Pharmacies across Europe and the US are running out of critical medicines as doctors see a post-pandemic rebound in winter viral infections. While the scarcity of several high-profile prescription drugs is nothing unusual, even when demand is not sky-high, medicine shortages happen regularly, even if the public is usually not well informed of this.
The shortage of essential medicines is becoming very worrying as key antibiotics like amoxicillin and the treatment Adderall are forcing patients to search for pharmacies that have still not run out of stock of these drugs. The head of the Central Procurement and Supplies Unit (CPSU), Karl Farrugia, told Times of Malta: “A chronic global medicine shortage is estimated to last another six months in Malta but there is no cause for alarm.”
Health Minister Chris Fearne has sought to reassure the public that, in Malta, this is a private not government sector issue and that the government is providing support to the latter.
There are various reasons why pharmacy shelves may be short of certain medicines. Some drugs are generally more vulnerable to shortage due to a lack of economic incentives to produce them.
Sometimes, manufacturing disruptions, labour issues or ingredient shortages will reduce availability. Many raw materials for making medicines are sourced from just two countries, China and India. Even with normal production levels, high demand during a severe cold and flu season, like the one many European countries are experiencing, can make it hard for patients to find what they are looking for.
Bindiya Vakil, CEO of Resilinc, a California-based firm that helps companies from various industries mitigate supply chain problems, says that “the well-documented shortages of medicine are not going away any time soon”.
Biopharma had lagged in building supply chain resilience compared to other business sectors when COVID-19 erupted three years ago. In 2020, many became aware of the microchip shortage and how it affected the manufacturing of most consumer goods that used electronic parts. Many manufacturers invested in robust supply chain mapping and monitoring programmes to ensure that vital supplies were never too difficult to source.
The pharmaceutical industry has not really taken a proactive approach to understanding its supply chain dependencies. Vakil argues that it is not easy to build resiliency but the time to do it was yesterday.
The unwavering belief that globalisation needs no fixing is flawed. China and India are estimated to produce between 60 per cent and 80 per cent of the world’s active pharmaceutical ingredients. This concentration comes with substantial risks, as any glitch in the supply chain can easily cause disruption.
The government needs to take the public into its confidence by communicating clear and truthful information on how it is dealing with medicine shortages.
It should have immediately acceded to the opposition’s request for an urgent parliamentary health committee meeting to discuss the shortages.
This serious public health challenge is not a partisan issue. The public must know how the country’s political leaders are addressing their genuine health concerns. Some countries like France have taken some short-term measures, like instructing pharmacies to prevent people from hoarding medicines. The French government has also taken financial steps to repatriate all those industries that produce essential medicines.
Last March, the European Medicines Agency established a steering group to address supply problems. Health professionals and patient representatives are hoping for more action as part of a new regulation being discussed in Brussels.
At the EU level, action is needed to put people’s minds at rest. We are ultimately discussing the availability of potentially life-saving medicines.