Table 1

Manufacturing problems as causes of supply chain disruptions

Risks to manufactureNon-medical examplesMedical examples
Geographically concentrated manufacturing: Production concentrated in one or few locations, such that a localised disruptive event (natural or political) risks major disruption to product manufacturing13
  • Earthquake and tsunami in Japan, and flooding in Thailand, disrupts automotive and electronics industries in 201135

  • Acute sterile saline shortage after hurricane damage to manufacturing plants, 20177

  • Risk of medical gloves shortage due to COVID-19 lockdown in Malaysia, the home of ~65% of the global supply36

Limited numbers of manufacturers: Few manufacturers, such that events affecting a single firm (eg, disruptions or decisions) risks major disruption to product manufacturing17
  • Fire at Philip’s semiconductor plant in 2000 disrupts Ericson’s sole-source of chips for mobile phone production37

  • Critical shortage of propofol (2009–2010) as two of three suppliers left US market38

  • Shortages of nine childhood vaccines, 2000–2005, due to problems with the limited numbers of suppliers39

Scarcity of critical inputs: Resource inputs or parts whose scarcity risks major disruption due to non-substitutability of resources14 or tightly-coupled production arrangements (just-in-time, short-cycle manufacturing)17
  • Multiyear delays in production of Boeing Dreamliner due to shortage of aerospace fasteners40

  • Disruptions in supply of raw or bulk materials responsible for drug shortages33

  • Lack of meltblown, non-woven polypropylene for the production of surgical masks and N95 respirators41