New Zealanders could lose access to life-saving medicines in a trade-ending global catastrophe because imported ingredients are needed to locally manufacture commonly used medicines, research led by the University of Otago, Wellington shows.
The researchers say events such as a Northern Hemisphere nuclear war, a volcanic winter, a bioengineered pandemic, or a major solar storm, could all contribute to a collapse in international trade which would lead to critical shortages of imported medicines.
The research is published in the New Zealand Medical Journal.
Professor Nick Wilson
The senior researcher, Professor Nick Wilson, from the Faculty of Medicine's Department of Public Health at the University of Otago, Wellington, says the research shows none of the most widely prescribed 10 medicines for acute conditions, including pain relievers and medicines for treating infections, are able to be made in New Zealand. This is because of a lack of access to the key ingredients, many of which require petrochemical refining which the country no longer has.
Professor Wilson says global manufacturing of medicines has become dependent on just a few countries, with Europe, for example, obtaining 60-80 per cent of its ingredients for generic medicine manufacture from China.
The medicines examined in the study are: the popular pain reliever paracetamol; omeprazole used for acute gastritis and treating gastric ulcers; the antibiotic amoxicillin, used to treat severe bacterial pneumonia; the anti-inflammatory ibuprofen, used for acute pain relief; aspirin, used to manage strokes and heart attacks; the blood pressure medication metoprolol; salbutamol, used for acute asthma attacks; prednisone, a steroid used for severe allergic reactions; the antihistamine cetirizine; and the calcium channel blocker amlodipine, used to manage angina.
Professor Wilson says not only is modern pharmaceutical manufacturing highly dependent on ingredients from petrochemical refining, but New Zealand lacks many other necessary ingredients for the 10 medicines – and the complex industrial infrastructure to synthesise modern medicines at scale.
"The country's current pharmaceutical industry is focused on secondary manufacturing and formulation, the packaging of imported active ingredients and quality control and testing.
"So once stocks of imported medicines had been exhausted in a post-catastrophe situation, there would likely be increased deaths from infections, heart disease, stroke and asthma.
"New Zealand could potentially build new infrastructure to produce some of the ingredients needed for medicines production by modifying the wood pyrolysis plant in Timaru to produce phenols and furans, or the Glenbrook steel plant to produce benzene/phenol from coke gas. A micro-refinery could also be built for oil extracted in Taranaki or from coal tar from West Coast coal mines.
"But all of these options would be expensive and challenging to undertake in a crisis situation."
Another of the study authors, independent researcher Dr Matt Boyd, says New Zealand could also consider producing natural alternatives to some medicines, for instance by using salicylic acid from the bark of willow trees as an alternative to aspirin, growing opium poppies to make morphine and codeine, or by using hormones derived from livestock to produce insulin.
But he says, one of the most sensible approaches would be for the New Zealand and Australian Governments to come up with a joint plan to produce and trade key pharmaceuticals.
"Australia still has petrochemical refining, produces some of its own medicines, and is a major global producer of legal morphine from opium poppies. The New Zealand Government could contribute funding towards medicines production in Australia, but it could also help ensure the viability of post-catastrophe Trans-Tasman trade by using locally produced biofuel to keep cargo ships running."
The research paper, 'Capacity to manufacture key pharmaceuticals in Aotearoa New Zealand after a global catastrophe' is authored by Professor Nick Wilson, Peter Wood and Dr Matt Boyd and is published in the New Zealand Medical Journal.
