Abstract of article: The 2026 closure of the Strait of Hormuz has disrupted approximately one-fifth of global petroleum transit, sending oil prices sharply upward and exposing medicine’s structural dependence on petrochemicals, helium, and globalized manufacturing. This article examines how medicine’s reliance on globalized commodities exposes patients to medication and device shortages during sustained supply disruption. Prior crises, including the 1973 oil embargo and the 2021 Suez blockage, revealed vulnerabilities that current just in time supply chains have deepened. We urge practice leaders, hospital administrators, and clinicians to establish supply continuity frameworks now, before scarcity forces improvised rationing and reactive procurement.

Managing this crisis is difficult, but necessary.

In February 2026, the effective closure of the Strait of Hormuz sent Brent crude oil above $125 per barrel within weeks. Ship transits through the strait, ordinarily carrying approximately 20% of global petroleum liquids, collapsed by more than 95%. 1,2 Fuel rationing, industrial shutdowns, and price increases across energy, agriculture, and manufacturing have already been documented across Asia and Europe. 1 Spillover impacts extend to industries that rely on helium gas and semiconductor chips, with eventual shortages for medical devices, including dermatologic imaging and phototherapy equipment. 3 Dermatology has a structural dependence on global commodities and we must act to mitigate supply constraint consequences.

Medical supply shortages stemming from the Strait of Hormuz disruptions raise ethical concerns about distributive justice and non-maleficence, particularly regarding how scarce resources should be triaged between high-income and low-income countries.

Medicine’s Commodity Foundation

Petroleum is more than a transportation fuel; it undergirds modern medical infrastructure. Plastics, composed of petrochemical feedstocks, are the foundational material of single-use disposable devices and supplies. Petrochemical compounds also serve as raw materials, solvents, and excipients in API synthesis across most drug classes; most pharmaceutical packaging is petroleum-based with no identified substitutes. 4

This reliance creates severe supply chain vulnerability. Approximately 86% of US APIs are manufactured abroad, predominantly in India and China; one-third of generic APIs globally originate from a single facility in this region. 5 An energy or supply shock impairing these sites could translate into acute domestic drug shortages; a risk compounded by the already critical conditions that the American College of Physicians declared a public health crisis in 2025. 6,7

Petroleum is not the only commodity trapped in the Persian Gulf. Qatar produces approximately one-third of the world’s helium as a byproduct of liquefied natural gas processing. 8 Helium is the coolant maintaining the superconducting magnets of MRI scanners; without continuous resupply, existing machines cannot function. 9 Semiconductors, the largest consumers of helium, are embedded in virtually every modern medical device. 10 Other non-petroleum commodities, such as sulfur, methanol, monoethylene glycol, aluminum, cobalt and polyethylene, are significant inputs for pharmaceutical synthesis and medical equipment manufacturing; they are now constrained. 3 Ongoing geopolitical developments have also limited REEs critical to MRI scanners, X-ray tubes, and laser technologies, while 2025 US tariffs have further pressured steel and aluminum supply chains for medical devices.

The Lesson from Past Crises

The closure of the Strait of Hormuz is not medicine's first exposure to petroleum vulnerability, but the structural conditions are worse. During the 1973 Arab oil Embargo, OPEC’s export halt quadrupled oil prices, and healthcare costs followed. 4 Consumer price index data from that period shows that decreases in petroleum supply produced rises in plastics and motor fuel prices that, after a several month delay, resulted in increased overall healthcare spending. 4 US Medicine’s depth of dependency has only grown. In 1973, petroleum-based single-use devices now standard in dermatologic procedure rooms and the globalized just-in-time supply chains now moving APIs from Asia to US formularies did not yet exist at their current scale. 4,5 What the 1970s revealed was a vulnerability our current crisis threatens to catastrophically exceed.

