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by the WTO Secretariat

Trade in medical goods stabilises after peaking during pandemic

By Edvinas Drevinskas, Eric Ng Shing and Thomas Verbeet

The COVID-19 pandemic had an overall negative impact on global trade in goods, with one notable exception: trade in medical products. Accounting for just 6.4 per cent of total world trade in 2018, medical goods rose to an 8.3 per cent share in 2020.

This increase can be attributed to a decline in international trade overall, coupled with a surge in demand for medical goods at the peak of the pandemic. Between 2019 and 2020, trade in medical goods grew by 13 per cent – primarily driven by an increased demand for personal protective equipment – while global trade contracted by 6.6 per cent.

This positive trend continued into 2021, with further growth of 14.1 per cent for medical goods, largely due to a significant increase in pharmaceutical trade.

More recently, the share of medical goods in total merchandise trade has reverted to pre-pandemic levels, declining to 6.9 per cent in 2022.

Personal protective equipment and pharmaceutical products

The surge in medical goods trade was largely due to increased trade in personal protective equipment (PPE) and pharmaceutical products during the pandemic (see Figure 1).

In 2020, trade in PPE recorded a remarkable increase of 53 per cent, generally due to the increased demand for face masks and other protective equipment essential to curb the transmission of the coronavirus.

In 2021 and 2022, trade in PPE slightly declined, by 5.7 per cent and 5.2 per cent respectively, but the values remained considerably higher than pre-pandemic levels.

In 2022, the value of PPE remained above US$ 200 billion, significantly higher than the US$ 146 billion recorded in 2019.

Trade in pharmaceutical products followed a slower upward trajectory, due to the long period between developing such products and distributing them. The share of global pharmaceutical trade saw a significant increase in 2021, growing by as much as 19.7 per cent. This increase can be attributed to trade in COVID-19 vaccines, which got under way in 2021.

Medical goods are divided into five product categories:

Product category Coverage
A - Pharmaceutical products Products as defined by the WTO Pharma Agreement (HS chapter 30, and headings 2936, 2937, 2939, 2941)
B - Medical equipment Medical equipment and machines (majority of products in HS chapter 90) including magnetic resonance imaging apparatus, X-ray tubes, or operating tables
C - Orthopedic equipment Orthopedic devices such as wheelchairs, spectacles, hearing aids, or artificial teeth
D - Personal protective equipment Equipment and single-use items such as gloves and face masks (excluding protective garments as HS classifications largely overlap with products for nonmedical use)
E - Other medical supplies Hospital and laboratory inputs and consumables, such as syringes

Exporters of medical goods

In 2022, the top 10 exporters of medical goods accounted for nearly three-quarters of the global total.

Germany was the top exporter of medical goods, with total exports of US$ 202.6 billion, representing 12.9 per cent of the world’s exports (see Figure 2).

The United States, with exports of US$ 189.6 billion (12 per cent of world exports of medical goods), and China, with exports of US$ 137.3 billion (8.7 per cent of world exports), ranked second and third.

While Germany was the top exporter of medical goods, the United States was the top exporter of medical equipment, orthopaedic equipment and other medical supplies. China was the top exporter of personal protective equipment.

Between 2019 and 2022, China moved from fifth to third place, primarily because of a significant increase in exports of personal protective equipment.

During the same period, Belgium rose from seventh to fourth place, becoming the second-largest exporter of pharmaceutical products.

The top exporters also figure among the top importers.

Importers of medical goods

Importers of medical goods are not as concentrated as exporters, with the top 10 importers accounting for roughly two-thirds of the world’s medical goods rather than three-quarters.

In 2022, the United States was the top importer, with US$ 306 billion worth of medical goods (see Figure 4). This constitutes a significant share of the market, representing 19.2 per cent of the world total.

Germany ranked second, with imports of medical goods worth US$ 134.2 billion, less than half of the US import value.

Belgium was the third top importer in 2022, due to its imports of pharmaceutical products, followed by China.

Belgium and Switzerland slightly improved their ranking position between 2019 and 2022, mainly due to their increased imports of pharmaceutical goods. The ranking of the other main importers remained relatively stable.

The information originally published by the WTO on the evolution of trade in medical products is available in a series of reports issued by the WTO entitled “Trade in medical goods in the context of tackling COVID-19”. These reports present the effects of the pandemic on international trade flows. The most recent one was released in July 2022.