The report, from the Access to Medicine Foundation (AMF), said many countries had or were currently experiencing shortages of vital antibiotics because they are only produced in a few factories, they offer slim margins for manufacturers and demand mainly comes from poorer countries.

The report said antibiotic supply chains were complex with batches passed between multiple distributors before reaching the patient, leading to low visibility and accountability, shortages and poor quality.

This lack of visibility is also leading to excessive use of antibiotics and the growth of antimicrobial resistance (AMR), among the key medical challenges facing the world.

“Governments with high purchasing power are using increasingly stringent tendering processes focused on price, creating competition among producers that puts further pressure on already slim margins,” said the report.

“What’s more, when a new antibiotic enters the market, it will be used sparingly due to the risk of AMR, meaning there is little prospect of ensuring the high-volume sales that may be needed to justify the investment in R&D. As a result, there is little commercial incentive to develop new antibiotics.”

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