Between 2021 and 2024, medication shortages became a pervasive global issue, affecting both developed and developing countries and impacting a wide spectrum of drugs and medical supplies.

These shortages were primarily driven by supply chain disruptions, demand surges, and manufacturing delays, with significant consequences for ordinary patients and healthcare systems.

Authorities and healthcare providers responded with a range of strategies, from regulatory interventions and international collaborations to technological innovations and community initiatives.

**Drugs and Products Affected** A broad array of medications and medical supplies experienced shortages during this period.

In the United States, over-the-counter pediatric medications such as children’s Tylenol and ibuprofen became scarce during spikes in respiratory illnesses, leading to increased emergency visits and parental anxiety .

Antibiotics, notably amoxicillin and penicillin G benzathine, were in short supply across the U.S., Canada, and Europe, with the penicillin shortage prompting U.S.

health officials to consider declaring a public health emergency and major medical centers to ration treatment for rising syphilis cases .

Cancer drugs, particularly chemotherapy agents like carboplatin and cisplatin, were also affected, with 72% of U.S.

cancer centers reporting shortages, forcing delays or rationing of care .

A national shortage of Adderall disrupted treatment for patients with ADHD and narcolepsy, attributed to increased demand and regulatory production limits .

In Europe, Ireland faced shortages of paracetamol during a surge in flu and COVID-19 cases, while Malta experienced a scarcity of Methylphenidate for ADHD, linked to procurement delays exacerbated by Brexit .

France reported nearly 5,000 drug shortages in 2023, affecting oncology care and causing widespread patient anxiety .

In the UK, shortages of common cold and flu medications, including throat lozenges and cough mixtures, were reported due to increased winter illness and supply chain issues .

Developing countries faced acute shortages of essential and life-saving medicines.

In India, government hospitals in Karnataka reported shortages of 733 essential medicines, including anti-TB drugs, due to procurement delays and unpaid bills .

In Nigeria, the depreciating naira led to skyrocketing drug prices and shortages, forcing patients to seek alternative remedies .

Ethiopia experienced poor availability of essential antidotes in community pharmacies, and a nationwide study found that 21.8% of sampled drugs failed quality tests, highlighting the prevalence of substandard and counterfeit medications .

The Gambia suffered a tragic outbreak of acute kidney injury linked to contaminated medicines, resulting in 70 child deaths .

**Reasons Behind the Shortages** The root causes of these shortages were multifactorial.

Global supply chain disruptions, often triggered by the COVID-19 pandemic, played a central role.

Lockdowns, reduced manufacturing capacity, and logistical bottlenecks delayed production and distribution of medical supplies worldwide .

In Botswana, these disruptions led to shortages of hypertension and anti-retroviral drugs .

Manufacturing problems, including quality issues and plant closures, contributed to shortages of generic drugs in the U.S., with over 250 medications listed as in shortage .

Demand spikes, driven by illness outbreaks or panic buying, further strained supplies.

In Malaysia, social media-fueled panic buying led to shortages of paracetamol and flu treatments .

The popularity of weight loss drugs like Ozempic and Wegovy in the U.S.

resulted in nationwide shortages .

Regulatory and bureaucratic delays also played a role.

In India, delays in floating tenders and clearing pending bills hindered timely procurement of essential medicines .

In Malta, Brexit-related procurement challenges disrupted the supply of ADHD medications .

Patent monopolies and high costs of patented drugs limited access in countries like South Africa, where the poorest populations struggled to afford life-saving treatments .

The prevalence of substandard and counterfeit drugs in Ethiopia and The Gambia underscored the impact of weak regulatory oversight and quality control failures .

**Impact on Ordinary Patients** The consequences for patients were severe and widespread.

In the U.S., shortages of chemotherapy drugs forced hospitals to delay or ration cancer care, with patients expressing anxiety over compromised treatment and providers facing ethical dilemmas in prioritizing care .

The penicillin shortage led to rationing of syphilis treatment, with pregnant patients prioritized and others receiving less effective alternatives .

Opioid shortages left chronic pain patients struggling to obtain necessary medications, often enduring increased pain or resorting to less effective treatments .

In the UK, a shortage of riluzole, the only licensed drug for motor neurone disease, forced patients to visit multiple pharmacies, with some unable to access their sole treatment option .

In developing countries, the impact was often more acute.

In Nigeria, high drug prices and shortages forced many to abandon prescribed treatments or seek alternative remedies, with the pharmaceutical industry struggling to maintain supply .

In Ethiopia, the lack of essential antidotes and the prevalence of substandard drugs posed direct risks to patient safety, including deaths from ineffective treatments .

The Gambia’s contaminated medicine crisis resulted in dozens of child fatalities .

In India, shortages of anti-TB drugs threatened treatment adherence and increased the risk of drug-resistant TB strains .

**Healthcare System and Authority Responses** Authorities and healthcare systems implemented a range of responses to mitigate the impact of shortages.

Regulatory flexibility was a common approach.

FDA allowed the importation of chemotherapy drugs from overseas manufacturers to alleviate shortages .

The American Society of Health-System Pharmacists called for urgent congressional action to address root causes, while the Federal Trade Commission and Department of Health launched investigations into the role of supply chain intermediaries .

In Ireland, the government recommended alternative medications and emphasized patient safety during shortages, while the Health Minister acknowledged the global nature of the problem .

International collaboration was also critical.

The European Commission proposed a “voluntary solidarity mechanism” to enable EU countries to share vital medicines and established an early warning system for drug shortages .

The EU4Health program allocated €5.3 billion to strengthen healthcare systems and ensure the availability of essential medicines .

The World Health Organization provided direct support to countries like Sri Lanka, coordinating international assistance to ensure sufficient medical supplies .

The World Trade Organization agreed to waive certain intellectual property rules to expand access to COVID-19 vaccines, allowing developing countries to produce vaccines without infringing patents .

Local production and supply chain innovations were promoted to enhance resilience.

African nations, with international support, focused on increasing local vaccine manufacturing to reduce dependence on imports .

In South Africa, advocates called for increased local production of antiretroviral drugs .

India emphasized boosting domestic production of key raw materials to reduce reliance on imports and prevent future shortages .

In the Philippines, drone technology was deployed to deliver vaccines and medical supplies to remote areas, improving access in rural communities .

Technological innovations played a growing role.

AI and automation improved inventory management and procurement, enabling hospitals to better match supply with demand and reduce operational expenses .

Blockchain, IoT, and digital tracking systems enhanced supply chain transparency and security .

Cold chain logistics were upgraded with temperature monitoring sensors and data loggers to ensure the integrity of temperature-sensitive products like vaccines .

Automation in distribution centers, such as the partnership between SSI Schaefer and Nahdi Medical Company in Saudi Arabia, significantly increased warehouse efficiency .

Community and civil society initiatives addressed local shortages.

In France, civil society organizations advocated for greater transparency from pharmaceutical companies and better monitoring of medicine stocks .

In Italy, the Pharmaceutical Bank organized a drug collection day, gathering nearly 600,000 packs of medicines for those in need .

In India, NGOs donated critical medications and supported local procurement to address shortages for vulnerable populations .

Pharmacists in the UK and Texas transferred prescriptions between pharmacies and communicated with patients to find suitable alternatives during shortages .

**Summary of Global Trends and Lessons** Medication shortages between 2021 and 2024 were driven by a convergence of supply chain disruptions, demand spikes, manufacturing delays, regulatory challenges, and economic instability.

The impact on ordinary patients was profound, ranging from delayed or

Between 2021 and 2024, medication shortages became a pervasive global issue, affecting both developed and developing countries and impacting a wide spectrum of drugs and medical supplies.

Between 2021 and 2024, medication shortages became a pervasive global issue, affecting both developed and developing countries and impacting a wide spectrum of drugs and medical supplies.

Between 2021 and 2024, medication shortages became a pervasive global issue, affecting both developed and developing countries and impacting a wide spectrum of drugs and medical supplies.

These shortages were primarily driven by supply chain disruptions, demand surges, and manufacturing delays, with significant consequences for ordinary patients and healthcare systems.

These shortages were primarily driven by supply chain disruptions, demand surges, and manufacturing delays, with significant consequences for ordinary patients and healthcare systems.

These shortages were primarily driven by supply chain disruptions, demand surges, and manufacturing delays, with significant consequences for ordinary patients and healthcare systems.

Authorities and healthcare providers responded with a range of strategies, from regulatory interventions and international collaborations to technological innovations and community initiatives.

Authorities and healthcare providers responded with a range of strategies, from regulatory interventions and international collaborations to technological innovations and community initiatives.

Authorities and healthcare providers responded with a range of strategies, from regulatory interventions and international collaborations to technological innovations and community initiatives.

**Drugs and Products Affected** A broad array of medications and medical supplies experienced shortages during this period.

**Drugs and Products Affected** A broad array of medications and medical supplies experienced shortages during this period.

**Drugs and Products Affected** A broad array of medications and medical supplies experienced shortages during this period.

In the United States, over-the-counter pediatric medications such as children’s Tylenol and ibuprofen became scarce during spikes in respiratory illnesses, leading to increased emergency visits and parental anxiety .

Title:

Content: The COVID-19 pandemic has brought the issue of access to affordable medicines to the forefront of Intellectual Property (IP) debate in recent months. The tension between the patenting and circulation of drugs is nothing new, but it is felt most keenly in the least-developed and middle-income countries, which suffer under heavy burdens of infectious diseases such as Ebola, HIV, tuberculosis and malaria. South Africa, though 36th in the world in terms of Gross Domestic Product (GDP), is one such belabored country, with a high level of economic inequality and multiple health crises.

The crux of the matter is that patented medicines are costly, often prohibitively for the poorest nations. Ultimately, this impediment derives from the fact that the research and development (R&D), testing and approval processes required to bring a drug to market are exorbitantly expensive – with the average cost per product exceeding $1 billion USD. Patents provide the incentive to conduct the R&D necessary to develop new medicines, as the patentee can be confident they will be able to recover their costs and reap sufficient reward through profits.

How, then, should the needs of the consumer, that is to say, of patients, for reasonably priced medicines be balanced against the needs of the producer to recoup their massive financial investments? The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) proposes various solutions to this quandary, discussed here using South African law as a case study.

Flexible by design

Article 1 and Article 8 of TRIPS provide for broad adaptability. Article 1, dealing with how member states are to implement the framework appropriately in the context of their national laws, permits countries to afford more extensive patent protections than the minimum standard set by the Agreement, provided that the same is not contravened in doing so. In addition, Article 8 allows members to adopt measures to protect and promote the public interest. Between them, these provisions grant leeway for public health considerations and, consequently, appropriate access to medicines.

Article 66 of TRIPS addresses the availability of medicines and advanced technologies in the least-developed countries. This is vital as many such countries do not have the manufacturing capabilities to produce required medicines domestically, and hence compulsory licensing is not an appropriate way for them to obtain patented products.

Overall, TRIPS provides both flexibility in implementing the Agreement and specific measures for improving access to life-saving medicines, particularly for the most vulnerable populations. However, challenges still exist in fully utilizing these provisions and ensuring equitable access to necessary medications.

Articles 30, 31 and 31bis provide greater specificity in this respect and allow for the unauthorized use of patented subject matter under rigorous conditions as well as for compulsory licensing.

Walk-in rights

Section 4 of South Africa's Patents Act No. 57 of 1978 (the Act) provides for the use of a patent by the state, while Section 78 outlines the state's acquisition of a patent. These provisions are what would be used to facilitate ready access to medicines in the event of a national emergency or pandemic. However, these solutions are only effective when the state can manufacture the drug or import it from a country where patent protection is not in place. Therefore, this mechanism is not ideal for low- and middle-income countries.

Compulsory licensing: reasonability and controlled pricing

Section 56 of the Act permits compulsory licensing in the case of an abuse of rights, with paragraphs 56(c) and 56(e) specifically outlining that unreasonable licensing terms and excessive pricing constitute abuse. These stipulations allow for compulsory licensing to a licensee who will locally manufacture the drug. Once again, as with the walk-in rights, this is premised on the assumption that local manufacturing capability is available, which is not often the case in South Africa.

Open Source Pharma, the Bolar Provision and generic medicines

Open Source Pharma (OSP) is a project akin to the openly licensed software movement, going so far as to describe itself as "Linux for Drugs." This model centers around collaborative R&D and drug trials around the world to produce medicines more quickly and cheaply. We witnessed the speed with which the various COVID-19 vaccines were developed, in no small part due to concerted data-sharing efforts and cooperative research across both the private sector and academic institutions. Partnerships between universities are commonplace, but the idea of combined trials is an intriguing one, as this is where the highest costs of drug development lie. Typically, pharmaceutical companies shoulder these costs and seek to ensure adequate recompense through patents and supplementary protection certificates (SPCs).

OSP proposes an alternative model, where costs are shared among member organizations and any profits from successful drugs are pooled and reinvested into future research and development.

As a parallel option, open-source test data for generics would expedite the drug approval process and allow faster access to cheaper alternatives once patent protection for a medication has expired.

While open test data is not provided for in South African law, the Bolar Provision (Section 69A of the Patents Act No. 57 of 1978) grants a manufacturer of generic medicines the ability to exercise the rights reserved by a patent solely to obtain regulatory approval for the distribution of the product once exclusivity expires. However, each manufacturing company is required to submit its own docket to the medicine regulatory authority, resulting in a great deal of redundancy. Perhaps a middle-ground solution would be to allow the submission of regulatory approvals in other jurisdictions for the same formulation, thereby walking a line between OSP and the Bolar Provision and slightly expediting the process of making generics available. This approach could be considered "open test data."

Substantive examination, patent opposition and the prevention of evergreening

South Africa has a formal examination system as opposed to a substantive examination procedure. This means a patent application is not examined in relation to the novelty and inventive step conditions provided for in the Act, and only administrative requirements are assessed. There is no post-grant opposition period save for full-scale litigation before the Court of the Commissioner of Patents. In contrast to a substantive examination jurisdiction, where the patentee bears the costs for reviewing the subject matter of a patent, litigation is a financially burdensome way for a party to apply for revocation or compulsory license in South Africa. This is, of course, a preferential situation for a patentee in the pharmaceutical industry, as the fees for patenting are low, the validity of the subject matter is not open to immediate question and litigation is discouraged by high costs.

South Africa's patent law has certain provisions that are favorable to the pharmaceutical industry. One such example is the Bolar Provision, which allows generic manufacturers to research and develop their own versions of patented drugs before the patent expires, as long as they do not commercially exploit them until then.

Restricted evergreening is also present in South Africa in that the Companies and Intellectual Property Commission (CIPC) accepts second medical use applications as well as claims premised on specific and narrow dosage regimes. This practice, coupled with the fact that only a formal examination is conducted, invariably leads to a patent register that contains potentially invalid patents that must be questioned before the courts. Specific dosage regimes and second medical uses are not contentious per se but can be problematic in an environment that does not carry out substantive examinations. Non-allowance of second medical use and / or dosage regime patents would tighten the noose on evergreening and is perhaps an option to be considered in a way that fairly accounts for the R&D and trial costs associated with developing drugs.

Public-private partnerships and tax incentives

South Africa delivers tax incentives for R&D and has laws that regulate public-private partnerships for certain entities and where public funding is used in R&D (Intellectual Property Rights from Publicly Financed Research and Development Act No. 51 of 2008). This legislation can make the innovation landscape difficult to negotiate and less attractive for private partners, given that they control the ownership of patents stemming from such R&D.

It may be interesting to see tax incentives not only for R&D but also for licensing regimes – facilitating lower costs in medication production and correspondingly increasing capacity, but without necessarily raising patent holder profits.

The most feasible solution to affordable medicine access is to be found not so much in national patent law or the TRIPS Agreement but in a broader survey of the economics of drug development, manufacture and distribution. By increasing production volumes, tax and licensing incentives could boost sales figures to levels that a patentee does not necessarily have to forfeit any profit in light of lower consumer-end prices.

A version of this article was first published in WIPR Issue 3, 2022.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

Antibiotics, notably amoxicillin and penicillin G benzathine, were in short supply across the U.S., Canada, and Europe, with the penicillin shortage prompting U.S.

Antibiotics, notably amoxicillin and penicillin G benzathine, were in short supply across the U.S., Canada, and Europe, with the penicillin shortage prompting U.S.

Antibiotics, notably amoxicillin and penicillin G benzathine, were in short supply across the U.S., Canada, and Europe, with the penicillin shortage prompting U.S.

health officials to consider declaring a public health emergency and major medical centers to ration treatment for rising syphilis cases .

Title:

Content: Drastic cutbacks in the supply of prescription opioids, tougher monitoring of where those pills go and other efforts to curb abuse have had an unintended consequence, Long Island doctors and pharmacists say: People who have a legitimate need for the medicine to relieve severe pain now often have a hard time finding it.

Patients say the shortage means they must endure more pain after they run out of medication. Physicians' staffs sometimes have to call pharmacy after pharmacy to fill patients' prescriptions.

“I have a dozen messages every day from people saying their pharmacy doesn’t have” opioids, said Dr. Edward Rubin, a pain management specialist with offices in Garden City and Lake Success, who said he is careful to prescribe opioids only to patients without good alternatives, particularly those recovering from major surgery.

The opioid medicine shortage that doctors and pharmacists say has emerged over the past few years comes after decades during which pain pills like OxyContin flooded the market and addicted countless Americans. Prescription-drug overdose deaths spiked in the late 1990s and early 2000s.

WHAT TO KNOW

  • Doctors and pharmacists said efforts to reduce the supply of legal opioids to prevent diversion and abuse have gone too far and made it difficult for those with legitimate pain needs to access their medicine.
  • The Drug Enforcement Administration has drastically reduced its annual caps on opioid manufacturing, leading to shortages at pharmacies, which receive a limited number of opioids each month, doctors and pharmacists say.
  • Doctors say opioids were overprescribed in the past, and they are cautious in deciding whether to authorize them for patients. But they said opioids remain the best alternative for some people with severe pain.

Although fentanyl, much of it illegally manufactured, now kills a far greater percentage of people, the number of prescription-drug overdose fatalities in 2021 — 16,706 — is only slightly below the 2017 peak and five times more than in 1999, according to Centers for Disease Control and Prevention data. On Long Island in 2022, more than 700 people died of overdoses of legal and illegal opioids, most of them from fentanyl, Nassau and Suffolk officials said this week.

Rubin and other doctors and pharmacists put principal blame for the opioid shortage on the Drug Enforcement Administration’s declining cap on the amount of opioids pharmaceutical manufacturers can produce each year. For example, the DEA slashed the quota for the most widely produced opioid, oxycodone, which includes the brand names OxyContin and Percocet, from 164 million grams in 2013 to about 54 million in 2023.

“Continuing to throttle the legitimate supply is only hurting legitimate patients at the moment,” Rubin said.

Patients who can’t find their prescribed medicine "are scrambling and switching medications, and we’re adding more risk … [because] I don't know how they're going to respond to a totally different medication," he said.

Tom D’Angelo, owner of pharmacies in Franklin Square, Garden City and Point Lookout and former president of the Pharmacists Society of the State of New York, said the DEA should increase quotas so patients with legitimate pain needs can obtain relief.

He fears that some people in severe pain may resort to buying pills on the street, where something sold as oxycodone may actually be a potentially fatal dose of fentanyl.

“If you’re in enough pain, you’ll try anything,” he said.

Rationing pain-relief pills

John Douglas, 66, of Lake Grove, has been taking opioid medications for several years, first for neck pain, and now also for joint pain from prostate cancer drugs.

“I’m in pain constantly,” he said.

He’s tried several alternatives to opioids and, although the hydrocodone he takes “doesn’t give me 100% relief,” it reduces pain and allows him to work as a physical therapist assistant.

Yet, multiple times, he’s faced delays or uncertainty in obtaining medication, and he’s had to cut pills in half to ration them, which increases his pain.

“I’m sick and tired of every time you go to the drugstore, you don’t know if your medicine is going to be there or not,” he said. “It’s just not right.”

People with legitimate pain are being “penalized” for those who abuse opioids, he said.

Patients nationwide have struggled to obtain their opioid medications. Hundreds of chronic pain patients, medical professionals and others submitted remarks to the DEA last year about the agency's 2023 quotas, some expressing concern that decreases “have resulted in a shortage of opioid medications, interfered with the treatment of patients, and impacted the quality of life for patients possibly leading to suicide,” according to a DEA summary of comments released in December.

Critics, in comments submitted to the DEA and in statements from pharmaceutical executives and others, said DEA quotas on ingredients for attention deficit/hyperactivity disorder medications also are among the reasons for a nationwide shortage of those drugs.

But faced with an ongoing opioid crisis, the DEA has been under pressure to reduce quotas. A 2020 letter to the DEA from Senate Judiciary Committee Chairman Dick Durbin (D-Ill.) and Sen. John Kennedy (R-La.) said despite huge previous cuts in quotas, they were still “excessively high.” Spokespeople for Durbin and Kennedy did not respond to requests for comment.

The DEA in the December report said its quotas are set “in a manner to provide for all legitimate medical purposes.” It also said the limits "help prevent the misuse and diversion of pharmaceutical controlled substances,” and overdoses. A DEA spokeswoman declined to comment further.

The DEA acknowledged in the report that fewer than 1% of five common opioid medications were diverted for illicit uses. Numerous comments also pointed out that despite the drop in quotas, overdose deaths were up — especially from fentanyl and pain pills manufactured illegally outside the quotas.

Mary Silberstein, senior director of strategic alliances and special projects for Hicksville-based CN Guidance and Counseling Services, said restrictions on opioid supply and distribution were “much needed” and have saved lives.

“When you had so many people giving out the prescriptions in such large quantities, you had to have restrictions,” she said.

Silberstein said even though most people with opioid problems currently coming to CN Guidance are misusing fentanyl, a significant number are addicted to prescription opioids.

