Antibiotic supply chains on ‘brink of collapse’

GARDP, Eisai & Takeda searching for new antibiotics
Credit: ESB Professional

Antibiotic supply chains are on the brink of collapse and putting basic healthcare at risk, warns the Access to Medicines Foundation in a new white paper.

Shortages, stockouts and scarcity: the issues facing the security of antibiotic supply and the role for pharmaceutical companies calls for urgent action to rebuild the antibiotics market.

“Antibiotic shortages are occurring because the antibiotics market just doesn’t work well enough,” said Jayasree K. Iyer, Executive Director of the Access to Medicine Foundation.

“Pharma companies need to be incentivised to keep producing antibiotics. There is definitely no easy fix. But without a global push to address the systemic causes, we risk being unable to treat common infections, such as from contaminated food or simple wounds.”

The paper pinpoints underlying factors causing antibiotic shortages. The active ingredients for an antibiotic are generally produced at only a few factories, which means a single manufacturing failure can have huge knock-on effects.

Further, fragile antibiotic supply gets little attention on the global political stage, and the pharmaceutical industry has little incentive to take action on its own. This is because R&D is risky and expensive, antibiotics offer slim margins, and growth in demand comes mainly from poorer countries.

Antibiotic supply chains are complex. Batches are passed between multiple distributors before reaching the patient. This leads to low visibility and accountability, with little alignment to ensure supply matches demand.

As a result, some populations face shortages, while others are offered poor quality medicines, or gain easy access to antibiotics that should be tightly controlled to keep antimicrobial resistance (AMR) in check.

The excessive use of antibiotics is driving up rates of AMR. An estimated 70% of bacteria are already resistant to at least one antibiotic that is commonly used to treat them.

Left unchecked, AMR could stop antibiotics from working within a few decades. Shortages are also linked to AMR, as they mean doctors must resort to less optimal treatments. This makes infections harder to cure, and in turn creates opportunities for bacteria to adapt their defences.

The paper links the causes of antibiotic shortages to recommendations for governments, regulators, the pharmaceutical industry and others. The Foundation aims to jump-start the broader conversation about how pharmaceutical companies and other actors can take action.