A world where Michael Osterholm is right is a dangerous world.

And four years ago, during a conference at Mayo Clinic in Rochester, the renowned University of Minnesota infectious disease expert got one right. He warned that the fragility of the world's pipeline for prescription medicines would be exposed by something as unsurprising as a hurricane steaming through Puerto Rico.

"It's as predictable as could be," he recalled saying.

Then, in the fall of 2017, Hurricane Maria ripped through Puerto Rico, damaging manufacturing plants responsible for producing much of the nation's supply of medical saline solution, which is vital for diluting medications and keeping patients hydrated. Shortages occurred in hospitals throughout the country.

"Nothing was done to prepare for that," he said.

Now Osterholm and the U's Center for Infectious Disease Research and Policy are taking key initial steps to identify other potential medication shortage risks, and to suggest ways for the nation to avoid them.

The center this week announced a $5.4 million gift from the Walton Family Foundation — the charitable arm of the family behind the Walmart retain chain — to study weak links in the nation's prescription drug pipeline.

"We don't pretend we're going to fix it yet," Osterholm said in an interview. "We've just got to get people to understand the vulnerability."

Inventories of certain drugs are thin, but there also are limited supplies of the equipment necessary for dispensing those drugs, he said. Those supply shortages shouldn't be overlooked. "Its like buying a beautiful car but not having a steering wheel," he said.

The first step by Osterholm's center has been to identify 150 drugs that are essential or lifesaving in the medical system. Then researchers will examine the distribution process for each one and any vulnerabilities.

"What we are doing now is working backward, looking at the entire global supply chain for these products," said Osterholm, who said the Walton gift came after a conversation with one of the family members.

People also need to understand the potential political vulnerabilities of the drug pipeline because so many medications and medical supplies are now manufactured in China, he noted.

"Frankly, if the Chinese want to go to war with us, they wouldn't have to fire a single shot," Osterholm said. "They would just shut down the drug distribution overnight."

Jeremy Olson • 612-673-7744