Opioid prescription rates drop on Long Island

The massive decrease in opioid quotas came after dramatic increases in the 1990s and 2000s. The quota for oxycodone, for example, rose from 3.5 million in 1993, before FDA approval of one of the most widely abused opioids, OxyContin, to its peak of 164 million in 2013. Other opioids had less extreme increases or were taken off the market.

Although the number of opioid prescriptions began falling after 2010, there still were about three times as many opioids prescribed in 2015 as in 1999, when calculated by “morphine milligram equivalents,” to account for differences in drug type and strength, according to a 2017 article in the CDC’s Morbidity and Mortality Weekly.

On Long Island, the number of opioid prescriptions per 100 people fell by more than half in Suffolk between 2012 and 2020, from 66.4 to 29.9, while Nassau’s rate decreased from 49.2 to 41.3, below the national rate of 43.3, according to the CDC. The rate includes people with multiple prescriptions in a year.

Experts say rates are declining in part because doctors turn to opioids more sparingly and there are more controls to flag physicians who prescribe unusually large amounts of opioids. In the past, people abusing opioids “would doctor-shop,” said Dr. Paul Pipia, president of the Medical Society of the State of New York and deputy medical director of Nassau University Medical Center in East Meadow. “There was no way to know who went where.”

There now is an electronic registry of patients’ controlled-substance histories that the state requires medical professionals to review before writing prescriptions. A law capping initial opioid prescriptions for acute pain at seven days, with refills only after further evaluation, limits overprescribing, Pipia said.

Pharmacists say ceilings on how many opioids they dispense each month mean that even though the number of opioid prescriptions is declining, they can't always fill them.

As part of a $21 billion settlement for their alleged role in the opioid crisis, the nation’s three largest pharmaceutical distributors agreed to increase their scrutiny of opioids and limit the quantity they send each pharmacy.

D’Angelo said if he runs out of his monthly opioid allotment, he has to make hard decisions on who gets their medications.

Mukash Patel, owner of pharmacies in Dix Hills and Patchogue, said he sometimes can’t get certain opioids “for days on end.”

“The patient should not have to run around calling 30 different places to see if the drug is in stock,” he said.

Often, pharmacies won’t tell patients if they have a medicine, so Rubin said his staff must make the calls.

“We don't have the bandwidth to be calling a dozen pharmacies for everybody who can’t get their medication,” he said.

Lauren Esposito, spokesperson for one of the distributors in the opioid settlement, Pennsylvania-based Amerisource Bergen, said in a statement that distributors “have been asked to walk a legal and ethical tightrope by both maintaining access to products while simultaneously limiting potential diversion.”

She called for better federal guidance “to support patient access.”

State opioid tax

D’Angelo said a state excise tax on most opioids, approved by the New York Legislature in 2019 as part of the state budget, aggravates the problem.

Wisconsin-based Independent Pharmacy Cooperative stopped selling opioids covered by the excise tax before it went into effect because “we thought that continuing to sell would likely mean that it would have been unprofitable,” said the company’s general counsel, Paul Karch. Last year, the company stopped selling all opioids nationwide because of high monitoring costs, he said.

Assemb. Linda Rosenthal (D-Manhattan), who headed the Assembly’s alcoholism and drug abuse committee when the tax was enacted, opposes the way the tax is structured because it can lead to higher prices for consumers, as well as lower supply. She called on the Department of Health to study the problem and find solutions.

Dr. Thomas Jan, a Massapequa pain management and addiction physician, said pain patients shouldn't have such difficulty obtaining prescribed medications. But, he said, in the past, many well-intentioned doctors were too quick to prescribe opioids, and they often prescribed too much, putting patients at increased risk of addiction. Jan said around 2010, his then-16-year-old son was prescribed 90 Vicodin pills after having a wisdom tooth pulled.

Dr. Yili Huang, a regional manager for pain management services for Northwell Health, said additional controls have caused doctors to think more carefully about alternatives to opioids. But opioids still have an important role, especially in relieving pain after surgery and for cancer, palliative and end-of-life care, he said.

Yet some doctors are hesitant to prescribe opioids, for fear of being “stigmatized as a doctor that prescribes a lot of opioids,” Huang said.

Rubin said he is conscious of the risk of developing dependence or addiction to opioids, so about nine in 10 of his new patients “probably will never see an opioid."

“We have more options than we ever had to treat patients with injections and those types of therapies,” he said.

Rubin most often writes opioid prescriptions for patients in severe pain after major surgery. For chronic pain patients who previously weren't prescribed opioids, “we’re really trying to save it as a last resort," he said.

The CDC’s 2022 guidance for opioid prescribing says there is insufficient evidence to determine the long-term benefits of opioid therapy for chronic pain. But, the CDC said, doctors should carefully weigh the risks and benefits of discontinuing opioids for those already prescribed them.

Rubin is reluctant to take chronic pain patients off opioids if the medication has been helping them long-term.

“There are lawyers and accountants and people like that who couldn't sit in a chair all day and work at their desk without their pain medicine,” he said. “Society has to separate those people who are using medication judiciously and not lump them in with people who are trying to take high doses in an abuse-type situation to get high.”

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Cancer drugs, particularly chemotherapy agents like carboplatin and cisplatin, were also affected, with 72% of U.S.

Cancer drugs, particularly chemotherapy agents like carboplatin and cisplatin, were also affected, with 72% of U.S.

Cancer drugs, particularly chemotherapy agents like carboplatin and cisplatin, were also affected, with 72% of U.S.

cancer centers reporting shortages, forcing delays or rationing of care .

Title:

Content: |

FTC, US Health Dept Launch Probe Over Chemo Drug Shortages

The investigation is targeting so-called middlemen that broker deals between hospitals and pharmaceutical companies.

Sign up for smart news, insights, and analysis on the biggest financial stories of the day.

Each year, roughly 2 million Americans are diagnosed with cancer, and for some, getting the proper treatment has become a very serious waiting game.

This week, the Federal Trade Commission and the US Department of Health jointly launched a probe seeking information on how middlemen — group purchasing organizations (GPOs) and drug wholesalers — may be contributing to a lack of chemotherapies and other generic drugs.

The Cost of Cheap Drugs

While various cancer treatments have gone in and out of short supply for years, the problem became particularly acute in 2023. In May, a survey from the National Comprehensive Cancer Network found that 93% of treatment centers reported they were short on carboplatin and 70% reported they were short on cisplatin. Those two drugs are used together and are prescribed to 10% to 20% of cancer patients. Those shortage rates dropped in the fall, but still sat at uncomfortably high levels, with many patients experiencing longer wait times between chemo sessions.

Access to raw materials for making drugs and an increase in patients play a part in the shortages, but the FTC and the Health Department suspect the middlemen buying and selling the medications might be at the heart of the issue:

  • Hospital transactions for medications are controlled almost entirely by three GPOs — Vizient, Premier, and HealthTrust — that purchase drugs on behalf of health centers, and three wholesalers — AmerisourceBergen, Cardinal Health and McKesson — that supply 90% of the pharmaceuticals, The Wall Street Journal reported.
  • Doctors, drugmakers, and patient advocate groups have argued that because the three GPOs represent so many hospitals, they’re able to win extremely low prices from wholesalers. But the prices may be so low that some drugmakers slash production or stop making the drugs entirely if they feel they can no longer turn a profit.

“For years Americans have faced acute shortages of critical drugs, from chemotherapy to antibiotics, endangering patients,” said FTC Chair Lina Khan. “Our inquiry requests information on the factors driving these shortages and scrutinizes the practices of opaque drug middlemen.”

A Growing Concern: A short supply of cancer treatments isn’t a great development, especially with new evidence that the disease is on the rise among younger generations. Most cancer patients are 65 and older, but one study published in JAMA last summer found cancer rates among people 50 and younger are going up, mostly driven by women and people in their 30s.

A national shortage of Adderall disrupted treatment for patients with ADHD and narcolepsy, attributed to increased demand and regulatory production limits .

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EU4HEALTH PROGRAM

The EU4Health program was created by the EU member states to provide annual funding for a number of priority areas in health care in the EU and its member states. The priorities include prevention in healthcare, the fight against COVID-19, digitalization of healthcare, cancer control, the fight against bacterial resistance, etc.

Participating countries have access to competitive funding for healthcare projects in the form of grants and procurement. Funds are available to organizations and institutions in the participating countries, regardless of their form of ownership.

The program’s funding until 2027 is EUR 5.3 billion.

The program budget for 2022 is EUR 835 million.

Program budget for 2023 is EUR 735.8 million.

Within the framework of the EU4Health program, the European Commission has already approved Ukraine’s participation in 9 projects and confirmed more than EUR 4.6 million in total funding for their implementation.

Questions and answers
  • What areas does the EU4Health program cover?

    1. Strengthening and improving health

    1.1. Disease prevention and health promotion.

    1.2. International initiatives and cooperation in the field of health care.

    2.  Overcoming cross-border health threats

    2.1. Prevention, preparation and response to transboundary health threats.

    2.2. Supplementation of national stocks of essential products (goods or means) to overcome the crisis.

    2.3. Create a reserve of medical, nursing and support staff.

    3. Improvement of medicines, medical devices and goods.

    3.1. Ensuring access to medicines, medical devices and goods.

    4. Strengthening the healthcare system, ensuring sustainability and resource efficiency.

    4.1 Strengthening the system of medical data, digital tools and services, digital transformation of healthcare.

    4.2. Improving access to health care.

    4.3. Development and implementation of EU healthcare legislation and evidence-based decision-making.

    4.4. Integration between national health systems of the member states.

  • What are the forms of participation in the EU4Health program?

    Grants are divided into grants aimed at achieving EU policy objectives - action grants, grants aimed at the functioning of a body whose purpose is to formulate and support EU policy - operational grants, and direct grants, which are mainly directed to scientifically authorized state bodies.

    The program also provides for such a form of participation as procurement conducted by the European Health and Digital Agency (HaDEA).

  • Who can participate in the program and receive funding?

    A wide range of Ukrainian organizations and institutions may apply for the grant: government agencies, scientific, academic and educational institutions, educational institutes, research institutes, hospitals, expert networks, private organizations, member state authorities and civil society organizations, healthcare professionals’ associations, trade unions, patient organizations (associations, foundations, non-profit and similar organizations), public procurers, central procurement agencies, private organizations, national and regional health authorities, expert networks, etc.

  • What do I need to do to become a member of the program?

    To apply for a grant, participants must meet the following requirements:

    1. Grant applicants (organizations, government agencies) and partners must meet the following selection criteria:

    a) have stable and sufficient sources of funding to support their activities throughout the duration of the grant and participate in its financing;

    b) have sufficient operational and professional capacities to implement the activities for which co-financing is required (“operational capacity”).

    2. Organizations participating in multiple projects should have sufficient financial and operational capabilities and the ability to implement multiple projects.

    The financial capacity test does not apply to international organizations and government agencies.

    Proposals will be evaluated based on the following criteria:

    a) compliance with the priorities of the call for proposals;

    b) quality of the proposed action;

    c) the impact of the proposed action.

    Grants are subject to co-financing. The maximum possible rate of Union co-financing has been increased to 60% of the total eligible cost of the action, unless otherwise specified in the specific measures for proposals. In cases of extraordinary utility, the Union's contribution may be increased to 80% of the total eligible costs.

    The proposals will be rated in accordance with the criteria described in the call for proposals.

    3. Beneficiaries and affiliated organizations must register in the Register of Participants¹ - before submitting a proposal - and must be verified by the Central Verification Service (REA Validation). For verification, they will be asked to upload documents confirming their legal status and origin.

  • Deadlines for applications for participation

    Stage

    Date

    Publication of announcements

    15.09.2022

    Submission of applications

    15.09.2022

    Application deadline

    26.01.2023

    Assessment

    By the end of May 2023

    Announcement of results in separate letters

    By the end of June 2023

    Preparation of agreements with the winners

    September 2023

    Signing agreements with the winners

    October 2023

    Getting started

    From the date of signing the grant agreement

  • Apply for participation

  • Questions and answers about participation

    What is the EU4Health program?

    EU4Health is the fourth EU health program, which will run from 2021 to 2027.

    It is an ambitious health response to the COVID-19 pandemic and general health challenges.

    EU4Health will allocate EUR 5.1 billion over the lifetime of the program to improve and promote health to reduce the burden of communicable and non-communicable diseases by:

    - protecting people from serious cross-border health threats;

    - improving the availability and affordability of medicines, medical devices and other products;

    - strengthening national health systems.

    The EU4Health program goes beyond the COVID-19 crisis, supporting, among other things, disease prevention measures, including cancer, digital transformation of health systems, health system strengthening and health professionals’ skills. This program will pave the way for strengthening the health sectors of the participating countries and improve and protect the health of all citizens.

    What makes EU4Health different from other previous programs?

    This is the largest grant ever invested by the EU in healthcare. The pandemic has shown that the healthcare system needs more coordination during health crises.

    EU4Health is a separate program with a budget that is ten times larger than that of previous health programs. Actions such as tackling cross-border health threats, providing affordable medicines, and strengthening and digitalizing health systems will receive financial support.

    What are the main objectives of the EU4Health program?

    The EU4Health program has the following objectives:

    1. Improving and promoting health by:

    - Supporting actions to prevent disease, promote health and tackle the problems that determine health;

    - Supporting global health commitments and initiatives.

    2. Protecting people from serious cross-border health threats by:

    - Strengthening Ukraine’s capacity to prevent, prepare for and respond to cross-border health threats;

    - Supporting actions that complement the national stockpiling of essential crisis-related products;

    - Establishing a structure and training resources for a pool of medical and support workers.

    3. Increasing the availability and affordability of medicines, medical devices and products by:

    - Encouraging sustainable production and supply chain innovation while supporting the efficient use of medicines.

    4. 4. Strengthening the resilience of health systems and the efficiency of resource use, while

    - Strengthening health data, the use of digital tools and services, and the digital transformation of health systems, including by supporting the establishment of a national health data space;

    - Promoting best practices and facilitating data exchange;

    - Improving access to quality, patient-centered, outcome-based health care and related services;

    - Supporting integrated work between member states, including their health systems.

    How will the new program address non-communicable diseases, such as cancer?

    Non-communicable and lifestyle diseases are among the biggest challenges facing health systems. Non-communicable diseases such as cardiovascular disease, cancer, chronic respiratory disease, and diabetes are the leading causes of disability, health-related retirement, and premature death in Ukraine, resulting in significant social and economic costs. It is important to focus on prevention, coupled with efforts to strengthen health systems, to reduce the impact of NCDs on individuals and society and reduce premature mortality to achieve the Sustainable Development Goals by one-third by 2030.

    EU4Health will support disease prevention programs (including cancer screening and early diagnosis) and health promotion programs. EU4Health will facilitate networking through Ukrainian and European reference networks, which are virtual networks aimed at facilitating discussion of complex, rare and non-communicable diseases, improving access to diagnostics and providing high quality healthcare.

    Will the program contribute to the implementation of the Cancer Action Plan in Ukraine and the EU?

    The pandemic has severely impacted cancer care by disrupting treatment, delaying diagnosis and vaccination, and affecting access to medicines. Even before COVID-19, it was estimated that cancer cases would increase by almost 25% by 2035, making it the leading cause of death. To reverse this alarming trend, the EU4Health program will also finance measures to combat cancer, which is one of the Commission's top priorities. This will be done by providing funding to eligible legal entities based in the participating countries, such as healthcare organizations and non-governmental organizations.

    How will EU4Health address cross-border health threats?

    The Commission is working to improve prevention, preparedness, surveillance and response to cross-border health threats. EU4Health can fund a pool of medical and support staff, as well as stocks of medical equipment.

    Cross-border health threats require cross-border cooperation, and the EU will play a greater role in supporting capacity building and responding to new challenges in Ukraine.

    Will this also solve the problem of shortages of medicines and personnel?

    EU4Health can finance additional stockpiles of medicines, medical devices and other emergency medical supplies to supplement national reserves.

    One way to make sure that we have enough medical supplies is to use what we have more efficiently, particularly antimicrobials. Another way is to encourage domestic pharmaceutical production and innovation. EU4health will support Ukraine’s Antimicrobial Action Plan and Pharmaceutical Strategy.

    It is not enough to have the right amount of medicines and medical supplies. We will also need a strong health workforce equipped with the necessary skills to face cross-border health threats. That is why EU4Health will also support training of healthcare workers in specific areas.

    How will this improve the healthcare system?

    By making health systems more resilient, EU4Health will not only help prepare Ukraine for the upcoming health crisis, but also prepare member states for long-term challenges such as ageing populations and health inequalities. Vulnerable groups need to have access to health and health care services, and inequalities between member states and between regions within those member states need to be addressed.

    How much funding will be available under the EU4Health program and how will it be spent?

    EU4Health is investing EUR 5.1 billion over seven years to solve health challenges. Around EUR 316 million has been allocated for the first annual budget. Over the 7 years of its existence, the program will take into account a number of provisions for overall spending:

    - a minimum of 20% for health promotion and disease prevention;

    - maximum 12.5% for the accumulation of crisis-related products at Union level;

    - a maximum of 12.5% to support global health commitments and initiatives;

    - a maximum of 8% for administrative costs.

    The program should also contribute to the integration of climate action into EU policies and achieve an overall target expenditure of at least 30% of the total budget and Recovery Instrument for climate action.

    How will EU4Health be implemented?

    EU4Health will be implemented primarily by the Commission through direct management, including delegation to an implementing agency. The program will be implemented with relevant legal entities from member states and third countries, which will receive EU funding in the form of grants, prizes and procurement, as well as indirect management by relevant EU agencies, such as the European Medicines Agency or the European Center for Disease Control.

    The new Healthcare and Digital Executive Agency (HaDEA), which will start operating on 1 April, will be tasked with developing and managing annual work programs.

    The EU agencies - the European Center for Disease Prevention and Control and the European Medicines Agency - play a key role in protecting Europe from serious cross-border health threats and pandemics, both on the prevention and crisis management fronts. The program’s actions will improve the work of these EU agencies, as well as the European Food Safety Authority and the European Chemicals Agency.

    To prepare annual work programs and monitor results, the EU4Health Regulation also establishes an EU4Health Advisory Steering Group, which brings together the European Commission and the member states. The Steering Group will consult on annual priorities, promote coherence and complementarity with member states’ health policies, monitor EU4Health implementation and propose any necessary adjustments based on evaluations.

    In addition, the Commission will consult with relevant stakeholders, including representatives of civil society and patient organizations, to obtain their views on the needs to be addressed through the annual work program, annual priorities and deliverables.

    The results of the stakeholder consultations and steering group discussions will be presented once a year to the European Parliament before the last steering group meeting.

    How will the program support research and innovation?

    The EU4Health program is a tool for implementing EU health policy and can support and encourage innovation in medicines and medical devices, as well as products related to crisis situations in Ukraine.

    EU4Health will work closely with Horizon Europe’s main research program, which includes the Health Cluster. Horizon Europe will fund research and innovation on topics such as good health throughout life; environmental and social determinants of health; non-communicable and rare diseases; communicable diseases; tools, technologies and digital solutions for health and health systems. The program will also include Horizon Europe’s research and innovation mission on cancer, one of the Commission’s top priorities in health policy. The EU4Health program will help ensure that research results are used to their best advantage and will facilitate the uptake, scale-up and deployment of health innovations in health systems and clinical practice.

    What areas are covered by the program?

    The program includes four general and ten specific goals.

    EU4H is investing EUR 5.3 billion for 10 defined objectives in 4 key areas:

    1. Promote and improve health

    1.1. Disease prevention and health promotion.

    1.2. International initiatives and cooperation in the field of health care.

    2. To address cross-border health threats

    2.1. Prevention, preparation and response to cross-border health threats.

    2.2. Supplementation of national stocks of essential products (goods or means) to overcome the crisis.

    2.3. Create a reserve of medical, nursing and auxiliary personnel.

    3. Improve medicines, medical devices and goods to overcome the crisis.

    3.1. Make medicines, medical devices and crisis-related products available and affordable.

    4. 4. Strengthen health systems, their resilience and resource efficiency.

    4.1 Strengthen the system of medical data, digital tools and services, digital transformation of healthcare.

    4.2. Improving access to health care.

    4.3. Development and implementation of EU healthcare legislation and evidence-based decision-making.

    4.4. Integration between national health systems.

    In 2022, the program allocated EUR 7 million to the Mental Health and Psychosocial Support for Displaced Persons Arriving from Ukraine activity.

If you have any questions, please contact us:

Anna Shchetinina, [email protected]

In Europe, Ireland faced shortages of paracetamol during a surge in flu and COVID-19 cases, while Malta experienced a scarcity of Methylphenidate for ADHD, linked to procurement delays exacerbated by Brexit .

Title:

Content: Calls for local pharma to produce more ARVs in South Africa for jobs, health security

December 1, the world commemorates World Aids Day to show support for people living with and affected by HIV and to remember those who lost their lives to HIV/AIDS. Picture: Doctor Ngcobo/Independent Newspapers

Published 4h ago

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By Oceans Marasha

A health advocacy body has called for local pharmaceuticals to produce a bigger share of the country’s antiretroviral (ARV) drugs programme to fight not only HIV/Aids, but also to create an economic boom in the sector.

MMH & Partners Africa, a company that assists in the facilitation and establishment of new public health order for Africa with equitable access to healthcare products, says local producers of ARVs were only supplying 51% of the government tendered drugs, while the remaining 49% was with Indian manufacturers abroad.

For health security, the group said it would be more beneficial if a larger share of the drugs was produced locally.

The group has argued that local pharma has shown they have the skills to produce more than just 51%, while also arguing that increasing local production would benefit a number of industries in the supply chain.

Michael Mynhardt, the co-founder and chief executive at MMH & Partners Africa, says the Covid-19 pandemic and the rollout of the vaccines has shone the spotlight on the need to ensure access to pharmaceuticals and other critical goods.

“Unless aided by international organisations such as the World Health Organisation (WHO) and other NGOs, African countries would have had to wait even longer than was already the case, just to receive a vaccine for a disease affecting every single human on the planet, implicitly suggesting that some people’s lives matter more than others”.

