Supply tensions are causing uncertainty regarding the availability of some of the most commonly prescribed medicines, such as Amoxicillin, across Europe.
The drug is an antibiotic in the penicillin family and is often sold in combination with clavulanic acid. The medicine is commonly prescribed for children, especially for angina, ear infection, and chest infections. There is typically a surge in prescriptions of these drugs during the winter period.
But the supply is severely strained this winter in many European countries. In France, there are shortages of the chemical in its paediatric formulation, the French Public Drug Agency (ANSM) warned in December. Shortages are set to last until March. In Belgium, seven brands of amoxicillin are unavailable until next spring. In the UK, three penicillin-based treatments are now subject to a “severe shortage protocol.”
Even across the Atlantic, public authorities are warning of imminent shortages and in Canada and Australia, pharmacists have been asked to prescribe alternatives.
This global shortage is largely driven by a rebound in infections from viruses following several years of anti-epidemic measures. Masks, PPE, and social distancing helped to limit our exposure to the Covid-19 virus but also led to a dip in infections from flu and other viruses. With Covid measures mostly gone, these viruses have returned with force.
Pharmaceutical factories where antibiotics are made are playing catch-up after having lowered production during the pandemic.
Profit at the expense of public health
The shortages may also be symptomatic of a more structural problem with the world’s for-profit pharmaceutical sector. Antibiotics are old medical technology whose patents are now held in the public domain. These chemicals are generic, meaning that they can be produced by many companies and cheaply.
Unfortunately, this makes them less appealing to large laboratories with large production capacities, as the profit margin is far lower than for patented medicines. This has led to years of underinvestment into the production of this important medicine.
Most of the production of the active ingredients found in antibiotics now takes place in Asia, pushing up import costs for laboratories. As a result of all these factors, only ten factories still produce amoxicillin.
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To combat this immediate shortage, doctors are suggesting that amoxicillin be substituted wherever possible, and the course of antibiotics shortened where appropriate.
In the long term, a more sustainable economic model will be needed to make antibiotics such as amoxicillin. Experts say that the pharmaceutical sector is part of the global strategic infrastructure and therefore requires protections to ensure supply.
