Why It Matters

What happens if the world’s pharmacy decides to close? From ibuprofen to amoxicillin, a majority of the essential medicines used in the United States depend on ingredients from China. This dependence has left the United States vulnerable to a geopolitical rival that could decide to cut off its access at any time. On this episode of Why It Matters, Rush Doshi, senior fellow at CFR, and Olivia Kosloff, senior fellow at the American Economic Liberties Project, unpack how the dependency came about and what’s at risk if the pharma supply chain snaps. Host: Gabrielle Sierra, Director of Podcasting, Council on Foreign Relations (CFR) Guest: Rush Doshi, C.V. Starr Senior Fellow for Asia Studies and Director of the China Strategy Initiative, Council on Foreign Relations (CFR) Olivia Kosloff, Senior Fellow, American Economic Liberties Project Read More: Thomas J. Bollyky, Rush Doshi, Prashant Yadav, Olivia Kosloff, and Elena Every, “The Pharma Choke Point,” CFR.org Tim Rühlig, “The China Drug Dependency,” CFR.org “Executive Order 13944 List of Essential Medicines, Medical Countermeasures, and Critical Inputs,” U.S. Food and Drug Administration ​​Want to keep up with Why It Matters? Sign up to receive an email alert when new episodes drop. Why It Matters is a production of the Council on Foreign Relations. The opinions expressed on the show are solely those of the host and guests, not of the Council, which takes no institutional positions on matters of policy.

This episode outlines the global network sustaining both sides of the war in Ukraine, with NATO allies on one side and Russia with backing from China, Iran, and North Korea on the other, and how the limits and tensions within these alliances are shaping the war’s next phase and raising broader global security risks. Host: Gabrielle Sierra, Director of Podcasting, Council on Foreign Relations (CFR) Guests: Liana Fix, Senior Fellow for Europe, Council on Foreign Relations (CFR) Joseph Torigian, Senior Fellow for Asia Studies, Council on Foreign Relations (CFR) We discuss: How the war in Ukraine has become a global conflict fueled by competing networks of allies and partners on both sides. Why Ukraine’s survival depends on sustained military, financial, and intelligence support from the United States and NATO. How Russia has built its own wartime coalition, relying on Iran for drones, North Korea for munitions, and China for economic backing. Why the Russian alliance with China is driven more by shared opposition to Western power than true strategic alignment. How cracks are emerging within both coalitions, from political fatigue in the West to quiet limits in China’s support for Russia. As Liana Fix puts it: “A more transactional idea of alliances is exactly where we are headed.” How sanctions, supply chains, and defense production have turned global economics into a second front in the war. How shifting alliances could expand the conflict’s risks beyond Ukraine and reshape global security dynamics. What this war reveals about the return of bloc politics in a new era of great power competition. Read More: Liana Fix, “Defending Europe if Russia Steps Out of the Gray Zone,” CFR.org Liana Fix, Heidi E. Crebo-Rediker, Thomas Graham, Paul B. Stares, and Sam Vigersky, “Securing Ukraine’s Future: Adapting to New Realities After Four Years of War,” CFR.org Joseph Torigian, “Xi Jinping’s Russian Lessons,” Foreign Affairs Clara Fong and Lindsay Maizland, “China and Russia: Exploring Ties Between Two Authoritarian Powers” Anya Konstantinovsky, “China, Russia, and Ukraine: December 2024” Molly Carlough and James Kennedy, “How North Korea Has Bolstered Russia’s War in Ukraine” Want to keep up with Why It Matters? Sign up to receive an email alert when new episodes drop. Why It Matters is a production of the Council on Foreign Relations. The opinions expressed on the show are solely those of the host and guests, not of the Council, which takes no institutional positions on matters of policy.

As 2025 draws to a close, U.S. foreign policy stands at an inflection point. Under the second Trump administration, traditional alliances have been tested, a hard-edged national security strategy has been rolled out, and for the first time, CFR’s annual Preventive Priorities Survey has ranked a military conflict with Venezuela as a top threat facing the U.S. in 2026. Whether these and other flashpoints erupt next year will hinge on how world leaders manage mounting pressures, both at home and abroad. Read the full 2026 Preventive Priorities Survey. Featured Guest: Paul B. Stares (General John W. Vessey Senior Fellow for Conflict Prevention and Director of the Center for Preventive Action) Why It Matters is a production of the Council on Foreign Relations. The opinions expressed on the show are solely those of the guests, not of CFR, which takes no institutional positions on matters of policy.