He said as the issue of Covid-19 fades, the HIV/AIDS epidemic remains a challenge for South Africanss.

He said the government tender for the supply of ARVs allocated a significant portion of the production capacity for ARVs to local manufacturers.

This, he said, demonstrated a commitment to enhancing domestic capabilities and addressing the healthcare needs of the South African population.

“From a self-sufficiency perspective, greater domestic production means greater security in terms of access to ARVs; from a long-term perspective, greater domestic production also ensures we can keep up the momentum in the fight against HIV,” he said.

By entrusting 51% of the production capacity to local producers and 49% to Indian manufacturers, the government acknowledged the importance of fostering a resilient and self-reliant pharmaceutical industry to combat the HIV epidemic effectively.

“From an economic perspective, whether it is produced locally or abroad, producers are remunerated – but if produced locally, jobs are created, ARV production grows, and adjacent, upstream, and downstream industries benefit.

“The local creation and provision of active ingredients of ARVs, for example, similarly benefits South Africa’s access to ARVs over the long term,” argued Mynardt.

He said the benefits of producing ARVs locally was that they could also be distributed to other African countries as well.

“This would ultimately contribute to the Africa Centers for Disease Control and Prevention’s (Africa CDC) vision to build a new public health order for the continent, by improving equitable access to medicine on the continent,” he said.

Mynardt said striving for self-reliance and self-sufficiency in medicinal needs not only enhances a nation's resilience to global disruptions but also fosters economic development and promotes long-term health security.

IOL

Title:

Content: Ireland has been suffering a paracetamol shortage as cases of Covid-19 and the winter flu in the country soared over the festive and new year period.

The revelation was made by Health Minister Stephen Donnelly after his department received notification of a supply issue from the Health Products Regulatory Authority.

It is understood the shortage impacted some prescription paracetamol products.

Read More:Irish people complain of ‘worst ever’ winter bug sweeping country that feels like Covid but isn’t

Two suppliers affected have stated that resupply will be sometime in January 2023.

However, there are other prescription paracetamol suppliers with some stock available on the shelves.

Paracetamol is one of the medicines used most often in Ireland and especially for the flu, aches and pain.

But Mr Donnelly pointed out that there are multiple forms of the drug with different strengths and brands available from various sources.

He said: "In the event that there are some supply issues for individual medicines, alternative options such as alternative strengths and brands, generic medicines will usually be available to ensure continuity of treatment.

"In some cases where the medicine initially prescribed for the patient is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional."

The Health Minister said medicine shortages have been increasingly prevalent worldwide over the past decade. The causes of such shortages are multifactorial including shortage of raw materials, manufacturing difficulties and industry consolidations.

He stated: "Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways as the supply models and clinical use of therapies can vary across national health systems.

"Management of medicines shortages necessitates a multi-faceted, multi stakeholder response to ensure patient safety , continuity of care and protection of public health.

"Patients or their carers who have any concerns in relation to temporary alternative products provided because of medical shortages are advised to speak with their pharmacist or other healthcare [professionals] involved in their care."

Mr Donnelly was responding to a number of written Dail questions on the shortage of medicines.

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France reported nearly 5,000 drug shortages in 2023, affecting oncology care and causing widespread patient anxiety .

Title:

Content: National

PM asks pharma industry to increase output of raw materials for medicines and vaccines

Our Bureau Ahmedabad | Updated on November 18, 2021

‘Popularise Indian traditional medicines globally’

Prime Minister Narendra Modi, on Thursday, asked the Indian pharmaceutical industry to focus on increasing domestic production of key raw materials for medicines and vaccines, with a clear intent to make India self-reliant in this crucial pharma space.

The Prime Minister, while addressing the Global Innovation Summit 2021 by Indian Pharmaceutical Alliance (IPA), asked the industry to also focus on development of traditional Indian medicines/ herbal medicines in the backdrop of their growing global demand.

Highlighting the two areas, the PM asked the industry to explore them carefully.

On the raw material requirements, Modi said: “While we have been fighting the pandemic, we found that this was one issue that needed much more attention. Today, when 1.3 billion people of India have taken it upon themselves to make India Atmanirbhar (self-reliant), we must think about ramping up domestic manufacturing of key ingredients for vaccines and medicines. This is one frontier that India has to conquer,” he said in his virtual address.

Supply shortages

Notably, during the pandemic, the Indian pharmaceutical industry had to suffer due to supply shortages of key active pharmaceutical ingredients (APIs) from China due to pandemic-induced logistical disruptions. China commands dominance in supply of APIs to Indian formulations makers and supply disruptions cause sharp price rise.

On the vaccine production front, when India was passing through the worst second wave, the vaccine production at Serum Institute of India (SII) for Covishield faced uncertainties following the decision by its raw material supplier US invoking the Defense Production Act curbing the export of crucial vaccine raw materials. The issue was resolved only after a top-level diplomatic involvement.

In a bid to secure raw material supplies for medicines and vaccines, the PM asked the entrepreneurs to invest for raw material production. “I am sure that investors and innovators are keen to work towards overcoming this challenge,” he said.

The Union Minister for Health, Mansukh Mandaviya, also reiterated the point while inviting the global pharmaceutical investors to invest, innovate and produce in India.

“India has all the necessary infrastructure and ecosystem to become the healer of the world. This pandemic has given the world many lessons. The importance of drug security is one of that. “When any country invests in India, the drug security is an important factor they consider while putting up a manufacturing facility.”

The Prime Minister also emphasised on popularising the Indian traditional medicines on the global front. “There is now significant and growing demand of these products in the international markets. This can be seen through the sharp rise in exports of these products as in 2021 India exported herbal medicines worth $1.5 billion. Also, the WHO is working to set up its global centers for traditional medicines in India,” said Modi

Industry doyens, including Pankaj Patel, Chairman of Zydus Cadila, and Samir Mehta, Chairman of Torrent Pharmaceuticals, who is also the Chairman of IPA, addressed the gathering, giving a highlight about the prowess of India’s pharmaceutical industry

“India constitutes 20 per cent share of the global supply chain of medicines by volume and supplies about 60 per cent of the vaccines required globally. The Indian pharma industry is a $45 billion in size and ranks third in production of volume and 13th in value. India has played a vital role in supply of high-quality medicines for several chronic diseases. India is polio-free because of strong collaboration between vaccine makers, healthcare providers, government and development organisations,” said Patel.

IPA Chairman Samir Mehta stated that the theme of the summit is ‘Discover in India: Accelerating the Innovation Journey of the Indian Lifesciences Industry’ and apt in the current Covid backdrop. “The summit is the first-of-its-kind being organised in the country with key objectives such as discuss recommendations to improve innovation landscape in India, share learnings and emerging trends in the global innovation landscape and provide a platform for entrepreneurs and researchers to showcase their ideas/innovation.”

Published on November 18, 2021

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In the UK, shortages of common cold and flu medications, including throat lozenges and cough mixtures, were reported due to increased winter illness and supply chain issues .

Title:

Content: Transforming Hospital Supply Chain with AI and Automation

Medical supplies procurement is the second largest expense which constitutes approximately 1/3rd of a hospital’s Total Cost of Operations (TCO). Technology like AI can give precise stock projections so hospitals can purchase the appropriate quantity of medical equipment, devices, and consumables at the right time. Hospitals can reduce operational expenses in the procurement of medical supplies and manage inventories efficiently. This, in-turn, will make healthcare affordable for the patients.

Vivek Tiwari, Founder and CEO of Medikabazaar elaborates on the need to deploy automation in inventory management in hospitals as it helps to cut costs and bring in financial efficiency by saving on the Total Cost of Operations (TCO) and indirectly result in affordable medical bills for the patients.

How COVID 19 has exacerbated the stress on the healthcare system, causing a supply-demand crunch during an emergency situation. What was your role when the pandemic hit? Impact the pandemic has created in the medical supply chain space?

The outbreak of COVID-19 affected almost every business and healthcare, no matter how badly affected, has been up-front and centre of the world’s response in fighting the pandemic. Initially, there was a pressing need for medical equipment and supplies like ventilators, infrared thermometers, PPE Kits, masks, sanitizers etc., the use of which is now more widespread than before with extremely erratic demand-supply patterns across the country. This led us to create one platform which enrols both suppliers and customers of COVID-19 supplies, so we could aggregate accordingly. We devised the COVID Combat Collaboration Platform which brought together the COVID-19 product buyers, suppliers and experts on a single platform to address the huge demand-supply gap and host relevant and reliable information related to this disease.

During the second wave, when the oxygen crisis arose, we procured, delivered and installed oxygen supply systems like oxygen concentrators across India. As part of Project Breathe, we delivered over 10,000 oxygen concentrators to organisations, corporate and prominent hospitals like CMC Vellore, Apollo Hyderabad and Indore, Motherson and Medicover hospital.

We were involved with every stage of the Covid-19 era, right from incorporating modern testing booths at hospitals, installing beds at government recognised COVID centres, to supporting vaccination with VACCICOOL, our proprietary cold-chain vaccine transportation solution and ICU packages designed for COVID patients (adults and children).

Many healthcare digital platforms are coming up in the B2B space. How have you changed the Indian medical supply chain segments, if you can specify trends and changes you have brought into this segment?

While there are many emerging healthcare B2B digital platforms, we offer much more than just a marketplace in the form of our technological product offerings. There are multiple factors that differentiate us from every other competitor in the market.

Our marketplace is dedicated to making healthcare procurement easier, smarter and more efficient for hospitals and medical establishments, which would in turn help them provide care facilities at better prices for patients. The marketplace started with a few thousand products, but now hosts the largest catalogue of medical, dental and veterinary supplies, consumables, equipment and other devices, running up to more than 700,000 SKUs, serving over 18 countries, more than 200,000 customers.

We have successfully delivered over 500 million units to more than 20,000 pin codes across India and connected over 200,000 medical establishments and healthcare professionals globally.

As for costs we help hospitals unlock savings of up to 30 percent with smart-decision making tools like VPO and the patent-recognised AI-ML based inventory management system VIZI. We identify AI has a emerging technology opportunity that can benefit the businesses and healthcare organisations. We are developing cutting-edge research and technology to leverage these opportunities and help businesses. We are into conducting research, applying AI to products and to new domains, and developing tools to ensure that we leverage technology to transform the industry. VIZI and VPO have led to savings in many hospital chains like Jaslok Hospital, Fortis Hospitals, Wockhardt Hospitals, Sir HN Reliance Foundation Hospital, Apollo Hospitals, Artemis Hospitals and Max Healthcare.

With the help of finance partners, Medikabazaar is assisting healthcare providers set up hospitals with smart and easy payment options like revolving credit, no cost EMI, long term asset financing and more. And with our asset lifecycle management service MBARC, service thousands of equipment with our team of 100+ engineers.

Hospitals procure at cheaper rates, but patients are always charged with more margins. How do you see this?

Although hospitals provide a significant humanitarian service where they cure people from life-threatening diseases, they are also like companies with common operational expenses such as staff salaries, debts, etc. Medical supplies procurement is the second largest expense which constitutes approximately 1/3rd of a hospital’s Total Cost of Operations (TCO).

The reason for such high operational costs in procurement is due to offline supply chain systems which are still utilised by Indian healthcare facilities. Lack of channels for gaining product information, the limited scope of comparing them along with restrained communication lines between manufacturers and hospitals are some of the main limitations of offline procurement.

These disadvantages result in uninformed purchases by hospitals where they end up buying mid-quality supplies at disproportionate prices. This in turn severely affects patient care. Additionally, as hospitals purchase supplies at high prices, patients have to bear expensive medical bills making healthcare unaffordable for many in a country like India.

Automation of medical supplies: How does it help in Total Operational Cost (TOC) of a hospital? Can you explain to us how your procurement platform impacts the operating cost of hospitals, why do you think tier II and III hospitals should adopt online procurement of medical supplies?

Hospitals have an established and conventional procedure to procure their medical supplies where the purchase manager searches and reviews potential vendors. After the vendor is selected, hospitals contact them to inquire about their required supplies, negotiate prices, and then procure them. Such an offline procurement process can be complicated and costly.

The objective of medical establishments should be to make the procurement process qualitative, cost-effective which can allow them to save on their Total Cost of Operations (TCO) and indirectly result in affordable medical bills for the patients.

Since there is a lack of automation in inventory management, hospitals find it difficult to manage their inventories due to an erratic demand of medical devices for patient care.

With the integration of AI in our patented application, VIZI, we provide hospitals with precise stock projections so that they can purchase the appropriate quantity of medical equipment, devices, and consumables at the right time. This way they can reduce their operational expenses in the procurement of medical supplies and also manage their inventories efficiently without having to face excesses, shortages, and expiries in stock.

Our largest online catalogue of medical supplies and equipment that hosts over 700,000 SKUs of medical devices, equipment, and consumables, hospitals can choose their required supplies. With us acting as a single point of purchase, hospitals don’t have to contact multiple vendors and handle numerous quotations which save them valuable time and transactional costs. This way, medical establishments can save significantly in their operational expenses thus in-turn making healthcare affordable for the patients.

In India especially, medical facilities in tier-2, 3 cities, and remote locations can get their supplies via our efficient last-mile delivery, something which fragmented offline distribution systems have failed to achieve. Our online platform also provides flexi-finance options such as zero-cost EMIs and rolling credit limit for easing the payment process for healthcare facilities, thereby ensuring better accessibility and availability of medical supplies in tier-II and III hospitals.

What transformation will UK's CDC group new investment bring into Medikabazaar?

CDC’s investment in Medikabazaar will help to streamline the medical supply chain in India, resulting in improved availability of a wide assortment of medical supplies, transparent pricing and lower search costs for small providers. In turn, such products and services would enable these providers to meet the health needs of smaller groups and communities that live beyond large cities. Currently, about 50 percent of our sales are to smaller hospitals and nursing homes, and around 60 percent of the medical establishments that we serve are based outside metro cities.

The new investment is also helping augment our ability to pre-empt any further threat from another wave of COVID-19. Following the recent launch of our ICU packages for adults and children, CDC’s involvement will accelerate our effort to help medical establishments rapidly augment critical care facilities, in preparation for any furtherpandemics or health emergencies. Over and above their investment, we will also benefit greatly from CDC’s sector expertise to support us in scaling our operation across the country to deliver greater variety of essential medical supplies at affordable cost to more customers.

What are the key technologies trends that are increasingly changing the medical supply chain and how it will help in bridging the accessibility and affordability gap?

Supply chain management is one of the largest expensive business functions for healthcare service providers. One of the most effective ways to manage the healthcare supply chain is by using emerging technologies. Some emerging technologies that can impact the healthcare SCM include Intelligent AI and Analytics, Internet of Thing (IoT), Blockchain, and 3D Printing.

The use of AI in areas such as decision support for traditional inventory management has changed the way healthcare providers used to manage, interpret and analyse the data that they collect from various sources. Data analytics has shifted from descriptive to predictive and prescriptive analytics, which allow them to predict future events and decide the next course of action based on that intelligence.

Internet of Things (IoT)-enabled devices are revolutionising remote monitoring in the healthcare sector. Efficient remote monitoring of patients helps in reducing the length of hospital stays and prevents re-admissions. IoT also has a major impact on reducing healthcare costs significantly and improving treatment outcomes.

Blockchain can help healthcare providers in tracking and tracing the supplies remotely, efficiently and securely. Blockchain can also provide visibility and traceability of products across the value chain – right from the raw material provider to manufacturers to healthcare providers with detailed information about every step, without risks of data tampering.

With the help of 3D printing technology, it will soon be possible to produce products in mass, with the added functionality of adding personalisation. Healthcare is one of the sectors that can immensely benefit by adopting the 3D printing technology for various surgical items. 3D printing technology has the power to streamline the supply chain with mass production for quality care.

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Developing countries faced acute shortages of essential and life-saving medicines.

Developing countries faced acute shortages of essential and life-saving medicines.

Developing countries faced acute shortages of essential and life-saving medicines.

In India, government hospitals in Karnataka reported shortages of 733 essential medicines, including anti-TB drugs, due to procurement delays and unpaid bills .

Title:

Content: Malaysia's influencers are causing people to hoard medicines believed to treat Covid-19, creating shortages

PETALING JAYA (THE STAR/ASIA NEWS NETWORK) - Information sharing on medicine by social media influencers is unwittingly leading Malaysians to hoard medications, and worsening the medicine shortage, pharmacists say.

A pharmacist in Hulu Kelang who wishes to remain anonymous said viral videos on social media had caused an increase in demand for certain brands of paracetamol.

"Before this, some brands were selling slow, but when influencers promoted certain brands on TikTok, it was sold out," she said.

All Day Pharmacy's Leow Fui Woon shared the same concern, adding that some buyers would insist on buying a particular brand as promoted by these influencers.

"Some customers blindly follow and ask for a certain type of medicine that these influencers claim can treat Covid-19.

"They buy just to keep, some even panic buy. When asked for whom the medicines are for and how young the patient is, they said they're only buying to stock up," she said, adding that the market has enough supplies of cough syrup, as long as customers don't insist on a particular brand.

The buyers, Leow added, also refused to listen to pharmacists' explanations and insisted on following the influencers' recommendations.

"The power of influencers is unimaginable ... Sometimes it is hard for us to even explain to buyers about the medications because they only listen to the influencers.

"Medicine can only help to ease the symptoms, so customers shouldn't have the wrong mindset, be rational and understand the uses of the medicine instead of following the influencers' recommendations blindly," she said.

She added that medicine for flu-like symptoms, especially of certain brands such as Difflam and Panadol, have been on low supply since January.

Leow said that recent increase in cases of Covid-19, HFMD and influenza has also caused demand for medicine to increase, adding that supplies are slowly coming back.

"Supplies are slowly improving in many pharmacies nationwide, but the amount is still not as many as before.

"If Covid-19 lingers, it is possible for the shortage to last longer, especially if there are no policies or measures to ease the shortage, and improve the availability of raw materials and logistics," she said.

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Title:

Content: Patients with Attention Deficit Hyperactivity Disorder (ADHD) are being forced to pay hundreds of euros for medication that is usually supplied free of charge by the government.

A shortage of various dosages of Methylphenidate is affecting patients of all ages, including young children who rely on the medication to maintain their day-to-day routine which includes going to school.

If they do not take their medication, I will have no option but to take them out of school- Parent David Brooks

David Brooks, the father of two boys aged six and nine with ADHD, said he was recently informed that the medication was unavailable.

This was a repeat of what had happened in March, he noted.

Brooks said he had not been given any explanation by the pharmacy and was simply told there were issues at the government’s Central Procurement and Supplies Unit.

The government replied to questions on the issue on Wednesday evening, saying it was expecting the medication to arrive in the coming days.

Procurement from UK takes longer due to Brexit

“Since these products are being imported from the UK, a different registration process must be triggered due to Brexit, which unfortunately lengthens the procurement process,” a spokesperson said.

But for now, Brooks has no option but to purchase the medication at a cost of more than €250 every month.

He is afraid that, if the shortage persists, he may not be able to cover the expenses each and every month.

“I can get the money for the next month or two but longer will be a problem. If they do not take their medication, I will have no option but to take them out of school,” Brooks said.

He also called on the authorities to, at least, provide information to families who have been impacted.

A spokesperson for the NGO ADHD Malta said the issue has persisted for months. The medication is “very expensive” and those with ADHD do not benefit from any kind of allowance.

The spokesperson added that relying on agents who supply the drugs privately may not be a long-term solution since they also have limited stock.

These agents, she said, would need to plan ahead.

This is not the first time that issues with ADHD medications have made headlines.

In 2021, there were calls on the government to revert to branded medication as the treatment offered for free was having a detrimental effect on some of the children and adults.

This issue is still unresolved, the NGO says.

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In Nigeria, the depreciating naira led to skyrocketing drug prices and shortages, forcing patients to seek alternative remedies .

Title:

Content: SAFETYLIT WEEKLY UPDATE

We compile citations and summaries of about 400 new articles every week.
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Journal Article

Citation

Kifle ZD, Yimenu DK, Demeke CA, Kasahun AE, Siraj EA, Wendalem AY, Bazezew ZA, Mekuria AB. Inquiry (Rochester, NY) 2022; 59: e469580211062449.

Copyright

(Copyright © 2022, Inquiry Journal and Excellus Health Plan)

DOI

10.1177/00469580211062449

PMID

35114845

Abstract

BACKGROUND: Morbidity and mortality related to acute poisoning is a major public health issue in both developing and developed countries. Community pharmacists have a crucial role in ensuring drug availability, increasing drug safety, counseling patients, overdose risk reduction and management, and provision of appropriate drug information. This study aimed to assess the availability of necessary antidotes in community pharmacies in Gondar and Bahir-Dar cities, Ethiopia, and the role of community pharmacists in the management of acute poisoning.

METHODS: A cross-sectional survey was conducted in Gondar and Bahir-Dar cities. A self-administered, structured questionnaire was used for data collection and Statistical Package for Social Sciences (SPSS) version 24.0 was used for data analysis. Chi-square analysis was computed to identify the associated factors with a confidence interval of 95% and a P value less than.05 was used as a cut-point for statistical significance.

RESULTS: Out of 101 community pharmacies invited to participate in the study, 80 of them completed the survey with a response rate of 79.2%. The overall mean antidote availability score was.59 (SD =.837), which falls within the definition of Poor availability. None of the pharmacies had kept all of the antidotes, and the maximum number of an antidote kept by a single pharmacy was 7 out of nineteen essential antidotes surveyed. The most commonly reported reason for the unavailability of essential antidotes was stock was not ordered (56.3%) followed by stock ordered but not delivered from suppliers (wholesalers) (20.0%). More than 3 fourth of the respondents (83.8%) had poor knowledge about the antidotes for the common poisonings.

CONCLUSION: There was a significantly very low availability of essential antidotes in the community pharmacies. Strategies should be implemented to improve pharmacist's knowledge about antidotes, and management of poisoning emergencies through on-job training and provision of reference materials.

