ANALYSIS | Trump’s NIH Cuts and Drug Price War May Hit Turkey Hard

Washington Cuts Scientific Funding — Turkey May Be Collateral Damage

Following a directive from U.S. President Donald Trump, the National Institutes of Health (NIH) has begun suspending grants that fund active scientific research projects. Simultaneously, downsizing efforts have been initiated at the Food and Drug Administration (FDA). Experts warn that these and similar moves will have ripple effects globally — including in Turkey.

According to Dr. Kemal Oğuz Kalafat, Director of Life and Health Sciences at a Boston-based portfolio management firm, Turkey is highly vulnerable. “As long as Turkey remains dependent on foreign pharmaceuticals and life sciences technologies, these developments will hit us directly,” Kalafat said.

Kalafat, a former director of Turkey’s National Drug Project launched in 2011, is now focused on connecting healthcare entrepreneurs with investors. During a recent visit to Istanbul, he spoke to Diken about the implications of the evolving U.S. healthcare strategy.

80% of Turkey’s Active Pharmaceutical Ingredients Are Imported

Turkey remains heavily dependent on imports in both the pharmaceutical and medical device sectors. The country has yet to develop a single original molecule. While there is some local production of active ingredients, it is largely limited to antibiotics and analgesics.

Over 80% of Turkey’s pharmaceutical raw materials are imported, and as of 2017, only about 70 active ingredients were produced locally. Experts believe that number is likely lower today.

Due to the high cost and complexity of production, as well as limited domestic demand for certain drugs, local manufacturing of many pharmaceutical products remains unfeasible. This puts Turkey squarely in the line of fire as global pharmaceutical supply chains and trade dynamics shift — especially under U.S. pressure.

“Turkey’s Pharma Sector Has No Guardian”

Dr. Kalafat stressed that the situation is precarious: “No one knows what Trump will do next. But we do know that 70% of the world’s new drugs originate from the United States, and 20% from Europe — but most of that European funding also comes from the U.S.”

Kalafat warned that Turkey’s pharmaceutical industry could be significantly disrupted by these commercial shifts: “We’re dependent on imports in both drugs and medical equipment. Sadly, Turkey’s pharma sector is leaderless. The U.S., Japan, South Korea, and Belgium all protect and promote their pharmaceutical industries with strategic plans. We have TÜBİTAK and many programs — but no original molecules, no vaccines. It’s truly heartbreaking.”

Trump’s Drug Price Push Could Backfire Abroad

Recently, Trump claimed that Americans pay five to ten times more for medication than citizens of other countries. He promised to sign a presidential order to slash drug prices — a move that could have unintended consequences abroad.

According to Kalafat, Trump consulted with the pharmaceutical lobby before even meeting with the defense industry. “He’s coordinated every step with drug companies,” Kalafat said. “In the U.S., drug prices are outrageously high. In Europe, much cheaper. One widely used weight-loss medication retails for $1,500 in the U.S. but just $170 in Turkey.”

This growing price disparity is politically untenable in the U.S., Kalafat said, and may lead to further market disruptions. “From now on, the prices of complex drugs like cancer treatments that we import are likely to rise.”

India and Egypt Lobbying to Fill the Gap

With China’s pharmaceutical exports facing U.S. resistance, India and Egypt have begun lobbying in Washington to fill the vacuum in areas including healthcare.

Kalafat is critical of Turkey’s lack of preparation: “We entered this process without a plan or sufficient funding. Turkey must urgently assemble all stakeholders in the healthcare sector — not just government-aligned players — and establish an independent strategy board.”

Because most of Turkey’s drug ingredients are imported, costs will surge. “There are only two product categories where Turkey can potentially export to the U.S.: antibiotics and analgesics,” Kalafat said.

Countries like South Korea and Ireland, once behind Turkey, have built world-class pharmaceutical companies through long-term strategic planning. “Turkish drug companies today are insular and fighting just to survive,” Kalafat added.

Turkey Lags Behind in Clinical Research

In 2023, the U.S. led the world in industry-sponsored clinical trials. China, Spain, and Canada followed. Turkey ranked 21st, launching only 168 trials — behind the Czech Republic, Hungary, Brazil, and Argentina.

According to the AIFD Economic Value Survey, clinical trial investments by research-based pharmaceutical companies in Turkey reached $425 million in 2023.

While Turkey does produce both generic and reference drugs, the scope of locally manufactured active pharmaceutical ingredients (APIs) remains narrow. Of approximately 7,900 known API molecules globally, Turkey still mostly produces antibiotics and painkillers. In 2023, the production value of Turkey’s pharmaceutical and medical supplies industry reached TRY 181 billion, according to TÜİK.

Turkey Trails OECD and EU in R&D Investment

Turkey spends just 1.3% of its GDP on R&D across all sectors — far below the OECD average of 2.7% and the EU’s 2.1% benchmark. Israel leads globally, investing 6% of GDP into R&D, followed by South Korea at 5.2% and the U.S. at 3.6%.

Turkey’s pharmaceutical industry urgently needs a national innovation strategy — before it’s too late.

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