Antibiotic Shortages: magnitude, causes and possible solutions: A new WHO meeting report

2019-03-22

Unavailability and shortages of antibiotics is an increasing problem for many countries with consequences both for patient safety and societal cost. At a WHO meeting 10-11 December 2018, a project funded by ReAct through Sida, the magnitude, causes and possible solutions of antibiotic shortages were discussed. To address causes such as few actors in the production, fragile supply chains, regulatory issues, procurement and business models, a comprehensive set of short-term and long-term solutions are needed.

A failing ecosystem

Securing access to effective antibiotics is not only a matter of innovation of new antibiotics, but also about sustainable production and supply of old antibiotics. Accessibility to antibiotics is a vulnerable ecosystem that is challenged by a range of problems, and this failing system must be rebuilt to find sustainable solutions to manage the problems.

ReAct’s commitment to find solutions

Last year ReAct together with leading experts pointed to the critical situation of unavailability of antibiotics in a Commentary in the Lancet Infectious Diseases. Building on this work, ReAct engaged with several stakeholders to continue exploring the causes and solutions to this problem. Through a grant from Sida, ReAct funded WHO to undertake an assessment of manufacturing capacity for selected antibiotics facing shortages risks in Europe. As part of this project, WHO and the Norwegian Directorate of Health and the Norwegian Institute of Public Health hosted a meeting in collaboration with ReAct.

Conclusions of the meeting

The meeting focused on market dynamics to assess the root causes of shortages, including transparency of the supply chain and prices. The meeting was a multi-stakeholder discussion that openly reflected on different sides of the perceived challenges and possible solutions.

Some of the key questions at the meeting were:

• What are the main obstacles and how can we overcome them?
• What are the most promising solutions?
• How can shortages of antibiotics be elevated to the political agenda?

Some ways forward identified at the meeting were:

Short-term:

• Improve demand forecast, early warnings, and communication.
• Improve access to use of old antibiotics by engaging professional societies and normative work.
• Improve political awareness on the real consequences and costs.

Long-term:

• Changes in regulatory practices and registration of old antibiotics.
• Ensure healthy and sustainable production, procurement and supply models.

These are high-level ideas that will require further consideration and evidence collection and taken forward as a package of actions to manage the root causes of the problem.