Language: en

Keywords

availability; poisoning; antidote; community pharmacy; pharmacists

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All SafetyLit records are available for automatic download to Zotero & Mendeley
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Ethiopia experienced poor availability of essential antidotes in community pharmacies, and a nationwide study found that 21.8% of sampled drugs failed quality tests, highlighting the prevalence of substandard and counterfeit medications .

Title:

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: Advertisment

TB and HIV Advocates Appeal to PM Modi Over Anti-TB Drug Shortages Ahead of World TB Day

Activists and health experts urgently request PM Modi's intervention on the eve of World TB Day to address the ongoing anti-TB drug shortages across India.

BNN Correspondents
New Update

In a significant plea for intervention, activists, public health experts, tuberculosis survivors, and individuals living with HIV have sent a distress letter to Prime Minister Narendra Modi on the eve of World TB Day, urgently requesting his attention to the ongoing shortages of anti-TB drugs across India. This call to action underscores the dire situation for those afflicted by tuberculosis, emphasizing the need for immediate governmental response to prevent further health crises.

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Urgent Call for Governmental Action

The letter addressed to PM Modi detailed the specific anti-TB drugs currently in shortage, particularly those vital for treating drug-sensitive tuberculosis (DS-TB). The activists highlighted the grave implications of these shortages, including treatment disruptions and the heightened risk of drug-resistant TB strains. This situation not only jeopardizes the health of individuals currently undergoing treatment but also poses a significant threat to public health at large. The communication also shed light on the logistical challenges and bureaucratic delays in drug procurement at the state level, further exacerbating the issue.

Impact on Treatment and Patient Lives

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The consequences of these drug shortages are far-reaching, affecting TB patients' ability to adhere to their treatment regimens. Many are forced to make repeated visits to health centers, often at the cost of their day's wages, posing a harsh dilemma between earning a livelihood and seeking life-saving treatment. The letter poignantly outlines the predicament faced by those who, due to the unavailability of drugs, might have to purchase medication out-of-pocket, a financial burden too heavy for many to bear. This crisis highlights the urgent need for a streamlined and effective response to ensure the availability of essential TB medications.

Previous Denials and A Call for Transparency

Despite previous denials from the Health Ministry regarding the existence of such shortages, the persistence of this issue speaks volumes. The activists' letter calls for a transparent and accountable approach to addressing these shortages, urging the government to undertake emergency procurement measures and ensure the uninterrupted supply of these critical drugs. As the country with the highest burden of tuberculosis globally, India's response to this crisis will be closely watched by the international community and public health advocates alike.

As World TB Day approaches, this urgent appeal to Prime Minister Modi serves as a reminder of the ongoing struggles faced by those living with tuberculosis and HIV in India. The resolution of the anti-TB drug shortage crisis not only requires immediate governmental intervention but also a long-term commitment to strengthening India's healthcare infrastructure to prevent such situations in the future. The health and well-being of millions hang in the balance, awaiting decisive action.

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The Gambia suffered a tragic outbreak of acute kidney injury linked to contaminated medicines, resulting in 70 child deaths .

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Content: NewsState

Actions

Nationwide weight loss medication shortage hits on local level

With prices surging and demand skyrocketing, patients are struggling to keep up
Posted at 10:04 AM, Jan 03, 2024
and last updated 2024-01-03 11:04:44-05

MILWAUKEE — With the new year comes the classic resolution: Get in shape.

One way many are hoping to battle the bulge is with popular weight loss drugs like Ozempic and Wegovy.

In fact, those drugs are in such high demand, there is a nationwide shortage of them and pharmaceutical companies are scrambling to keep up.

Growing up, Tiffany Rooker says she always struggled with her weight.

“I was always the big kid. Big kid with short hair. So, I got teased a lot, bullied a lot and it kind of stuck with me into adulthood,” said Rooker.

Tiffany says she carried that hurt for years.

From giving birth to her three children to now being a grandmother of four, she says reaching her highest weight of 284 pounds was more than just physically heavy.

“When people look at you and they see that you're overweight, they just think you over eat, but they don't understand you have baggage, things that weren't your responsibilities that you took on,” said Rooker.

In June 2022, Tiffany decided that she had had enough.

She met with her doctor who suggested she look at weight loss medications, also known as GLP-1s.

During the last few years, some of the most popular products on the market, like Ozempic, Wegovy and Mounjaro, have surged in popularity and led to a nationwide shortage.

“It’s very difficult to lose weight and people have tried all sorts of different things and when you find something that works as well as these medications do, people want to use it. So, the demand has gone up tremendously,” said Dr. Christopher Weber, Medical Director, Ascension Wisconsin Bariatric Services.

On top of the demand, a big issue people face when dealing with the shortage is the price.

Depending on the drug and insurance, they can cost patients thousands of dollars a year to stay on them and research shows people may need to stay on them to maintain that weight loss.

Ascension Wisconsin’s Dr. Christopher Weber says that uncertainty can make an already tough issue even worse.

“Some of those are very expensive, some of them are difficult to find and so patients and providers are running into difficulties and so the questions come up, ‘What do we do in this situation?’” Weber said.

At one point, Tiffany went almost two months without her medication.

“Day to day, we don’t know which pharmacy is going to have which dose of them. Sometimes they don’t have any, sometimes they have this dose or that dose, so it’s very difficult to navigate,” Weber said.

Still, Weber says he works with patients like Tiffany to come up with ways to keep up their progress while they wait for their medications to come in.

“You made have tried everything, everything. This diet or that diet, this medication and other things. There almost always something else that we can try,” Weber said.

Tiffany says that hope is what keeps her going.

Now, almost two years into her journey, she’s down 88 pounds and has gone from a size 22 to a size 8.

While she doesn’t have an exact number in mind, she says her goal is to keep feeling this way for as long as she can.

“When you look at me now, at this size, I'm free from all the baggage because it wasn't mine. So, I decided life,” Rooker said. “I’m free. I'm healthy. I'm free.”

**Reasons Behind the Shortages** The root causes of these shortages were multifactorial.

**Reasons Behind the Shortages** The root causes of these shortages were multifactorial.

Global supply chain disruptions, often triggered by the COVID-19 pandemic, played a central role.

Global supply chain disruptions, often triggered by the COVID-19 pandemic, played a central role.

Global supply chain disruptions, often triggered by the COVID-19 pandemic, played a central role.

Lockdowns, reduced manufacturing capacity, and logistical bottlenecks delayed production and distribution of medical supplies worldwide .

Title:

Content: WHO assures full support for Sri Lanka to overcome current health-related challenges

May 26, 2022   02:57 pm

Minister of Foreign Affairs Prof. G.L. Peiris has met with the World Health Organisation (WHO) Representative to Sri Lanka Dr. Alaka Singh, at the Ministry of Foreign Affairs, to discuss the current challenges Sri Lanka is facing, particularly with regard to pharmaceutical products.

During the discussion, the Foreign Minister outlined the multiple challenges currently encountered by the country and thanked the WHO Representative for the proactive steps undertaken by her Office to support the Government at this difficult juncture.

 Dr. Singh assured the Minister of the WHO’s full support for Sri Lanka to overcome the current health-related challenges, the Ministry of Foreign Affairs said.

Minister Peiris informed that efforts are underway to establish a central mechanism that would streamline requests for assistance emanating from different State agencies and allowing for the identification of the urgent requirements of the country.

This would assist multilateral donor agencies, development partners and foreign countries in providing focused and targeted assistance to Sri Lanka.

He also welcomed her expertise on steps that could be taken to address the medical challenges and ensuring that the maximum benefit of efforts undertaken by the Government and the WHO reach the people.

Dr. Singh informed that the critical period is till the end of July 2022 and that from August 2022 to July 2023 there will be sufficient medical supplies in the country. Currently there are several offers of assistance received from many countries. In this context, they are coordinating with the UNDP in Sri Lanka in setting up a platform for donations, particularly private donations.

Minister Peiris conveyed the sincere appreciation of the Government of Sri Lanka for the strong, consistent and continuous support received from WHO, in particular the Country Office in Sri Lanka, as well as the support of many foreign countries in assisting the Government address the current health related challenges.

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In Botswana, these disruptions led to shortages of hypertension and anti-retroviral drugs .

Title:

Content: COVID-19 the impact on global freight strategies

By Matt East
Matt East, Senior Advisor, Logistics & Infrastructure Policy, UK, Europe & Middle East, GHD, discusses the impact of COVID-19 on global freight...

Matt East, Senior Advisor, Logistics & Infrastructure Policy, UK, Europe & Middle East, GHD, discusses the impact of COVID-19 on global freight strategies.

COVID-19 has generated unprecedented disruption in the global logistics and freight industries, severely impacting operations and delivery activities. However, could these current challenges ultimately pave the way for a more streamlined, efficient and environmentally-friendly future?

Demand for essential goods, such as produce, medical supplies and Personal Protective Equipment, has significantly increased, while manufacturing capacity has decreased due to various lockdown restrictions. In the short term, hauliers, international gateways and retailers are facing a climate of uncertainty, as we experience:

·       disruption to points of supply and quantities of freight available

·       disruption to freight handling across international borders

·       reduced number of vessels, vehicles and personnel available across the supply chain, affecting routes taken

·       changing demand patterns as consumer and business needs change

·       population re-locations from urban to rural areas.

In the UK, for example, this has resulted in a 30% reduction of freight movements across all modes, including maritime, rail and HGV. As we move into the recovery phase following COVID-19, we need to understand if these changes to the supply chain configuration will be temporary, or if the way in which we operate and plan the logistics network will be transformed from this point on.

Beyond economic stimulation, the need for a more resilient supply chain to mitigate potential disruptions from future similar events could see producers and distributors looking to local manufacturers rather than international suppliers. These manufacturers would ideally be located near to where the key supplies are required.

The current situation provides an opportunity to consider strategic locations where local manufacturing and production hubs could be key in providing this resilience while acting as an economic booster to those regions.

The reconfiguration of the supply chain and modal shift is an idea that has been mooted previously, with the intention that these modifications would help us achieve particular industry goals, such as the net zero targets. In 2017, the UK Government issued the Freight Carbon Review, which identified options for making more effective use of current capacity on the rail, water and road networks. The report notes that a significant reduction of Greenhouse Gas emissions could be achieved through increased use of rail freight, deployment of longer semi-trailers and improved logistical efficiency by means of more widespread industry collaboration.

The report also recognised the constraints around network capacity due to passenger demand, however, it is anticipated that more people will elect to work from home following COVID-19, resulting in an estimated 20% reduction in passenger train movements on the rail network. If similar impacts are experienced across the overall transport network, additional capacity for freight paths may become available, where it previously did not exist.

Therefore, the pandemic may have just provided the industry with a window of opportunity to accelerate modal shift while configuring the network to provide more efficient distribution.

The industry can proactively plan to respond to these changes and grasp this opportunity by collaboratively developing a holistic strategy for the movement of freight across and within countries.

This strategy would:

A clearly defined strategy will provide confidence around resilience for current and future disruptions by addressing existing and potential policy and regulation amendments. This in turn will inform decisions to optimise the supply chain to achieve cost efficiencies (supply to demand ratio) and reduce the environmental footprint.

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Content: WACO, Texas (FOX 44) — The holiday season weather has played a big part in the ongoing Tripledemic we have been fighting. RSV, COVID, and the Flu.

The Waco-McLeannan County Health District monitors the rise of cases and hospitalizations we have been seeing in these illnesses this fall and winter season.

“We have seen an uptick of Flu cases or Influenza-like-illness as well as COVID-19. We have started to see some increase just because we’re in the the traditional cold and flu season. But we are a little bit concerned about the increase at this point,” shares Waco-McLennan County Public Health District Director LaShonda M. Malrey-Horne.

With a steady rise of cases comes an increase of visits in and out of clinics and hospitals. This is where many doctors and pharmacists like Steve Mitchell of Circle Drugs are running into supply issues.

“A nationwide demand is up. And so, you know, we only have so much medication in the warehouse. And when the orders go up, the shortages start occurring. Even common medications that we wouldn’t even think twice about ordinarily. We’re having trouble receiving. “

Pharmacies are experiencing a shortage of Flu medications, limited supply on antibiotics such as Augmentin and on common prescriptions like Tamiflu.

General medications to treat other illnesses outside of the high profile ones, are facing inexplainable shortages as well.

“A lot of times we were able to find a pharmacy here in town that has our members and transfer prescriptions out. So, you know, it’s unfortunate. You send your business elsewhere, but we do what we have to do to take care of these folks,” says Mitchell.

Health experts are encouraging people to get vaccinated and take precautions.

They also suggest doing the simple things like washing your hands, getting vaccinated, wearing masks, and using alcohol based hand sanitizers.

For more information on cases, vaccinations, and health related questions within McLennan County, you can visit their health district website.

You can also stay in the know right here at FOX 44 news.

Demand spikes, driven by illness outbreaks or panic buying, further strained supplies.

Demand spikes, driven by illness outbreaks or panic buying, further strained supplies.

In Malaysia, social media-fueled panic buying led to shortages of paracetamol and flu treatments .

Title:

Content: Home Health Drug collection day, almost 600,000 packs collected (02/21/2023)

Drug collection day, almost 600,000 packs collected (02/21/2023)

by admin

598 thousand packages of medicines (bet of one worth 4.9 million euros). 400,000 people in health poverty who can be helped. 22 thousand volunteers involved. They are some of the data of the 23rd Pharmaceutical Bank Drug Collection Day (developed from 7 to 13 February). I am 1,892 affiliated welfare realities with the Pharmaceutical Bank Foundation. These realities have expressed a requirement of 1,188,758 drugs covered thanks to the GRF at 50.2%.
At the initiative 5,635 pharmacies joined (752 more than the 4,883 of the last edition) in 2,197 municipalities, with the involvement of over 18 thousand pharmacists. The owners of the pharmacies have donated over 840 thousand euros.

Despite the important results – underlines a note from the Banco Farmaceutico Foundation – it is necessary to continue to support the welfare realities that take care of the needy. A poor person has only 9.9 euros available a month for their health (a non-poor person is six times as much, i.e. 66.83 euros). Suffice it to say that for the purchase of medicines, the poor have only 5.85 euros available, the non-poor 26. Due to the high cost of living, even many non-poor families will find it increasingly difficult to bear the costs necessary for treatment.
Furthermore, Banco Farmaceutico is engaged in numerous missions and humanitarian emergencies (eg in Ukraine) and, recently, has received requests for medicines from various institutions and international organizations for the population affected by the earthquake in Syria and Turkey.

«The success of this GRF was due to those who supported us with so much commitment and conviction: first of all the volunteers, the new ones and those faithful over the years who, in addition to making the GRF possible, build the work every day; the pharmacists, whose participation has never been so high and who guaranteed the implementation and credibility of the initiative; our supporting partners, who have contributed in an essential way to the sustainability of the gesture; and, of course, all the citizens who have donated and who have testified to the beauty of gratuitousness with their generosity”, declared Sergio Daniotti, president of the Onlus Pharmaceutical Bank Foundation.

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«More than 5,600 pharmacies have participated this year with commitment and with a great spirit of social responsibility in Drug Collection Day, to give concrete help to families in difficulty from a health, social and economic point of view. Just as they respond promptly and effectively to the health needs of the population on a daily basis, in recent days pharmacies have worked to promote a gesture of solidarity in favor of the most fragile and destitute segments of the population, achieving an unprecedented result”, says the president of National Fedefarma, Marco Cossolo.

“Once again this year the Banco Farmaceutico initiative has triggered an extraordinary virtuous circle of solidarity that has seen pharmacists at the forefront of collecting medicines for those who need it most”, he comments Andrea Mandelli, president of the Federation of Italian Pharmacists’ Orders – Fofi. «A heartfelt thanks goes to all the colleagues who have made themselves available, to the volunteers and to the many citizens who, with their solidarity, have made a valuable contribution to helping people in difficulty. The excellent results achieved are a concrete response to health poverty and confirm the close link between pharmacists and the communities in which they operate, an aspect that makes this initiative even more special and our work even more rewarding”.

The GRF was held under the High Patronage of the Presidency of the Republic, with the patronage of Aifa and in collaboration with Cdo Opere Sociali, Federfarma, Fofi, Federchimica Assosalute, Egualia – Industrie Farmaci Accessibili and BFResearch. Intesa Sanpaolo is the Institutional Partner of the initiative. The GRF is realized thanks to the important unconditional contribution of Ibsa Farmaceutici, Teva Italia, EG Stada Group and DHL Supply Chain Italia and the support of Doc Generici, Piam Farmaceutici, Zentiva and Chiapparoli Logistica.
The Collection was supported by Rai for Sustainability – Esg, Mediafriends, La7, Sky for social issues, and Pubblicità Progresso.

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The popularity of weight loss drugs like Ozempic and Wegovy in the U.S.

The popularity of weight loss drugs like Ozempic and Wegovy in the U.S.

The popularity of weight loss drugs like Ozempic and Wegovy in the U.S.

resulted in nationwide shortages .

Title:

Content: Prescription drug shortages lead to higher prices

Reporter: Andryanna Sheppard
Published: Updated:
Lea este artículo en Noticias WINK

Millions of people in the United States depend on prescription drugs to manage pain, treat medical conditions, and even to help them stay alive. However, the country’s drug shortage is making it hard for some people to get the medication they need or pay for the drugs that are available.

Federal Drug Administration data shows 90 percent of prescriptions in the US are for generic drugs. According to the National Institutes of Health, most prescription drugs involved in shortages are generic options.

There are currently more than 250 medications on the nation’s prescription drug shortage list, according to the American Society of Health-System Pharmacists. The organization says 2023 marked the worst year for shortages in about a decade.

Jessica Kahn’s two sons were diagnosed with ADD.

“I would say tricky, tricky to navigate,” Kahn described.

For the past year, Kahn said getting their medication has been frustrating.

“I have my list of all the pharmacies. I’ve even driven all the way up north to Walgreens or a CVS, some random place to go pick up a kids’ prescription,” Kahn added.

According to the FDA, prescription drug shortages are often linked to manufacturing and quality problems, delays, and discontinuations. Two drugs used in chemotherapy, Adderall, lidocaine, and amoxicillin are just a couple of the prescription medications on the shortage list.

When drug supplies are low, prices tend to increase. According to the US Department of Health and Human Services, there is a 16.6 percent increase in the price of drugs involved in a shortage. And in some cases, alternative drugs were priced at least three times higher.

“You got to be very conscientious that it might not be available and that it is not an option,” Kahn advised. “No matter how many places you call, it’s not there.”

Beating the prescription drug shortage

Health experts offer these tips:

  • Check the national drug shortage list for your medication and possible alternatives.
  • Don’t wait until your prescription is almost gone to refill it.
  • Check other pharmacies for availability and if you can’t find the generic version, look for coupons or programs that offer payment help. Some patients have reported that they receive additional help to reduce some prescription costs from $100 to $10, it’s not allowed if you are already on Medicare.
  • Websites and apps like GoodRX, RX Saver and WellRX can help you find the cheapest place that has your medication and coupons for it.

Contributors to this news report include: Lindsay Dailey, Producer; Bob Walko, Editor

Copyright ©2024 Fort Myers Broadcasting. All rights reserved.

This material may not be published, broadcast, rewritten, or redistributed without prior written consent.

Regulatory and bureaucratic delays also played a role.

Regulatory and bureaucratic delays also played a role.

In India, delays in floating tenders and clearing pending bills hindered timely procurement of essential medicines .

In Malta, Brexit-related procurement challenges disrupted the supply of ADHD medications .

Patent monopolies and high costs of patented drugs limited access in countries like South Africa, where the poorest populations struggled to afford life-saving treatments .

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Content: © 2024 All Rights reserved WUSF
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Patients with narcolepsy face a dual nightmare of medication shortages and stigma

A national shortage of Adderall is affecting more than just ADHD patients. Those with narcolepsy, a much rarer condition, are often treated with the medication. Without it, they're often unable to drive or function as usual.

Nina Shand couldn’t stay awake.

She had taken afternoon naps since she was a teenager to accommodate her “work hard, play hard” attitude, but when she was in her mid-20s the sleepiness became more severe.

Menial computer tasks put her to sleep, and a 20-minute drive across St. Petersburg, where she lives, brought on a drowsiness so intense that her eyelids would flutter, forcing her to pull over. She knew something was really wrong when she no longer felt safe behind the wheel.

In 2021, she received a diagnosis: narcolepsy, a rare disorder that causes excessive daytime sleepiness.

Her doctor prescribed her Adderall, the brand-name version of the amphetamine-powered medication commonly known for treating attention-deficit/hyperactivity disorder.

It worked. For the first time in years, Shand, now 28, felt energized. She was no longer struggling at work, sneaking naps or downing coffees to trick her body into staying awake. She felt hope.

But by 2022, a national Adderall shortage meant pharmacies were no longer able to fill her prescription. Shand and countless others across the country were being turned away, left to piece together a new — and often less effective — treatment plan with doctors scrambling to meet their needs.

More than a year later, the shortage continues. In October, Democrats in the U.S. House of Representatives implored the FDA and Drug Enforcement Administration to work with drug manufacturers to ensure better supply.

“We cannot allow this to be the continuing reality for Americans,” read their letter, led by Rep. Abigail Spanberger (D-Va.).

But for now, it is.

Each month is accompanied by familiar anxieties as patients navigate a web of messy logistics and uncertainty while trying to get the medication they need to live normally.

Media coverage of the shortage — and even the House Democrats’ letter — has focused primarily on the harms to people with ADHD. But for those with sleep disorders, like Shand, the effects may be even more consequential.

Basic tasks — like driving — become dangerous or impossible without medication. Job and school performances are threatened by the onset of sudden sleep and sometimes even paralysis. Hobbies and social lives can fall by the wayside, too.

“Adderall gave me my life back,” said Shand. “Going from having a medication to not, it’s like a roller coaster you desperately want to get off.”

The resulting challenges, she said, have made particularly clear the loneliness of living with a rare and misunderstood disorder.

