Middle East Conflict Threatens Cancer Drug Deliveries Worldwide

Ongoing Middle East warfare is forcing pharmaceutical companies to scramble for alternative shipping routes as key cargo airports close. Temperature-sensitive cancer medications and other critical drugs face potential shortages if the conflict continues, with hospitals possibly running low on supplies within weeks.

Pharmaceutical companies worldwide are scrambling to find new shipping routes for life-saving medications as Middle East conflicts force the closure of major cargo airports, threatening the supply of temperature-sensitive cancer treatments and other critical drugs.

The escalating tensions, which began with U.S. and Israeli military actions against Iran two weeks ago followed by retaliatory Iranian strikes across the region, have effectively shut down crucial aviation hubs and maritime passages that serve as lifelines for medical supplies reaching Gulf nations.

Although significant medication shortages haven’t materialized yet, industry leaders warn this could rapidly change if hostilities continue. Gulf countries depend heavily on imported pharmaceuticals, many of which have limited shelf lives and require precise temperature control during transport, making lengthy ground transportation impractical.

Drug company officials report they’re actively pursuing backup routes into Gulf regions and transporting medications by truck from alternative airports including those in Jeddah and Riyadh, Saudi Arabia. Additional routing options include facilities in Istanbul and Oman.

Critical aviation centers such as Dubai, Abu Dhabi and Doha have suspended operations due to Iranian military responses to earlier U.S. and Israeli strikes. These airports serve as vital cargo connections between Europe, Asia and Africa, with carriers like Emirates and Etihad, plus logistics companies including DHL, specializing in transporting medications requiring strict temperature maintenance for safety and effectiveness.

According to Wouter Dewulf, a professor at Antwerp Management School, industry statistics reveal that more than 20 percent of worldwide air freight – the primary transportation method for urgent or life-saving medications and vaccines – faces potential Middle East-related disruptions.

One industry leader warned that establishing alternative “cold-chain corridors” – temperature-regulated pathways for sensitive pharmaceuticals – requires significant time and isn’t always feasible.

A pharmaceutical company representative revealed their organization has formed specialized teams to prioritize shipments crucial for patient care, including cancer therapies, noting that some temperature-controlled cargo might miss scheduled connections without proper storage and handling arrangements.

A medical equipment company official explained their initial response involves tracking shipments currently in transit or awaiting departure, then determining which cargo requires rerouting and whether new shipping plans are necessary.

This executive, who requested anonymity when discussing internal procedures, noted that Europe-to-Asia freight normally passing through Dubai or Doha airports is being redirected through China or Singapore. Ocean transport isn’t viable due to extended travel times and Iran’s closure of the strategically important Strait of Hormuz.

“If you have an urgent surgery with a patient waiting for treatment, you have to choose the faster mode of transport,” the executive said.

Prashant Yadav, a senior fellow for global health at the Council on Foreign Relations, explained that inventories of medications with short shelf lives, temperature requirements and higher costs typically last about three months, with cancer drugs – particularly monoclonal antibodies – facing the greatest risk.

Delivery delays for cancer medications can have devastating effects on patients, potentially forcing them to begin treatment programs over again or allowing their condition to deteriorate.

Yadav confirmed the disruption is already impacting some companies, with certain clients indicating they may face supply shortages within four to six weeks without improvement.

More than 100 pharmaceutical and logistics industry representatives participated in a webinar hosted by Pharma.Aero, a life sciences logistics organization, to address the Gulf crisis and its effects on supply chains and transportation.

Some logistics companies report the industry is managing the current situation. Dorothee Becher, who oversees air logistics for healthcare at freight company Kuehne+Nagel, said carriers are operating flights to Jeddah, Riyadh and Oman while utilizing ground transportation to reach final destinations.

“I do not see any risk yet that the inventory would go dramatically down,” she said, noting that healthcare cargo receives priority handling.

However, maintaining shipment flow requires constant effort.

Doaa Fathallah, chief operating officer at biopharma logistics company Marken, confirmed that cold-chain cargo continues moving, but only through continuous rerouting as airspace restrictions change rapidly.

The rerouting results in extended transit periods and increased fuel expenses, raising transportation costs and requiring additional dry ice to maintain medication temperatures.

Industry executives emphasize that risks increase if disruptions continue, as Gulf and Asian supplies diminish.

Transportation complications could also impact products that indirectly affect drug supplies, including shortages of vial stoppers, IV bag materials and packaging components.

“It’s not always a shortage of the medicine itself,” said David Weeks, who monitors the supply chain industry for ratings agency Moody’s. “In some cases, it’s the little stopper on the vial where the dosage is extracted.”