Is having a trade deficit necessarily a bad thing? Many experts argue that the U.S. trade deficit is largely good for our economy. It allows Americans to enjoy a wider variety of cheap goods, attracts foreign investment, and reflects the strength of the U.S. dollar. Others believe it’s a warning sign that we’re relying too much on imports, hurting American jobs, and racking up debt owed to other countries. This season, Why It Matters is taking you through the ins and outs of trade. In this episode, we unpack the trade deficit. What is it and why has it become a primary focus of the second Trump administration? Featured Guests: Brad W. Setser (The Whitney Shepardson Senior Fellow specializing in global trade and capital flows, financial vulnerability analysis, and sovereign debt restructuring, CFR) Heather Hurlburt (Associate Fellow for the U.S. and the Americas Programme, Chatham House) For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/wim/mind-trade-gap

What role does the president have when it comes to making trade deals? In this episode, we dig into the expansive powers of the U.S. president when it comes to trade. From unilateral authority to congressional oversight, we unpack who truly calls the shots when the U.S. negotiates trade agreements. This season, Why It Matters is taking you through the ins and outs of trade. In this episode, Why It Matters dissects the current state of U.S. trade agreements; what deals exist, which ones are under strain, and how President Donald Trump’s unconventional approach to trade negotiations is shifting the United States away from the norm. Featured Guest: Inu Manak (Fellow for trade policy at the Council on Foreign Relations) For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/wim/trade-agreements-deal-or-no-deal

Tariffs are often discussed in big, abstract terms—trade wars, economic strategy, global power struggles. But for ginseng farmers in Wisconsin, their effects are painfully personal. In this episode, Why It Matters dives into how tariffs work and how they’re hitting one of America's most niche yet lucrative exports: Wisconsin-grown ginseng. Featured Guests Matthew P. Goodman, Distinguished Fellow and Director of the Greenberg Center for Geoeconomic Studies, CFR Will Hsu, President of Hsu's Ginseng Enterprises Inc. For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/wim/tariff-turmoil-part-1-how-tariffs-are-affecting-farmers

There was once a broad consensus in Washington that trade was a force for good—a way to connect, grow, and prosper. But today, trade has evolved into something much bigger than just the exchange of goods. It’s become a powerful tool to rewrite the rules of foreign policy, reshape how the United States is viewed by the rest of the world, and steer us toward an increasingly uncertain future. When did this change begin, and where did we go off course? This season, Why It Matters is taking you through the ins and outs of trade. In this episode, we’re diving into the history books to learn what can the past tell us about the future of U.S. trade policy. Featured Guest Edward Alden, senior fellow specializing in U.S. economic competitiveness, trade, and immigration policy For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/weve-been-looking-trade-all-wrong

As the climate crisis intensifies, so do discussions about the utilization of nuclear energy. In the aftermath of nuclear meltdowns such as Chernobyl and Fukushima, climate skeptics say the environmental benefits do not outweigh the associated costs and risks. But others think that nuclear energy might be the best option for a greener future. Weighed against the world’s continued reliance on fossil fuels, how could nuclear be a safeguard for our energy supply? This episode was originally released on October 29, 2021. Featured Guests Leslie Dewan, CEO, RadiantNano Shirley Ann Jackson, President, Rensselaer Polytechnic Institute For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/the-climate-for-nuclear-energy

Fresh water sustains all life, but in many regions, especially arid ones, it is becoming increasingly scarce due to climate change. Aging infrastructure and ineffective policies are only making the situation worse, affecting communities, economies, and even the political stability of some countries. As water shortages intensify, it’s crucial to rethink how we manage this vital resource and develop more adaptable systems that can better withstand the effects of climate change. This episode was originally released on July 8, 2021. Featured Guests Sandra Postel, Founder and Director, Global Water Policy Project Mark Giordano, Professor of Geography and Cinco Hermanos Chair in Environment and International Affairs, Georgetown University For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/water-scarcity

What does it mean to price our climate? The goal of fees like the “carbon tax” is to put a price on pollutants such as carbon dioxide that contribute to climate change, and incentivize businesses to reduce their emissions and make cleaner choices. But many companies are continuing to value profit over protecting the planet, backing out of their clean energy goals and sinking more money into fossil fuels and other short-term investments that harm the Earth. This has been happening for years, but has ramped up in anticipation of a new Trump administration which has pulled away from climate initiatives like the Paris Accord and Inflation Reduction Act since taking office. This episode was originally released on July 29, 2020. Featured Guests Kate Mackenzie, Green Columnist, Bloomberg Michael Greenstone, Professor of Economics, University of Chicago For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/pricing-our-climate

Our editors top picks of Why It Matters episodes on climate.

Tumultuous events have rocked the last four years: the COVID-19 pandemic, Europe’s largest land war in eighty years, and an escalating Middle Eastern conflict between Israel and Iran-backed forces. On top of that, the United States faces an intensifying geopolitical struggle with China and Russia. Now, U.S. President Joe Biden is running out of time to secure his legacy while the transition to a second Donald Trump administration comes sharply into focus. The U.S. president-elect has been quickly nominating leaders to his cabinet and receiving calls from foreign leaders. Why It Matters sits down with the hosts of The World Next Week to talk about what the United States–and a closely watching world–should expect in the weeks and months to come as incoming President Trump takes office. Featured Guests: Robert McMahon (Managing Editor, CFR) Carla Anne Robbins (Senior Fellow, CFR) For an episode transcript and show notes, visit us at https://www.cfr.org/podcasts/why-world-next-week-matters