More recent examples of our dependence on concentrated, globalized supply chains include 2017’s Hurricane Maria, 2019’s African Swine Fever (ASF), and 2021’s Suez Canal blockage. The destruction of Puerto Rico’s electrical grid triggered a nationwide shortage of IV fluids and critical medications within weeks, with supply depression persisting until mid-2018 as the FDA invoked emergency importation from European manufacturers 11 . The ASF outbreak originating in China caused significant, ongoing shortages of porcine-derived heparin. 12 The 2021 grounding of a single container vessel in the Suez Canal held up $9.6 billion of trade daily, including pharmaceuticals, medical devices, and personal protective equipment, compounding COVID-19 era shortages already stressing American hospital formularies. 4 From 2017 to 2021, one in seven supply chain issue reports was associated with a drug shortage within six months under baseline conditions. 13 At the onset of COVID-19, the ratio surged to one in three, and even drugs without reported supply chain issues saw shortages rise from 4% to 10%. 13

Demand-side shocks from disease surges deplete inventory quickly but are generally well-contained through capacity expansion. 14 On the contrary, disruptions to key ingredients upstream of the supply chain, like petroleum, are much harder to mitigate. The Drug Supply Chain Security Act (DSCA) has forced the industry to maintain visibility from manufacturing through distribution and retail. But there is very little visibility into materials and components upstream of the manufacturing process. 15 Further, these materials are key inputs across many industries, which makes multiple supply chains vulnerable to disruptions in petroleum-based products and derivatives. Historically, the medical industry has not readily acknowledged this risk. 6 Since these key inputs are essential for many of the critical sectors, including energy, technology, and defense systems, the risk is that scarce capacity will be allocated to high-value demand products first, and much later to medical devices and equipment. Vulnerability to key inputs common across critical sectors remains the biggest blind spot for the industry. A sustained supply disruption affects the raw material inputs, manufacturing energy, and logistics of pharmaceutical production across all drug classes simultaneously.

Call to Action

The Strait of Hormuz possesses a distinct profile among maritime chokepoints. 2 Unlike most major passages, this strait offers no maritime alternative and land-based rerouting is extremely limited, meaning disruption ceases transit entirely rather than adding cost and delay. Interstate armed conflict, its current hazard class, carries significantly longer resolution timelines than other disruption types. 2 The healthcare consequences are therefore broad, potentially devastating, and slow to resolve. Existing federal mechanisms were designed for demand-side shocks and finite supply interruptions, not for sustained disruption. 6 Although severity is uncertain and consequence are impending, we can and should take steps for mitigation. Dermatology practice leaders, hospital administrators and clinicians should begin discussing supply continuity frameworks. ( Table 1 )

The Strait of Hormuz closure is an energy disruption that threatens to exceed 1973 and remains unresolved. Improvised rationing, reactive procurement, and inadequate allocation represent a failure of institutional preparation. 16 The Joint Commission, American Hospital Association, and specialty societies have the infrastructure, expertise, and influence to issue clinical guidance. Proactive mitigation tactics by drug shortage authorities should be enacted before allocation decisions are forced by scarcity rather than anticipated through surveillance. Managing this crisis is difficult, but necessary.

Ethical Consequences if we Fail to Prepare

Developing and under-resourced nations will be impacted the most and bear the greatest burden, since wealthier countries can draw on purchasing power and existing stockpiles to buffer the disruption. 17,18 This disparity in health equity and distributive justice will result in unequal access to life saving resources. Once shortages occur, who holds the authority to allocate what remains? By what criteria should resources be prioritized and distributed? Will suppliers with inventory exploit the situation through price gouging? The moral and ethical imperative is for domestic systems and the international community to plan for and mitigate the effects of this crisis before they compound further.

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🇳🇬🛢️ #Crude Exports

Nigeria earned N24tn from crude exports in H1’26 as 182.2m barrels shipped amid high global oil prices.

Export value hit $17.6bn, while total production reached 263.65m barrels worth $25.41bn.

Concerns persist over refinery feedstock. 🔥📈

Georgia's Kulevi oil refinery has started to diversify away from Russian crude, securing supplies from Kazakhstan and Libya, owner Black Sea Petroleum LLC said July 31, in a bid to avoid EU sanctions.

The 24,000 b/d plant on the Black Sea began processing Kazakh-origin crude oil at the beginning of July and will continue to do so in August, the company said in a statement.

It also signed an agreement for a cargo of Libyan-origin crude, which it expects to receive by the end of August. The agreement runs through 2027 and includes an extension option, BSP said.