# Global Medication Shortages: Comprehensive Report (2021-2024)

## Executive Summary

Medication shortages have emerged as a critical global health crisis between 2021-2024, affecting both developed and developing nations.

This report examines the scope of these shortages, their underlying causes, affected medications, and coping strategies.

As a caretaker for a parent with chronic life-threatening conditions, understanding this landscape is essential for ensuring continuity of care and preparing for potential disruptions in medication access.

## Scope of the Problem

Medication shortages are a worldwide phenomenon with varying severity across regions:

- **Nigeria** is experiencing extreme shortages with dramatic price increases for essential medications
- **United Kingdom** faces shortages of specialized drugs, including the only medication available for Motor Neuron Disease (MND)
- **United States** contends with high prescription costs and intermittent shortages of various medications
- **African countries** struggle with limited manufacturing capacity (fewer than 400 manufacturers for over 1 billion people) and heavy reliance on imports (70-90% of drugs consumed)
- **Ukraine** suffers from dangerous shortages exacerbated by conflict, particularly affecting insulin supplies
- **Botswana** and other nations report ongoing shortages since late 2020

## Affected Medications

The following medications have been significantly impacted by shortages or extreme price fluctuations:

### Respiratory Medications
- **Ventolin inhaler** (asthma treatment): Out of supply in Nigeria, previously sold for N1,600
- **Seretide inhaler**: Price increased from N6,000 to N40,000 in Nigeria

### Pain and Fever Management
- **Paracetamol**: Price increased from N50 to N200-N300 per packet in Nigeria

### Antibiotics
- **Augmentin** (infection and pneumonia treatment): No fixed price, now determined by buyer in Nigeria
- **Ampiclox**: Price increased from N500-N1,000 to N10,000-N20,000 pe

# Global Medication Shortages: Comprehensive Report (2021-2024)

## Executive Summary

Medication shortages have emerged as a critical global health crisis between 2021-2024, affecting both developed and developing nations.

Title:

Content: OPEN APP
Home / Companies / Food and medicine shortages in Ukraine prompt global relief effort

With food and medicine supplies threatened across Ukraine, domestic and international food manufacturers, distributors and aid workers are mobilizing to keep grocery stores and pharmacies open and shelves stocked.

In recent days, much of Ukraine’s domestic food production and distribution ground to a halt, triggering shortages in parts of the country, especially in areas hardest hit by the Russian invasion. So far, that hasn’t escalated into widespread hunger, thanks in part to a domestic and international effort to get food around the country.

Russia and Ukraine had agreed Saturday to open humanitarian corridors for evacuating civilians from the besieged eastern cities of Mariupol and Volnovakha, and for resupplying them with food and medicines, but the agreement collapsed as Kyiv accused Moscow of violating the cease-fire.

Earlier this week, Fozzy Group, Ukraine’s largest supermarket chain, had plenty of food—including fresh produce like cucumbers and tomatoes—sitting in warehouses dotted around the country, according to a spokesman. But a shortage of drivers and loaders, active fighting on roads, and a lack of gasoline is hampering the movement of supplies from its warehouses to stores.

Over 90% of the company’s roughly 1,000 stores—operating under banners like Silpo, Fora and Fozzy—are open, including most stores in Kyiv, said the spokesman.

Even in Kharkiv, Ukraine’s second-largest city and site of some of the heaviest shelling by Russian forces in the invasion, Fozzy has been trying to keep stores mostly open, sometimes closing them for an hour or two when it determines the situation is getting dangerous, but then reopening as quickly as possible. The company is regularly alerting shoppers about store hours and product availability on its websites and through social media, said the spokesman.

Fozzy’s chain of restaurants are closed. Its chain of pharmacies, Bila Romashka, is open. The company has taken to Facebook, Instagram and other social media to call for volunteers to help drive trucks and load goods from its six logistics centers.

Dutch food retailer Spar International said as of Monday 95% of its stores in western Ukraine, further away from the most intense fighting, remained open, although many were operating only for a few hours. The company, which has 65 supermarkets across Ukraine, has set up an internal fund to assist its Ukrainian operations in procuring products locally from existing suppliers. It is simultaneously working to establish new suppliers for essential goods to send to its distribution center in Ukraine, located about 60 miles from the Polish border.

“With the ongoing escalation of the war, and the prospect of the local supply chains being further impacted, it is essential to ready the ability to maintain supply from our operations in neighboring countries," said Spar.

Imports from foreign suppliers have been disrupted. Dr. August Oetker KG, a German company that usually exports yeast, baking powder and other baking ingredients from Germany, Poland and Romania to Ukraine, halted this last week and closed its warehouse in Kyiv, said a spokesman. “There are no trucks who can deliver our goods at the moment," he said.

To help fill the void, global nonprofits are ramping up efforts to get food to Ukrainians. The World Food Programme said its first trucks of food rations to the country arrived earlier this week at Ukraine’s border with Poland. The food is coming from Turkey, according to a spokeswoman, who says WFP’s focus will initially be on providing food for people clustered at the border, mostly women and children.

In areas where people are on the go and can’t cook, the WFP is offering emergency rations of tinned and packaged food—its first shipment contains 200 tons of these. In places where people still have access to stores and cooking facilities, it is offering cash and food vouchers.

The International Committee of the Red Cross, meanwhile, is trying to bring in medical supplies. But trucks “simply can’t move because of the hostilities," said a spokesman. The Red Cross has 600 people on the ground in Ukraine but in areas of active fighting, staff are having trouble moving around. The organization will initially focus on bringing in medicines, tarpaulin and blankets, he added.

Some medical supplies are already running low. The World Health Organization on Sunday warned that hospitals are running out of medical oxygen because trucks can’t transport it from plants, due to road disruptions and a lack of drivers willing to make the journeys.

Ukraine was in the midst of a polio vaccination campaign for young children after a toddler suffered paralysis from the virus in October, the first case in more than five years. The campaign began on Feb. 1 but was halted when fighting broke out.

The WHO is air freighting supplies for trauma care to neighboring Poland and has a warehouse of supplies in Ukraine. Doctors Without Borders is also working on securing safe routes for medical supplies to move around the country, said Kate White, an emergency manager for the international aid organization.

“We can get kits to the country," said Jarno Habicht, WHO’s representative in Ukraine. “But are they getting where they are most needed in the health system, that’s the question."

Those difficulties are creating dangerous shortages of drugs like insulin, according to several groups working in the country. “What we’re hearing from our contacts within hospitals and health facilities inside Ukraine is there is a significant shortage of insulin right now," said Doctors Without Borders’ Ms. White. “For insulin-dependent diabetes patients that is a significant concern."

Novo Nordisk, a major insulin supplier, said deliveries from its warehouse have been disrupted due to shortages in driving staff. “We are doing everything we can to get medicines to the patients that need them either through pharmacies or humanitarian organizations," a company spokeswoman said.

Healthcare officials and aid workers have also warned that the crowded conditions faced by refugees will likely lead to a surge in Covid-19 infections. “Infectious diseases ruthlessly exploit the conditions created by war," said Bruce Aylward, senior adviser to the WHO director-general. That is because of increased transmission, but also because lack of healthcare means higher numbers of avoidable deaths.

