War in the Middle East threatens the supply of oncology drugs

The military conflict in the Middle East is beginning to disrupt key logistics channels for drug supplies to the Gulf countries, putting the supply of oncology medications and other therapies that require strict temperature control during transport at risk. Pharmaceutical companies are already being forced to reroute flights and seek alternative land routes to access the region, industry representatives report. This was reported by Reuters.

The conflict, which escalated following US and Israeli strikes on Iran two weeks ago and subsequent Iranian attacks in the region, has led to the closure of key air corridors and logistics hubs. This is hindering the movement of goods—from medicines to food and oil.

So far, there are no clear signs of serious medication shortages, but according to industry representatives, the situation could change rapidly if the conflict continues. Gulf nations rely heavily on imported medicines, and some medications have a short shelf life and require a constant “cold chain” for storage and transport, making long land routes significantly more difficult to implement.

Executives at Western pharmaceutical companies report that they are already seeking alternative routes to the region. Some shipments are being rerouted to airports such as Jeddah and Riyadh in Saudi Arabia, from where the medications are transported by land to the final markets. Istanbul and Oman are also being considered as possible alternative logistics points.

Major airports in the region, including Dubai, Abu Dhabi, and Doha, were closed following the Iranian strikes carried out in response to the US and Israeli attacks. These cities are key air cargo hubs connecting Europe with Asia and Africa. A significant portion of transported pharmaceutical products passes through them, including temperature-sensitive drugs carried by airlines such as Emirates and Etihad and logistics operators like DHL. These medications must be stored within a strictly defined temperature range to maintain their safety and efficacy.

According to Wouter Dewulf, a professor at Antwerp Management School, industry data shows that more than one-fifth of global air cargo traffic—the primary channel for delivering critical and life-saving medicines and vaccines—is at risk of disruption related to the conflict in the Middle East.

Pharmaceutical sector representatives warn that establishing alternative “cold logistics corridors,” which ensure controlled temperatures for sensitive medications, cannot be achieved in a short time and often requires complex coordination between multiple logistics operators.

Another pharmaceutical company executive notes that internal teams are already prioritizing shipments related to patients in critical condition, including oncology therapies. He warns that some temperature-controlled shipments risk missing transport connections if proper storage and handling conditions are not ensured during transit.

A representative of a medical device company adds that the first step in such a crisis is mapping all shipments already in transit or prepared for dispatch. A decision is then made on which cargo should be rerouted and whether it is necessary to plan new deliveries.

According to the same source, some cargo between Europe and Asia, which usually passes through airports in Dubai or Doha, is already being rerouted through China or Singapore. However, sea routes are not a practical alternative, as transport time is significantly longer, and Iran has also closed the strategic Strait of Hormuz—one of the key maritime trade routes in the region.

“When there is a patient waiting for urgent surgery or treatment, the fastest mode of transport must be chosen,” the executive director commented.

Prashant Yadav, a senior fellow for global health at the Council on Foreign Relations, notes that stocks of medications with short shelf lives and temperature requirements are typically around three months. Among the most vulnerable products are oncology drugs, particularly monoclonal antibodies.

Delays in the delivery of oncology therapies can have serious consequences for patients. In some cases, patients may be forced to restart their treatment or face the risk of disease progression.

According to Yadav, there are already signals from some clients that their stocks could be depleted within four to six weeks if the logistics situation does not improve.

Last week, more than 100 representatives from the pharmaceutical and logistics industries participated in a webinar organized by the life sciences logistics group Pharma.Aero to discuss the crisis in the Persian Gulf and the potential implications for global supply chains.

Some logistics operators believe the sector is managing the situation for now. Dorothea Becher, who is responsible for air logistics in healthcare at the freight company Kuehne+Nagel, points out that cargo flights continue to operate to Jeddah, Riyadh, and Oman, from where deliveries are transported by land to final markets.

“For now, I do not see a risk of stocks decreasing drastically,” she says, adding that healthcare-related cargo is being given priority.

However, maintaining a continuous flow of supplies requires constant effort. Doa Fathallah, Chief Operating Officer of the biopharmaceutical logistics company Marken, notes that temperature-controlled shipments continue to reach their destinations, but this is achieved through continuous rerouting of flights depending on changing airspace restrictions.

These diversions lead to longer transport times and higher fuel costs, which also increases transport fees. Furthermore, companies are having to use larger quantities of dry ice to maintain the required temperature of medications during longer routes.

If disruptions continue, the risk to the pharmaceutical industry will increase, experts warn, as stocks in Gulf countries and parts of Asia will gradually decrease.

Logistics difficulties could also affect products that indirectly impact the production and delivery of medicines—including shortages of rubber stoppers for vials, plastic materials for infusion bags, and other elements used in medication packaging.

“Sometimes the problem is not a shortage of the drug itself,” comments David Weeks, a supply chain analyst at the rating agency Moody’s. “In some cases, it is simply the small rubber stopper on the vial from which the dose is drawn that is missing.”