What Is narcolepsy?

An estimated 1 in 2,000 people in the United States live with narcolepsy — more than 160,000 people nationwide. The disorder is part of a broader group known as hypersomnolence disorders, or conditions characterized by difficulty staying awake during the day.

There are two major types of narcolepsy.

Both types affect one’s ability to stay awake, but Type 2 is typically less severe. In addition to sleep disturbance, most people with Type 1 narcolepsy experience sudden, temporary loss of muscle control or paralysis, called cataplexy.

Cataplexy attacks are typically triggered by emotion — like laughter or surprise. For one person living with narcolepsy, an attack might look like a slack jaw or limp hand. For another, it could trigger full-body paralysis.

Causes of Type 1 narcolepsy can include autoimmune disorders and brain injuries, but the underlying issue is believed to be low levels of hypocretin, a hormone that is thought to affect REM sleep — the dream state.

“Narcolepsy is due to a faulty switch in the brain for REM sleep,” said Muhammad Ali Syed, a physician and the medical director of the University of Florida Health Sleep Center in Gainesville.

People with narcolepsy go into REM extremely quickly, Syed said. A person without a sleep disorder will enter REM around an hour or 90 minutes after falling asleep. But a person with narcolepsy may go into REM almost immediately and could have a fully fleshed-out dream in just minutes, Syed said.

In some circumstances, symptoms can also include sleep paralysis and hallucinations.

Increased demand

Every week since the Adderall shortage began, Fareeha Hussaini, a sleep medicine specialist at University of South Florida Health in Tampa, has had calls to her office from patients struggling to access their medication.

College students are worried about plummeting grades and final exams. Patients in their 70s, who have managed symptoms with Adderall for decades, are forced to switch to other medications, like Ritalin.

Hussaini and her staff at USF Health have worked to help patients adjust treatment plans, but there’s no denying the added stress. Some patients worry what a new plan may mean for their quality of life as shortages continue.

Drug shortages in the U.S. aren’t new, but the past couple of years have brought an all-time high, said Michael Ganio, who directs pharmacy practice and quality for the American Society of Health-System Pharmacists, which represents pharmacists nationwide.

The Adderall shortage, Ganio said, is linked to increased demand.

The COVID-19 pandemic brought on a flood of new ADHD diagnoses. Studies have found absence of routine with increased screen time may have played a role. With those diagnoses came an increase in stimulant prescriptions, Ganio said — often via telehealth.

Adderall is a Schedule II controlled substance. It’s highly regulated because of the potential for being diverted for recreational use. Prior to the pandemic, patients were required to have an in-person doctor appointment to get a prescription. But that requirement was waived during the public health emergency, and telehealth appointments were allowed. The telehealth allowance has since been extended.

“There’s a broad group of patients who never had access, or suddenly have easier access, to providers who can make that diagnosis and prescribe,” Ganio said.

Another reason for the shortage are production limitations put in place by the DEA. Each drug manufacturer is effectively given quotas of how much of the drug they can produce. But because manufacturers are shielded by trade secret protections, it can be hard to know whether the DEA quotas are too low or if the manufacturers just aren’t producing to full capacity.

In a joint letter in August, the leaders of the FDA and DEA called on manufacturers to work together to increase production and confirm they are working to produce up to their quotas.

A Logistical Nightmare

From the parking lot of a Pinellas County Walgreens in November, Nadine Dixon, 50, waited anxiously to have her Adderall prescription filled. It was the third time she’d sat in a pharmacy parking lot that day.

For Dixon, who gets her prescription through monthly in-person visits with a neurologist, the past year has been a logistical nightmare. The effects of the shortage, she said, have been compounded by the layers of red tape around Schedule II drugs.

Unlike, say, blood pressure medication — which can be dispensed to patients in a 90-day supply — Dixon can get enough Adderall only for 30 days, and automatic refills are not allowed.

As the end of each month approaches and her pill bottle empties, her anxiety spikes.

At her doctor appointment, she picks up her prescription, commencing a cumbersome routine.

Some months, she has had to drive to upward of 10 pharmacies to find her medication. Sometimes she calls in advance to ask if they have it, but she rarely gets answers.

When she finds a pharmacy that has Adderall, a new challenge hits. Minuscule details — like a number written with numerals instead of being spelled out, or a doctor’s signature that looks slightly different than it did the month before — can result in the pharmacy turning her away. Her only option then is to drive back to the doctor’s office and ask for the paperwork to be adjusted.

Doctors can send electronic prescriptions to a pharmacy to avoid the issues with handwriting, but those pose their own complications: They can be sent to only one pharmacy at a time, and can’t be transferred.

If the receiving pharmacy is out of medication, patients have to go back to their doctor to ask that they send the prescription elsewhere. And often only the doctor — not a nurse, nor a physician assistant, nor a staff member — is allowed to address that call for help.

Luis Enrique Ortiz, a sleep medicine specialist at Johns Hopkins All Children’s Hospital in St. Petersburg, said that’s put a strain on doctors, who are juggling efforts to rewrite prescriptions, guide patients, and handle appointments and research.

The result is often a delayed response.

“It can be really nerve-wracking,” Ortiz said. “Their time is running out, and they need this medication to function normally. When they finally do get it, they don’t know what the next month will hold. They have to go through it all again.”

Dixon, who was diagnosed with narcolepsy with cataplexy in 2010, estimated she’s spent up to eight hours a month trying to get her medication since the shortages began. In three of the past six months, her prescription hasn’t been filled on time. She’s experienced delays of four or five days.

The results are terrible migraines, mood swings, muscle weakness, and — of course — sudden sleep, she said.

“It feels like you’ve been awake for four days straight and are trying to keep your eyes open,” Dixon said. “The second I sit down, I fall asleep.”

Dixon described herself as an energetic person when she’s on medication. She’s a single mom and a caregiver for an older woman, and she works an online job for extra money. She has a full social life, too.

But without medication, she said, her life comes to a standstill. She can’t go have drinks with friends. She can’t go for walks. Simple conversations about stressful topics can trigger cataplexy attacks, which cause her limbs to go numb.

“It’s really horrible,” Dixon said. “Irregularities with the medication are hard on your body.”

Almost an hour after she arrived at the pharmacy that November day, she got a phone call asking her to come in from where she’d been waiting in the parking lot. They couldn’t fill her prescription, the pharmacist told her. The prescription had an error.

They sent her away with a sticky note spelling out the necessary adjustments.

She drove back to her doctor’s office, but when she got there, she learned the doctor had left for the day.

She would have to try again the next day.

Stigma and hope

Adderall isn’t the only treatment used for narcolepsy. Other stimulants, as well as newer drugs made specifically for treating sleep disorders, can help, but those can come with hefty price tags and insurance battles.

And when a patient finds a drug that works, any change can be scary, Shand said.

Since her diagnosis, Shand said, she’s tried at least three other treatments.

“Adderall has been the only stimulant that really keeps me awake and feeling like I can go through my entire day without having to sleep,” she said.

She’s been able to get her prescription refilled since fall began, she said, but she’s learned not to get comfortable. She never knows what the next month will hold — what stock local pharmacies will have available.

For Shand, who has narcolepsy with cataplexy, the years since her diagnosis have brought waves of frustration and grief but also a sense of loneliness.

In television and movies, narcoleptics are often the butt of a joke, she said. Most people, she’s found, don’t really know what narcolepsy is.

“It’s not actually all that funny,” Shand said. “It’s genuinely debilitating. It’s life-altering.”

This article was produced through a partnership of the Tampa Bay Times and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. Learn more about KFF.

Copyright 2024 Health News Florida

Tampa Bay Times

The prevalence of substandard and counterfeit drugs in Ethiopia and The Gambia underscored the impact of weak regulatory oversight and quality control failures .

**Impact on Ordinary Patients** The consequences for patients were severe and widespread.

**Impact on Ordinary Patients** The consequences for patients were severe and widespread.

**Impact on Ordinary Patients** The consequences for patients were severe and widespread.

In the U.S., shortages of chemotherapy drugs forced hospitals to delay or ration cancer care, with patients expressing anxiety over compromised treatment and providers facing ethical dilemmas in prioritizing care .

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Rise in syphilis, lack of penicillin worry officials

by Mark Dooley | Today at 4:00 a.m.

A shortage of penicillin to treat a skyrocketing number of syphilis cases is so dire that U.S. health officials are debating the need to declare a public health emergency, according to people familiar with the matter.

Major U.S. medical centers are rationing the recommended treatment for the deadly sexually transmitted disease because of a supply crunch. From Michigan to Missouri to Texas, some health care providers are prioritizing giving a key treatment -- penicillin G benzathine -- to pregnant patients and babies, because the drug can pass through the placenta and also treat the fetus.

Syphilis has been sickening more people over the past few years, but the latest surge in cases has been especially worrying to the federal government. The Department of Health and Human Services is mobilizing a new federal task force to tackle the problem, and staff members are discussing the possibility of declaring a public health emergency, which could give officials access to more funding to address the crisis, according to people familiar with the matter.

"This is a remarkable shortage," said Joseph Cherabie, an assistant professor at Washington University in St. Louis' medical school, who treats syphilis patients. Because of the need to conserve the drug for pregnant patients, other people are getting less-than-ideal treatments for the infection.

The government's efforts are being led by Assistant Secretary for Health Adm. Rachel Levine, according to one of the people, who asked not to be identified discussing private information. Levine has spent months recruiting experts to tackle the syphilis crisis, including officials at HHS, the Centers for Disease Control and Prevention and the Food and Drug Administration, which has been brought in to address ongoing drug shortages.

Levine and U.S. health officials at the CDC are weighing the benefits of the public health emergency declaration, such as the additional flexibility and money it would give HHS, one of the people said. They're also considering the potential drawbacks. Some are wary that a pandemic-fatigued public may consider it an overreaction and ignore similar declarations in the future. Ultimately, HHS Secretary Xavier Becerra has the power to make a declaration.

"The department is closely monitoring the alarming rise in cases of syphilis and will continue working to address this public health threat," an HHS spokesperson said.

Drug shortages, though not uncommon, have hit nine-year highs in the U.S. Over the past year there have been shortages of antibiotics, chemotherapies and ADHD medicines, to name a few.

The situation is partly a result of under-investment in manufacturing after years of falling generic drug prices. Companies have also been caught off-guard by unexpected changes in demand, creating far-reaching consequences that imperil lives.

The penicillin shortage began in April. The FDA said it was caused by increases in cases of syphilis and strep throat. Because a common antibiotic used to treat strep was in short supply this winter, patients were prescribed penicillin as an alternative, driving up demand for the drug.

That created an acute problem at a time when syphilis cases were rising precipitously. Rates of syphilis in 2021 were the highest since 1990, according to the most updated government data. In 2021, at least 176,000 cases of syphilis were reported, 32% more than the year before. The infection disproportionately impacts gay and bisexual men.

Pfizer Inc. is the only company that makes penicillin G benzathine for the U.S., selling it under the brand name Bicillin L-A.

The company has told the FDA that supply disruptions for the two most common doses of penicillin G benzathine will likely continue into the second quarter of 2024. Pfizer has added night and weekend shifts to increase production. To free up manufacturing resources, it's also deprioritized production of a smaller dose of Bicillin L-A that's not widely used.

Syphilis is especially dangerous for pregnant people, who can pass it on to a fetus, which often results in pregnancy loss, death of a baby shortly after birth or severe disability in children. Cases of this type of syphilis, called congenital syphilis, are also at their highest rates since the 1990s. In 2021, there were 2,855 cases reported, up 32% from the year prior. The disease is completely preventable with penicillin G benzathine.

Penicillin G benzathine is also often the most recommended treatment for people who aren't pregnant. Yet with supplies running short, the CDC is advising that doctors turn to another antibiotic, doxycycline. That's less convenient for patients, because doxycycline is a pill given twice a day for at least two weeks, whereas penicillin G benzathine is an injection that can sometimes clear the disease completely with one dose.

That makes doctors worry that some patients might not complete their treatment with doxycycline. Syphilis particularly affects people suffering from substance abuse, housing instability or homelessness, which makes it more difficult to sustain long-term medical care.

There's also less evidence backing the drug than there is for penicillin, according to physicians.

"We're learning in real time how effective doxycycline can be," Cherabie said.

Some states or health systems are directing doctors to use doxycycline for syphilis. The Michigan Department of Health and Human Services has instructed state-funded clinics to use doxycycline for certain patients because of the shortage, spokesperson Chelsea Wuth said.

At Houston Methodist, a health system with seven hospitals in the Houston area, penicillin G benzathine is reserved for pregnant patients and babies with syphilis, spokesperson Gale Smith said.

Some clinics have been able to get sufficient amounts of the Pfizer drug, at least for the time being. State-operated health clinics in South Carolina have been able to purchase as much as they need, a spokesperson for the health and environment department said.

While rates of HIV have been declining, other sexually transmitted diseases have become more prevalent in recent years. Condom use has fallen as more effective medications for HIV have become available, leaving people vulnerable to illnesses like syphilis, chlamydia and gonorrhea.

There are also fewer resources to identify people who need treatment and get them help. STD prevention work happens largely at local and state public-health departments, which have been losing money and staff over the years. The covid-19 pandemic diverted already scarce public health resources away from STD work.

The rise in syphilis cases is also prompting concern at a state level. Last year, New Mexico renewed a statewide public health order mandating that health care providers screen pregnant women for syphilis multiple times to catch the disease. The state had only one case of congenital syphilis reported in 2017. It had 42 in 2020.

Print Headline: Rise in syphilis, lack of penicillin worry officials

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The penicillin shortage led to rationing of syphilis treatment, with pregnant patients prioritized and others receiving less effective alternatives .

Opioid shortages left chronic pain patients struggling to obtain necessary medications, often enduring increased pain or resorting to less effective treatments .

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Content: A Greater Manchester pharmacy leader has moved to reassure those suffering from cold and flu symptoms that there are remedies available to help them, despite shortages being reported.

The Association of Independent Multiple Pharmacies (AIMP) said today (Wednesday) that pharmacists across the country were struggling to obtain supplies of the most common cold and flu medicines including both branded and unbranded throat lozenges, cough mixtures and some painkillers, particularly those that were soluble.

They say a surge in demand due to a high number of winter illnesses circulating combined with supply chain issues have led to gaps on the shelves of many supermarkets and local chemists. High street pharmacies have also reported an increase in demand for cold and flu products but that 'suitable alternatives' should always be available.

READ MORE: "Not a cough bottle in sight": M.E.N readers share experiences as pharmacy leaders of warn of cold and flu medicines shortages

Fin McCaul, Chairman of the Greater Manchester Local Pharmaceutical Committee (LPC), and himself a pharmacist based in Prestwich, said there was 'definitely a shortage of lots of medicines' in the local pharmacy system, including virtually all of the major cough and cold remedies.

However, he said he although patients may not be able to immediately get their hands on their preferred or usual brand, if they speak to their pharmacist they will almost certainly have an alternative that will help soothe their symptoms.

"There's definitely been a shortage of lots of medicines," Mr McCaul told the Manchester Evening News . "Not just the coughs and colds, you also had the antibiotics problem just before Christmas

"And it's ongoing issues with manufacturing and transport around the world. A lot of these things are not made in England, they are actually made abroad and made for England. So they're imported in that way.

"I think also, this winter has caught the manufacturers by surprise. Because if we look at the last two winters, we have not been anywhere as busy as we are now for this sort of medicine. Mainly because we've all been wearing masks and not moving about as much and not seeing as many people as much.

"So there's definitely a supply shortage. But that supply shortage is national, it's not just in Greater Manchester. And I don't think Greater Manchester is any worse or any better than the rest of the country.

Asked which items were worst affected he said: "It's all of them really, it would be wrong for me to pick out any particular brand.

"The advice I would give to your readers is, if you're used to one brand, take the advice of the pharmacist, they will undoubtedly be going out of their way to get you any medicine they can that will ease and soothe the symptoms of the sore throats, and the coughs and the colds.

"So whilst it might not be what you usually have, we will have something that will do the job and will help you." "There will be some version of it available, it just may not be the brand that they want" he added.

"There are certain lines we can't get" Mr McCaul continued. "But next week they may come in. So it's a very fluid and changing situation.

"But we've always managed to have something in for dry coughs, for chesty coughs and for sore throats. At the minute, where we would normally have a range of all the best sellers - Lemsips, Beechams, Benylins and the likes - we cannot get all of those brands.

"But whenever we get something we try and keep it for our customers in that sense."

He said when supplies come in some are kept behind the counter to be dispensed on pharmacists advice as well as being stocked on open shelves.

Mr McCaul added that he and his colleagues weren't currently restricting sales as there was no need. "Most people are very, very sensible and wouldn't abuse it anyway," he said. "Most people who are coming in are only buying one for themselves at a time.

"We would have conversations if needed. There's something wrong if you need more than one cough bottle, certainly no more than two. We would restrict if we needed to but people haven't been silly in that respect. People have been only buying it when they need it and that's helping ease the situation."

Mr McCaul said supermarkets, health stores, convenience stores and other types of shops who also stocked the products got them from the same suppliers and were 'all in the same boat' as pharmacists when it comes to supply issues.

AIMP chief executive Leyla Hannbeck, whose group represents community-based pharmacy businesses with multiple stores, warned that a shortage of self-care products in pharmacies could lead to more pressure for the NHS.

And she accused the government of“being in denial” over problems with the supply chain and of a 'lack of planning' in dealing with the problems.

"Tthis is part of a bigger issue – from HRT to antibiotics to this, we are constantly finding ourselves in a situation when as soon as the demand for something goes up we are struggling with the supply" she said.

"Unfortunately part of that is a lack of planning by officials (at the Department of Health and Social Care) in terms of foreseeing the problems and trying to plan in advance to sort it.

“For example, with cold and flu, we knew some months ago cases were going up and it was anticipated that there would be higher demand for these products. So you would have thought that plans would have been in place in terms of managing this with regards to liaising with manufacturers and getting the products in.”

Mr McCaul said he believed the government 'could have worked better' in solving the issues around the supply of antibiotics which he said was an ongoing issue in the region.

"I'm not an expert on the logistics and understanding of the cough medicine situation so it's difficult for me to comment on that" he said.

"But if we go back four weeks, the government was clearly saying 'there are loads of antibiotics there are no shortages.' But when 50, 60, 70 percent of the pharmacies in Greater Manchester can't get antibiotics, there is definitely a problem.

"They are working to solve that problem at the minute and it is getting better. It has eased but it is not completely fixed. Whether they had a duty of care with the cough medicine situation.

"This has only really come to a head in the last 10 days over Christmas, so I don't know is the answer to that."

Mr McCaul added: "All of the pharmacy teams, just like the doctors and the hospitals, are severely stretched at the minute, so just try to have patience with the pharmacy team and they will look after you as best they physically can."

Niamh McMillan Superdrug pharmacy superintendent said: “We are currently experiencing exceptionally high demand for cold and flu products. If your usual products are unavailable and you’re looking to relieve your symptoms, our pharmacists can offer advice on the most appropriate pain relief and decongestant products to help you.”

A spokesperson from Boots added: “General availability of cough and cold relief at our stores across the UK is good, and enough to meet current demand. There may be temporary shortages in some stores of a particular brand, eg Lemsip, but there will almost always be suitable alternatives available. Customers should speak to their pharmacist for advice on alternatives, if needed."

Read more of today's headlines here

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In the UK, a shortage of riluzole, the only licensed drug for motor neurone disease, forced patients to visit multiple pharmacies, with some unable to access their sole treatment option .

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Content: As drug shortage list grows, many hospitals face tough decisions on rationing care

More than half of hospital pharmacists are reporting a critical shortage of chemotherapy drugs and nearly all are reporting overall medicine supply gaps as prescription drug shortages near an all time high, according to a new survey.

Hospital pharmacists said drug shortages have forced 1 in 3 health systems to delay, cancel or ration care or switch to alternate drugs to continue to treat patients. And 99% are reporting some drug supply shortages, an American Society of Health-System Pharmacists survey of more than 1,000 pharmacists released Thursday found.

The organization reported shortages of 309 drugs, near the all-time high of 320 shortages in 2014. The scarcity of key drugs is prompting hospitals to find or substitute drugs and change treatment plans as needed.

“In some cases, there are no alternatives to the affected drugs, which puts patients at risk," ASHP Chief Executive Officer Paul W. Abramowitz said in a statement. "This issue requires quick action from Congress to address the underlying causes of shortages and ensure patients have the medications they need.”

Cancer drug shortages

In June, the Food and Drug Administration said it will temporarily allow overseas drug manufacturers to import some chemotherapy drugs.

The FDA allowed Qilu Pharmaceutical, a drug manufacturer in China, to import the injectable chemotherapy drug cisplatin in 50-milligram vials. Toronto pharmaceutical company Apotex Corp. will distribute the medication in the United States.

More than a dozen cancer drugs have been in shortage in recent months, including cisplatin and carboplatin, used to treat lung, breast, prostate and gynecologic cancers. The National Cancer Institute said cisplatin and similar drugs are prescribed for 10% to 20% of all cancer patients.

In June, the National Comprehensive Cancer Network released a survey of 27 academic cancer centers that found 93% reported shortages of carboplatin and 70% faced shortages of cisplatin.

When cancer hospitals face such shortages, they attempt to make sure there's enough medication for patients to finish the course of treatment, said Mike Ganio, ASHP's senior director of pharmacy practice and quality.

Cancer hospitals facing such shortages might change medications for new patients starting on chemotherapy, said Ganio, a former pharmacy manager at an academic cancer center.

"You try to keep that patient on the same regimen as much as you can, unless they're failing it for some reason, and then you would switch," Ganio said.

Steroids, hormonal drugs also in short supply

More than 1 in 5 hospital pharmacists also reported shortages for steroids, hormonal drugs and oral liquids such as lidocaine, ibuprofen and amoxicillin.

