Antibiotic supply chain crisis emerging

Antibiotic shortages may be imminent for many nations, warns a report from the Access to Medicine Foundation (AMF).

“Antibiotic supply is patchy, complex and at risk of collapsing,” said the authors from the Dutch-based organisation.

Supply chain complexities contributed to low transparency and accountability, as a result hampering volume and quality of medication. As antibiotics are produced in a small number of factories, distribution channels end up inefficient, particularly for lower income nations who require a higher supply.

The issues are believed to be leading to rising rates of antimicrobial resistance (AMR), as many patients cannot receive the correct medication at the required dosage.

“Less effective or more toxic treatment alternatives can contribute to AMR because every time we use an antibiotic, we give bacteria the chance to adapt and develop resistance,” says the report. “To reduce the threat of AMR, doctors must ensure that the right antibiotic is used against the right organism.”

The report criticised the effect higher income players were having on the supply, as well as pointing to the impact AMR was having on development.

“Governments with high purchasing power are using increasingly stringent tendering processes focused on price, creating competition among producers that puts further pressure on already slim margins,” it said.

“What’s more, when a new antibiotic enters the market, it will be used sparingly due to the risk of AMR, meaning there is little prospect of ensuring the high-volume sales that may be needed to justify the investment in R&D. As a result, there is little commercial incentive to develop new antibiotics.”

Several antibiotics in particular were pointed out to be particularly worrisome.

A number of countries were found to lack access to benzathine penicillin G, resulting in higher rates of congenital illnesses in newborns. Additionally, a 2016 explosion in a Chinese factory contributed to a shortage of piperacillin-tazobactam, an intravenous antibiotic and antibacterial combination. The factory was the sole producer of the drug’s active ingredient.

The US FDA points to more than 100 drugs believed to be in short supply currently, corroborating the report’s concerns.

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