Novartis unveiled plans to build a flagship North Carolina manufacturing hub with end-to-end biologics, sterile packaging and solid-dose capabilities, part of a $23 billion U.S. infrastructure plan to produce key medicines domestically and create roughly 700 direct jobs. CEO Vas Narasimhan framed the investment as a resilience and supply-chain strategy to serve U.S. patients. Separately, AstraZeneca committed $2 billion to expand an Maryland rare-disease manufacturing footprint as part of a larger $50 billion pledge to boost U.S. operations. Both moves signal accelerating onshoring by large drugmakers to secure capacity for biologics, radioligand and cell- and gene-therapy production.