Customs Organization’s (WCO) reports “HS Classification Reference for Covid-19 Medical Supplies” and the World Health Organization (WHO) and World Customs Organization (WCO) report  “HS classification reference for Covid-19 medical supplies”.

The Commission’s report identifies the 10-digit codes of COVID-19 related goods in the Harmonized Tariff Schedule of the United States (HTS) for merchandise imported into the United States. Specifically, the study is based on the June 2020 (revision 13) version of the HTS. It is worth noting that the government data reporting U.S. exports does not use the same version of the HTS. Therefore, with respect to exports, in some instances and whenever possible, it was necessary to use different HS codes to identify U.S. exports of Covid-19 related goods when the codes mentioned in the USITC report did not match export data statistics, provided that the description was identical or sufficiently similar so as to confirm that the older version had the same scope as the one used by the USITC for import data.

In some instances, volume data was not available at the needed level of detail or was accounted for in different units of measurement by bilateral trade relationship. The 1999-2019 data is not adjusted for inflation because doing so is not necessary to compare the relative rank of import sources. In contrast, the 2019-2020 monthly data, which measures growth in value over time, is adjusted for inflation to base month July 2020 so that the measurement is growth in real terms.

The table below contains the HTS codes used to retrieve recent import and export data of COVID-19 related goods. In addition, it contains the HTS codes used to identify the different subcategories of COVID-19 related goods, such as medical devices or personal protective equipment.

Critical Medical Goods Categories	HTS-10	Exports HTS Codes (when different)	USITC Category for subset of COVID-19 related goods in the HTS-10	HTS-10 statistical reporting number description	Example of COVID-19 related product within the HTS-10
Test kits	3002.15.0000		COVID-19 test kits/testing instruments	Immunological products, put up in measured doses or in forms or packings for retail sale	Certain diagnostic reagents and test kits
	3821.00.0000		COVID-19 test kits/testing instruments	Prepared culture media for development of microorganisms	Viral transport medium
	3822.00.5090	3822.00.0000; 3822.00.0002	COVID-19 test kits/testing instruments	Composite diagnostic or laboratory reagents other than those of heading 3002 or 3006, not elsewhere specified or included	Certain COVID-19 test kits and reagents
	8421.19.0000		COVID-19 test kits/testing instruments	Centrifuges, including centrifugal dryers, not elsewhere specified or included	Centrifuges
	8543.10.0000		COVID-19 test kits/testing instruments	Particle accelerators, not elsewhere specified or included	Particle accelerators
	9027.50.4015	9027.50.5000; 9027.50.9000	COVID-19 test kits/testing instruments	Other chemical analysis instruments and apparatus using optical radiations	Blood analyzers
	9027.80.2500		COVID-19 test kits/testing instruments	Nuclear magnetic resonances instruments and apparatus (except those of heading 9018)	COVID-19 diagnostic test instruments and apparatus
Disinfectants and Sterilization Products	2207.10.6090		Disinfectants and sterilization products	Ethyl alcohol, undenatured, of an alcoholic strength by volume of 80 percent volume or higher, for nonbeverage purposes, excluding for fuel use	Alcohol solution (at least 80 percent alcoholic strength)
	2208.90.8000	NA	Disinfectants and sterilization products	Undenatured ethyl alcohol of an alcoholic strength by volume of less than 80 percent volume, not elsewhere specified or included	Alcohol solution (less than 80 percent alcoholic strength)
	2828.90.0000		Disinfectants and sterilization products	Hypochlorites, chlorites, and hypobromites, not elsewhere specified or included	Bleach (sodium hypochlorite), non-retail sale