A smaller number of pharmacists said heart medications, emergency prefilled syringes and drugs used for intensive care unit patients were in short supply. Others reported shortages of attention deficit hyperactivity disorder medicines, antimicrobial drugs and injectable opioids.

In all, about two-thirds of pharmacists said the shortages were "moderately impactful," which means they are managing shortages but patients are affected.

Pharmacists are managing the shortages by offering therapeutic alternatives, buying different vial sizes or concentrations and rationing medicines.

This article originally appeared on USA TODAY: Survey: Drug shortages are widespread, hospitals ration care

In developing countries, the impact was often more acute.

In developing countries, the impact was often more acute.

In developing countries, the impact was often more acute.

In Nigeria, high drug prices and shortages forced many to abandon prescribed treatments or seek alternative remedies, with the pharmaceutical industry struggling to maintain supply .

In Ethiopia, the lack of essential antidotes and the prevalence of substandard drugs posed direct risks to patient safety, including deaths from ineffective treatments .

The Gambia’s contaminated medicine crisis resulted in dozens of child fatalities .

In India, shortages of anti-TB drugs threatened treatment adherence and increased the risk of drug-resistant TB strains .

**Healthcare System and Authority Responses** Authorities and healthcare systems implemented a range of responses to mitigate the impact of shortages.

**Healthcare System and Authority Responses** Authorities and healthcare systems implemented a range of responses to mitigate the impact of shortages.

Regulatory flexibility was a common approach.

Regulatory flexibility was a common approach.

FDA allowed the importation of chemotherapy drugs from overseas manufacturers to alleviate shortages .

The American Society of Health-System Pharmacists called for urgent congressional action to address root causes, while the Federal Trade Commission and Department of Health launched investigations into the role of supply chain intermediaries .

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Content: French health groups put forward proposals to limit the damage of worsening drug shortages

Medicines such as cough syrup, lozenges and ointment are seen on a table in an apartment in Berlin, Tuesday, December 20, 2022. Copyright Stephanie Pilick/dpa via AP
Copyright Stephanie Pilick/dpa via AP
By Lauren Chadwick
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Pharmaceutical companies’ lack of transparency leads to rising drug prices and less control over public resources, the group of health organisations say.

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A group of French organisations have called for more transparency from pharmaceutical companies as drug shortages increase.

In a joint report, 14 civil society organisations outlined their recommendations to solve a “situation that has only worsened” since 2018.

The French medicines regulator signalled 4,925 drug shortages in 2023, compared to 3,761 in 2022 and 2,160 in 2021.

A 2024 survey from France Assos Santé, which represents patients, found that 44 per cent of people in France said they had faced a drug shortage this year.

One of the pharmacy unions in France has even planned a strike at the end of the month over drug shortages and what they say is worsening access to care.

Each health organisation contributed an article with recommendations for dealing with the drug shortages.

The League Against Cancer urged complete transparency on drug shortages and potential substitutions for health professionals.

They also called for monitoring of medicine stocks and their location in the country to guarantee equal access.

The organisation found in a survey published in February that 78 per cent of health professionals in oncology had been faced with a drug shortage.

Drug shortages or delays have led to anxiety among cancer patients, lost time, and worsening symptoms, the organisation said.

France Assos Santé, meanwhile, wrote that an urgent response should not be to support “the industrial sector which bears serious responsibilities” for abandoning the production of less profitable drugs, relocating drug production, and keeping insufficient medicine stocks.

They would like any cost increases justified by production costs or the risk of withdrawing a drug from the market due to it being unprofitable. They called for cost evaluations to be made public.

Their concerns also range from the use of public money to bring drug production to Europe to new government plans to prevent shortages.

Some changes at the EU level criticised

Last year, the European Commission announced several measures to reform the pharmaceutical industry and address critical drug shortages.

The European Parliament went on to adopt a position on pharmaceutical reform last month, that included “incentives for innovation” and an effort to limit overuse of antibiotics.

The non-profit organisation Prescrire, which focuses on information about medicine, wrote in a chapter they contributed to the report that while some of the European Commission’s measures were welcome, others were concerning.

One of the many measures they rejected included the Commission’s proposal to reduce the number of days of scientific evaluation of drugs from 210 to 180, which they said was necessary time rather than an “administrative obstacle”.

While the NGO welcomed some measures such as government drug shortage prevention plans, it said the Commission should allow EU states to require pharmaceutical companies to have safety stocks of medicine and sanction those that do not respect them.

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French consumer organisation UFC-Que Choisir and the European Consumer Organisation (BEUC) said that they had hoped MEPs would shorten the length of time for “data protection” to allow generic medicines to be marketed more quickly.

Instead, MEPs approved shortening the period to 7.5 years, “which is almost the same duration as the current 8 years [yet] within the framework of the text adopted by Parliament, companies can gain additional months of protection under certain conditions to reach a total of 8.5 years,” UFC-Que Choisir said.

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In Ireland, the government recommended alternative medications and emphasized patient safety during shortages, while the Health Minister acknowledged the global nature of the problem .

International collaboration was also critical.

International collaboration was also critical.

The European Commission proposed a “voluntary solidarity mechanism” to enable EU countries to share vital medicines and established an early warning system for drug shortages .

Title:

Content: Global health campaigners disappointed with WTO deal to waive some patent rules on vaccine exports

A decision by the World Trade Organization (WTO) to waive certain intellectual property (IP) rules in order to widen access to COVID-19 vaccines has been met with disappointment by global health campaigners.

The much-debated Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver was first proposed by India and South Africa in October 2020 to allow COVID-19 vaccines to be manufactured in developing countries without infringing patents held by big pharmaceutical companies, mostly in the global North.

The deal allows governments and vaccine producers to forego the procedural requirement of issuing a compulsory license for the production and exportation of COVID-19 vaccines for a five-year period, but it does not waive any IP rights.

Only 16 per cent of people in low-income countries have received a single vaccine dose, compared to 80 per cent in high-income countries, according to the World Health Organization (WHO).

However, health equity advocates say the so-called “compromise” deal reached at the WTO’s 12th Ministerial Conference in Geneva on 17 June is insufficient to secure production of vaccines and other medicines in developing countries.

“We are disappointed with the limited and inadequate outcome after nearly two years of negotiations at WTO,” said Yuan Qiong Hu, senior legal and policy advisor at Médecins Sans Frontières (MSF).

“There are a number of shortfalls…most notably that it does not waive any IP rights to enable rapid global production scale-up and more independent supply of COVID-19 medical tools.”

Compulsory licensing is used by governments to allow another party to produce a patented product or process without the consent of the patent owner, or to use the patent-protected technology itself. Patents give pharmaceutical companies exclusive rights to manufacture and market their drugs and prevent others from doing so for a period of 20 years.

Even the process to arrive at this outcome has been flawed, discriminatory, lacking in transparency and inclusivity.”

Yuan Qiong Hu, senior legal and policy advisor, Médecins Sans Frontières

WTO director-general Ngozi Okonjo-Iweala said the declaration would make access to medical supplies “more predictable in this pandemic – and in the next one”.

“The TRIPS waiver compromise will contribute to ongoing efforts to deconcentrate and diversify vaccine manufacturing capacity, so that a crisis in one region does not leave others cut off,” she told ministers at the close of round-the-clock negotiations in Switzerland.

But around 300 civil society and public health organizations put their names to a statement condemning the decision and calling on governments to circumvent or “outright defy” the WTO rules.

According to Yuan, the ruling limits the number and scope of flexibilities within the TRIPS agreement to certain countries and within a limited timeframe.

The adopted text also excludes essential medical technologies, such as ventilators and testing kits, limits the range of countries that can make use of the mechanism, and does not cover the full range of IP necessary to enable production and supply, MSF argues. The deal currently only applies to vaccine production and requires WTO members to decide on an extension covering treatments and therapeutics after six months.

“As a result, MSF believes these limitations set a negative precedent for addressing future global health challenges,” said Yuan.

“Even the process to arrive at this outcome has been flawed, discriminatory, lacking in transparency and inclusivity. [Civil society organizations] have been criticized for raising legitimate concerns,” she added.

Stand up to ‘bullying’

Fatima Hassan, founder of the South Africa-based Health Justice Initiative, said it was hard to say whether the outcome was a “waiver” or just a “deal”.

“It will now depend on each country to use what it can in this tiny deal,” she said.

Countries in the global South still lack access to COVID-19 diagnostic tests and treatments, said Hassan, adding: “The best way forward is for every southern government to admit they got bullied, stand up to the big pharma and issue compulsory license now to address testing and treating gaps.”

According to a senior WTO official, who asked not to be identified for bureaucratic reasons, there has been some confusion over what is meant by an IP waiver.

“This is not to get too technical, but the COVID-19 debate has seen multiple versions of this concept, and the real-world differences are incredibly important,” he told SciDev.Net.

He said neither the WTO nor any other international organisation could waive IP rights.

“Depending on what is meant by waiving, this is something that can only be done by national governments, and most likely national parliaments,” he said.

“What was proposed in the WTO was a waiver of international treaty obligations that would open up a wider range of choices for national governments to waive, suspend or curb IP rights — a very different thing.

“Any government wanting to suspend the effect of IP rights would have to take action domestically, either by executive action or through the legislature.”

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Unleashing Automation for ME Pharma Supply Chains: SSI Schaefer & Nahdi Partnership Continues to Drive Growth and Resilience

'Revolutionized' Jeddah facility increases efficiency by 98.5% and reaches 100,000 items of maximum daily picking capacity, Nahdi shares in recent interview

  • Two years after launch, Nahdi's IMDAD facility developed in partnership with SSI Schaefer shows marked gains in capacity, efficiency, and competitive advantage
  • Future-ready automation systems and data analytics are keys to its success
  • Partnership demonstrates potential for digital transformation and automation to transform pharmaceutical supply chains across Middle East

JEDDAH, Saudi Arabia, March 26, 2024 /PRNewswire/ -- SSI Schaefer, a global leader in intralogistics and automated warehouses, is announcing several key milestones of its partnership with Saudi Arabia's Nahdi Medical Company on the 250,000 m2Jeddah-based IMDAD facility - the Middle East's first automated pharmaceutical distribution center. As March 2024 marks the two-year anniversary of its opening, both companies are celebrating their joint achievements:

  • 98.5% increase in warehouse efficiency with automation, helping to meet growing online orders
  • Fully automated order fulfillment capabilities; comprehensive data analysis and real-time inventory tracking; temperature-controlled logistics; and built-in flexibility and scalability
  • 100,000 items of maximum daily picking capacity, exceeding 5,500 shipping totes

To explore starting your automation journey with SSI Schaefer, please contact its experts at info.sg@ssi-schaefer.com.

In a recent interview with Global Supply Chain Magazine, Eng. Yasir Jamal, the Chief Supply Chain Officer at Nahdi, shared his experience working with SSI Schaefer and what has made the project a success. Read the full interview here.

The case for automation in healthcare

Mr. Jamal explained: "Ultimately, automation is the cornerstone in our pursuit of excellence. We firmly believe that it plays a pivotal role in elevating customer satisfaction by ensuring operational efficiency, unwavering compliance with industry standards, and, most crucially, the consistent and timely delivery of critical medical supplies."

"If you're unsure where to begin, SSI Schaefer is the recommended partner of choice to guide you through your design and consultancy phase up till the implementation phase with over 80 years of industry experience."

Enhancing competitive positioning with automation

Elaborating on automation's business impact, Mr. Jamal shared: "The incorporation of SSI Schaefer's solutions has revolutionized our competitive positioning. We've streamlined our operations, which prepared us to be adaptable to changing market demands and trends. On top of that, data-driven decision-making has become integral to our approach. The enhanced customer experience is a direct result of our efforts, and accuracy and timeliness in order fulfillment have been significantly improved."

Digital transformation at IMDAD

Mr. Jamal noted, "Thanks to WAMAS, SSI Schaefer's proprietary logistics software, our maximum daily picking capability is up to 100,000 order lines exceeding 5,500 shipping totes since the pickers do not need to walk down endless aisles to locate and consolidate the products."

"Data is power. Many successful organizations establish their footwork into robotics and automation through the power of data. Likewise, in Nahdi, data helps the company generate insights and exposes gaps for improved performance, higher efficiency, and profitability. The digital transformation has yielded a significant sum of investments in its capabilities, particularly with a strong logistics analytics system."

About SSI Schaefer

The SSI Schaefer Group is a leading global solution provider for all areas of intralogistics. With innovative technologies and software, the company empowers small to medium-sized enterprises as well as large companies to increase the efficiency and sustainability of their storage, picking, and transport processes -- offering complete solutions spanning fully automated warehouses with tailored service and maintenance packages, to robotics and automated guided vehicles, to manual and semi-automatic systems such as workstations, racks, and containers.

For further information, please visit the company's newly updated website: https://www.ssi-schaefer.com/en-asia/

View original content:https://www.prnewswire.co.uk/news-releases/unleashing-automation-for-me-pharma-supply-chains-ssi-schaefer--nahdi-partnership-continues-to-drive-growth-and-resilience-302096849.html

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The World Health Organization provided direct support to countries like Sri Lanka, coordinating international assistance to ensure sufficient medical supplies .

Title:

Content: Brussels is planning for EU countries to share vital medicines and take emergency measures to avoid a repeat of shortages that hit the bloc a year ago.

The European Commission is proposing a “voluntary solidarity mechanism” requested by France and Germany and an early warning system flagging when drugs become scarce, according to draft proposals seen by the Financial Times. If insufficient donors come forward, EU capitals will be allowed to tap into an EU-funded stockpile set up during the Covid-19 pandemic and take other emergency measures.

In December and January western countries suffered a shortage of antibiotics including penicillin and amoxicillin, and painkillers such as paracetamol, especially in medicines used by children.

Among the emergency measures floated to prevent a repeat of that crisis, the commission could allow the extension of a drug’s shelf life, fast track approvals of alternative suppliers and support production increases.

Brussels will also encourage joint procurement of drugs from 2024 and medicine swaps with countries in the southern hemisphere, where peak winter demand happens at a different time.

The commission will draw up guidance for national stockpiles in 2024 and establish a Critical Medicines Alliance bringing governments, industry and civil society together. The commission declined to comment.

Three-quarters of countries reported a worsening of drug shortages in 2022, according to an industry survey. EU manufacturing is heavily reliant on imported active pharmaceutical ingredients from China and India.

Rising demand and disruption to supply chains have been compounded by inflation hitting the production of generic drugs, which typically sell at much lower prices than branded versions.

France has been actively encouraging the reshoring of basic medicine supply, with a giant paracetamol factory set to open in the country next year.

The EU is discussing whether to provide more funding for domestic production.

The commission’s proposal is scheduled to be approved on October 25 and could still change. Initially non-binding, it could lead to a Critical Medicines Act, with Brussels drawing up a list of vital medicines by year-end.

The commission also urges member states and the European parliament to approve its overhaul of pharmaceutical legislation, put forward in April. It includes plans to take control of drug production in the event of a public health emergency, a requirement for stockholders to inform Brussels of supply levels and for manufacturers to give early warnings of shortages.

An analysis by the European Medicines Agency and the commission found that unless there is unexpected demand the EU should avoid an antibiotics shortage this year.

“The information available today suggests that — if demand in the coming winter season does not differ significantly from the demand of recent years — the supply to the EU of key antibiotics seems to generally match demand,” the analysis said.

“However, this depends strongly on the compliance of industry with their legal obligations to ensure supply and their ability to adapt.”

Copyright The Financial Times Limited 2023. All rights reserved.
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The World Trade Organization agreed to waive certain intellectual property rules to expand access to COVID-19 vaccines, allowing developing countries to produce vaccines without infringing patents .

Title:

Content:
Pharma races toward its future

Whether inside the four walls or between locations, the pharma supply chain is becoming increasingly complicated. The reasons range from new Federal regulations to increasing demand for delivering more drugs faster than ever before. This is a game changer.

Talk to the people in the know about trends in pharma these days, and it becomes clear pretty quickly that things are in flux. And we’re not talking a tweak here, a tweak there, either.

These shifts include:

  • The spiraling expiration of patents and the rise of generics,
  • The ascendancy of drugs that require precise cold chain control, and
  • Federal regulations requiring iron-clad track and trace of drugs at the unit level.

Each is a disruptor of the pharma supply chain in its own rite. Taken together, they challenge the industry mightily, and it’s not always possible to take on all challenges at the same time.

For instance, one expert says pharma supply chains are almost focused on creating track-and-trace systems that meet the federal regulations that go into full force in 2023 (see timeline, p. 55). While others say regulations are certainly dominant, but efficiencies of handling drugs and processing orders is not being overlooked by any means. Interestingly enough, those are not contradictory statements.

As it turns out, the two are intertwined. While one (regulations or efficiencies) may be dominant on a given day, the other is part of developing the right solution. It’s a complex web. Bar codes, software and blockchain all figure prominently.

So does automation. Beyond regulations, demands from customers at each stage of the pharma supply chain are continuing to increase, explains Michael Pietras, executive sales manager at SSI Schaefer.

“At all stages, the customer wants shorter shipping times even as distribution points increase along with SKU counts,” Pietras says. While he wouldn’t call the situation manic, Pietras will say that the demands are moving beyond what can be done in conventional manual order fulfillment environments. “The move is away from manual person-to-goods fulfillment to automated goods-to-person,” he adds.

There’s also the Amazon effect with the e-commerce giant’s purchase of PillPack, explains Dan Gilmore, chief marketing officer at Softeon. He explains that, in many cases, supply chain efficiencies have not traditionally been a top-level concern for pharma. However, that is likely to change. After all, PillPack’s tag line is: “Your medication delivered.”

At the same time, pharma growth is strong, says El Marie Hugo, JDA’s senior director of industry strategy. She says overall compound annual growth of the industry is estimated to be between 12% and 14%, “just as pharma is becoming a much more complicated supply chain.”

Sorting it out

Probably the best place to start is regulations. They have had a tortured path to this point and the going is not about to get any easier anytime soon.

It all started with California and Florida establishing their own state track-and-trace regulations almost a decade ago, explains Adam Kline, senior director of product management at Manhattan Associates. However, it became apparent early on that different regulations state-to-state would be debilitating for the industry.

Amid a barrage of lobbying, the federal regulation known as the Drug Supply Chain Security Act (DSCSA) was passed Nov. 27, 2013. As the timeline shows, key milestones include serialized product from manufacturers, repackagers, wholesale distributors and dispensers, all key points in the pharma supply chain. The end point is unit-level traceability, also known as the chain of custody, across the entire supply chain by Nov. 27, 2023.

That said, those federal deadlines are still in flux. In October, the FDA delayed this year’s Nov. 27 deadline requiring wholesale distributors to verify a product identifier. That was pushed out until exactly one year later, according to the Federal Register on Sept. 24, 2019. Obviously, making all this work is real challenge.

That was certainly evident speaking with DMLogic’s Matt Deep, vice president product development. He described all the points at which data about a drug shipment at the unit level could be compromised.

It starts with all the cases on a pallet load and goes all the way down to the individual container for each unit-level dose. Then, there’s the matter of breaking down the supply chain into what is received by the next node, how it’s tracked at that node and then when it is shipped to the next node. Don’t forget about drugs that are returned, accounting for a significant percentage of all volume. “There are just so many opportunities to compromise tracking and tracing of a drug before it gets to its final destination,” says Deep.

Fortunately, the case for making this work goes well beyond the regulations themselves. “This is all about patient safety,” explains Hugo of JDA.

Enter technology

At first, the answer appeared to be RFID. Tag everything, build a pallet load and read all tags at the same time with 100% accuracy. However, RFID was not up to the job.

Today, bar codes are the focus of data collection for the DSCSA. Traditional one-dimensional bar codes are giving way to two-dimensional bar codes. This shift bypasses the need to access a central database to know what is in a shipment with traditional bar codes. Instead, 2D bar codes are a traveling database in and of themselves, providing key data on the spot.

Kline of Manhattan says regulations require that half of all shipments from manufacturers use 2D bar codes by 2019. And by 2023, the regulations require full adoption of 2D codes across the entire pharma supply chain.

Meanwhile, high-speed automated scanners are on conveyor lines and in automated order fulfillment systems, manual data capture still dominates. Quite simply, so much of pharma order fulfillment is still manual person-to-goods operations, explains Mark Wheeler, director of supply chain solutions for Zebra.

The idea, he says, is to outfit people with wearable scanners that speed the scanning process and flow of goods. For instance, Zebra is replacing its standard two-finger ring scanner with a single-finger 2D ring scanner. Bluetooth capabilities speed the movement of data from the point of collection to a data management platform, says Wheeler. “Essentially, those scanners make it economical to capture extended item data at every step of the process,” he adds.

According to Pietras of SSI Schaefer, a shift is underway from pick-to-light, voice and RF systems to collect data in pharma order fulfillment. He says the alternative is automation such as automated storage and retrieval systems (AS/RS) and A-frame item dispensers.

“More aggressive order windows are the trend, yet operations will have to ensure order integrity of the order,” he says. “The answer is often to automate order fulfillment as much as possible, including data capture. The target is 100% order verification right down to the unit-dose level,” says Pietras.

Tecsys, says product strategy manager Jean-Philippe Racette, is primarily focused on the pharmacy supply chain, especially for hospitals, which also must comply with the DSCSA. While track-and-trace capabilities at the unit-dose level benefit from bar codes, so do other activities.

Racette says these include the ability to better manage drug shortages (something that is making its own headlines recently) with demand visibility and distribution planning. It also makes centralized distribution more manageable, reducing unnecessary inventory as well as expired inventory. And centralized distribution is less common now than individual hospital pharmacies doing their own buying and inventory management.

“Hospitals just don’t have access to much of this data now. And while patient safety is paramount, track-and-trace of drugs will have a broader impact on the efficiencies and cost effectiveness of the pharma supply chain,” says Racette.

Building the network

Meanwhile, various points in the pharma supply chain, especially distributors, have “a reasonably strong interest in warehouse management systems (WMS),” says Gilmore of Softeon. He continues to say that many are still running on spreadsheets, but that is changing.

