The United States government has identified the health care sector as part of the critical infrastructure for homeland security to protect citizens against health risks arising from terrorism, natural disasters, and epidemics. Citizens also have expectations about the role that health care plays in enjoying a good quality of life, by providing response systems to handle emergencies and other illness situations adequately. Among the systems required to supportdesired performance levels is a robust and resilient pharmaceutical supply chain that is free of disruption. Shortages of drugs place undue pressure on healthcare providers to devise alternative approaches to administer patient care. With climate change expected to result in increasingly severe weather patterns in the future, it is critical that logistics engineers understand the impact that a catastrophic weather event could have on supply chain disruption to facilitate the design of supply systems that are robust and resilient. This study investigates the main causal and intermediate events that led to risk propagation in, and disruption of, the U.S. pharmaceutical supply chain following Hurricane Maria. A causality Bayesian model is developed to depict linkages between risk events and quantify the associated cumulative risk. The quantification is further examined through different advanced techniques such as predictive inference reasoning and sensitivity analysis. The general interpretation of these analyses suggests that port resilience is imperative to pharmaceutical supply chain performance in the case of Puerto Rico.

美国政府已将卫生保健部门确定为国土安全的关键基础设施的一部分，以保护公民免受恐怖主义，自然灾害和流行病造成的健康风险。市民也对医疗保健在提供优质生活中所扮演的角色抱有期望，他们提供了适当的应急系统来应对紧急情况和其他疾病。在支持所需性能水平所需的系统中，有一个健壮而有弹性的药品供应链，而且没有中断。药物短缺给医疗保健提供者带来了不小的压力，要求他们设计出替代方法来管理患者护理。预计气候变化将在未来导致越来越严重的天气状况，物流工程师必须了解灾难性天气事件可能对供应链中断产生的影响，这对于设计坚固耐用且具有弹性的供应系统至关重要。这项研究调查了导致飓风玛丽亚之后美国药品供应链中的风险传播和破坏的主要因果关系和中间事件。建立了因果贝叶斯模型来描述风险事件之间的联系并量化相关的累积风险。通过不同的高级技术（例如预测推理和敏感性分析）进一步检查量化。这些分析的一般解释表明，在波多黎各的情况下，港口弹性对药品供应链的表现至关重要。