Natural Disasters and Drug Shortages: How Climate Change Is Breaking the Medicine Supply Chain

When Hurricane Helene hit North Carolina in September 2024, hospitals didn’t just lose power-they lost life-saving medicine. Within 72 hours, intravenous fluids, the backbone of emergency care, vanished from shelves. Cancer patients delayed treatments. Newborns in NICUs went without sterile saline. Surgeons postponed operations. This wasn’t an accident. It was a predictable collapse of a system built on fragile assumptions.

Why Your Medicine Vanishes When the Weather Gets Bad

Most people assume drug shortages happen because of cost, demand, or corporate greed. But the real story is simpler: climate disasters are now the top cause of medicine shortages in the U.S. Between 2017 and 2024, nearly one-third of all drug shortages were directly tied to hurricanes, floods, and wildfires. The FDA now tracks these events as a primary threat.

The problem isn’t just that storms damage factories. It’s where those factories are. Over 65% of U.S. pharmaceutical manufacturing facilities sit in counties that have declared a weather disaster since 2018. Puerto Rico alone used to produce 10% of all FDA-approved drugs and 40% of sterile injectables. After Hurricane Maria in 2017, insulin supplies dropped by 80% and took 18 months to recover. Why? Because the island’s power grid took 11 months to fully restore-and without electricity, you can’t make medicine.

The Hidden Geography of Medicine

You might not realize it, but your IV fluids, antibiotics, and even insulin come from a handful of places. Baxter International’s plant in North Cove, North Carolina, makes 60% of the country’s IV bags. If that one facility goes down, the whole country feels it. That’s not redundancy-that’s risk.

Even more alarming: 78% of sterile injectable drugs in the U.S. have only one or two manufacturing sites. No backups. No alternatives. When a tornado hit Pfizer’s facility in Rocky Mount, North Carolina, in 2023, 27 different medicines disappeared overnight. Hospitals scrambled. Patients waited. Some died.

And it’s not just the U.S. The same pattern exists globally. In 2018, a 7.3-magnitude earthquake in Iran killed 700 people and injured 10,000. But unlike the U.S., Iran’s drug production was spread out. No single facility held more than 5% of the country’s supply. The result? No nationwide shortage. The U.S. system, by contrast, is built like a house of cards.

Why Hurricanes Are the Worst

Not all disasters are equal. Hurricanes cause the most damage to drug supplies. They account for 47% of all climate-related disruptions, far ahead of wildfires (28%) and floods (19%). Why?

Hurricanes don’t just break windows-they destroy power grids, flood warehouses, and shut down ports for weeks. After Hurricane Maria, saline solution shortages lasted 14 months. Hospitals rationed it. They gave it only to patients in critical condition. Kids with dehydration? Delayed. Elderly patients with infections? Left without antibiotics.

The timeline is brutal. It takes 6 to 12 months to build a new pharmaceutical facility. Two to three years to install the specialized equipment needed to make sterile injectables. By the time you recover, the next storm is already on the horizon.

What’s Being Done-And Why It’s Not Enough

Some progress is being made. After Hurricane Maria, the FDA created an Emergency Declaration pathway to import drugs from overseas. But it took 28 days to get saline from Europe. In a crisis, that’s too slow.

Now, companies like Sensos are using AI to predict storms before they hit. One system flagged Hurricane Helene’s threat to IV fluid supply 14 days in advance. A few hospitals used that warning to stockpile emergency supplies. They avoided rationing. Others didn’t. The difference? Preparation.

The Strategic National Stockpile is testing pilot programs to store critical injectables in hurricane-prone regions. Early results show a 40% reduction in shortage duration. That’s promising. But only 31% of major pharmaceutical companies have actually implemented any meaningful climate resilience plan.

The Cost of Inaction

The financial cost is rising. The market for pharmaceutical supply chain resilience is projected to hit $9.7 billion by 2029. But money won’t fix this unless we change how we think about medicine.

Right now, the industry runs on “just-in-time” inventory. That means factories make exactly what’s needed, when it’s needed. No extra stock. No backups. It works fine in normal times. But when a storm knocks out a single plant, the whole system collapses.

The FDA is pushing a new rule: manufacturers of critical drugs must keep a 90-day emergency inventory. That’s a start. It could prevent 60% of climate-related shortages. But it’ll add 4-7% to production costs. Some companies will push back. Patients will pay more.

And here’s the uncomfortable truth: the people who suffer most are the ones who need medicine the most. Cancer patients. Diabetics. Newborns. Elderly patients on dialysis. Hospitals with fewer than 500 beds are 3.2 times less likely to map their supply chains than big systems. That means rural clinics, community hospitals, and safety-net providers are the last to know-and the first to run out.

What Needs to Change

Experts agree: we need three things.

First, geographic diversity. Don’t put all your factories in one region. Build in multiple climate-resilient zones-like the Midwest, the Pacific Northwest, and the Mountain West. No single storm should take out half the country’s supply.

Second, mandatory stockpiles. Not just for the federal government-for manufacturers. If you make insulin, you need to store enough to last 90 days. Not 30. Not 60. 90.

Third, faster regulatory responses. The FDA’s emergency import system needs to be automated. Think of it like a fire alarm: when a disaster hits, approved foreign suppliers get automatic clearance. No paperwork. No delays.

What You Can Do

You can’t fix the supply chain alone. But you can be informed.

If you rely on a specific medication-especially injectables like insulin, epinephrine, or saline-ask your pharmacy: Do you have a backup source? Do you know if this drug is at risk? Many hospitals now post shortage alerts on their websites. Check them.

Talk to your doctor. Ask if there are alternative treatments. Sometimes, switching from an IV to an oral version can make a difference.

And demand accountability. When your local hospital runs out of medicine because a storm took out a factory in North Carolina, ask: Why wasn’t this prevented?

The Bottom Line

Climate change isn’t a future threat to medicine. It’s happening now. Every time a hurricane hits, someone’s treatment gets delayed. Every time a factory floods, a life is put at risk. The system wasn’t designed for this. But it can be fixed-if we act before the next storm comes.