	2847.00.0000		Disinfectants and sterilization products	Hydrogen peroxide, whether or not solidified with urea	Hydrogen peroxide in bulk
	2905.12.0050		Disinfectants and sterilization products	Propan-2-ol	Isopropyl alcohol
	3004.90.9210		Disinfectants and sterilization products	Anti-infective medicaments put up in measured doses or forms or packings for retail sale, not elsewhere specified or included	Chlorhexidine; hydrogen peroxide presented as a medicament; imipenem and cilastatin; lopinavir; oseltamivir; povidone-iodine; remdesivir; ribavirin; ritonavir
	3402.19.1000	NA	Disinfectants and sterilization products	Organic surface active agents, other, aromatic or modified aromatic	Wipes (disinfecting or antibacterial), with aromatic or modified aromatic organic surfactants, non-retail sale
	3402.20.1100	NA	Disinfectants and sterilization products	Preparations containing any aromatic or modified aromatic surface-active agent, put up for retail sale	Wipes (disinfecting or antibacterial), with aromatic or modified surfactants, retail sale
	3402.20.5100		Disinfectants and sterilization products	Surface-active, washing and cleaning preparations, whether or not containing soap, put up for retail sale, not elsewhere specified or included	Bleach (sodium hypochlorite), retail sale
	3808.94.1000	NA	Disinfectants and sterilization products	Disinfectants containing any aromatic or modified aromatic disinfectant	Disinfectants (containing aromatics), including certain disinfecting wipes
	3808.94.5000	NA	Disinfectants and sterilization products	Disinfectants, not elsewhere specified or included	Disinfectants (other), including certain disinfecting wipes
	3824.99.9295	3824.99.9270	Disinfectants and sterilization products	Chemical products and preparations and residual products of the chemical or allied industries, not elsewhere specified or included	Hand sanitizer
	3824.99.9297	3824.99.9270	Disinfectants and sterilization products	Chemical products and preparations and residual products of the chemical or allied industries, not elsewhere specified or included	Hand sanitizer
	5603.12.0010	5603.12.0000	Disinfectants and sterilization products	Nonwovens, of man-made filaments, weighing more than 25 g/m2 but not more than 70 g/m2, impregnated, coated or covered with material other than or in addition to rubber, plastics, wood pulp or glass fibers; “imitation suede”	Disinfectant wipes
	5603.92.0010	5603.92.0000	Disinfectants and sterilization products	Nonwovens, other than of man-made filaments, weighing more than 25 g/m2 but not more than 70 g/m2, impregnated, coated or covered with material other than or in addition to rubber, plastics, wood pulp or glass fibers; “imitation suede”	Wipes with isopropyl alcohol (e.g., alcohol prep pads)
	8419.20.0010	8419.20.0000	Disinfectants and sterilization products	Medical or surgical sterilizers	Medical or surgical sterilizers
	8419.20.0020	8419.20.0000	Disinfectants and sterilization products	Laboratory sterilizers	Laboratory sterilizers
Ventilators and Oxygenation Products	9018.19.9550		Oxygen therapy equipment and pulse oximeters	Electro-diagnostic apparatus, used in medical, surgical, dental or veterinary sciences, not elsewhere specified or included	Fingertip pulse oximeter (for use by medical professionals)
	9018.39.0040	9018.39.0030	Oxygen therapy equipment and pulse oximeters	Bougies, drains and sondes, and parts and accessories	Intubation equipment; parts and accessories
	9018.90.6000		Oxygen therapy equipment and pulse oximeters	Electro-surgical instruments and appliances and parts and accessories	Extracorporeal membrane oxygenation (ECMO)
