Antibiotic Resistance Crisis Worsening Because of Collapse in Supply Chain

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Healthcare Purchasing News

July 9, 2018

The Access to Medicine Foundation warns that antibiotic supply chains are on the brink of collapse, putting basic healthcare at risk, in a new white paper titled “Shortages, stockouts and scarcity: the issues facing the security of antibiotic supply and the role for pharmaceutical companies.” Urgent action is needed to rebuild the antibiotics market. The paper shows how some pharmaceutical companies are responding.

Between 2001 and 2013, 148 national antibiotic shortages occurred in the United States alone. In 2010, 15 countries reported national shortages of injectable streptomycin, jeopardizing the treatment of tuberculosis patients. An ongoing penicillin shortage is currently affecting at least 39 countries, now including Brazil, Germany, the Netherlands, the U.S. and India. In Brazil, this shortage coincided with a syphilis outbreak that, as a result, could not be brought under control. Between 2012 and 2015, the number of babies born in Brazil with congenital syphilis has more than doubled.

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

The white 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. For example, an explosion at a Chinese factory in 2016 triggered an ongoing global shortage of the key broad-spectrum antibiotic piperacillin-tazobactam. 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. Global demand for antibiotics climbed by 65% between 2000 and 2015. Four of the six countries with the highest antibiotic consumption rates were low- or middle-income 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 defenses.

The paper links the causes of antibiotic shortages to recommendations for governments, regulators, the pharmaceutical industry and others. Source:

Copyright 2018 ProQuest Information and Learning. All Rights Reserved. Copyright 2018 KSR Publishing July 2018.

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