This story has been published from a wire agency feed without modifications to the text

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Title:

Content: BONELA calls for axing of incompetent medical supply officers

  • Says shortage of medicines is a matter of life and death
  • MoH blames it on COVID-19

GAZETTE REPORTER

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) has called on President Mokgweetsi Masisi to fire incompetent officers for their failure to procure medicines and drugs for public health facilities.

The Assistant Minister of Health and Wellness (MoH), Sethomo Lelatisitswe, recently told Parliament that public health facilities were running short of medicines and condoms, saying the situation was being addressed.

According to BONELA, the situation got worse after the outbreak of COVID-19.

In an interview with The Botswana Gazette this week, the Executive Director of BONELA, Cindy Kelemi, said those responsible for the dearth of drugs and medicines should be fired.

“There is a serious shortage of medicines,” Kelemi said. “Whether you are talking about hypertension medication or anti-retroviral drugs, there are shortages. This is a concern for us because BONELA exists to ensure that the right to health is made a reality in Botswana.”

“The question we often ask is what the ministry is doing to address this, especially for people in hard-to-reach areas? We have always maintained that we have not explored fully our procurement potential, including looking at the private sector.”

She added that in addition to medicines and drugs, condoms are also in short supply at public health facilities. “We have had condom shortages since last year and we were informed that logistical problems were preventing distribution of a donation through the US embassy,” she said. “Central Medical Stores must understand that this is a life and death situation.”

Kelemi expressed hope that the budgetary vote for MoH being the largest, medical supplies to public health facilities will be replenished.

“But we had this problem even before COVID-19,” she noted. “This goes to show that we can throw money at a problem when there are underlying problems.”

The Chief Public Relations Officer at MoH, Dr Christopher Nyanga , has acknowledged the shortage of medicines and drugs at public health facilities but blames it on COVID-19 slowing down production and delivery timelines.

“Health facilities in Botswana and across the world have been experiencing shortages and delayed delivery of certain drugs and medical supplies,” Nyanga said.

He added that the problem has become more pronounced since the last quarter of the 2020/2021 financial year.

This report examines the scope of these shortages, their underlying causes, affected medications, and coping strategies.

Title:

Content: The real reason for the Children’s Tylenol shortage

After two years of lockdowns, colds are back and consumers are likely hoarding. ‘We’re seeing increases in demand that are running close to 20 to 40 per cent.’

Kim Mackay has resorted to giving her 11-year-old son expired children’s Tylenol desperate to ease his pain.

The 44-year-old mother and her husband scoured the aisles of at least 10 pharmacies in Vancouver and Burnaby in British Columbia in search of the pain medication for their child’s pancreatitis but could not find the product on shelves.

After friends, also on the look out, came back empty-handed, Mackay posted a plea for help on Facebook.

“I managed to get some expired Tylenol from somebody, and another person had gone down to the U.S. in the last month and brought back a big pack of Tylenol so I have that too,” Mackay said, adding that she currently has enough medicine for another week or so. After that, she’s resigned to repeating her search.

“It has been stressful on top of my child’s illness but I’m grateful for the people who have helped,” Mackay said.

Drugstores nationwide have been grappling since May with supply shortages of over-the-counter medications for children containing acetaminophen (also known by the brand name Tylenol), and ibuprofen (Advil) due to heightened demand and supply chain constraints.

“After two-years of social distancing, kids, adolescents, even young adults are getting exposed again to regular viruses,” said Dr. Sumon Chakrabarti, an infectious disease physician in Toronto, adding that a resurgence of colds and flus was expected after lifting COVID-19 restrictions.

“Kids normally would have a certain level of immunity when they’re being exposed to viruses. But we’re seeing a general increase and kids getting sicker than they normally would have because of the last two years of social distancing,” said Chakrabarti.

Supply of pain relievers for children has been especially impacted by unprecedented demand driven by an uptick of cold and flu viruses as well, treatment for milder COVID-19 symptoms is impacting the supply, according to the Ontario Pharmacists Association.

“We have seen higher transmission of respiratory illnesses such as coughs, colds and COVID-19 since the relaxation of public health precautions,” said Jen Belcher, vice-president of the Ontario Pharmacists Association. “Manufacturers have been unable to keep up with the high demand for all these products,” she added.

The Retail Council of Canada, which deals with supply chain issues on behalf of retailers across Canada, said overall demand is outpacing production for children’s cold and flu medications.

“Retailers are experiencing rolling shortages,” said Retail Council of Canada spokesperson Michelle Wasylyshen. Staffing shortages at the manufacturing level are also impacting production, she added.

These drug shortages are primarily consumer-driven, said Anthony Fuchs, a spokesperson for Food, Health & Consumer Products of Canada, the national trade association representing Canada’s food, beverage and consumer goods manufacturer which includes pharmaceutical company Johnson & Johnson Inc., the maker of Tylenol, as a member.

While there are staffing shortages among all members, they “have not been identified to me by companies making these types of products as an issue,” said Fuchs. “These companies have increased production of the products that they’re providing but particularly when it comes to children’s medication, we’re seeing increases in demand that are running close to 20 to 40 per cent above historical highs,” Fuchs said.

When asked about shortages, Johnson & Johnson confirmed that it is continuing “to experience increased consumer-driven demand.”

“We are taking all possible measures to ensure product availability,” the email said.

Dr. Rupert Kaul, director of the division of infectious diseases at the University of Toronto, said demand could also be spiking because people are stock piling the drugs.

In August, Health Canada in a twitter post urged Canadians not to buy more acetaminophen and ibuprofen medications for children than necessary to prevent drug shortages.

“It may well be that people are panic-buying children’s Tylenol in the same way we were panic-buying toilet paper at the start of the pandemic without any true increase in use,” Kaul said.

He pointed out that acetaminophen can be made in certain pharmacies on-site, so there isn’t any worry that drug stores will run out of it, he said.

“If we can rein in any panic buying, it will reduce the pressure on those supplies so the people who need them will be able to access them,” Kaul said.

Ghada Alsharif is a Toronto-based staff reporter for the Star. Reach Ghada via email: galsharif@torstar.ca
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Title:

Content: Nationwide Adderall shortage impacting area pharmacies in the Panhandle

Published: Oct. 19, 2022 at 5:07 PM CDT|Updated: 19 minutes ago

AMARILLO, Texas (KFDA) - The Food and Drug Administration has declared a nationwide Adderall shortage and the Panhandle is feeling the affects.

The FDA blames the shortage on manufacturing delays.

Health experts say a shortage in stimulant medications is actually not a rare occurrence.

“The amount of medication that is produced is limited and regulated by the government, so there have been other years where towards the end of the year in particular, we start to struggle with supply issues. In this case, however, while that does seem to be probably one of the contributing factors, the other issue we’re facing, at least what we’re hearing about it right now, is that the manufacturing delays have been an issue and some of that has been secondary to the labor shortages,” said Dr. Carolyn Lentsch-Parcells, pediatrician and assistant professor at Burnett School of Medicine at TCU.

Martin Tipton Pharmacy is being impacted by this shortage.

“We’re having to order from various manufacturers right now, not our normal manufactures just because we cannot get them from our normal ones,” said Mark Vogler, Martin Tipton Pharmacy.

