Leadership1 publisher3 min readPublished
The generic drugs the US buys from India still start with Chinese feedstocks
A Foreign Affairs essay credits Beijing with escalation dominance built on 80 to 90 percent of rare-earth production, and argues that cutting direct imports from China has made American supply chains harder to trace.
The Board Room · Leadership desk

What happened
- The Trump administration went into its October 2025 summit with Xi Jinping asserting that it held leverage over China because the United States runs the trade deficit in the relationship.
- To ease Beijing's restrictions on rare-earth elements, the United States conceded on tariffs, technology controls and visa policies over the course of negotiations.
- The United States imports numerous generic drugs from India, and India relies on China for the feedstocks and components used to make them.
- The essay's near-term prescription for Washington is to build up short-term inventories of the strategic goods that are ultimately sourced from China.
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Why it matters
- constraint A country-of-origin field at the first tier cannot see this exposure: a buyer whose generics arrive from India records no Chinese content and still stops when the feedstock stops.
- decision Sequencing is the choice in front of a procurement team, because stock can be raised inside a quarter while the essay puts diversification of supply, with allies, on a longer-term track.
- precedent Two administrations offered market access and other compensation to stand up alternative sources and did not get there, so a plan whose first step is federal policy resolving the dependency has no date attached.
"What do we lose by the Chinese raising tariffs on us? We export one-fifth to them of what they export to us, so that is a losing hand for them," Bessent said [2]. Take his ratio as given and it implies China sells about five dollars of goods to the United States for every dollar it buys back [3]. That is a measure of the revenue each side forgoes in a mutual embargo. Replacement time is a different question: how long either side needs to replace what stops arriving. The essay's argument is that the second question decides outcomes, and that trade wars are easy to lose when a country depends on an exporter for hard-to-replace inputs while still treating trade as a zero-sum game [18].
On that second question the essay credits Beijing with escalation dominance, meaning that at any level of threat it can inflict more pain on the United States than the reverse [17]. Rare earths are its example. Chinese control of 80 to 90 percent of production [4] leaves every other producer in the world 10 to 20 percent between them [5].
For anyone maintaining a bill of materials, the operative finding comes from economists Mary Lovely and Christine Wan, cited in the essay. Declining direct US imports from China have made supply chains more attenuated and less transparent [7]. China is still the source of rare earths, specialized magnets and the lower-end semiconductors used in cars and appliances, even where intermediate production steps now happen elsewhere [8]. A purchasing record that captures country of origin at the first tier books that content wherever the last step took place.
Two administrations have tested the alternative. Neither the Trump nor the Biden government meaningfully decoupled even the most sensitive industries from China [10]. Both tried to incentivize alternative sourcing through wider access to the US market or other compensation, and both failed [11]. The argument attributes that difficulty to economics: strong commercial fundamentals built these arrangements, and unwinding them is slow and costly [21].
So the near-term choice is between holding stock and qualifying a substitute, and the two run on different clocks. Inventory can be raised inside a quarter and is paid for in working capital. Qualification waits on someone else building capacity, which the essay places on a longer-term track requiring cooperation with allies [14].
The policy case is explicit. The essay wants Washington to pursue increased imports of key strategic goods and increased Chinese direct investment at the coming summit [13]. Beijing, it holds, is comfortable with the status quo and has little interest in escalation [15], and a tit-for-tat conflict would hurt China's own economy [16]. Those are claims about intent, and the sourcing facts underneath them hold whichever way the summit goes. The essay does not say how large the inventories it recommends should be [20].
What to watch
- Whether the coming Xi-Trump meeting produces the increased imports of strategic goods and Chinese direct investment the essay recommends.
- Whether Beijing reimposes rare-earth restrictions after the concessions Washington made on tariffs, technology controls and visa policy.
- Whether allied diversification produces a qualified non-Chinese source for specialized magnets or generic drug feedstocks.