If Trump chooses to threaten Denmark militarily over Greenland, Denmark cannot respond militarily. It does not have the scale. But it does have the sort of leverage that matters in the modern global economy because Denmark is not just a small NATO state of about the size of Scotland; it is also a critical supplier of medicines to the United States, and the US healthcare system is built in a way that makes rapid substitution for the drugs it supplies nigh on impossible.
The most significant of its pharmaceutical exports is insulin. Reported trade figures suggest that around 74% of US insulin imports (by value) come from Denmark. That is not a marginal share. It effectively means that the USA is dependent on Denmark for the insulin it needs, with no alternatives being available, and millions of Americans require that insulin continuously. A disruption in supply would not, then, just be an inconvenience. It would not even create rationing. It could create clinical harm and a domestic political crisis.
This matters because it reveals the real nature of the US position vis-à-vis Denmark. Trump might believe he can coerce Denmark over Greenland, but he can only do so by putting at risk the health of millions of US people who are dependent on the supply of Danish insulin.
This is globalisation backfiring on the USA. The usual claim is that markets optimise supply chains and diversify risk. That story is false. The reality has always been that, at a global level, markets concentrate profits and, in doing so, often concentrate production. Denmark is where that concentration of insulin production has ended up.
Insulin is not, however, the only Danish pharmaceutical product for which the USA is desperate. Denmark is also home to Novo Nordisk, creator and manufacturer of one of only two leading GLP-1 anti-obesity drugs in the world, with around 55% of the global market share, but slightly less in the US, according to available data. Novo Nordisk is certainly one of the largest, if not the largest, single exporter of Danish products to the USA, although some of its GLP-1 sales might originate in its plants in the west of Ireland. The key point is that America's drug supply and Denmark's export structure are now thoroughly entangled.
So what would happen if Denmark used this entanglement as a defensive weapon?
There are two scenarios that can be imagined: an insulin squeeze and a GLP-1 squeeze. They have different ethical consequences, different political effects, and different escalation risks.
If Denmark interrupts insulin exports to the US, the impact would be fast and severe. Insulin is a daily-necessity medicine. US insulin inventories are almost certainly not designed for an abrupt shock, and substituting between insulin types is likely to be both clinically difficult and not instantly scalable. So the likely chain of events is straightforward. Shortages would appear quickly, rationing would follow, clinical distress would quickly become news, and the issue would land on the desk of US politicians who could not ignore it. That is what leverage looks like, even if it is morally dangerous leverage, because it would harm ordinary people long before it harms the political class, although let's be clear, war always does that.
It would also be politically combustible. Trump would frame Denmark's action not as self-defence but as attacking Americans or holding patients hostage, even if the action was a direct response to his own insane and wholly unjustified threats of an attack on Denmark's sovereign territory, whilst the underlying truth would be that the US had made itself dependent, and Denmark did not ask it to become so. The problem is that what the reaction to this situation would be is hard to foretell. In that case, it is certainly not the option of first choice, but something to leave on the back burner.
For that reason, if Denmark were to use pharmaceutical supply as leverage, the GLP-1 route is a much more plausible option. Ozempic and Wegovy are not trivial medicines, but they are also not akin to insulin. The immediate health impact of a disruption in their supply would be lower. People would not be at medical risk, but the political impact could still be substantial, precisely because these drugs reach influential demographics and because shortages of them are already well known. A GLP-1 disruption might generate anger, litigation, lobbying pressure, and maybe an intense corporate response, but from the point of view of Denmark, the product is saleable elsewhere, and the noise that would be created in the US, without triggering the same immediate life-and-death moral backlash that an insulin shock would create, would be of massive value if Trump pushes ahead with his threats, so long as the messaging was very carefully managed.
The consequence is that Denmark is far from being without bargaining chips in any confrontation with the USA, meaning that whilst Denmark will never need to match the United States tank-for-tank, it could use Trump's favourite weapon of trade war to achieve its goals. The critical question is whether it is willing to do so and then manage the long-term consequences of that.