Fortunately its patients have been able to get their needed medication, just a different brand.

Amarillo Pharmacy is also being impacted, saying the drug has been back ordered for the past two months.

The Amarillo Pharmaceutical Care Center at Texas Tech Physicians is also seeing a back order on one of the strengths of the drug.

“The drug company manufacturers short-acting and extended-release, for example. So, a pharmacist, in this situation, will work collaboratively with the patient’s provider to find an available strength and dosage to meet the patient’s needs until the original strength becomes available again,” said Amarillo Pharmaceutical Care Center at Texas Tech Physicians.

Dr. Lentsch-Parcells acknowledged this may be an uneasy time for those depending on Adderall, especially with the end of the semester and holidays approaching. She encourages you to reach out to your providers.

“There are various strategies that we will sometimes use to help our patients get the best care possible, while we are trying to ride out the shortage, so that might be changing dosage or using dosage forms that are available to replace their typical medication,” said Dr. Lentsch-Parcells

She emphasizes not to make any changes to your medications without speaking to your providers first.

Pharmacy chains, like CVS and Walgreens, both confirm they are seeing intermittent supply issues with the generic form of the drug.

Title:

Content: Hospitals spanning England face critically low levels of intravenous paracetamol - as a national shortage of the popular painkiller runs on. Paracetamol administered via an IV is the safest and most effective drug to give patients who are in post-operation pain - but staff at one hospital trust in particular have been told to pull the plug on the drug from anaesthetic rooms immediately.

The shortage of IV paracetamol is expected to run into November at earliest, with a Department for Health and Social Care spokesman blaming 'capacity constraints with a manufacturer' as the cause. One hospital worker detailed how deeply worried they were at the shortage - citing how it is much more effective than the orally consumed version.

They said: "It is deeply worrying. We use IV paracetamol because tablets taken orally are only 30% effective. Given by IV it is a potent and direct drug and it restricts pain very quickly."

Read more: Doctor warns that silent pandemic 'scarier' than Covid-19 is already killing a million a year

It is reported by The Mirror that they went on: "The alternatives are oral morphine, which is very slow-acting, or nonsteroidal anti-inflammatories such as ibuprofen and aspirin, which can have negative side effects such as bleeding and allergic reactions."

Drug shortages have become a global problem, worsened by the recent Covid pandemic, the ongoing war in Ukraine, the energy crisis and record levels of inflation. Last winter, France completely culled the internet sales of paracetamol products in a widespread shortage blamed on a Chinese export ban on raw materials.

In Great Britain meanwhile, it is Brexit which is primarily blamed for making matters worse. This is because drug imports from the EU - which historically make up two thirds of the National Health Service's supply - are at their lowest ever levels since leaving.

The health department’s spokesman, said: "Guidance has been issued to the NHS advising on how to manage the issue and we are working with those in the supply chain to resolve this as soon as possible."

Labour’s shadow health minister, Liz Kendall, said: "Concerned staff and patients will understandably be seeking reassurance that the pain relief they need is available. The Government must spell out the urgent steps being taken to resolve the shortage."

It comes after a Covid Inquiry heard that a lack of nurses left the NHS and Great Britain vulnerable to the pandemic - with the infection control lead at the Royal College of Nursing telling of a national shortage of PPE due to a lack of planning for an airborne virus.

Rosemary Gallagher, the RCN’s professional lead for infection prevention and control, explained: "The resilience of the health and care workforce is absolutely essential in order to be able to deliver health care services that meet the public's needs. We know that we went into the pandemic with a significant shortage, about 50,000 nurses short.

"That immediately put us at risk when we needed to surge capacity to support patients at home and in hospitals."

The intervention came the same day that a damning international study warned that Britain has fewer nurses than other developed nations.

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Millions of Americans Can't Afford Their Prescription Drugs. Now What?

As the cost of medication soars, patients are turning to online coupons and financial assistance programs.

When 27-year-old Savanna Braun changed jobs last December, she had more to worry about than meeting co-workers and adapting to an unfamiliar schedule. A new job meant different insurance, and that meant jumping through hoops to get approval for her lifesaving prescription drugs.

With insurance coverage, which costs her around $5,100 a year, she pays an extra $960 annually for medications to treat her severe asthma, psoriatic arthritis and depression. Those pharmacy benefits soften the bill -- without insurance, she'd be looking at a staggering $200,000 a year.

As basic expenses increase, soaring prescription drug prices are eating up an even larger portion of household income. Over just the last year, prescription drug prices rose at an average rate of 31.6%, with some increasing up to 500%, according to a recent Department of Health and Human Services government report. Americans, who pay the highest prices in the world for prescription drugs -- two to three times more than people in other countries -- are finding any way possible to get around the entangled pharmaceutical industry.

Exorbitant prescription drug costs disproportionately hurt lower-income households, particularly the uninsured and underinsured populations (9% and 23% of US adults, respectively). Black, Latino and Native American people are less likely to have health insurance and more likely to face cost-related barriers to treatment, according to the Commonwealth Fund, a nonprofit focused on health policy reform. Without insurance, patients are forced to sacrifice their medications for more immediate needs, such as housing or food. Those who are reliant on prescription drugs to manage their chronic conditions can often accumulate medical debt

Almost a third of the US adult population, including those with insurance, can't take their prescriptions because they can't afford it, according to Frederick Isasi, executive director of the health advocacy group Families USA. The crisis has damaging consequences: Nearly three in 10 adults end up skipping doses, cutting pills in half or not filling their prescription, resulting in long-term health complications. Others get desperate -- as many as 8% of American households have purchased medications outside the US to get a lower price.

But there are far less risky workarounds. Some patients score significant cost savings by opting for generic medications, requesting alternative medication from their providers or even switching pharmacies. Others who are financially vulnerable turn to advocacy organizations, sliding-scale health centers or patient assistance plans. And many turn to third-party sites like GoodRx, NeedyMeds.org or, more recently, Mark Cuban's Cost Plus Drug Company to cost-compare medication prices, get coupons and save at the register.

When drug costs stand in the way of patient health

Braun had her first run-in with high-cost medicine when she was 3 years old. After she had a life-threatening asthma attack, her doctors said the best treatment was an adult-only prescription. The insurance company didn't want to cover a drug that wasn't approved for her age group by the Food and Drug Administration, though it eventually gave in.

Controlling her asthma soon became a whirlwind of nebulizers, inhalers and steroids, all of which cut into her family's budget. Every time her father changed jobs, she had to wait months until his benefits kicked in, and the bureaucratic obstacles to get her meds began again.

With the 2010 enactment of the Affordable Care Act, Braun's family could no longer be denied insurance coverage or charged more for her preexisting condition. But a few years later, after Braun was diagnosed with psoriatic arthritis, she struggled with trying to find the right medication, and most of them took months for insurance to authorize. Her list of tested drugs read like a pharmaceutical representative's brochure: Methotrexate, Humera, Solara, Remicade and Xeljanz. When her asthma worsened, her pulmonologist told her to take Xolair, but insurance initially denied her, saying she needed to have less lung function to warrant its use.