	9019.20.0000		Oxygen therapy equipment and pulse oximeters	Ozone therapy, oxygen therapy, aerosol therapy, artificial respiration or other therapeutic respiration apparatus; parts and accessories	Medical ventilators (artificial respiration apparatus); extracorporeal membrane oxygenation (ECMO); Continuous Positive Airway Pressure (CPAP) units; bilevel positive airway pressure (BiPap or BPap) units; oxygen concentrators; oxygen humidifiers for oxygen therapy applications; oxygen delivery devices to supply oxygen from the device to the patient; flow splitters
	9026.80.4000	9026.80.0000	Oxygen therapy equipment and pulse oximeters	Heat meters incorporating liquid supply meters, and anemometers	Flowmeter, Thorpe tube for oxygen 0-15L/min
	9029.20.4080	9029.20.5000	Oxygen therapy equipment and pulse oximeters	Speedometers and tachometers (excluding bicycle speedometers), not for use in civil aircraft	Fingertip pulse oximeters
Personal Protective Equipment (PPE)	3926.20.1010		Personal protective equipment	Gloves, seamless, surgical and medical, of plastic	Seamless surgical and medical gloves
	3926.20.1020	3926.20.1060	Personal protective equipment	Gloves, seamless, except surgical and medical, disposable, of plastic	Seamless disposable gloves
	3926.20.9010	3926.20.9050	Personal protective equipment	Aprons, of plastic	Plastic aprons
	3926.20.9050		Personal protective equipment	Articles of apparel and clothing accessories, of plastic, not elsewhere specified or included	Protective unisex garments, such as medical and surgical gowns; plastic sleeve protectors
	4015.11.0110	NA	Personal protective equipment	Surgical gloves, of natural rubber, other than hard rubber	Surgical gloves (natural rubber)
	4015.11.0150	4015.11.0000	Personal protective equipment	Surgical gloves, of vulcanized rubber other than hard rubber, not elsewhere specified or included	Surgical gloves
	4015.19.0510	NA	Personal protective equipment	Medical gloves, mittens and mitts (except surgical) of natural rubber, other than hard rubber	Medical gloves (natural rubber)
	4015.19.0550	NA	Personal protective equipment	Medical gloves, of vulcanized rubber other than hard rubber, not elsewhere specified or included	Medical gloves
	4015.19.1010	4015.11.0100	Personal protective equipment	Seamless, disposable gloves, of vulcanized rubber other than hard rubber	Other seamless rubber gloves
	4015.90.0010	NA	Personal protective equipment	Aprons, of vulcanized rubber other hard rubber	Protective aprons
	4015.90.0050	4015.90.0000	Personal protective equipment	Articles of apparel and clothing accessories, excluding aprons, for all purposes, of vulcanized rubber other than hard rubber, not elsewhere specified or included	Protective unisex garments made of rubber sheeting, textile reinforced rubber or textile backed rubber.
	4818.50.0020		Personal protective equipment	Articles of apparel and clothing accessories of paper pulp, paper, cellulose wadding or webs of cellulose fibers	Hospital/medical gowns or scrubs
	4823.90.8600	NA	Personal protective equipment	Articles of uncoated paper or paperboard or of webs of cellulose fiber, cut to size or shape, not elsewhere specified or included	Paper shoe covers
	6113.00.1012	6113.00.0012	Personal protective equipment	Garments, knitted or crocheted, outer surface impregnated, coated, covered, or laminated with rubber or plastic material, surface completely obscured	Unisex surgical gowns
	6116.10.6500	6116.10.0000	Personal protective equipment	Other gloves, knitted or crocheted, containing less than 50 percent by weight of cotton, man-made fibers or other textile fibers, or any combination thereof, no fourchettes, impregnated	Gloves impregnated or covered with plastics or rubber
	6210.10.2000	6210.10.0000	Personal protective equipment	Garments, made up of fabrics of heading 5602 or 5603: of fabrics formed on a base of paper or covered or lined with paper	Protective garments
	6210.10.5000	6210.10.0000	Personal protective equipment	Garments, made up of fabrics of heading 5602 or 5603: nonwoven disposable apparel designed for use in hospitals, clinics, laboratories and other areas	Disposable garments for use in hospitals, clinics, laboratories, etc.