Whatever happens, just putting this issue on the table matters. What it reveals is that globalisation and the so-called markets it facilitates are not neutral mechanisms but are instead a complex system of mutual dependencies that thuggery - even US thuggery - challenges at its own peril. If Denmark needs leverage, the uncomfortable truth is that it already has it. It is sitting inside American supply lines. The US needs to wake up and smell the coffee that its obesity crisis has created for it, the solution to which appears to be in Danish hands. Maybe Greenland is not so valuable, after all.
I stress that I think these are ugly options, but these are ugly times. That is where we have got to. This is where fascism takes us. Suboptimal, ugly choices might have to be made, or at least threatened. This is how standing up to fascism has to work. It will not be easy, but it is required.
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“but he can only do so by putting at risk the health of millions of US people”
And that is supposed to stop Trump?
Since when does he care about anyone (except himself and maybe his boot-licking cronies)?
“They have different ethical consequences”. I wonder what the correlation is between those taking insulin (&/or anti-obesity druigs) and voting for Trump. I bet there is one.
How you vote should have consequences, both for the voter and for who they vote for.
As for the US reaction – send in the marines? Bomb Lego-land? Said it once, say it again: Europe needs to turf the USA out of Europe, & it needs to stand on its own two feet. The USA has never been a friend of Europe, rather a predator and that situation has existed since circa 1897.
The US military industrial complex needs the rare earth metals that are being exposed by the melting ice in Greenland and I think Trump cares more about that than he does about poor people in the US dying from diabetes.
Mr Hoare, I agree with the need for rare earth metals (actually they ain’t so rare – just difficult to refine).
Denmark/Greenland have for some years (15 years++) been trying to interest western companies in undertaking mining in Greenland.
The problem is two fold: the place (freeze in winter/mozzie blood sacrifice in summer) and the cost to refine (China does it cos it has lots of low cost energy).
This has meant that it is cheaper to source from other locations = no business case. & thus nowt has happened.
This leads me to conclude that Trump will be happy to subsidise the mining & refining effort for Greenland. Does that require an invasion/takeover? Probably not.
But such action makes Trump look strong.
Doesn’t Denmark have an important role in shipping, which could also be useful? But Europe should not leave it all to Debnark. Expel the US enemy military forces and corporations as well
Yes. Maersk controls about 15% of US container trade. Some estimates say more.
Thank you, Richard.
Possibly more, if one includes trade in, say, Europe and the Far East before another shipping line takes over for the US leg.
One can add the provision of containers, logistics services / admin, credit etc.
My former better half, with whom I remain on good terms, is a Maersk country manager in mitteleuropa. She used to be a bankster. That’s how we met.
Thanks
I recoil at the thought of Denmark holding American diabetics hostage…. but it does make a wider point.
The trade war is being fought by Trump on the basis that the “US holds all the cards” because they are the “customer of the world” – that the world can’t survive without selling to the US. In reality, it is the other way round – the US can’t function without all the stuff that the rest of the world sells it. Sure, a lot of this stuff is tat… but a lot is essential stuff.
Of course, the argument can be made both ways – the US is the dominant supplier in other sectors – but surely it is the $1trn deficit country that is most vulnerable?
Yes…
I get your arguments and with any sensible world leader they would work. With Trump however, he does not seem to understand or care about such things. I guess it could be like economic sanctions against South Africa for apartheid. Whilst it appeared that the people at the bottom suffered most and the government was indifferent, they did slowly wear the government down. In Trump’s case, it would accelerate rebellion internally against him, which is now inevitable.
Novo Nordisk has always been a major supplier of insulin and that was its key product before weight loss drugs came along.
It would be a sad day indeed if the Danes were sufficiently backed into a corner to compromise the health of millions of Americans. I can just hear how Trump would spin that!
I wonder how the Danes could mitigate the economic hit if they followed through…. hopefully the threat will be sufficient.
