【摘要】 奥巴马政府以来，历届美国政府对医药供应链的重要性及其风险来源的认知持续演变，呈现出既相互关联又各有侧重的脉络。美国政府一方面日益聚焦于医药供应链安全，并将其提升至国家战略高度；另一方面，则逐步构建并强化了以对华依赖为核心的供应链安全风险叙事。基于此认知转向，美国政府通过“重塑本土供应”与“重构进口布局”双轨并进，旨在实现国内供应的本土化和先进化，以及进口布局的“民主化”与“去中国化”。然而由于受到经济规律、产业基础、政策连贯性、制度矛盾的四重深层约束，美国医药供应链再造仍处于早期阶段，尚未取得显著突破。更多还原

【Abstract】 Since the Obama administration, the U. S. government’s perceptions of the medical supply chain have undergone a significant shift. Despite a consistent acknowledgment of the supply chain’s strategic importance, each administration has framed the primary sources of risk differently. This evolving outlook has cemented medical supply chain security as a core national strategy, underpinned by a dominant risk narrative focused on “ dependence on China. ” Guided by this shift, the U. S. government has pursued a dual-track approach of reshaping domestic supply and overhauling import landscape to reshore medical manufacturing, advance biotechnologies, foster a more ‘democratized’ supply chain, and reduce dependence on China. However, constrained by economic realities, industrial base weaknesses, policy incoherence, and institutional frictions, this restructuring remains at an early stage, with tangible outcomes yet to be realized.更多还原