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Though the current coronavirus still dominates global health news, the health sector is also suffering from other issues. Not only is the world suffering from a global antibiotic shortage, but it is also failing to develop many necessary antibacterial treatments. Moreover, none of the current drugs are offering an adequate solution for the drug resistance problem. 

“The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fueling the impact of antimicrobial resistance (AMR) and threatens our ability to successfully treat bacterial infections,” says Dr. Hanan Balkhy, WHO Assistant Director-General on AMR.

A growing problem

The antibiotic shortage has been increasingly taking place over the last decade all around the world. For example, manufacturers have withdrawn ceftibuten from most countries in 2016. The shortage often causes patients to depend on other more expensive substitutes. It also results in longer hospitalization duration, rise in morbidity, and even mortality; in case of substitute unavailability. This often occurs in most third-world countries with patients receiving suboptimal or broad-spectrum antibiotics, leading to an increase in drug resistance.

Causes behind the antibiotic shortage

The antibiotic shortage was the product of various expected and unexpected problems piling up. The ongoing covid-19 pandemic, production disruptions, quality problems are examples of unexpected accidents obstructing the antibiotics’ production. However, the core of the problem is, unfortunately, the low-profit margin of antibiotics. Since many competitors can produce the same kinds of antibiotics, their prices kept decreasing throughout the years to a point where suppliers no longer want to provide them. 

Moreover, since most suppliers offshored most API production to places like China and India, they are now suffering the increased risk of natural disaster, as well as geopolitical problems.

Youngsters bearing the risk

Since the antibiotics treating sepsis are rendered ineffective by drug resistance, doctors are failing to treat vulnerable patients. Thus, a WHO report stated that three in 10 newborns developing blood infections end up dying. Another rising cause of childhood mortality among under-fives is Bacterial pneumonia. It is yet another preventable disease that developed resistance to current drugs. 

On the other hand, the evolution of these diseases isn’t really surprising since almost all of the antibiotics available today are mere variations of those discovered by the 1980s.

The coronavirus’ impact

While the current pandemic played an indirect role in the antibiotic shortage, it also provided the world with a rare opportunity. Not only did it demonstrate firsthand the tragic implications of an uncontrolled epidemic on health and the economy, but it also provided the world with a deeper understanding of the issue. Thus, it drew attention to the gaps in sustainable funding while proving the possibility of rapid progress in the case of strong political will and enterprise.

“Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in R&D of new and effective antibiotics,” said Haileyesus Getahun, Director of AMR Global Coordination at WHO.  “Antibiotics present the Achilles heel for universal health coverage and our global health security.  We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the AMR threat.”

New solutions

The lack of substantial progress in the antibiotic field raises the need for other non-traditional treatments. Countries must invest in new innovative approaches in order to treat bacterial infections. Thus, scientists are working on 27 new, non-traditional antibacterial agents utilizing various new methods, including antibodies and bacteriophages. They also involve therapies that assist the patient’s immune response while weakening the overall effect of the bacteria. 

However, due to the small profit of successful antibiotic products and the inherent scientific challenges, only a few of these promising products will make it to the market. Small- and medium-sized companies are almost the only driving forces of such innovations since the stated challenges limited the interest of major private investors, along with most of the large pharmaceutical companies. Moreover, many of these small and medium-sized enterprises are struggling to finance their products till they reach the late stages of clinical development

“Overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance,” the UN agency concluded.

References:

Alert over shortage of new drugs for ‘world’s most dangerous. (2021, April 20). UN News. https://news.un.org/en/story/2021/04/1089822Global shortage of innovative antibiotics fuels emergence and spread of drug-resistance. (2021, April 16). UN. https://www.who.int/news/item/15-04-2021-global-shortage-of-innovative-antibiotics-fuels-emergence-and-spread-of-drug-resistanceKouassi, V. (n.d.). Causes of antibiotic shortages and the solutions to address them – by Enrico Baraldi. REVIVE. Retrieved April 24, 2021, from https://revive.gardp.org/causes-of-antibiotic-shortages-and-the-solutions-to-address-them/ReAct. (2020, March 12). Shortages and AMR – why should we care? 4 consequences of antibiotic shortages – 2020 –. https://www.reactgroup.org/news-and-views/news-and-opinions/year-2020/shortages-and-amr-why-should-we-care-4-consequences-of-antibiotic-shortages/