When Braun turned 26, she got kicked off her parents' insurance plan and lost coverage for all her medications. For months, she was stuck relying on her doctor's samples to keep her symptoms at bay. Not having access to her specialized drugs and treatment set her back. "I was losing lung function rapidly," Braun said, noting that she now has permanent lung damage from not being able to control her asthma. Braun was constantly worried about ending up on a ventilator in the hospital without insurance coverage. "I was pretty scared for my life," she said.

When insurance obstacles stand in the way of patient health

Julie Whitehead, 52, who has bipolar disorder, tackles similar insurance hurdles, which take a huge toll on her mental health. In 2015, Whitehead's doctor prescribed a new mood stabilizer, Abilify, but her insurance company balked. At the time, Abilify didn't have a generic option, so it would cost her $1,000 a month out of pocket.

Because Whitehead couldn't afford the hefty price tag, she was prescribed a different medication, Geodon, for her bipolar disorder. But after six months taking it, she became suicidal. "I had been in a good place for five years, and then I was hospitalized," Whitehead said.

In 2020, Whitehead's doctor wanted to change her medication to Latuda, which required prior authorization. Prior authorization requires a lot of time-consuming paperwork, and if doctors agree to do it, they often charge for it. Whitehead had to wait three months for a green light, and in the meantime she struggled to pay out of pocket for Latuda, which cost more than her monthly Social Security disability check. Luckily, Whitehead's husband had enough income to help her cover the cost. But the process made her angry -- she was trying to "forestall a medical catastrophe," and wasn't allowed to because of an insurance denial.

Today, Whitehead pays around $200 a month for her 11 prescriptions under her husband's insurance plan. "It's one thing to be without insurance and have to depend on Medicaid and Medicare Part D," she said. "But to pay a king's ransom for insurance and for it to still not cover what you need, that's in some ways worse."

A David versus Goliath fight

As many as 28% of adults end up having to take a prescription that isn't covered by their health insurance, and 13% have had a prescription medication dropped by their health insurance plan, according to a survey conducted by GoodRx Health. In 2016, Americans spent some $66 billion total for out-of-pocket retail prescription drugs.

Additionally, many pharmaceutical companies place the drugs that treat chronic diseases such as diabetes, asthma, HIV/AIDS and hepatitis B and C in higher specialty tiers with greater out-of-pocket prices. People of color are disproportionately impacted by these types of serious illnesses and health conditions, making such drug-tier policies openly discriminatory, according to the National Academy for Health Policy.

Disputing a denial from an insurance company for an important medication takes time and effort -- it also requires a certain amount of financial literacy and tools, which aren't generally accessible to historically disadvantaged groups. Some patients never try negotiating with or appealing to their providers or insurance companies on costs.

Vulnerable consumers going up against the pharmaceutical behemoth is a David and Goliath fight, according to Isasi. From 2000 to 2018, 35 pharmaceutical companies reported a combined $11.5 trillion in revenue. With so much in profits at stake, the pharmaceutical industry focuses its lobbying efforts on keeping drug prices high and reducing its competition by gaining monopoly power through patents.

While pharmaceutical companies claim that high drug prices are needed to cover research and development, a recent study conducted by an international team of researchers showed no association between pricing policies and R&D investments. Drug companies set the price, regardless of how much it costs to make the medication. "It's usually a half a penny, or one cent, to actually produce that drug," Isasi said. "Why is it that a drug company can charge whatever they can get away with?"

Alternative paths to obtaining affordable medicine

The debate over prescription drug prices has for decades taken center stage in congressional hearings and among lawmakers. The recently passed Inflation Reduction Act has an extremely limited provision allowing Medicare to annually negotiate prices with pharmaceutical companies on 10 pricey medications, starting in 2026. It also caps out-of-pocket prescription drug costs at $2,000 for those with Medicare Part D drug plans, but not until 2025.

A multitude of organizations focus exclusively on pushing common-sense reforms and achieving policy changes to lower the price of prescription drugs. But until there's a monumental overhaul to the global pharmaceutical industry, there are a few government-based solutions that help medically underserved populations obtain lifesaving medication. For example, Federally Qualified Health Centers offer a sliding scale for certain drugs, and the federal 340B program allows certain hospitals and clinics to buy discounted outpatient prescription drugs for low-income and uninsured patients.

The next step, according to Isasi, is for patients to check if they qualify for Medicaid, through the website. Though eligibility income levels are very low, the expansion of Medicaid in 39 states has helped many financially vulnerable households cover the cost of prescription drugs. And Medicare patients age 65 or older can try applying for the Extra Help federal program to get their medicine at a very reduced, income-adjusted rate.

Patients can also try looking for coupons, rebates or price comparisons online. GoodRx offers discount coupons for all FDA-approved medications, both brand name and generic, regardless of insurance status. If there isn't a GoodRx coupon available, the site will offer a coupon from the manufacturer to bring down the price, or show options for similar medications that may be more affordable, according to co-founder Doug Hirsch. Patients can present a GoodRx coupon to the pharmacy immediately, and the price is better than an insurance copay more than half the time, said Hirsch.

The Cost Plus Drug Company, launched by the billionaire Mark Cuban, is a new online pharmacy that slashes prices on generic prescription drugs. A recent study in the Annals of Internal Medicine, co-authored by Harvard Medical School fellow Dr. Hussain Lalani, found that Medicare could've saved $3.6 billion in 2020 if it purchased 77 prescription medications through Mark Cuban's company. Uninsured and underinsured patients get the biggest benefit from using Cost Plus, Lalani said. But patients should look elsewhere if they need a brand name or clinician-administered drug, or if they need their generic medication immediately, since generics from Cost Plus come through the mail.

Read more: How to Get Cheaper Prescription Medicine With Cost Plus Drugs

Then there's NeedyMeds.org, an organization started in 1997 by Dr. Richard J. Sagal, which assembles roughly 40,000 patient-assistance programs for people who can't afford medication and health care costs. It's a free, nonaffiliated information outlet, and visitors to the site are anonymous. Sagall said it receives up to 15,000 daily users looking for low-cost clinics, prescription savings, rebate programs and more. The organization also gets up to 6,000 calls a month to its toll-free hotline from patients seeking resources.

Sagall, a former family physician, said he's helping more people through the website than he ever did in private practice. "Our ultimate goal is to go out of business for lack of need," said Sagall. "I don't see that happening in the near future."

Title:

Content: Shortcomings Creon, confirmations from Aifa and the company: “Difficulties until the end of 2025”

#Shortcomings #Creon #confirmations #Aifa #company #Difficulties

Rome, 30 January – The situation of shortages on the pancreatic enzymes market, reported in recent days by the singer Fedez and ended up on the pages of newspapers, TV news and information sites, it had been addressed by AIFA since last autumn, when – after a discussion with the owner/sales licensee (Viatris Italia Srl) and in agreement with the same – the the national regulatory agency had issued an information note aimed at healthcare professionals which clearly represented the terms of the problem. The drug – which replaces the functions of the pancreas when compromised and is necessary for patients to assimilate food – began to register significant shortages on the distribution circuit in autumn 2023.

Due to production problems/high demand for pancrelipase-based medicines Creon 10,000, Creon 25,000 and Creonipe 35,000″ explained AIFA in the note dated 25 October 2023, “they are currently distributed on a contingent basis; this situation will presumably continue until 12/31/2025. The shortage is not due to safety or quality issues and has already been communicated to the regulatory authority in accordance with current legislation”.