	6210.10.9010	6210.10.0000	Personal protective equipment	Garments, made up of fabrics of heading 5602 or 5603: coveralls and overalls, not knitted, of impregnated fabric	Protective garments (coveralls and overalls)
	6210.10.9040	6210.10.0000	Personal protective equipment	Garments, made up of fabrics of heading 5602 or 5603: not knit felt and non-woven fabric, except coveralls and overalls, of impregnated fabric	Protective garments
	6210.50.5555	6210.50.1000; 6210.50.2000	Personal protective equipment	Women’s or girls’ not knit man-made fiber other apparel, impregnated fabric not elsewhere specified or included	Unisex surgical gowns
	6211.42.1081	6211.42.0000	Personal protective equipment	Women’s or girls’ other apparel, of cotton, not knitted not elsewhere specified or included	Patient gowns; unisex surgical gowns
	6211.43.1091	6211.43.0000	Personal protective equipment	Women’s or girls’ other apparel, of man-made fibers, not knitted, not elsewhere specified or included	Patient gowns; unisex surgical gowns
	6216.00.5420	6216.00.5000	Personal protective equipment	Gloves, mittens and mitts: of man-made fibers: no fourchettes, sidewalls, less than 36 percent of wool or fine animal hair	Gloves
	6307.90.9889	6307.90.9995	Personal protective equipment	Other made-up articles, not elsewhere specified or included	N95 particulate respirators; other respirators; other textile face-masks, including surgical and disposable masks; shoe covers; textile face masks with plastic face shield
	6505.00.0100		Personal protective equipment	Hair-nets, any material, whether or not lined or trimmed	Disposable hair nets
	6505.00.8015		Personal protective equipment	Nonwoven disposable headgear without peaks or visors of manmade fibers	Disposable headgear
	6505.00.9089	6505.00.8600	Personal protective equipment	Hats and other headgear, knitted or crocheted, or made up of lace, felt or other textile fabric, in the piece, whether or not lined or trimmed, not elsewhere specified or included	Other headgear
	9004.90.0000		Personal protective equipment	Spectacles, goggles and the like, corrective, protective, not elsewhere specified or included	Protective goggles
	9020.00.6000	9020.00.8000	Personal protective equipment	Other breathing appliances and gas masks	Gas masks with mechanical parts or replaceable filters for protection against biological agents; masks incorporating eye protection or facial shields; powered air purifying respirators (PAPRs)
	9020.00.9000	9020.00.8000	Personal protective equipment	Parts and accessories for breathing appliances and gas masks	Parts of gas masks and masks incorporating eye protection or facial shields; parts of powered air purifying respirators (PAPRs)
Gas & Face Masks with Filters	6307.90.9889	6307.90.9995	Personal protective equipment	Other made-up articles, not elsewhere specified or included	N95 particulate respirators; other respirators; other textile facemasks, including surgical and disposable masks; shoe covers; textile face masks with plastic face shield
Pharmaceutical products	2501.00.0000		Medicines (Pharmaceuticals)	Salt (including table salt and denatured salt) and pure sodium chloride, whether or not in aqueous solution or containing added anti-caking or free-flowing agents; sea water	Saline solution
	2907.19.8000	2907.19.9000	Medicines (Pharmaceuticals)	Other monophenols	Propofol
	2922.29.2700	2922.29.0000; 2922.29.9000	Medicines (Pharmaceuticals)	Amino-naphthols and other amino-phenols and their derivatives used as drugs	Dobutamine
	2922.50.1300	NA	Medicines (Pharmaceuticals)	Isoetharine hydrochloride; isoxsuprine hydrochloride; nylidrin hydrochloride; phenylephrine hydrochloride; salbutamol (albuterol); and terbutaline sulfate	Salbutamol (albuterol)
