Global antibiotic shortages, caused by a fragile drug supply chain, are contributing to the rise of multidrug-resistant bacteria known as superbugs, according to a report from the Access to Medicine Foundation.
The report outlines the various causes of antibiotic shortages, their consequences and what actions stakeholders must take to remedy the situation.
Here are five things to know:
1. Antibiotic shortages are, unfortunately, a common occurrence. The U.S. experienced 148 national antibiotic shortages between 2001 and 2013. Fifteen countries reported shortages of injectable streptomycin in 2010, which hindered treatment for tuberculosis patients. At present, 39 countries are experiencing a shortage of penicillin.
2. AMF attributes the shortages to an unstable global drug supply chain that relies on only a few suppliers for key drug ingredients. Under such a system, one supplier's manufacturing snag can cause serious consequences for drugmakers and patients worldwide. For example, piperacillin-tazobactam, a crucial broad-spectrum antibiotic, has been in short supply globally since a 2016 explosion at a Chinese drug factory.
3. In addition, drug companies have little incentive to create new antibiotics, since "[research and development] is risky and expensive, antibiotics offer slim margins and growth in demand comes mainly from poorer countries," according to AMF.
4. AMF also believes antibiotic shortages are contributing to the rise of superbugs, as physicians must rely on less effective treatments when key antibiotics are in short supply.
"This makes infections harder to cure, and in turn, creates opportunities for bacteria to adapt their defences [sic]," the nonprofit group wrote in the report.
5. AMF shared various strategies some drugmakers are already using to mitigate shortages, such as investing in networks of production facilities to prevent over-reliance on a small pool of suppliers.
"The global health community including the pharmaceutical industry has experience in getting medicines to people who need them," said AMF Executive Director Jayasree K. Iyer. "What is critically needed now is to puzzle out how this knowledge can be used to secure antibiotic supply, especially in low- and middle-income countries where the need for antibiotics is simply staggering."