AIFA therefore invited healthcare professionals to prescribe these drugs “only for authorized indications, to inform patients already undergoing treatment also in order to avoid hoarding phenomena and to prescribe Creon 10,000 and 25,000 e Creonipe 35.000 only if strictly necessary, in the minimum effective dose, and if for the indication in question there are no valid therapeutic alternatives or if, for patients under treatment, it is not possible to switch to other medicines. This is to ensure that the available packaging, as limited, is used for indications for which the medicine cannot be replaced”.

The difficult situation has not seen any improvement since then but, in the meantime, reports of patients seeking the drug have multiplied, and Fedez has acted as spokesperson for this in recent days. On the problem – after the clarifications of Minister Schillaci in question time in the Senate in recent days, the undersecretary also spoke yesterday Marcello Gemmato (in the picture). who in a statement to Adnkronos wanted to remind you that “AIFA allows healthcare facilities to import similar medicines authorized abroad. In addition to this, I invite pharmacies, if they cannot find the drug from the usual suppliers, to place the order directly with the manufacturing company”.

“The situation has been under the attention of the Ministry of Health and the Italian Medicines Agency for some time, in constant dialogue with the manufacturing companyand to manage its supply in the area so that the therapeutic continuity of the medicine for citizens is guaranteed as much as possible” then reiterated Gemmato, who wanted to point out how the issue of the unavailability of some drugs in our country has been “one of the issues that I wanted to address, already in the first months as undersecretary, through the establishment of an ad hoc table to deal with all issues regarding access, availability and sustainability of pharmaceutical goods for citizens”.

Viatris itself, the company that holds the authorization to market and distribute Creon pancreatic enzymes in Italy, also intervened on the issue, requested by telephone from Ansa. “We are in daily contact with the manufacturing company to mitigate supply difficulties and reduce the impact on patients” company representatives told the agency, confirming the difficulty in supplying Creon. Which, however, they explain from Vatris, are due “in high demand globally” and not, as some initially hypothesized, “to issues of quality, safety or effectiveness”. In any case, the situation does not yet seem to be resolved. Indeed, as already announced last October, Viatris has confirmed that “difficulties in supply could continue until 12/31/2025”.

Also Read:  MPOX virus is spreading rapidly

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Content: Health Secretary faces mounting pressure from campaginers to address drug shortages

Campaigners have called for Health Secretary Victoria Atkins to urgently tackle a dire shortage of the only licensed drug available to people living with motor neurone disease.

Health Secretary Victoria Atkins (Image: getty)

Patients have been forced to visit multiple chemists to find riluzole, which slows the progression of the brutal terminal condition by a few months, due to a supply issue that has created a UK-wide stock shortage since September.

One MND sufferer, who did not want to be named, recently had to go to 15 pharmacies before they could get the drug.

Tanya Curry, chief executive of the MND Association, has written to the minister saying: "We are now receiving reports daily from across the country that patients are unable to access their prescribed medicine, with no stock available in pharmacies and no indication of when it will become available.

“Some newly diagnosed patients are being denied their only medication option due to the lack of available supply. This is absolutely not good enough.”

She added: “The lives of people with MND are already limited by this devastating condition. They do not have time to wait, and certainly should not have to spend their precious days fighting to get the medication they deserve.”

Patient Lee Millard said: “We have but one drug, riluzole, for MND currently and anything that risks patients not receiving this one single tablet adds to the distress of day to day life.

“Our main charity, the MNDA, have raised with the Department of Health and Social Care (DHSC) but have received no details of what the issue is nor how it will be resolved. This just adds to the concern.”

A DHSC spokesperson said: “We understand how distressing medication shortages can be, which is why we’ve been working closely with manufacturers to resolve these issues as soon as possible and ensure patients have continuous access to MND medication in the UK.

“We are aware of an issue with one supplier but alternative suppliers should have stock available for patients who require it.

“We are determined to improve the lives of people with MND. That’s why, in November 2021, we committed to spend at least £50million on MND research over five years ending in March 2027.

“It is hoped this will enable faster progress towards treatments for this debilitating condition.”

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Content: Pacific Islands

Solomon Islands govt working to resolve ongoing medicine supply issue

August 18, 2023 1:25 pm

[Source: RNZ News]

Solomon Islands Ministry of Health & Medical Services has acknowledged concerns raised by the opposition.

About the shortage of medicines and other health supplies in the country.

The issue of access and supply of essential medicines has been an ongoing one in the Solomon Islands.

Article continues after advertisement

The opposition leader, Matthew Wale, called the drug shortage life-threatening earlier this week.

“My office has been reliably informed that there is a serious drug shortage situation around all hospitals and clinics around the country. We have been informed of the same situation in Honiara, Gizo, Auki and Buala,” Wale said.

“It is anybody’s guess what the situation is like for the health centres in the other provinces. It is truly disturbing.”

Essential drugs such as are Panadol, antibiotics, anti-fugal, anti- inflammatory, ibuprofen, ampicillin, diclofenac, including IV antibiotics and dressings are out of stock, according to Wale.

In March, Wale had slammed the government for allowing the problem to persist and called on Prime Minister Manasseh Sogavare to address the situation.

However, the health ministry said it was close to resolving the matter.

In a statement, it said it has been working closely with the Minister of Finance and Treasury and this has allowed medical supply containers to be cleared from the wharf in Honiara.

“The Ministry acknowledges the concerns raised and understands the public outcry. However, the ministry also continues to do its best through providing the necessary health care and services to the general population while at the same time managing the processes required to maintain our stockpile of medicines and consumables,” it said.

The health officials say the medical stocks at the National Medical Store are now at 79 percent of optimum while consumables are at 95 percent.

But they point out that getting the material to the provincial medical clinics is dependent on available shipping because of the high cost of air freight.

The ministry is now urging shipping owners to be flexible and to prioritise the delivery of the medical cargo to the provinces.

The ministry has also stressed that the daily deaths being recorded at the National Referral Hospital in Honiara are not due to the drug shortages but more from the progression of patients’ illnesses.

It also said it is aware of drugs disappearing along the supply chain and says this is serious matter.

The ministry has urged people who may be aware of what is going on to report this information to the relevant authorities.

Title:

Content: Health

October 31, 2023

Depreciating Naira value pushes medical care beyond Nigerians

•N1, 170 to US$1 monumental tragedy — PSN President

•Medical supplies priced beyond Nigerians, patients seek alternative care

•Wholesalers, retailers hoard essential life-saving drugs

•Pharmacies record low sales

By Chioma Obinna

It is not the best of times to be sick in Nigeria or to require any form of medical treatment as a result of a disease infection or accident trauma. This is because the continuous free fall of the naira value over the last few years has worsened the already weakened healthcare delivery services in the country.

From the pharmaceutical sector to the healthcare delivery services, Nigeria’s treatment of one ailment or the other has been rendered helpless. Hospitals are also not spared.

Apart from escalating the cost of medicines in Nigeria, its adverse effects on the population leave much to be desired.