“They’re interested in WMS not for order picking but for traditional inventory management and replenishment capabilities,” continues Gilmore.

“WMS mitigates so many chain-of-custody issues within the four walls,” explains Kline of Manhattan. “The software not only collects and manages data but expedites data handling to improve the flow of inventory and orders,” he adds.

“At the same time,” says Gilmore, “distributed order management (DOM) is gaining interest. From hospitals to distributors and manufacturers, the pharma supply chain needs to be able to look across the entire network to determine where is the place to source today what they need today. They have the same sorts of basic order sourcing challenges that omni-channel retailers do,” Gilmore adds.

Hugo of JDA sees much the same trends, emphasizing the need for improved forward planning. “This is a huge shift for an industry that has not been nearly as focused on forward planning as it will be in the future,” she adds. Drivers here include the shift to new drugs, often called personalized medicine, that will proliferate SKUs at the same time as product life cycles shorten.

One of the more ambitious projects in the pharma supply chain is the MediLedger Project. “Using blockchain, MediLedger provides secure, trusted product data and verification at all nodes in the pharma supply chain,” explains Susanne Somerville. She is CEO of Chronicled, a technology company that writes software for blockchain and started the MediLedger Project.

She continues to say, “Blockchain enables the industry to operate safely in a shared network that will enable improved communication of transactions and business rule enforcement.”

Even though the FDA has pushed out the date for wholesale distributors to verify a product identifier last month, MediLedger went ahead with its plans to do that using blockchain now, says Somerville. She says it will:

  • keep an immutable record of transactions and data,
  • enforce cross-industry business rules without compromising individual company data,
  • protect each participant’s business intelligence, and
  • connect trading partners across the pharma supply chain.

All of that said, pharma is certainly a hot spot in the supply chain today. And, by all indications, that’s going to be case for the foreseeable future.

Companies mentioned in this article

Chronicled
DMLogic
JDA
Manhattan Associates
Softeon
SSI Schaefer
Tecsys
Zebra

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Local production and supply chain innovations were promoted to enhance resilience.

Local production and supply chain innovations were promoted to enhance resilience.

African nations, with international support, focused on increasing local vaccine manufacturing to reduce dependence on imports .

Title:

Content: HealthIn-Depth AnalysisSocial Affairs
Trending

In-depth: A Dollar a Dose, a Life Saved: The search for safer pharmaceuticals amid the challenge of widespread substandard medications

By Million Beyene @MillionBeyene

Addis Abeba – In the world of illicit trade, a dangerous threat looms in the form of substandard and illegally sold pharmaceuticals that endanger millions of lives worldwide.

A recent study conducted by the World Health Organization (WHO) has uncovered the massive scale of this problem, revealing that the illicit drug trade generates nearly a trillion dollars annually.

Surprisingly, this makes it the second-largest illicit financial stream globally, coming in just behind arms sales. However, the true impact of this hidden industry extends far beyond just monetary value.

In sub-Saharan Africa, including Ethiopia, the cost is counted in human lives.

Every year, almost half a million individuals fall victim to the dangerous consequences of using substandard and counterfeit medical products.

The ramifications of this issue are severe, as individuals often unwittingly procure and consume medications that prove to be ineffectual or even detrimental to their well-being.

The recent experience of Getachew Belay, a resident of Addis Abeba, serves as a poignant illustration of the predicament faced by such individuals.

He told Addis Standard about the distressing ordeal of procuring medications at a substantial cost of 90,000 birr, only to find them ineffective in treating his mother’s liver disease.

Regrettably, despite the doctor’s acknowledgment of the ineffectiveness of the “albumin” medication and subsequent refusal to administer it, this intervention was belated.

“Consequently, my mother succumbed to her condition shortly after discontinuing the ineffective treatment and before a suitable alternative could be provided,” recounted Getachew, reflecting on the most devastating experience of his life.

Dr. Mehari Tesfaye (name changed), a prominent medical director at a public hospital in Addis Abeba, shared insights with Addis Standard regarding Ethiopia’s escalating issue of substandard medications.

According to him, a notable example is “albumin,” a vital medicine employed in treating liver disease.

“The substandard variants of this medication are not only ineffective but also potentially harmful,” he emphasized, underscoring the peril associated with such drugs.

A nationwide study conducted in 2013 found that 7.8% of medications in Ethiopia were substandard.

Nevertheless, medical experts interviewed by Addis Standard disclosed that the incidence of substandard drugs has notably increased in Ethiopia over the past decade.

This observation aligns with research findings.

According to a study published last year, 21.8% of the drugs sampled in Ethiopia exhibited failures in one of the product quality parameters: dissolution, disintegration, identity, or chemical assay.

An anonymous medical expert disclosed the extensive availability of substandard, illicitly manufactured, or imported drugs in numerous pharmacies throughout Addis Abeba.

The expert highlighted a particularly troubling trend: the heightened involvement of licensed drug importers in the illicit drug trade, particularly over the past two years.

In Ethiopia, a particularly troubling issue arises from the presence of ineffective medications, even among those legally imported.

Medical experts have apprised Addis Standard of instances where drugs lack medicinal properties, aligning with public grievances about medications failing to provide therapeutic benefits.

Dr. Solomon Tezera (name changed), an infectious disease specialist, is among the medical professionals who express profound concern regarding the prevalence of ineffective medications.

“These concerns extend beyond smuggled drugs to encompass medications legally imported by some organizations,” he states. “Patients diagnosed through lab tests and prescribed medication often fail to experience improvement due to these defective products, resulting in a frustrating situation for both patients and medical staff.”

Patients diagnosed through lab tests and prescribed medication often fail to experience improvement due to substandard medications.”

An infectious disease specialist

Dr. Solomon further emphasizes the critical role of effective medications in managing chronic conditions such as diabetes, hypertension, and heart disease. He underscores that substandard medications for these illnesses can lead to a rapid exacerbation of symptoms.

“Medical professionals have recently identified and reported these problematic drugs to the appropriate regulatory bodies,” he added.

Recently, the Ethiopian Diabetic Association (EDA) also raised concerns about the efficacy of a medication named ‘Galvanez’.

Tackling substandard medications

The Ethiopian Food and Drug Authority (EFDA), a governmental regulatory body responsible for ensuring the safety, quality, and efficacy of medicines, has addressed these concerns.

Officials from the EFDA have stated that no official reports regarding the specific medication in question have been filed.

Gezahegn Endale, the head of the EFDA’s South East Addis Abeba Branch Office, affirmed, “No reports of substandard or defective medications related to Galvanez have been presented to the authority thus far.”

While no issues with Galvanez have been reported, the EFDA has noted a concerning trend of unauthorized drugs entering the country. These drugs often lack registration, approval from their country of origin, and information about their manufacturers.

Additionally, the EFDA recognizes the ongoing challenge of smuggled medications, particularly those targeting critical areas such as cancer treatment. The Authority has stated its active efforts to strengthen controls at border entry and exit points.

In a recent statement, the EFDA underscored its commitment to “identifying and removing any smuggled drugs to safeguard public health.” The authority highlighted its rigorous protocols for ensuring the safety and efficacy of all medications entering the Ethiopian market.

This includes thorough pre-market registration checks, which meticulously examine a drug’s production methods, ingredient lists, and accompanying scientific documentation before granting a market license.

Furthermore, to ensure quality, imported medications undergo extensive sampling, testing, and verification procedures beyond registration. Additionally, the EFDA conducts physical inspections at entry and exit points to enhance its safeguards.

Acknowledging the challenge of precisely quantifying the volume of smuggled drugs, officials at the EFDA assert that their regulatory measures are more stringent compared to those of neighboring countries. They underscore their “continuous endeavors to ensure the quality, safety, and efficacy of medications” across the entire supply chain.

However, stakeholders emphasize that the shortage of legally imported medications has compelled certain private pharmacies, licensed drug importers, and domestic drug producers to resort to smuggled alternatives.

Dr. Mehari underscored the challenges Ethiopia encounters in securing an adequate supply of legal medications.

“This susceptibility exposes the population to the hazards of smuggled drugs,” he elucidated. “Patients who unwittingly depend on substandard medications are at an elevated risk of complications.”

Gezahegn acknowledges the potential vulnerabilities within the distribution system and unethical practices by some wholesalers, such as auctioning off medications of dubious origin to retailers, which could introduce smuggled or unregistered drugs.

“The recent license revocation of four wholesalers supplying unregistered drugs to St. Paul Millennium Medical College’s Hospital exemplifies the EFDA’s commitment to addressing such practices,” he highlights.

Forex shortage, soaring prices

However, Gezahegn attributes a significant factor in such health risks to the scarcity of foreign currency in the country.

“This limitation restricts the ability of importers to acquire essential medications in sufficient quantities, potentially leading to drug shortages,” he explains.

Ethiopia meets the yearly requirement for medications and medical equipment primarily through imports, as domestic production satisfies only 15% of the national demand.

The Ethiopian Pharmaceuticals Supply Service (EPSS) oversees the acquisition of drugs and medical equipment, whether sourced locally or imported.

The scarcity of foreign currency in the country restricts the ability of importers to acquire essential medications in sufficient quantities, potentially leading to drug shortages.”

Gezahegn Endale, the head of the EFDA’s South East Addis Abeba Branch Office

Annually, EPSS supplies over 1,000 medicines and medical equipment to more than 5,000 public health institutions. In the previous year, it allocated over 40 billion birr for the procurement of drugs and medical equipment, with drug procurement alone amounting to over 15 billion birr.

Dr. Solomon further contends that the limited availability of foreign currency is hampering the capacity of local pharmaceutical manufacturers to import essential raw materials necessary for drug production.

Leaders of the Ethiopian Pharmaceutical Manufacturers Association also attribute their underperformance to the unavailability of foreign currency. They highlighted that 85% of the challenges they face are related to foreign currency shortages.

Mukamil Abdella, vice president of the association, recently stated in a state media interview that foreign currency is not accessible in the required quantity and timeframe for procuring raw materials essential for medicine production, adversely affecting their operations.

Another senior manager from a local pharmaceutical company disclosed that his firm requested $21 million for the acquisition of raw materials and other essentials. However, after an 11-month waiting period, the company was only allocated $5 million, which proved insufficient.

The persistent scarcity of foreign currency in Ethiopia continues to render the nation vulnerable to the influx of smuggled drugs, exacerbated by disruptions in the global supply chain that have led to inflated prices for pharmaceutical products.

Studies indicate that disruptions caused by the COVID-19 pandemic, further compounded by the Russia-Ukraine conflict, have resulted in a more than 200% increase in drug costs.

During his appearance before parliament to present the central bank’s quarterly report in November 2023, Mamo Mihretu, the governor of the National Bank of Ethiopia (NBE), acknowledged the escalating pharmaceutical costs, which are depleting the country’s foreign currency reserves.

According to Mamo, the costs of three key import items for Ethiopia—pharmaceuticals, petroleum, and fertilizers—have more than doubled in the past three years.

Although acknowledging that Ethiopia encounters obstacles in ensuring a consistent provision of legally imported medications due to factors such as limited foreign currency reserves, public health experts contend that these challenges should not serve as justification for the increase in illegal drug trafficking and the availability of substandard drugs in pharmacies.

Officials, however, assert that they are actively addressing the issue of smuggled medications despite the persistent challenge of detecting and eliminating any illicit drugs that may already be present within the country.

“The Authority is intensifying surveillance at entry points to deter smuggling,” stated Gezahegn. AS

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In South Africa, advocates called for increased local production of antiretroviral drugs .

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U.S. cancer centers report ongoing shortage of chemotherapy drugs

By Cara Murez, HealthDay News
In all, 72% of cancer centers surveyed reported a continued shortage of carboplatin. And 59% were still seeing a shortage of cisplatin. Photo by klbz/Pixabay

U.S. cancer centers continue to have shortages of commonly used chemotherapy drugs, a new survey shows, though the medications are not as scarce as they were last June.

The National Comprehensive Cancer Network (NCCN), a nonprofit alliance of leading cancer centers, surveyed its network in September.

In all, 72% of cancer centers surveyed reported a continued shortage of carboplatin. And 59% were still seeing a shortage of cisplatin.

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These two platinum-based generic chemotherapy medications are recommended for treating many different cancers. Overall, 86% of centers surveyed said they were short on at least one type of anti-cancer drug. A survey in June showed that 93% of cancer centers had a shortage of carboplatin, and 70% of cisplatin.

"Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines," said Dr. Robert Carlson, chief executive officer for NCCN.

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"Drug shortages aren't new, but the widespread impact makes this one particularly alarming. It is extremely concerning that this situation continues despite significant attention and effort over the past few months. We need enduring solutions in order to safeguard people with cancer and address any disparities in care," Carlson said in a NCCN news release. Twenty-nine of the NCCN's member institutions responded to the September survey. They include leading academic centers across the United States. The findings may not reflect additional challenges that smaller community practices serving rural and marginalized patients are experiencing. The centers surveyed were using strict waste management strategies, so nearly all were still able to provide the medications to all patients who needed them. Other medications in short supply included methotrexate, with 66% of centers reporting a shortage; 5-fluorouracil, with 55% falling short; fludarabine at 45%; and hydrocortisone at 41%.

"These drug shortages are the result of decades of systemic challenges," said Alyssa Schatz, NCCN's senior director of policy and advocacy. "We recognize that comprehensive solutions take time."

Schatz said the network appreciates those who have put forth proposals to improve investment in generics.

"At the same time, we have to acknowledge that the cancer drug shortage has been ongoing for months, which is unacceptable for anyone impacted by cancer today," Schatz said. "These new survey results remind us that we are still in an ongoing crisis and must respond with appropriate urgency."

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The organization is continuing to advocate for more supplies.

CNN recently reported that two other drugs used for cancer, vinblastine and dacarbazine, went into shortage in September.

"These drugs are particularly used to treat patients with Hodgkin's lymphoma. Hodgkin's lymphoma is probably one of the most curable types of cancers out there," Dr. Doug Hawkins of the Children's Oncology Group, a research organization, told CNN.

"The problem is never-ending. It is horrible," he added. "I mean, to say to a patient, 'we know how to treat your child, but we can't get the drugs,' and this is America, and it's 2023 -- it's crazy."

More information

The White House has more on strengthening the supply chain for cancer drugs.

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India emphasized boosting domestic production of key raw materials to reduce reliance on imports and prevent future shortages .

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Karnataka Government Faces Heat Over Shortage Of Medicines In Govt Hospitals

Pharma companies blame state medical supplies corp for not clearing dues, say won’t participate in tender until payments are cleared.

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Prajwal Prasad

Karnataka health minister Dinesh Gundu Rao blamed KSMSCL for delay in floating tenders. (Image: PTI/File photo)

Even after three months of the formation of the new government in Karnataka, the state still seems to be grappling with a shortage of medicines in government medical facilities. The Congress-led government has also admitted that there’s a scarcity of life-saving drugs in the state.

A total of 733 medicines worth Rs 600 crore was needed for the current year in the state. However, due to the alleged negligence of the officials of the Karnataka State Medical Supplies Corporation (KSMSCL) under the health department, there is a shortage of medicines to treat serious ailments in government hospitals. As a result, patients are reportedly struggling to get life-saving medicines.

Delay in clearing dues discourage pharma companies from participating in tenders

In addition, pharma companies have reportedly been reluctant to participate in tenders due to delays in disposal of pending bills, with the number of companies participating in the tender coming down this year as compared to last year. A representative from a pharma company, speaking to Republic on the condition of anonymity, said, "Many of our bills are pending despite giving the requisite documents and stocks allotted details to the officials. This will result in huge losses for the firm and this is not the first time such a thing is happening. We will participate in the tender only when the bills are cleared."

KSMSCL procures various medicines, including bandage cloth, cotton, surgical gloves, antibiotic tablets and medical equipment, and supplies them to government hospitals. However, the corporation was supposed to complete the tender process by May this year and procure and stock all kinds of medicines and medical equipment, whereas the corporation is running late by three months.

Will float tender once in two years to tackle medicine shortage: State health minister

Karnataka Health Minister Dinesh Gundu Rao, speaking to the media, said, "It is true that there is a shortage of medicines in the state. Due to the negligence of some officials of KSMSCL, the tender could not be completed within the stipulated time and the medicines could not be stocked. In the coming days, tenders will be called once in two years instead of annual tenders to prevent shortage of medicines."

Pending bills for pharma companies yet to be cleared

As the corporation is dragging its feet on the process of clearing bills, pharma companies that have supplied 100 per cent of the medicines to KSMSCL are allegedly not being paid on time. Security deposits and EMDs are also pending. Though there is a rule that those supplying medicines have to be paid within 30 days, it is reportedly not being followed. An estimated Rs 30-40 crore was supplied to 'Namma clinics' under the National Health Mission (NHM) by the corporation. The medicine and medical equipment bills have not been paid yet. Also, no funds have been released to the corporation by the health department. Rs 90 crore for medicines and Rs 40 crore for medical equipment, which sums up to a total of Rs 130 crore, are pending and yet to be released by the health department.

Relatives of patients running from pillar to post for medicines

There is an apparent shortage of medicines for various ailments in government hospitals. Apart from tablets, there’s a paucity of injections, glucose, bandages and surgical equipment.

Attendants, caretakers and relatives of patients are complaining that they are struggling to find life-saving drugs and over-the-counter medicines. Beerappa, a caretaker, speaking to Republic, said, “We are being made to run around for some medicines as they are not available easily at hospitals. This causes a lot of problems for us, and when we question the pharmacist, they say there's no stock. We urge the government to take stock of the situation and not play with the lives of innocents."

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In the Philippines, drone technology was deployed to deliver vaccines and medical supplies to remote areas, improving access in rural communities .

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Content: Spokane, Washington  Est. May 19, 1883
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News >  Nation/World

Parents looking for children’s Tylenol, ibuprofen find empty shelves

Dec. 1, 2022 Updated Thu., Dec. 1, 2022 at 9:17 p.m.

By Jenna Portnoy, Daniel Gilbert, Ellie Silverman and Katie Shepherd Washington Post

People seeking over-the-counter medication for their sick children are often finding sparse or empty shelves, as a spike in respiratory illnesses pushes pediatricians and emergency rooms to the limit.

Usual supplies of fever- and pain-reducing medicines, such as liquid acetaminophen and ibuprofen recommended for children with RSV, flu or the coronavirus, have not kept up with demand in recent weeks in pockets of the country hit hardest by surging illnesses.

Unlike in Canada where the government has issued emergency orders to address a shortage of acetaminophen and ibuprofen, commonly known by the name brands Tylenol and Advil, and similar products, U.S. manufacturers and retailers emphasized that supplies should rebound within weeks. On the prescription side, increased demand for the antibiotic amoxicillin has caused shortages in the United States, Canada and parts of Europe.

In the meantime, pediatricians say they worry limited access to medicines could result in more urgent-care and emergency visits as parents struggle to keep sick children comfortable.

“It’s a huge problem,” said Kristina Powell, a pediatrician in Williamsburg, Virgina, and president of the Virginia chapter of the American Academy of Pediatrics. “This is a result of the ‘triple-demic.’ Parents run to Walmart or Target, the shelves are empty. … This is going to be a long fall and winter of viral infections.”

A crop of influenza-like illnesses, which includes RSV, hit the South and Southeast hard a month ago, federal data show, and those illnesses have slowly progressed westward. By mid-November, Texas, New Mexico and Tennessee reported the highest incidence of illness, while levels remained very high in Virginia and D.C., followed closely by Maryland, according to data tracked by the Centers for Disease Control and Prevention.

Kylie Moriarty, 30, of Buffalo, Misssouri, searched her local Walmart for Tylenol or ibuprofen to treat her sick 9-year-old daughter and found nothing but empty shelves. That seemed odd, she said, because just last week she had no trouble buying the same products for her 2-year-old son in a merry-go-round of illnesses affecting families with young children.

“I was very frustrated that it’s 2022 and we can’t keep something in stock for parents to help their children get better,” she said in a phone interview. “It makes me want to cry, almost, because these are my kids.”

She and her husband called other pharmacies looking for medicines to soothe the girl and couldn’t find any guaranteed availability.

“When they’re sick, there’s only so much that loving on them and cuddling with them you can do. So when there’s no medicine or something that you can give them … it’s hard,” Moriarty said.

Feeling powerless, the couple gave up and cautiously shared their younger child’s more concentrated medicine with the older one, which seemed to help. Just as they began to relax, their little boy came home from day care with a fever. Moriarty plans to schedule an appointment with his pediatrician for treatment – and samples to take home.

The ordeal reminded her of the height of the pandemic when supply chain problems left consumers scrambling for toilet paper and other basics.

Generic varieties play a large role in the market for over-the-counter comfort drugs, and that industry runs on profit margins so lean that companies typically lack capacity to boost production on short notice, according to supply chain experts. That left shelves bare during the early days of the pandemic.

The same dynamic is playing out now as RSV, flu and the coronavirus hit simultaneously, prompting sporadic shortages of commonly used ibuprofen and Tylenol at some hospitals and retail stores.

The extent of those shortages isn’t clear. The Food and Drug Administration hasn’t reported any shortages of fever or pain medications. Drugmakers, pharmacists and industry organizations say there aren’t any constraints to manufacturing and expect supplies to rebound within weeks.

The University of Utah’s Drug Information Service, which tracks drug shortages, received its first report of a shortage of liquid ibuprofen – generally for children – on Monday, and quickly confirmed it with several manufacturers. Most of the drugs tracked by the service are purchased in large quantities by hospitals, but some formulations had over-the-counter labels. Erin Fox, the service’s director, said it was impossible to know how widespread retail shortages were given the variety of store-branded versions.

“There are definitely distribution and supply chain problems that still exist,” she said, such as a company not being able to hire enough drivers. “These shortages seem to be mostly a demand spike and should resolve relatively quickly,” she added.

Until then, both chain stores and independent pharmacies are dealing with the unpredictability of high demand and uncertain supplies.