	2923.90.0100		Medicines (Pharmaceuticals)	Quaternary ammonium salts and hydroxides, whether or not chemically defined, other	Suxamethonium chloride
	2924.29.6210	2924.29	Medicines (Pharmaceuticals)	Acetaminophen	Acetaminophen (Paracetamol)
	2924.29.6250	2924.29	Medicines (Pharmaceuticals)	Other aromatic cyclic amides and derivatives for use as drugs	Metoclopramide; oseltamivir
	2925.29.2000		Medicines (Pharmaceuticals)	Aromatic imines and their derivatives; salts thereof, for use as drugs	Chlorhexidine
	2930.90.9135	NA	Medicines (Pharmaceuticals)	Other non-aromatic organo-sulfur compounds used as drugs	Cilastatin
	2932.19.5100	2932.19.0000; 2932.19.0002	Medicines (Pharmaceuticals)	Non-aromatic compounds containing an unfused furan ring (whether or not hydrogenated) in the ring	Ranitidine
	2933.29.2000	2933.29.0000	Medicines (Pharmaceuticals)	Aromatic or modified aromatic drugs containing an unfused imidazole ring (whether or not hydrogenated) in the structure	Ondansetron
	2933.33.0000		Medicines (Pharmaceuticals)	Alfentanil (INN), anileridine (INN), bezitramide (INN), bromazepam (INN), difenoxin (INN), diphenoxylate (INN), dipipanone (INN), fentanyl (INN), ketobemidone (INN), methylphenidate (INN), pentazocine (INN), pethidine (INN), pethidine (INN) intermediate A, phencyclidine (INN) (PCP,PE), phenoperidine (INN), pipradrol (INN), piritramide (INN), propiram (INN) and trimeperidine (INN); salts thereof	Fentanyl
	2933.39.3100	NA	Medicines (Pharmaceuticals)	Antidepressants, tranquilizers and other psychotherapeutic agents with an unfused pyridine ring (whether or not hydrogenated) in the structure	Haloperidol
	2933.39.4100	2933.39	Medicines (Pharmaceuticals)	Drugs containing an unfused pyridine ring (whether or not hydrogenated) in the structure, not elsewhere specified or included	Omeprazole; vecuronium bromide;
	2933.49.2600	2933.49.2250	Medicines (Pharmaceuticals)	Drugs containing a quinoline or isoquinoline ring-system (whether or not hydrogenated) not further fused, not elsewhere specified or included	Atracurium besylate (atracurium besilate)
	2933.59.3600	NA	Medicines (Pharmaceuticals)	Other aromatic or modified aromatic anti-infective agents	Lopinavir
	2933.79.0800	2933.79	Medicines (Pharmaceuticals)	Lactam products described in additional U.S. note 3 to section VI, not elsewhere specified or included	Milrinone
	2933.91.0000		Medicines (Pharmaceuticals)	Alprazolam(inn), camazepam (inn), chlordiazepoxide (inn), clonazepam (inn), clorazepate & other heterocyclic compounds with nitro atom(s) only	Lorazepam; midazolam
	2933.99.5300		Medicines (Pharmaceuticals)	Cardiovascular drugs, not elsewhere specified or included	Levosimendan
	2934.10.1000	2934.10.0000	Medicines (Pharmaceuticals)	Aromatic or modified aromatic products described in U.S. note 3 to section VI containing an unfused thiazole ring (whether or not hydrogenated)	Ritonavir
	2934.30.2300		Medicines (Pharmaceuticals)	Antidepressants, tranquilizers and other psychotherapeutic agents	Levomepromazine
	2934.99.3000	2934.99	Medicines (Pharmaceuticals)	Aromatic or modified aromatic heterocyclic compounds used as drugs, not elsewhere specified or included	Remdesivir
	2934.99.4700	2934.99	Medicines (Pharmaceuticals)	Heterocyclic compounds used as drugs, not elsewhere specified or included	Ribavirin; sulbactam;
	2937.19.0000		Medicines (Pharmaceuticals)	Polypeptide, protein and glycoprotein hormones, their derivatives and structural analogues, not elsewhere specified or included	Vasopressin/vasopressin injection