The Nigerian pharmaceutical industry is facing significant challenges due to rising drug costs, forcing importers and local manufacturers out of business. Many medicines for common ailments are no longer available, and few are accessible to most Nigerians.

Pharmaceutical companies like GSK are leaving the country, and essential medicines are being hoarded by wholesalers and retailers. The depreciating value of the naira to the dollar, coupled with sky-high inflation, has led to a sharp increase in the cost of importation of Active Pharmaceutical Ingredients and APIs, and the importation and manufacturing of finished products at the consumer level.

Currently, Nigeria is rated by the World Health Organisation, WHO, as one of the eight countries in the world with exceptionally exorbitant drug prices.

As you’re reading this article, US$1 is exchanging at the parallel market at N1, 200, as of 24th October 2023, the exchange rate between the naira and the US dollar is about N800, according to the Central Bank of Nigeria, CBN.

Vanguard investigations reveal that the cost of pharmaceutical drugs in Nigeria has increased by over 100 per cent, causing patients to return home without their prescriptions.

Prices for paracetamol, chemotherapeutic treatments, antimalarials, antibiotics, antihistamines, antihypertensives, antidiabetics, and other medications have risen by 200 to 800 percent. This issue is undermining local medicine makers, who rely on imported raw materials. Nigeria, which relies on imports for 70 percent of its medicine needs, may face the worst if immediate action is not taken.

Stakeholders are concerned that the rapid disappearance of pharmaceuticals could lead to a major scarcity of drugs and medicines for disease treatment. Additionally, the cost of medications in Nigeria continues to rise hourly due to the $1 per second increase in the dollar exchange rate.

A Vanguard investigation found that Augmentin, a GSK product for the treatment of infection and pneumonia, is no longer available at a fixed price. The price is now determined by the buyer. Ampiclox, another GSK product that was formerly priced between N500 and N1,000 per sachet, is now priced between N10,000 and N20,000 per sachet, depending on location.

If you can find the medicine to buy, it costs between N26,500 and N45,000 depending on where you live. The 1-gram sachet costs N45,000 in Okota and Isolo, whereas it costs N40,000 elsewhere.

Another life-saving drug – the Ventolin inhaler -that is utilized in treating asthma attacks is now out of supply. A few months ago, the Ventolin inhaler was sold for N1, 600.

Findings revealed that the scarcity of Ventolin inhalers has also pushed the price of another brand of inhaler, Seretide, through the roof.   It was formerly sold for N6, 000, but now goes for N40, 000.

Many Nigerians can no longer afford regular paracetamol; a packet of paracetamol that cost N50 a year ago now costs N200 to N300, depending on the location and brand.

An indeterminate number of patients are abandoning their treatments and adopting alternative methods like traditional healers and prayer houses. Online pharmaceutical marketers exploit the scarcity of drugs to flood the market with substandard and counterfeit medications, impacting patients like pregnant women, asthma, cancer, malaria, pneumonia, hypertension, and diabetes.

For Agnes Onyero, who was on treatment for malaria, it is not just that the drugs are expensive; her main worry is that she is not seeing the results.   “I have been treating malaria for three months now after a short relief it will come back again.   I have decided that after I finish this set of drugs, I will try herbs,” she lamented regretfully.

While Agnes is battling with resistance to malaria drugs apparently due to substandard or fake medicines, another Nigerian, Adebayo Ojo cannot even afford to buy any drug for treatment.   The 35 year-old now patronises herb sellers popularly known as  Alagbo  who hawk concoctions in his area.

Every morning, Adebayo purchases a cup of the mixture for N200, which, according to him, was formerly sold for N100.

“I did not just decide to be taking herbs but the situation of things forced me to do that.  I have no steady job and just manage what I get from the little one I do.   I was at the pharmacy close to my house and I asked for a malaria drug I was told it is now N2,500. The amount is higher than my daily earnings, so I left it, “ he said.

Agnes and Adebayo are not alone. There are millions of Nigerians in the same boat with them. Some are now building their fate in their faith.

Dollar rate determines the price of drugs in Nigeria

The Chief Executive Officer of HealthPeak Pharmacy, Lagos, Pharm. Azubuike Amakase adduced that several factors contributed to the high cost of drugs presently in Nigeria, but the major factor is forex. In his view, most drugs are imported and indigenous pharmaceutical manufacturers also rely on imported raw materials.

Importers are not helping matters as they continue to sell old stock at unreasonable prices, believing that repurchasing the value of the naira in dollars will not fetch them the same quantity of drugs as when they sell to manufacturers in India, China, Europe, or anywhere else.

“Now every morning before they give out products they will ask for the exchange rate and use it to compute the price for the drugs they sell for that day, that is why some days you get the price of a product in the morning by evening time the price will change, so it is affecting the cost of the drugs and other medications.

“The one that affected me emotionally was a day an asthma patient came in here and the commonest drug that we use when there is an asthma crisis is Ventolin inhaler and other brands.   But it happens that Ventolin inhaler is nowhere to be found in most pharmacies in Nigeria.   That was attributed to the fact that the company that manufactures this product, GSK, has left the country but the few stocks that we still have are in the hands of the wholesalers who are hoarding and creating an artificial scarcity.

“Inhaler that was sold at a maximum of N1600 in the past has no price now.   Some wholesalers will tell you they sell at N8,000 for one while some sell as high as N25,000.   For some people that use Seretide another inhaler for asthma, Seretide used to be like N6,000 but today if you ever see one, you will hear prices like N40,000.

“So, the day the woman came in here, she was gasping for breath, she needed an inhaler to get resuscitated but we did not have one.   What we did for her with my experience in clinical pharmacy was to get her some tablets to relieve her but those tablets could not give her immediate relief as should have done by inhaler but by the grace of God she came out of the crisis.”

But her case is one out of the 100s of cases.

Why drug shortage may persist

Azubuike who envisaged a long-term drug shortage supply in Nigeria, said most importers of pharmaceutical products are no longer bringing them in because of challenges at the Ports.

“Customs duties are getting higher and higher.  Before now, Customs used to calculate duties based on an exchange rate of about N500 to $1, but today, they are using an exchange rate of over N700 to $1 to calculate the duties.

“When you come out of the duty problem, you also face the problem of haulage, and logistics, taking these products from the wharf to the warehouses.    These trucks that convey these products from the wharf to the warehouse also run on diesel and the price of diesel is high, it starts from N700 to over N1,000.   There are so many factors that are pushing the prices of drugs in Nigeria.”

Impact on pharmacy sales

Azubuike noted that pharmacies are experiencing low sales due to high costs and the harsh economy, with many good-selling pharmacies now idle due to people’s inability to afford medications.

“Some patients will go to the hospital and bring a prescription but when they come to the pharmacy after you bring out all the drugs they were given in the prescription list, sometimes most of them will abandon the drugs and just walk away without even saying a word, some will now request that you give them something cheaper, some will come with a budget and when they get here the money they budgeted for their drugs cannot even get half of what is in their prescription. A lot of people are dying.

“Instead of buying drugs that are being prescribed for them, people now go to prayer houses while some will go to traditional healers and  alagbo  on the streets in the name of herbs. And these things as we know affect our organs, especially the liver.   If you go to some tertiary hospitals you will see the results of this act.

