Medicine and Science from The BMJ How the war in Iran will disrupt medical supplies around the world
Mar 20, 2026
Prashant Yadav, supply‑chain expert at the Council on Foreign Relations, explains how Gulf transport hubs and oil affect pharmaceutical logistics. Anny Huang, doctor and journalist, recounts Australia’s multi‑year IV fluid crisis and supplier concentration. Mark Dayan, Nuffield Trust policy analyst, analyses NHS procurement fragility and policy responses. They discuss transport disruptions, rerouting risks, stranded stock, and systemic supply‑chain vulnerabilities.
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Single Factory Fault Can Cripple Surgery Supply
- A single packaging fault at a dominant supplier can create nationwide shortages in critical surgical supplies.
- Horais Medical's German packaging fault threatened bone cement shortages affecting ~4,600 patients weekly across hip, knee, and fracture operations.
Price Pressure Made NHS Supply Chains Fragile
- Price pressure and long, concentrated supply chains have built fragility into NHS medicine and device supply.
- Mark Dayan noted supplier concentration and global long supply routes as root causes of multi-year elevated shortages.
Use Alternative Suppliers And Regulator Paths
- Use regulator flexibility and alternative suppliers to manage shortages proactively.
- NHS and MHRA can fund alternative suppliers and sign off new sources, but cost and supplier availability limit this approach.