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doi: 10.1016/j.chom.2013.04.010 36 CamaschellaC

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[6] In 2008, the FDA began to post employees to foreign countries, including China, India, Costa Rica, Chile, Belgium, and the United Kingdom

Demand has grown faster than the small number of qualified producers can fill, sterile multi-dose manufacturing capacity is constrained, and reseller-heavy distribution means many sellers hold thin inventory that stocks out quickly

Previous epidemiological studies have indicated significant differences in CMS prevalence among different ethnic groups, with a notably lower prevalence in Tibetan highlanders compared to Andean highlanders and Han Chinese