Takeaway: Shifting from one country at risk for sickness, death & political disruption to another is probably not a long term strategy, PINC, MCK, ABC

Editor's Note: Below is a complimentary Health Policy Unplugged note written yesterday by our Health Policy analyst Emily Evans. Click HERE to learn more about Emily's research process and the analysis subscribers receive.

The next chapter of "Why Pandemics and Global Supply Chains Don't Mix," is the reminder that public health emergencies have a tendency to upset a variety of geopolitical fruit baskets.

The primary driver of change has been the way in which pandemics and epidemics reshuffle humanity, particularly with the all important economic input factor called labor.

The Bubonic Plague which handed workers, then known as serfs, more economic power as the laboring class was decimated by the epidemic, altering the political landscape well into the 19th century. (see Gingrich and Vogler, 2020).

The U.S., like many developed counties, has lowered input costs on many items including for our purposes, medical devices, supplies and pharmaceuticals, by offshoring labor to the less expensive parts of the world.

Places with inexpensive labor are also frequently those without advanced medical technology, health care services, good nutrition and all the other things that make surviving an infectious disease more likely. More people die in developing countries than in wealthy ones. Those that don't often relocate, if they can.

Malaysia stepped up in the spring of 2020, filling in gaps in the supply chain as demand grew. Today, the country faces rising deaths and a more unsettled political dynamic, even with a robust vaccination rate of 33%.

With the prospect of waves of COVID variants washing across the world, a spotty rollout of vaccines and all manner of despots and dictators using the chaos as an opportunity, the chances are high that supply chains stability may never be restored until it is on/nearshored.

Health Policy Chart | Geopolitics, Covid, & Supply Chains - Trade Data