	2937.21.0020	2937.21.0000	Medicines (Pharmaceuticals)	Hydrocortisone	Hydrocortisone
	2937.29.9095	2937.29.0000	Medicines (Pharmaceuticals)	Steroidal hormones, their derivatives and structural analogues, not elsewhere specified or included	Methylprednisolone
	2937.90.0500		Medicines (Pharmaceuticals)	Epinephrine	Epinephrine
	2937.90.2000	2937.90.1500	Medicines (Pharmaceuticals)	Catecholamine hormones, their derivatives and structural analogues, not elsewhere specified or included	Norepinephrine
	2939.11.0000		Medicines (Pharmaceuticals)	Concentrates of poppy straw; buprenorphine (INN); codeine, dihydrocodeine (INN), ethylmorphine, etorphine (INN), heroin, hydrocodone (INN), hydromorphone (INN), morphine, nicomorphine (INN), oxycodone (INN), oxymorphone (INN), pholcodine (INN), thebacon (INN) and thebaine; salts thereof	Codeine; morphine
	2939.19.5000	2939.19.0000	Medicines (Pharmaceuticals)	Vegetable alkaloids, natural or reproduced by synthesis, and their salts, ethers, esters, and other derivatives, not elsewhere specified or included	Morphine glucuronide
	2939.79.0000		Medicines (Pharmaceuticals)	Vegetable alkaloids, natural or reproduced by synthesis, their salts and other derivatives, not elsewhere specified or included	Atropine methonitrate; atropine oxide; ipratropium bromide
	2941.10.1000		Medicines (Pharmaceuticals)	Ampicillin and its salts	Ampicillin
	2941.10.5000	2941.10.2000; 2941.10.6000	Medicines (Pharmaceuticals)	Other penicillins and their derivatives with a penicillanic acid structure; salts thereof	Amoxicillin; piperacillin; tazobactam
	2941.30.0000		Medicines (Pharmaceuticals)	Tetracyclines and their derivatives; salts thereof	Doxycycline
	2941.90.1050	2941.90.6000	Medicines (Pharmaceuticals)	Natural antibiotics, not elsewhere specified or included	Amphotericin B
	2941.90.3000	2941.90.6000	Medicines (Pharmaceuticals)	Aromatic or modified aromatic antibiotics (excluding natural)	Ceftazidime; vancomycin
	2941.90.5000	2941.90.6000	Medicines (Pharmaceuticals)	Other antibiotics (excluding natural, aromatic or modified aromatic antibiotics)	Amikacin; azithromycin; ceftriaxone; clavulanic acid; meropenem; imipenem
	3001.90.0190		Medicines (Pharmaceuticals)	Heparin and its salts; other human or animal substances prepared for therapeutic or prophylactic uses, not elsewhere specified or included	Enoxaparin; enoxaparin sodium; heparin sodium
	3002.13.0000		Medicines (Pharmaceuticals)	Immunological products, unmixed, not put up in measured doses or in forms or packings for retail sale	Interferon alfa
	3002.14.0000		Medicines (Pharmaceuticals)	Immunological products, mixed, not put up in measured doses or in forms or packings for retail sale	Mixed bulk immunologicals (medicines that trigger the immune system)
	3002.19.0000		Medicines (Pharmaceuticals)	Blood fractions, not elsewhere specified or included	Other immunologicals (medicines that trigger the immune system)
	3002.20.0000		Medicines (Pharmaceuticals)	Vaccines for human medicine	Human vaccines
	3003.10.0000		Medicines (Pharmaceuticals)	Medicaments (excluding goods of 3002, 3005, or 3006) containing penicillins or derivatives thereof, or streptomycins or their derivatives	Amoxicillin and clavulanic acid; ampicillin and sulbactam
	3003.20.0000		Medicines (Pharmaceuticals)	Medicaments containing other antibiotics (excluding penicillins and streptomycins)	Amikacin; amphotericin B; azithromycin; ceftazidime; ceftriaxone; doxycycline; imipenem and cilastatin; meropenem; piperacillin and tazobactam; vancomycin
