Shortage of essential antimicrobials: a major challenge to global health security

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Title: Shortage of essential antimicrobials: a major challenge to global health security
Authors: Shafiq, N
Pandey, AK
Malhotra, S
Holmes, A
Mendelson, M
Malpani, R
Balasegaram, M
Charani, E
Item Type: Journal Article
Abstract: The lack of access to safe and effective antimicrobials for human populations is a threat to global health security and a contributor to the emergence and spread of antimicrobial resistance (AMR). The increasingly common shortages of antimicrobials are an additional threat to the emergence of AMR. While the threat of such drug shortages is most acutely experienced in low-income and middle-income settings, their consequences impact the quality and effectiveness of antimicrobials worldwide. Furthermore, there is a need for robustly conducted studies examining the impact of these increasingly prevalent shortages on patient outcomes and on the emergence and spread of AMR. In this review, we have mapped common drivers for antimicrobial shortages and propose strategies for rethinking the regulation, supply and pricing of antimicrobials to secure their sustainable access across diverse healthcare systems and to help minimise the unintended consequences of weak and ineffective supply chains. Greater government involvement in antimicrobial manufacture and supply is essential to ensure no one is left behind. Dedicated demand systems need to be developed for antimicrobials which take into consideration evolving AMR patterns, burden of diseases, pandemic events and supply and demand issues and facilitate implementation of strategies to address them. Interventions, ranging from advocacy and forecasting to public–private collaborations, new economic models and international consortia working across countries and supply chains, will help assure access to safe and effective antimicrobials to all populations around the globe and ensure that shortages no longer contribute to AMR.
Issue Date: 2-Nov-2021
Date of Acceptance: 20-Oct-2021
DOI: 10.1136/bmjgh-2021-006961
ISSN: 2059-7908
Publisher: BMJ Publishing Group
Start Page: 1
End Page: 10
Journal / Book Title: BMJ Global Health
Volume: 6
Issue: 11
Copyright Statement: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Sponsor/Funder: ESRC
National Institute for Health Research
National Institute for Health Research
Funder's Grant Number: NF-SI-0617-10176
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
health services research
health policy
health policy
health services research
Publication Status: Published
Online Publication Date: 2021-12-02
Appears in Collections:Department of Infectious Diseases

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