“People are coming down with kidney problems.   Go to nephrology clinics, patients are there.   This is major because people are not buying the right drugs.   Hospitals like LASUTH and LUTH are battling with these complications. There is a need to address this problem.”

He said drugs used for the treatment of common ailments such as malaria, typhoid fever, infections pneumonia, and respiratory tract infections among others are majorly affected.

“The cheapest malaria products once sold at N250 is now N500, while those sold at N500 then, now start from N800, and the ones sold from N1,000 then are now N2,500 upwards. This is over a 100 per cent increase.

“The commonest ciprofloxacin that you can get before now as cheap as N400 for one pack is selling as high as N800. For higher brands, some are selling for N2,500.   Then you go to drugs like Augmentin, the problem is that you can hardly see it now.   It is a GSK brand and if you can see it, it has no price meaning that the price is determined by the seller and the person seeking to have those drugs.

“It can go as high as N45,000 for the one gram, then about N40,000 for the 625 if you ever see it. The hike in Augmentin has affected the prices of other Amoxicillin, some that were sold for N1,500 in the past, are now over N3,000, and some sold for N2,000 are now sold for N6,000.

“Brands like Amplicox which is one of the brands people are conversant with, sold for N1000 per sachet and is now N10,000 per sachet, It is also a GSK product popularly known as Beecham Ampiclox. Some may be kind enough to sell it for N9000, and a person who needs this Ampicloix will need two sachets to complete treatment. This means that the person must be ready to cough out N20,000 to get a drug he or she will use for five days, going by the right dosage.”

Azubuike emphasized the need for local drug production in the country and urged the government to intervene to address the uncontrollable fall in naira value by ensuring access to Fore for the importing and producing of pharmaceutical products.

Doctors, pharmacists react

President of the Pharmaceutical Society of Nigeria, Prof Cyril Usifoh,  criticised the current exchange rate of N1,170 to US$1, describing it as a significant tragedy. He warned that the 200 to 250 percent differential in drug prices currently being seen could get worse.

Usifoh lamented that Nigeria’s National Drug Policies (NDP) over the years had not achieved their goals and objectives. He argued that Nigeria imports 70 percent of essential drugs, with India and China producing a significant portion of the country’s consumption, noting that the NDP 2005 advocated for 70 percent of essential drugs to be manufactured locally.

Recommending a way out of the problem, he said the manufacturing of essential drugs and APIs in Nigeria has become crucial in the quest for medicine security and to attain a major boost in the contributions of the pharma sector to the GDP in the national interest.

“Achieving the status of an African hub in pharmaceuticals must become a cardinal objective of the Tinubu administration as we mobilize for the growth of the real sector of the economy. One major reason for the skyrocketing prices of drugs is the depreciation of the naira in the Fore market.”

He said: “President Bola Tinubu needs two key portfolios in the pharma sector to bring prosperity to bare and these are the office of an adviser, Pharmaceuticals and a Chairman of a Presidential committee on drugs distribution reform to redress the ills we have highlighted for productivity.”

In his views, a Superintendent Pharmacist, Engraced Pharmacy, Lagos Pharm Jonah Okotie traced the high cost of medicines to multiple factors of high exchange rate as a result of the poor economy and repatriation of funds.

For him, in the last 20 years, the exchange rate has been depreciating consistently at an astronomical rate.

He said some pharmaceutical companies have folded up because of the astronomical increases because, at the time they imported the products, the value of the naira was less than what it was when the payment was due, which threw them into debt.

Okotie emphasized the challenge of repatriating funds for forex trading in the international market, stating that the availability of funds is crucial for accessing essential medicines. If funds are not available, citizens may be excluded from the list of beneficiaries, denying them essential medicines.

“The economy is shrinking and the purchasing power of the citizens is reducing. The incentive for multinationals to come in is dwindling. I remember sometime back in the 1990s when our economy was faced with a similar experience, the companies then left saying that not only was the cost of doing business in Africa high, but the volume of business after conversion from local currencies to the dollar was not enough to take them home.”

Okotie is insisting that there has to be some intervention kind of funds to mitigate the challenges. “Unfortunately, corruption and wickedness on the part of some of the managers may not let the citizens benefit from it.   Take for instance, the Drug Revolving Fund, DRF, scheme, it has become a conduit pipe for those saddled with managing it.    Suppliers are not paid as at when due to give credibility to the system. Those who are supposed to be checkers are themselves the suppliers. Where is the check and balance? If things go right, we must start with sincerity, accountability, responsibility and interest to see that we improve. We may not have all the resources but judicious and responsible use of our lean resources will guarantee maximum benefit.”

In a chat, the Medical Director of St Raphael Hospitals, Lagos, Dr Anthony Omolola who confirmed that in practical terms, drugs and other hospital consumables have gone over 100 per cent, decried that energy consumption has worsened the already bad situation.

He said Hospital general maintenance is hitting the roof, and patients’ capacity to pay hospital ills has gone way down.

“Unfortunately, Health Maintenance Organisations, HMOs are not making business easy for hospitals because they operate tariffs lower than the cost of production in the hospitals. The patients are not smiling and the same with the hospitals.”

On his part, the Chairman, the Ekiti State branch of the Nigerian Medical Association, NMA, Dr. Babatunde Rosiji, said the development has taken medical supplies beyond the reach of average citizens.

Rosiji posited that if the state of affairs in the country continues unchecked, the inevitable might be on the horizon.

“As we all know and can bear witness to, our dear country is passing through a very difficult time and we as citizens bear the brunt. The times are unprecedented! Patients are finding it difficult to present early to the hospitals for economic reasons. “The exchange rate is making the cost of drugs and medical supplies beyond the reach of the average citizens. Patients on medications for chronic illnesses such as hypertension and diabetes are finding it difficult to access an uninterrupted supply of drugs.

“While health insurance is beginning to take root, the price of drugs in the insurance scheme is out of touch with current realities. If this continues unchecked, your guess is as good as mine.”

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Local pharmacies are seeing a huge drug supply and demand problem

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TERRE HAUTE, Ind. (WTHI) - We're nearing the end of cold and flu season, but many people are still getting sick.

Right now, many pharmacies are having trouble getting the drugs their customers need. That means patients are paying more for the drugs they do have.

Have you had a hard time getting any of your medication?

You voted:

A new survey was released by the "National Community Pharmacists Association." The survey finds that several drugs are in high demand at independent pharmacies.

Shawna Henshaw is a local mom in Terre Haute. She says basic medications are flying off the shelves.

"It's been kind of harder to get something to combat the cold and the flu. When we do find something, I'm grabbing it real quick, so I can feel better," said Henshaw.

Recently, she says she has been having trouble finding basic drugstore medications for her daughter and herself.

"I don't like to drive all around downtown trying to find something. I'll stop by something locally, but a lot of times, I have to drive around time to find it," said Henshaw.

Haley Funkhouser is the Pharmacist Technician at "Vigo Health Pharmacy."

In the past month, she says there has been a "40% price increase" on average in common medications. some are even more than that. This is due to inflation, discontinuations, and supply chain issues. With more people coming into the pharmacy sick, pharmacists can't keep up with demand.

Some drugs seeing an increase in prices are, Adderall, antibiotics, nebulizer solutions, child relief medicine and diabetes medication.