	3003.39.5000	3003.39.0000	Medicines (Pharmaceuticals)	Other medicaments containing hormones or other products of heading 2937 but not containing antibiotics	Epinephrine; hydrocortisone; methylprednisolone; norepinephrine; vasopressin/vasopressin injection
	3003.49.0000		Medicines (Pharmaceuticals)	Other medicaments containing alkaloids or derivatives thereof	Atropine methonitrate; atropine oxide; codeine; ipratropium bromide;  morphine; morphine glucuronide
	3003.90.0100		Medicines (Pharmaceuticals)	Other medicaments (excluding goods of heading 3002, 3005 or 3006) consisting of two or more constituents which have been mixed together	Acetaminophen (paracetamol); atracurium besylate (atracurium besilate); chlorhexidine; dobutamine; enoxaparin/enoxaparin sodium; fentanyl; haloperidol; heparin sodium; levomepromazine; levosimendan; lopinavir; lorazepam; metoclopramide; midazolam; milrinone; omeprazole; ondansetron; oseltamivir; povidone-iodine; propofol; ranitidine; remdesivir; ribavirin; ritonavir; salbutamol (albuterol); suxamethonium chloride; vecuronium bromide
	3004.10.5045		Medicines (Pharmaceuticals)	Combination antibiotics containing penicillins or derivatives thereof, with a penicillanic acid structure, or streptomycins or their derivatives, not elsewhere specified or included	Amoxicillin and clavulanic acid; ampicillin and sulbactam; piperacillin and tazobactam
	3004.20.0060		Medicines (Pharmaceuticals)	Medicaments containing other antibiotics, not elsewhere specified or included	Amikacin; amphotericin B; azithromycin; ceftazidime; ceftriaxone; doxycycline; meropenem; vancomycin
	3004.32.0000		Medicines (Pharmaceuticals)	Medicaments containing corticosteroid hormones, their derivatives and structural analogues	Hydrocortisone; methylprednisolone
	3004.39.0050		Medicines (Pharmaceuticals)	Medicaments containing hormones or other products of heading 2937 but not containing antibiotics, not elsewhere specified or included	Epinephrine; Norepinephrine; vasopressin/vasopressin injection
	3004.49.0020		Medicines (Pharmaceuticals)	Anticonvulsants, hypnotics and sedatives, in measured doses or in forms or packaging for retail sale	Morphine glucuronide
	3004.49.0040		Medicines (Pharmaceuticals)	Other medicaments primarily affecting the central nervous system, not elsewhere specified or included	Atropine methonitrate; atropine oxide; codeine; fentanyl; morphine
	3004.90.9220		Medicines (Pharmaceuticals)	Cardiovascular medicaments put up in measured doses or in forms for retail sale	Dobutamine; enoxaparin; enoxaparin sodium; levosimendan; milrinone
	3004.90.9228	3004.90.9225	Medicines (Pharmaceuticals)	Analgesics, antipyretics and nonhormonal anti-inflammatory agents, not elsewhere specified or included	Acetaminophen (paracetamol)
	3004.90.9230		Medicines (Pharmaceuticals)	Anticonvulsants, hypnotics and sedatives, primarily affecting central nervous system, put up in measured doses or in forms or packings for retail sale	Midazolam; propofol
	3004.90.9235		Medicines (Pharmaceuticals)	Antidepressants, tranquilizers and other psychotherapeutic agents, primarily affecting the central nervous system, put up in measured doses or in forms or packings for retail sale	Haloperidol; levomepromazine; lorazepam;
	3004.90.9240		Medicines (Pharmaceuticals)	Medicaments primarily affecting the central nervous system, put up in measured doses or in forms or packings for retail sale, not elsewhere specified or included	Atracurium besylate (atracurium besilate); suxamethonium chloride; vecuronium bromide
	3004.90.9260		Medicines (Pharmaceuticals)	Medicaments primarily affecting the digestive system put up in measured doses or in forms or packings for retail sale, not elsewhere specified or included	Metoclopramide; omeprazole; ondansetron; ranitidine
