Medical Supply Chains Failed During COVID: Have We Fixed Them?

This article was exclusively written for The European Sting by Dr Ahmed Bilal, MD, Vice President, PIMSA-GHWD– Pakistan International Medical Students  Association. The opinions expressed within reflect only the writers’ views and not necessarily The European Sting’s position on the issue.

In the spring of 2020, hospitals across Europe confronted a reality few policymakers had imagined possible. Intensive care units in Italy and Spain rationed ventilators. Nurses in France and the UK reused single use masks. Germany, despite its industrial strength, scrambled to source protective equipment from abroad. As borders closed and flights were grounded, medical goods supposedly global public necessities became instruments of national survival.

Within weeks, more than 80 countries imposed export restrictions on medical supplies. Global trade in critical health goods froze precisely when demand surged. The question Europe must now confront is uncomfortable but unavoidable: have medical supply chains been structurally repaired since COVID-19, or has the world simply moved on?

What Went Wrong?

The pandemic exposed how deeply medical supply chains had been optimized for efficiency at the expense of resilience. Production of personal protective equipment, pharmaceutical ingredients, and medical devices had become dangerously concentrated. China dominated PPE manufacturing. India supplied roughly half of the world’s vaccines and a large share of active pharmaceutical ingredients (APIs). Europe, despite its regulatory sophistication, relied heavily on imports for basic medical inputs.

When COVID-19 struck, this concentration collided with national reflexes. Export bans were imposed across the EU and beyond, despite warnings from the World Health Organization that such measures would worsen shortages elsewhere. “Just-in-time” logistics designed to minimize costs collapsed under sudden border closures and transport disruptions.

Crucially, there was no effective global coordination mechanism to manage supply allocation during the crisis. Multilateral institutions offered guidance, but lacked enforcement power. The result was a scramble: countries outbid one another, diverted shipments mid-air, and treated medical supplies as strategic assets rather than shared necessities.

The Cost of Failure

The human cost of these failures was severe. Delayed access to oxygen, diagnostics, and vaccines translated directly into preventable deaths, particularly during the early waves of the pandemic. Health systems already under strain faced compounding shortages that undermined frontline care.

The economic consequences were equally damaging. Prices for basic equipment soared. Black markets emerged. Governments especially in lower- and middle-income countries were forced into emergency procurement at inflated costs, diverting funds from other essential services. Inequality widened as wealthier countries secured early access to vaccines and treatments, while others waited months or years.

Europe was not immune to this dynamic. While the EU ultimately coordinated vaccine procurement more effectively than many regions, early missteps and export controls strained relations with trading partners and exposed vulnerabilities in pharmaceutical supply chains that remain unresolved.

What Has Changed Since COVID?

There have been genuine efforts at reform. The European Union has launched initiatives to strengthen health preparedness, including the creation of the Health Emergency Preparedness and Response Authority (HERA). Strategic stockpiles of medical equipment have expanded. Governments now speak openly about “strategic autonomy” in health manufacturing.

Some diversification has occurred. Regional manufacturing hubs for vaccines and APIs are being encouraged. Public funding has flowed into domestic production capacity. Companies have begun reassessing single-supplier dependencies.

Yet a closer look reveals persistent gaps. Production of critical inputs remains concentrated. Global rules governing export restrictions during health emergencies remain voluntary and weak. WHO recommendations still lack binding force. Many national preparedness plans exist largely on paper, untested outside crisis conditions.

The uncomfortable truth is that much of the post-COVID reform agenda prioritizes political reassurance over systemic resilience. Stockpiles expire. Domestic factories struggle to remain viable without sustained demand. And the global coordination problem the core failure of 2020 remains largely unaddressed.

A Global Problem with European Stakes

Europe’s exposure to supply disruptions is not hypothetical. The continent depends heavily on imported APIs, rare medical components, and overseas manufacturing capacity. While reshoring everything is neither feasible nor desirable, strategic dependence without safeguards is a vulnerability.

The pandemic also revealed missed opportunities for structured public-private partnerships. Temporary emergency measures were rarely converted into long-term industrial policy. Regional cooperation beyond the EU—particularly with neighboring regions and the Global South remains limited, despite clear mutual benefits.

For Europe, supply-chain resilience is not merely a health issue. It is a matter of economic security, industrial policy, and geopolitical credibility. A bloc that cannot guarantee access to essential medical goods in a crisis risks both domestic instability and diminished global influence.

The Next Crisis Will Move Faster

Future shocks are unlikely to grant the luxury of time. Climate change is accelerating the spread of infectious diseases. Armed conflicts threaten transport corridors and energy supplies. Cyberattacks increasingly target logistics and health infrastructure.

In such a world, disruption will be faster, more complex, and harder to predict. Response windows will shrink. Supply chains that are merely efficient will again prove brittle.

The lesson of COVID-19 is not that pandemics are rare anomalies, but that systemic stress is now a recurring feature of global life.

What Must Be Done Now

Governments must move beyond emergency rhetoric to sustained investment. This means supporting regional manufacturing of critical medical goods, not as protectionism but as risk diversification. Transparent procurement systems and regularly audited stockpiles are essential.

At the global level, crisis-time trade rules require teeth. Fair-sharing mechanisms for medical supplies particularly vaccines and therapeutics must be enforceable, not optional. Europe, as a regulatory power, is well placed to push for such standards.

The private sector has a role as well. Dual-sourcing, surge manufacturing capacity, and stress-testing supply chains should become standard practice, not crisis responses.

Finally, media and civil society must resist collective amnesia. Preparedness is politically inconvenient precisely because success looks like nothing happening.

The Real Test

Pandemics are inevitable. Medical shortages are not. COVID-19 offered a costly warning about the fragility of global health supply chains. Whether Europe has truly learned that lesson will only become clear when the next crisis arrives.

The danger is not ignorance, but complacency. The next pandemic will not wait for broken supply chains to be fixed.

Dr Ahmed Bilal, MD, is Vice President of PIMSA–GHWD and works on global health security and health systems resilience. He can be reached at ahmeddrsyed@gmail.com.