"We could not get in some insulin 'forever'. We couldn't get Trulicity, we couldn't get Ozempic, we couldn't get Mounjaro," said Funkhouser.

Funkhouser has kids of her own. She says these problems have also affected her family.

"As a mother myself, I had a hard time finding antibiotics for my two children, so I totally understand what people are going through. It's extremely frustrating," said Funkhouser.

With spring approaching, Henshaw hopes prices will decrease soon, but she says people still need their medications...Regardless of the prices.

"It's one of those things that people, you know if we have a short of this, we raise the price. People are still gonna buy it anyways," said Henshaw.

If people have trouble finding their medications, the pharmacy urges people to call their doctors and see if another similar drug is available.

Recommended for you

As a caretaker for a parent with chronic life-threatening conditions, understanding this landscape is essential for ensuring continuity of care and preparing for potential disruptions in medication access.

## Scope of the Problem

Medication shortages are a worldwide phenomenon with varying severity across regions:

- **Nigeria** is experiencing extreme shortages with dramatic price increases for essential medications
- **United Kingdom** faces shortages of specialized drugs, including the only medication available for Motor Neuron Disease (MND)
- **United States** contends with high prescription costs and intermittent shortages of various medications
- **African countries** struggle with limited manufacturing capacity (fewer than 400 manufacturers for over 1 billion people) and heavy reliance on imports (70-90% of drugs consumed)
- **Ukraine** suffers from dangerous shortages exacerbated by conflict, particularly affecting insulin supplies
- **Botswana** and other nations report ongoing shortages since late 2020

## Affected Medications

The following medications have been significantly impacted by shortages or extreme price fluctuations:

### Respiratory Medications
- **Ventolin inhaler** (asthma treatment): Out of supply in Nigeria, previously sold for N1,600
- **Seretide inhaler**: Price increased from N6,000 to N40,000 in Nigeria

### Pain and Fever Management
- **Paracetamol**: Price increased from N50 to N200-N300 per packet in Nigeria

### Antibiotics
- **Augmentin** (infection and pneumonia treatment): No fixed price, now determined by buyer in Nigeria
- **Ampiclox**: Price increased from N500-N1,000 to N10,000-N20,000 pe

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Content: BusinessDay

Strategies to strengthen infrastructural development in Africa’s public health sector

Across the continent, health infrastructure is unevenly distributed, with major gaps in the coverage of rural areas and often of poor quality. A third of Africans live more than two hours away from health services, and there are severe shortages of hospital beds, medical equipment, and drugs. Only 51% of primary health facilities in sub-Saharan Africa have access to basic water and sanitation services, and only a third have access to reliable electricity.

The continent has fewer than 400 drug manufacturers to cater to the more than 1 billion people on it. Meanwhile, China and India are countries with similar populations but as many as 5,000 and 10,500 drug makers, respectively. With so few manufacturers, Africa must rely largely on imports to keep its population healthy. In most of sub-Saharan Africa, imports account for as much as 70% to 90% of drugs consumed, and this drives up costs and limits the availability of medicines.

These gaps underlie Africa’s vulnerability to repeated health crises and consequent development reversals. Without regular access to basic healthcare services and even the most essential medicines, millions die or suffer from protracted illnesses. Widespread ill health can trap people in poverty, as those who are healthier are more productive. The COVID-19 pandemic has further highlighted major deficits in national health systems and related infrastructure across Africa. However, the crisis it has triggered has created a unique opportunity to address long standing deficits in health infrastructure and services.

African governments must urgently implement strategies to accelerate the development of health infrastructure in Africa as a non-negotiable pathway to securing increased access to quality health services for the people

Challenges limiting health infrastructure development in Africa

A major barrier to health infrastructure development in Africa is grossly inadequate health financing. The $4.5 billion in capital expenditure currently made by African governments each year is far below the estimated $26 billion in annual investment needed to meet evolving health needs over the next decade. While COVID-19 has highlighted the need for greater investment, the crisis has also left African countries with severely constrained resources and rising indebtedness. African countries will therefore need additional support to meet their health infrastructure needs, as well as assistance with mobilising funding from private investments, including from diaspora communities.

Africa’s pharmaceutical sector also faces unique challenges, resulting in poor quality of both the individual production sites and the quality management systems. Some of these challenges include the high cost of pharmaceutical manufacturing, a lack of supportive infrastructure for the regulatory compliance of pharmaceutical manufacturing companies, poor regulatory policies, and limited access to affordable and reasonable funding, among others.

Read also: Military coups in West Africa, Wagner group and threat to Nigerian democracy

Strategies to strengthen health infrastructural development in Africa

Concerted efforts by African governments and other stakeholders are needed to accelerate the development of quality health infrastructure in Africa and ensure that individuals and communities receive the health services they need without financial hardship. Bloom Public Health, an indigenous public health think-tank in Africa, identifies four essential categories of health infrastructure requiring urgent interventions. These include:

1. Pharmaceutical manufacturing infrastructure: Establishing pharmaceutical manufacturing hubs across Africa is a major step toward building a new pharma sector that better supports the continent’s economies. Through partnerships with state governments in Nigeria, Bloom Public Health is implementing the Pharmacity Project to establish pharmaceutical manufacturing parks in various states across Nigeria. The pharmaceutical parks refer to compact modern-day pharmaceutical industrial estates that bring together pharmaceutical companies of various sizes, service providers, and companies providing support services to co-locate and share infrastructure. The vision is to create a sustainable environment to make quality medicines available and affordable in Nigeria and beyond.

2. Primary health care (PHC) infrastructure strengthening is essential for underserved populations, with supporting infrastructure investment to ensure that facilities are connected to water and sanitation, energy, transport, and communications services. The provision of access to quality and affordable essential medicines is also critical in implementing PHC; thus, the Health Supply Chain Transformation Project Consortium, comprising Bloom Public Health, Zipline, Health Spaces, and Sterling Bank, has partnered with several state governments in Nigeria to implement innovative and sustainable healthcare supply chain systems in their states.

3. Diagnostic infrastructure: Strengthening diagnostic infrastructure can be achieved by utilising a range of delivery models, including public-private collaborations, to address serious bottlenecks in the efficient and effective diagnosis of diseases across the continent. The Bloom Public Health, Katchey Laboratories, and ND Western partnership that gave rise to Delta Plus Diagnostics, a world-class molecular diagnostic laboratory, still stands out. This role-model partnership is one that should be emulated by other stakeholders and deployed across the entire laboratory space in Africa.

4. Secondary and tertiary healthcare facilities: This involves developing new secondary and tertiary health care facilities, alongside specialist facilities for cancer, dialysis, and pain management. These investments will be particularly relevant in African countries, where the burden of non-communicable diseases is growing rapidly.

Other strategies include improving ICT infrastructure to strengthen national health information systems, supporting innovations in health service delivery, such as telemedicine and digital health solutions, and expanding health insurance coverage.

In conclusion

Given its relevance for the continent, African governments must urgently implement strategies to accelerate the development of health infrastructure in Africa as a non-negotiable pathway to securing increased access to quality health services for the people and promoting the achievement of SDG3 and the African Union’s Agenda 2063 goal on health.