	3004.90.9270		Medicines (Pharmaceuticals)	Medicaments primarily affecting electrolytic, caloric or water balance, put up in measured doses or in forms or packing for retail sale, not elsewhere specified or included	Ringer´s lactate; saline solution
	3004.90.9285		Medicines (Pharmaceuticals)	Medicaments primarily affecting the eyes, ears or respiratory system, put up in measured doses or in forms or packings for retail sale, not elsewhere specified or included	Ipratropium bromide; salbutamol (albuterol)
	3004.90.9290		Medicines (Pharmaceuticals)	Medicaments consisting of mixed/unmixed products put up in measured doses or in forms or packings for retail sale, not elsewhere specified or included	Heparin sodium; saline solution
	3905.99.8000		Medicines (Pharmaceuticals)	Other vinyl polymers in primary forms, not elsewhere specified or included	Povidone-iodine

*Sometimes multiple product categories are found under one 6-digit HS code; in such circumstances, the 6-digit HS code has been measured once for both products.

With respect to pharmaceuticals, we used a broader selection of goods to show that the U.S. problematic overconcentration of sources of imports of medical drugs does not limit to COVID-19 related medicines. The table bellow contains the HTS codes used:

Medicine Categories	HTS Codes
All Finished Medicines	3003, 3004
Finished Medicines Sold for Retail in Measured Doses	3004.90
Sulfonamides (Antibacterials)	3004.90.6005, 3004.90.9105, 3004.90.9205
Anti-Infective Medicines	3004.90.9210, 3004.90.9110, 3004.90.6010
Cardiovascular Medicines	3004.90.9220, 3004.90.9120, 3004.90.6020
Anti-Inflammatories & Painkillers	3004.90.6022, 3004.90.6024, 3004.90.6026, 3004.90.6028, 3004.90.9022, 3004.90.9024, 3004.90.9026, 3004.90.9028, 3004.90.9122, 3004.90.9124, 30049.09.126, 3004.90.9128, 3004.90.9222, 3004.90.9224, 3004.90.9226, 3004.90.9228
Sedatives	3004.90.6030, 3004.90.9230
Diuretics	3004.90.9265, 3004.90.6065, 3004.90.9165
Cough and Cold Medicines	3004.90.9176, 1704.9025, 3004.90.3000, 2106.90.39, 3004.90.6075, 3004.90.9276
Medicines Affecting Respiratory System, Eyes and Ears	3004.90.9185, 3004.90.9285
Antibiotics	3003.20, 3004.20

We are unsure why Jordan has such a significant share of antibiotic exports to the U.S., but it may be explained by U.S. Agency for International Development (USAID) assistance to Jordan’s antibiotic sector as well as benefits conferred upon Jordan from the U.S.-Jordan Free Trade Agreement. Ireland’s outsized role as the top import source for U.S. respiratory, ear, and eye medicine may be explained by actual production capacity in Ireland for these goods. Usually, Ireland ranks as a top import source by value, but not by volume. While the volume data set represents the amount of medicine that actually is sent to the United States, the value data set reflects the high prices of some medicines protected by monopoly patents as well as pharmaceutical corporations’ tax-avoidance strategies. This includes some firms’ corporate “inversions,” which are when firms relocate their legal “home” to countries with low tax rates and then charge their legal entities in their old base countries’ large patent-licensing fees, which then can be deducted from taxes as a business expense. Nevertheless, Ireland seems to actually be a significant volume producer of ear, eye, and respiratory medicine. It is unclear which subcategory Ireland exports to the U.S. as the tariff lines cannot be more specific. Finally, Mexico appears to have an outsized rank as the second largest import source by volume for all finished medicines.