Assessment Sacks predicted that in the years after May 2020 the U.S. would bring home production of strategic medical goods—antibiotics, medicines, PPE—so that these would be manufactured domestically instead of relying on China.

1. Medicines and antibiotics are still largely import‑dependent

Multiple recent analyses show that the U.S. continues to rely heavily on foreign—especially Chinese and Indian—suppliers for both finished drugs and active pharmaceutical ingredients (APIs):

• A 2024–25 risk assessment finds the U.S. now imports about 75% of its essential medicines; China and India dominate API production, and China supplies about 90% of the antibiotic APIs used in the U.S.(exiger.com)
• A 2025 industry study reports that China and India together provide roughly 70–80% of U.S. generic drug supply (counting both finished drugs and APIs), with China controlling most global production of key antibiotic ingredients.(prosperousamerica.org)
• Policy and think‑tank work in 2024–25 concludes that more than 60% of APIs used in the U.S. come from India and China, and only around 10% of APIs are made domestically.(5g.wilsoncenter.org)
• Academic and regulatory reviews note that over 92% of facilities making generic-drug APIs for the U.S. market are located overseas, primarily in India, China, and parts of Europe.(pmc.ncbi.nlm.nih.gov)

Taken together, these data indicate that dependence on foreign—often China-linked—supply chains for antibiotics and generic medicines has persisted or even deepened since 2020, rather than being broadly repatriated.

2. PPE production: domestic boosts, but China still dominant

PPE shows a similar pattern: a temporary domestic surge followed by renewed reliance on imports, especially from China.

• Industry groups note that before Covid more than 90% of PPE used in the U.S. was made in Southeast Asia, mainly China; they report that after an initial pandemic-era buildup of U.S. factories, many of those plants have since downsized or shut, while China’s market share has increased again.(ammaunited.org)
• By 2025, U.S. PPE manufacturers’ association data describe a collapse of the pandemic startup wave: out of 100+ new PPE makers, only a handful remain in operation, while China now produces the vast majority of medical protective gear used by U.S. healthcare workers.(ammaunited.org)
• Government oversight and trade reports find that the U.S. remains highly dependent on foreign suppliers—particularly for items like nitrile gloves and gowns—and that higher tariffs on Chinese medical imports are likely to shift sourcing to other low-cost countries more than to large-scale U.S. production.(files.gao.gov)

So although some U.S. PPE capacity was added, the overall system is still structurally reliant on imported gear, much of it from or tied to China.

3. There have been onshoring initiatives—but they are partial

The federal government has taken steps in exactly the direction Sacks described, including:

• A major BARDA contract with Phlow Corp in May 2020 to build domestic capacity for essential medicines and APIs at risk of shortage.(pharmajournalist.com)
• Dozens of Defense Production Act and related projects from 2020–21 onward to expand U.S. production of N95s, gloves, masks, and other critical supplies.(files.gao.gov)
• 2024 BARDA contracts—over $500 million—to source U.S.-made isolation gowns for the Strategic National Stockpile.(reuters.com)
• A 2025 FDA pilot to fast‑track approval of generics tested and manufactured entirely in the U.S., explicitly aiming to reduce reliance on foreign drug manufacturing.​(reuters.com)

These actions show meaningful movement toward greater domestic capacity, but they represent pockets of reshoring, not a wholesale return of “all that stuff.”

4. Conclusion

Sacks’ prediction was not just that there would be policy efforts or incremental shifts; he said that antibiotics, medicines, PPE, and similar survival‑critical products would “come back home,” ending U.S. dependence on China. Five-plus years later, the empirical record shows:

• The majority of essential medicines and APIs used in the U.S. are still imported, with China and India at the core of those supply chains.
• U.S. PPE production expanded temporarily but then contracted, while China again accounts for most of the medical protective gear used in U.S. healthcare.

Given that overall dependence on foreign—and especially China-linked—production remains high, the core outcome Sacks predicted has not occurred within the “coming years” after 2020.

Therefore, this prediction is best classified as: wrong.