Hmm.. I’m an insulin dependent diabetic and I take Insulin Lispro (Humalog) subcutaneously by injection 2-4 times a day. It keeps me alive, basically. Humalog is manufactured by Lily from Indianapolis, and, according to Wikipedia, comprised 5% of Lily’s revenues in 2024. I understand that there are alternative manufacturers of Insulin Lispro, but the Lily product is one of the lowest-cost sources as far as the NHS is concerned.
Both of those products, insulin and weight loss injections, could be handled with a flexible war-time export tariff affecting the USA solely.
As you say Richard, A GLP-1 disruption might be a tool Denmark might use against Trump without the moral issue of withholding Insulin supplies, but in doing so it may depend on Novo Nordisk’s exposure to retaliation via their exposure to American software, cloud infrastructure and everything else required to run their business. If Novo Nordisk don’t have this exposure then it’s in the box seat. Big If.
There is arguably a stance of saying if you invade Greenland then all supplies of Insulin and Wegovy will be banned for the duration of those military activities. The risk would obviously be that the US seeks to establish an alternative supply or stockpile to allow it to achieve its aims. However, it would, perhaps, obstruct the administration from taking such action immediately, because any such alternatives would take time.
One thing that Trump does not have is time. I believe that part of why he’s throwing caution to the wind is not just a dementia-related loss of impulse control, and not just because he’s surrounded himself with sycophants that will pander to any imperialist, fascist fantasy, but because he knows he is unlikely to be in power for a long time, and is trying to do everything now as a result.
On impeachment, at the moment if Trump and Vance were both impeached then Mike Johnson would be next in line. After that, Grassley, Rubio, Bessent, etc… now all the Secretaries of State are sycophants there’s not a good choice to be found in the whole line of succession.
If Democrats plan wait until the mid-terms and hope to remove both Trump and Vance to get a Democrat Speaker of the House to become President, then that’s a very long shot. I think it’s more likely they want to try to regain control of the House and possibly Senate in the mid-terms, and fear losing momentum if Trump is replaced beforehand. I suspect some are playing politics while risking global peace.
Meanwhile, the Republicans in the House and Senate seem to be trying to ignore that the leader they have handed their own powers to has literally declared no obligation to the Constitution, Domestic Law or International Law, only ‘his own morality’. As a convicted fraudster and adjudicated sexual assaulter, that’s no limit at all.
The US has to determine its own future, but those of us abroad hope that they choose hope not hate, cooperation over division, and international law over imperialism.
Big if, but IF the Democrats get control of both House and Senate IF the mid-terms happen, the process needs to be:
* Impeach Vance and refuse to ratify any new VP.
* Impeach Trump, Speaker becomes President, appoints his own VP.
* Let slip the dogs of Law. As Shakespeare didn’t quite say.
Presumably though if the US invaded Greenland all trade with Denmark would be halted immediatley?
Collapse of Stout (or is it Orange) Party
The most revealing thing about this whole confrontation is how quickly it exposes the myth of American invulnerability. For decades we’ve been told that the US is the indispensable nation, the customer of the world, the one actor no one can afford to cross. Yet the moment you look at the actual supply chains that keep the US functioning — medicines, shipping, rare earths, logistics — the picture flips. It’s the deficit nation, the import‑dependent nation, the nation whose political theatre rests on a global system it no longer fully controls.
Denmark’s pharmaceutical leverage isn’t a weapon anyone wants to use, but it proves a point European leaders have been terrified to say aloud: coercion cuts both ways. Modern power isn’t measured in tanks; it’s measured in chokepoints. And the US has built a system in which it is exposed at dozens of them.
What’s striking in this thread is how many people understand something our governments still refuse to articulate: Europe cannot keep responding to escalating threats with polite statements and wishful thinking. The world has changed. The dependencies have changed. The risks have changed. And the only responsible response is for Europe to act like a bloc that knows its own strength — economically, diplomatically, and morally.
If this moment forces Europe to rediscover its backbone, then perhaps something good can still come out of an otherwise dangerous and unnecessary crisis.