Medicine Cabinet
By Teodoro B. Padilla

A war thousands of kilometers away can quietly determine whether a patient in the Philippines receives life-saving treatment on time.
The ongoing conflict involving Iran, the United States, and Israel is not only a geopolitical crisis, it is a global supply chain shock with direct implications for medicine availability, cost, and access. Disruptions in key trade routes, rising fuel prices, and constrained logistics capacity are reverberating across sectors, including healthcare.
As the war in the Middle East enters its fifth week, timely and coordinated action will be critical to safeguard the country’s medicine supply.
One of the foremost recommendations put forward by Dr. Diana Edralin, president of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), is the shift to a six-month national inventory buffer for essential medicines. Given the 12- to 24-month manufacturing lead times for many pharmaceutical products, proactive and synchronized planning is essential to prevent stockouts.
Immediate and accurate forecasting enables both government and industry to anticipate demand for essential medicines and vaccines, and to place orders early, before supply chains become constrained. By doing so, it helps prevent stockouts during periods of global disruption. In a conflict scenario, where shipping routes may be affected and fuel costs may spike, countries with strong forecasting systems are better positioned to secure supply in advance, while others may be left competing for limited stocks. Toward this end, a formal joint forecasting process for biologics and vaccines for 2026 and 2027 should be prioritized. Strengthened government-private sector collaboration will be key to mitigating risks and ensuring supply continuity.
The government may also consider institutionalizing a National Medicines Logistics Command Center to enable real-time data sharing across agencies and industry stakeholders. Such a platform can support more responsive decision-making and equitable allocation of limited supply. Lessons from the COVID-19 pandemic have shown that coordinated, whole-of-system approaches are critical in managing large-scale disruptions.
To help manage rising logistics costs, green-lane prioritization for pharmaceutical shipments and expedited cargo processing can reduce delays and demurrage charges. Policy options such as targeted tax relief may also be explored to offset increases in war risk insurance and air freight premiums.
Ensuring sufficient fuel supply is likewise critical. Approximately 800,000 liters per month are required to sustain the nationwide distribution of medicines and vaccines across the archipelago. Without reliable fuel access, supply availability at ports and warehouses may not translate into timely access for patients.
Policy predictability will also be important in supporting affordability. Expanding Value-Added Tax (VAT) exemptions for medicines can help cushion patients from rising global cost pressures.
The Universal Health Care (UHC) Act provides an opportunity to further strengthen resilience through pooled procurement. By aggregating demand for 2026 and 2027, the country can achieve economies of scale and improve negotiating leverage, helping to offset higher importation and logistics costs. In times of uncertainty, forecasting and pooled procurement serve as critical shock absorbers against supply disruptions and price volatility.
Pooled procurement harnesses the strength of collective buying power by consolidating demand across purchasers. This enables bulk purchasing and strengthens negotiating leverage, ultimately helping to reduce medicine prices even amid global inflation. Evidence shows that pooled procurement can lower overall pharmaceutical costs. In a war scenario, this approach becomes even more critical, as it helps offset rising logistics and production costs.
Ultimately, maintaining a stable medicine supply chain is not just a health concern as it is an economic and national security imperative. Reliable access to medicines sustains workforce productivity, supports disease control programs, and reduces avoidable healthcare costs. Conversely, supply disruptions can lead to treatment delays, poorer health outcomes, and higher long-term expenditures.
The war in the Middle East underscores how deeply interconnected health security is with global events. In this environment, sustained collaboration between the government and the private sector is essential. By aligning policy, planning, and operational capabilities, the Philippines can build a more resilient system, one that protects access to life-saving essential medicines and vaccines even amid geopolitical uncertainty.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines, which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of developing, investing and delivering innovative medicines, vaccines, and diagnostics for Filipinos to live healthier and more productive lives.