The target is to reach 100% efficiency in all goods, trading only IPR products (tech, know-how, movies, books, music, etc). It might takes us a couple centuries to get there, but I'm confident that changing our consumer behaviour and innovation in materials will do the trick.
To build a self-sufficient city you do need to buy some machinery and stock pile some raw materials (steel, aluminum, iron, etc). Once you start building the city, the idea is that you don't need to import any more goods or materials, and most importantly, you don't need any more cash injection. I don't want to get in too much detail here, but the model also uses a multidimensional monetary system based on local digital currencies (like Bitcoin). This allows the city to kick-start its internal economy
and not rely on foreign investment. Remember that this city is not conceived to compete with Beverly Hills, but for the billions of people that otherwise would have to live in slums or overcrowded cities in developing countries. This also brings down the cost of building such a city.
So, once you have the terrain and you have some machinery and raw materials, you start finding substitutes for materials to produce what you need. Although the task seems daunting, most things can be produced locally. So, right of the bat we can leave aside furniture, clothing, food and most construction materials (the terrain must have of water, sand and other basic materials, and let's say we bought steal). So then you have to break down the materials you need to produce components. So let's say you need plastics, glass and gold to make a mobile phone (this is an oversimplification, but you know what I mean). Then you need to see how to produce plastic, which other than petrol, can be produced from milk, bacteria, etc. They might not be the same plastic, but it's about finding a material that does the job. This sounds far fetched, I know. BUt go to a makers hackaton if you have the chance and you will be surprised. I've seen guys build a washing machines and printers, from scrap over a weekend.
I lived in China for many years and had the opportunity to visit workshops where they produced components for electronics. Some of those places were just apartments with only 20 or 30 employees working in a makeshift production line. So, yes, iPhones are produced in high-tech factories with robots and strict security. But down the road in a shitty place they are producing the same components that go in that iPhone.
With medicine we are going to use the same approach: find what are the real needs and see what needs to be produced. One could argue that the quality of some locally-produced medicines might not be the same as that of Bayern products and that some would not be produced. So, for certain deceases, there might be a higher mortality rate compared to the population treated with Bayern's products. But the real interesting question is: would that mortality rate be higher than that of the population who live in a free-market economy city but who can't afford to buy the medicine?