Martin McCarthy struck out at 5 p.m. Wednesday when he stopped by Brookville Pharmacy in Chevy Chase, Maryland, looking for liquid Motrin for his 10-year-old son, who probably picked up a bug at school.

The pharmacy’s stock of children’s fever reducers was depleted after two busy weeks of parents and grandparents stopping in to buy Tylenol or Motrin for little ones suffering from colds, RSV, flu and other viruses.

By Wednesday evening, only three boxes of generic ibuprofen chewables, two boxes of generic acetaminophen chewables and six boxes of suppository acetaminophen remained. Other parents peeked down the aisle looking for liquid fever reducer and fever reducer for children younger than 3, only to leave empty-handed.

McCarthy scanned the cold-medicine aisle for a few minutes and called home to confirm that his son would tolerate grape-flavored chewable tablets instead of the liquid Motrin he was used to.

“It is surprising because it’s basically completely out,” he said. “And it’s just generic.”

A spokeswoman for Walgreens said McCarthy’s experience is typical. Even if their usual choice of medication is unavailable because of high demand, parents can usually find an alternative.

“Although demand for pediatric OTC medications have increased, Walgreens is prepared and able to continue meeting the needs of our customers and patients. We are working with our diverse set of suppliers and distributors to ensure our patients have the products they need most,” Walgreen spokeswoman Zoe Krey said in a statement.

Martha Welman, a pediatrician and medical director at Neighborhood Health, a primary care provider serving low-income and underinsured patients in Alexandria, Arlington and Fairfax, said staff will sometimes call pharmacies to find medicines for patients – a time-consuming process at a busy time.

“If it’s between helping someone find a medicine or seeing a sick child, we have to make that choice. We’re all kind of compromising right now,” she said.

Perrigo, an Ireland-based manufacturer of over-the-counter products, said “shortages are occurring in a number of markets we supply” because of high demand. The company has increased production of medications for fever and pain by 46% through October compared with a year ago, and increased shipments by a similar rate.

The Consumer Healthcare Products Association, which represents companies making over-the-counter drugs, said parts of the country are seeing a rise in pediatric illnesses but that there aren’t “overall widespread shortages here in the United States” of children’s pain relievers.

“We understand it might be frustrating for some parents who are unable to quickly locate these products from their usual pharmacy or retailer due to limited out-of-stocks in some stores,” the association said in a statement, but it emphasized the importance of calling around for medications and not hoarding, which could lead to widespread shortages.

Elizabeth Murray, a pediatric emergency medicine physician at Golisano Children’s Hospital in Rochester, New York, said from the bed shortage to overflowing emergency rooms, the last thing parents need is another hurdle. But until the early and aggressive onset of respiratory illness abates, health care providers and parents have no choice but to ride it out together.

“Everyone would like to have one thing to blame and there isn’t one thing to blame,” she said. “This is happening for a variety of reasons and we’re going to move through it and we’re going to be OK.”

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Technological innovations played a growing role.

Technological innovations played a growing role.

AI and automation improved inventory management and procurement, enabling hospitals to better match supply with demand and reduce operational expenses .

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.

Blockchain, IoT, and digital tracking systems enhanced supply chain transparency and security .

Title:

Content: NGO donates sickle cell medicine, GMCH now buying tabs locally

Nagpur: Social organizations are coming forward to help poor sickle cell patients at both the government medical colleges that have been facing shortage of Hydroxyurea, a life-saving drug.
TOI was the first to report about shortage of Hydroxyurea on July 27. On Friday, Janmanch donated 2,000 tablets of the medicine to GMCH. Even as the hospital has accepted the generous donation from the NGO, its administration also started procurement of the medicines on a large-scale.
Dr Atul Rajkondawar, medical superintendent of GMCH, said that the hospital is buying medicines from the market bypassing the time-consuming procurement process through Haffkine Bio-Pharmceutical Corporation Ltd. “We have enough stock of medicines now. Whatever shortage remains will end within a week,” he said.
Patients too told TOI that Saturday they have received at least two-week dose of the medicine.
GMCH dean also responded to memorandum of demands submitted on behalf of the Sickle Cell Society of India. “The medicines required for the sickle cell patients were not provided by Haffkine. To avoid shortage, the hospital has procured the medicines from the market as part of its local purchase. Now, medicine enough for 700 patients is available in the hospital,” reads the letter signed by the dean.
While all major purchases for the medical colleges must come through the Haffkine, the deans have powers to make emergency purchase up to Rs1 crore.
Rajeev Jagtap, president of Janmanch, said that he came to know about the medicine crisis through the TOI report. “We immediately decided to buy 2,000 tablets and donate them to GMCH so that poor patients coming from the villages don’t suffer. Our general secretary Vitthalrao Jawalkar, Milind Raut and Tamnuji Jagtap were present when the tablets were donated at GMCH. We also discussed several patient-related issues,” said Jagtap.
He also appealed to social organizations to donate tablets to GMCH as the requirement is big.
“The crisis has ended for now but the permanent solution is to ensure enough medicines for 5,000-odd patients in Nagpur district alone. We have enough funds for sickle cell patients but they should be used properly,” said Jaya Ramteke of Sickle cell society.
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Cold chain logistics were upgraded with temperature monitoring sensors and data loggers to ensure the integrity of temperature-sensitive products like vaccines .

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How Can Drones Deliver Life-Saving Vaccines In The Philippines?

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Drone operators, led by a doctor, are expanding the use of drones to delivering vaccines in the Philippines.

Over 60 million people in the Philippines live in rural areas, with many having limited access to vaccines.

Heidi Sampang, a medical doctor, managing director of Philippines Flying Labs and country program manager for Remote Area Medical, says the team delivered medicines and COVID-19 vaccines in two areas: an inter-island delivery in the province of Tawi-Tawi; and the mountainous terrain of Agusan Del Sur in Mindinao.

"We were successful in showing that using drones is an efficient, accurate, and safe way of service delivery in these islands and mountain communities at a five kilometer distance," she says, adding that they are the first organization to carry out medical drone deliveries in the country, with the Civil Aviation Authority of the Philippines (CAAP) granting beyond visual line of sight permissions for drone deliveries.

Sampang explains that as early as 2018, when Philippines Flying Labs was founded, the team wanted to use unmanned aerial vehicles to deliver these vital medical supplies in remote areas and decided on a retrofitted DJI M300 as a cargo drone.

"The cost of the project and the lack of technical people/pilots in these communities can limit the implementation of these services in these areas," she says, "But if the technology becomes more affordable and easier to operate, there will be lots of remote communities can benefit from it (not just in the Philippines but globally)."

The team is now moving ahead to expand the project.

"Based on what we learned from our set up, we are getting a more durable drone with longer battery life, travel longer distances with good connectivity, heavier payload capacity and cheaper drone so we can reach more remote communities," she says, "This new drone that we are testing will be more lay person friendly where one person can operate it eliminating the need for a second pilot.

Solutions from The Philippines

Sampang grew up in a farm community in Central Luzon, Philippines and was admitted to the country's science high school, Philippine Science High School.

"I took Molecular Biology and Biotechnology for college but then I decided to pursue medical school because I wanted to help people get better," she says, adding that she did her pediatric residency in New York, USA and went on to private practice in Virginia, USA, for 15 years.

"I went back to the Philippines and established Remote Area Medical, where I bring medical volunteers to the remote areas of the Philippines (GIDCA, geographically isolated, disadvantaged, and conflict areas) in the Philippines," she says, "During these trips, I observed a shortage of medical supplies in these last-mile communities especially in the island and mountain communities because of the lack of roads."

Sampang says local people are crucial in investigating and addressing common issues affecting their communities because of their holistic understanding of the problem , cultural sensitivity and trustworthiness.

"While international expertise and perspectives can bring valuable insights and resources, a collaborative approach that includes and values the input of local experts is often more effective in creating sustainable solutions that resonate with the community's needs and aspirations," she says.

Burkina Faso

On the other side of the world, Claudel Guiella, training coordinator at Burkina Faso Flying Labs in Africa's Sahel region, is leading a group of drone operators is making the surveying of land for irrigation and agriculture more accurate, quicker and cheaper.

He explains that agriculture based on a water management system is crucial to the socio-economic development of communities there.

"In 2023, we sought to exploit drone technology in the agricultural development sector, by working with the Projet de Développement Agricole de Soum, which has developed an irrigation scheme covering more than 1,000 ha in the village of Soum, benefiting more than 5,000 rural households," he says, adding that with conventional surveying techniques, engineers have to cover great distances, often dozens of miles on foot to survey points.

The drones, flying 360 feet above the ground, measured the physical or natural features of the land with under two inches of absolute accuracy, ending up with an accurate result, an 80% saving on the usual budget allocation and quicker delivery than conventional techniques.

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Automation in distribution centers, such as the partnership between SSI Schaefer and Nahdi Medical Company in Saudi Arabia, significantly increased warehouse efficiency .

Title:

Content: Cold Chain for Pharmaceuticals Markets, 2035:

Dublin, Feb. 27, 2024 (GLOBE NEWSWIRE) -- The "Global Cold Chain Market for Pharmaceuticals: Distribution by Type of Primary Packaging, Type of Secondary Packaging, Type of Usability and Key Geographical Regions: Historical Trends (2019-2022) and Forecasted Estimates (2023-2035)" report has been added to ResearchAndMarkets.com's offering.

The global cold chain market for pharmaceuticals is estimated to be worth $6.2 billion in 2023 and expected to grow at a compounded annual growth rate (CAGR) of 3.7% during the forecast period (2023-2035).

This market report features an extensive study of the current market landscape, market size and future opportunities associated with the temperature controlled packaging in pharma cold chain market, during the forecast period. Further, the market report highlights the efforts of several stakeholders engaged in this rapidly emerging segment of the pharmaceutical packaging industry.

One of the primary objectives addressed in this market report was the estimation of the current market size and the future growth potential within the cold chain market for pharmaceuticals in the upcoming years. Through a thorough consideration of various parameters, anticipated adoption trends, and validated by primary research, the report provides informed estimates on the expected evolution of the cold chain market for pharmaceuticals during the forecast period from 2023 to 2035.

Recent advancements in the cold chain monitoring market have revolutionized the cold chain industry. In this context, the advent of temperature monitoring sensors / devices, such as data loggers and indicators has enabled real-time monitoring and tracking of packaged products during shipment, increasing the overall efficiency of the cold chain.

However, there are still some challenges associated with the packaging and temperature monitoring of pharmaceuticals in cold chain storage, including risk of damage, contamination, and disrupted temperature control. This can be validated from the fact that, in some countries, about 80% of the drugs are assessed to lose their effectiveness due to inadequate packaging as well as temperature control during their cold chain transportation. Further, several unanticipated challenges, such as equipment breakdown and excessive heat exposure may lead to the disruption in cold chain.

Therefore, in order to circumvent these challenges, industry players have been actively engaged in the development of hybrid solutions. These solutions involve the use of temperature data loggers integrated within the cold chain shippers / insulated containers for improved visibility and efficient tracking of pharmaceutical shipment in the cold chain industry, posing as a promising alternative over conventional packaging solutions.

Given the ongoing pace of innovation in this field, coupled with the encouraging market growth of cold chain market in pharmaceutical industry and the continuous efforts of industry players, the cold chain market for pharmaceuticals is expected to witness significant growth during the forecast period.

Key Market Insights

Overall Market Landscape of Insulated Containers/Cold Chain Shippers Providers:

  • Presence of over 35 companies, with 58% established before 2000.
  • 51% of pharma cold chain companies based in North America.
  • Majority (68%) provide passive cold chain solutions, while 27% offer hybrid solutions.
  • Expansion initiatives and sustainable packaging alternatives drive market growth.

Overall Market Landscape of Data Logger Providers:

  • More than 65 companies, with majority offering data loggers.
  • 44% established before 2000, showcasing experience in cold chain monitoring.
  • 40% of data logger providers for pharmaceutical cold chain shipment monitoring based in Europe.
  • Novel temperature data loggers expected to drive market growth.

Key Drivers for Cold Chain Market Growth:

  • Increasing demand for temperature-controlled packaging due to biologics and cell and gene therapies.
  • Shift towards cryogenic storage for biologics.
  • Import/export needs driving cold chain transportation industry.
  • Innovation in cold chain technologies promoting adoption and application.

Advantages of Cold Chain Packaging Solutions:

  • Maintain quality, integrity, and efficacy of products.
  • Streamline packaging process and ensure compliance.
  • Real-time visibility and tracking enhance safety.
  • Focus on sustainability and recyclability reduces carbon footprint.

Pharma Cold Chain Market Trends:

  • Continuous upgrading of cold chain technologies by industry stakeholders.
  • Development of novel cold chain packaging solutions with real-time monitoring capabilities.
  • Passive solutions currently dominant, but hybrid solutions expected to gain market share.

Increasing Partnerships and Collaborations:

  • Strategic alliances to provide multiple services and expand portfolios.
  • High acquisition activity to enhance geographical reach and product offerings.

Cold Chain Market for Pharmaceuticals Market Size:

  • Expected annualized growth rate of over 3.7% during 2023-2035.
  • Cold boxes to drive market growth.
  • Vials predominant primary packaging solution, capturing 40% market share.
  • North America holds largest market share, with Europe growing at 4.5% annually.

Key Companies Profiled

  • Cold Chain Technologies
  • Cryopak
  • CSafe
  • EMBALL'ISO
  • Intelsius
  • Nordic Cold Chain Solutions
  • Peli BioThermal
  • SEE
  • SOFRIGAM
  • Sonoco Thermosafe
  • Tempack

Key Attributes:

Report AttributeDetails
No. of Pages255
Forecast Period2023 - 2035
Estimated Market Value (USD) in 2023$6.2 Billion
Forecasted Market Value (USD) by 2035$9.59 Billion
Compound Annual Growth Rate3.7%
Regions CoveredGlobal

Key Topics Covered:

1. PREFACE

2. RESEARCH METHODOLOGY

3. ECONOMIC AND OTHER PROJECT SPECIFIC CONSIDERATIONS
3.1. Chapter Overview
3.2. Market Dynamics

4. EXECUTIVE SUMMARY

5. INTRODUCTION
5.1. Chapter Overview
5.2. Introduction to Cold Chain Packaging
5.3. Historical Timeline of Cold Chain
5.4. Cold Chain Solutions for Pharmaceutical Industry
5.5. Applications of Cold Chain in Pharmaceutical Industry
5.6. Current Challenges and Future Perspectives

6. OVERALL MARKET LANDSCAPE: COLD CHAIN CONTAINER/SHIPPER PROVIDERS
6.1. Chapter Overview
6.2. Cold Chain Container/Shipper Providers: Overall Market Landscape

7. OVERALL MARKET LANDSCAPE: DATA LOGGER PROVIDERS
7.1. Chapter Overview
7.2. Data Logger Providers: Overall Market Landscape

8. COMPETITIVE BENCHMARKING
8.1. Chapter Overview
8.2. Assumptions and Methodology
8.3. Competitive Benchmarking of Cold Chain Container/Shipper Providers
8.3.1. Competitive Benchmarking: Players based in North America (Peer Group I)
8.3.2. Competitive Benchmarking: Players based in Europe (Peer Group II)
8.3.3. Competitive Benchmarking: Large Players based in Asia-Pacific and RoW (Peer Group III)
8.4. Concluding Remarks

9. COMPANY PROFILES
9.1. Chapter Overview
9.2. Cold Chain Technologies
9.2.1. Company Overview
9.2.2. Product Portfolio
9.2.3. Service Portfolio
9.2.4. Recent Developments and Future Outlook
9.3. Cryopak
9.4. CSafe
9.5. EMBALL'ISO
9.6. Intelsius
9.7. Nordic Cold Chain Solutions
9.8. Peli BioThermal
9.9. SEE
9.10. SOFRIGAM
9.11. Sonoco Thermosafe
9.12. Tempack
9.13. Other Leading Players
9.13.1. Almac
9.13.2. B Medical Systems
9.13.3. BioLife Solutions
9.13.4. CRS Mobile Cold Storage
9.13.5. Desert Valley Tech
9.13.6. Dubai Instruments
9.13.7. Envirotainer
9.13.8. Global Cold Chain Solutions (Headquartered in Australia)
9.13.9. Global Cold Chain Solutions (Headquartered in Singapore)
9.13.10. Klinge
9.13.11. Krautz-temax
9.13.12. Meds2go
9.13.13. phasetwo
9.13.14. Polar Tech Industries
9.13.15. Skycell
9.13.16. UPS Healthcare

10. PARTNERSHIPS AND COLLABORATIONS
10.1. Chapter Overview
10.2. Partnership Models
10.3. Cold Chain for Pharmaceuticals: Partnerships and Collaborations
10.4. Cold Chain for Pharmaceuticals: Acquisitions

11. PATENT ANALYSIS
11.1. Chapter Overview
11.2. Scope and Methodology
11.3. Cold Chain for Pharmaceuticals: Patent Analysis
11.4. Cold Chain for Pharmaceuticals: Patent Benchmarking Analysis
11.5. Patent Valuation Analysis

12. REGULATORY RECOMMENDATIONS AND GUIDELINES
12.1. Chapter Overview
12.2. Regulatory Guidelines Issued by International Authorities
12.3. Regulatory Guidelines Issued by Regional Authorities
12.4. Recommendations for Different Steps of Cold Chain
12.5. Comparative Analysis of Regulatory Authorities

13. UPCOMING TRENDS AND FUTURE GROWTH OPPORTUNITIES
13.1. Chapter Overview
13.2. Connected Cold Chain: Key Tools and Technologies
13.2.1. Artificial Intelligence
13.2.2. Augmented Reality
13.2.3. Automation and Robotics
13.2.4. Big Data Analytics
13.2.5. Block Chain Technology
13.2.6. Cloud Computing
13.2.7. Internet of Things
13.2.8. Radio Frequency Identification (RFID) Tags
13.3. Connected Cold Chain: Future Growth Opportunities
13.4. Real-Time Monitoring: An Application of Connected Cold Chain Solutions
13.4.1 Methods for Integration of Real-Time Monitoring in Cold Chain
13.4.1.1. RFID Based Real-Time Monitoring
13.4.1.2. Blockchain And IoT Based Real-Time Monitoring
13.4.2. Growth Opportunities for Real-Time Monitoring in Connected Cold Chain
13.4.3. Cost Benefits of Real-Time Monitoring in Cold Chain

14. MARKET IMPACT ANALYSIS: DRIVERS, RESTRAINTS, OPPORTUNITIES AND CHALLENGES
14.1. Chapter Overview

15. COLD CHAIN MARKET FOR PHARMACEUTICALS
15.1. Chapter Overview

16. COLD CHAIN MARKET FOR PHARMACEUTICALS, BY TYPE OF PRIMARY PACKAGING
16.1. Chapter Overview
16.2. Key Assumptions and Methodology
16.3. Vials
16.4. Ampoules
16.5. Pre-filled Syringes
16.6. Bags
16.7. Data Triangulation

17. COLD CHAIN MARKET FOR PHARMACEUTICALS, BY TYPE OF SECONDARY PACKAGING
17.1. Chapter Overview
17.2. Key Assumptions and Methodology
17.3. Cold Boxes
17.4. Vaccine Carriers
17.5. Insulated Containers
17.6. Data Triangulation

18. COLD CHAIN MARKET FOR PHARMACEUTICALS, BY TYPE OF USABILITY
18.1. Chapter Overview
18.2. Key Assumptions and Methodology
18.3. Reusable Containers/Shippers
18.4. Single-use Containers/Shippers

19. COLD CHAIN MARKET FOR PHARMACEUTICALS, BY KEY GEOGRAPHICAL REGIONS
19.1. Chapter Overview
19.2. Key Assumptions and Methodology

20. CONCLUSION

21. EXECUTIVE INSIGHTS
21.1. Chapter Overview
21.2. EMBALL'ISO
21.2.1. Company Snapshot
21.2.2. Interview Transcript
21.3. Tower Cold Chain
21.3.1. Company Snapshot
21.3.2. Interview Transcript

22. APPENDIX 1: TABULATED DATA

23. APPENDIX 2: LIST OF COMPANIES AND ORGANIZATIONS

For more information about this report visit https://www.researchandmarkets.com/r/6gbsc9

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Community and civil society initiatives addressed local shortages.

Community and civil society initiatives addressed local shortages.

In France, civil society organizations advocated for greater transparency from pharmaceutical companies and better monitoring of medicine stocks .

In Italy, the Pharmaceutical Bank organized a drug collection day, gathering nearly 600,000 packs of medicines for those in need .

Title:

Content: Health Minister blames “greedy and unscrupulous” people for AKI outbreak

215

By Omar Bah

The Minister of Health has blamed the recent deaths of 70 children due to Acute Kidney Injury caused by medicines manufactured in India on “greedy and unscrupulous people”.

Addressing the National Assembly extra-ordinary session on the matter yesterday, Minister Ahmadou Lamin Samateh said: “I believe that our country has been assaulted – This is an aggression against our people from greedy and unscrupulous people. The manufacturing, distribution and importation of contaminated drugs is criminal and the government sees it that way. However, due diligence needs to be carried out to get to the root of the problem.”

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He said the license of the importer has been suspended and the two pharmacy outlets of the importer have been closed.

Minister Samateh said the government has embarked upon health facility expansion and provision of more laboratories, equipment and massive capacity building exercises. “This is yielding results with very significant reductions in maternal mortality from 433 per 100, 000 birth in 2013 to 289 per 100, 000 birth in 2019-2022, to further reduction to 178 per 100, 000 live births this year. A reduction of under 5 mortalities from 54 per 1000 to 49 per 1000 in 2020. It therefore came as a big blow to have lost 70 children under the age of seven to Acute Kidney Injury in four months. He said a total of 82 AKI were diagnosed and 12 of them recovered.

“This has been very difficult for the families, the president and the entire cabinet and government and by extension the Assembly,” he said.

A surgeon himself, Dr Samateh said the issue of substandard medicine is a big global problem and a multibillion entity in which some selfish individuals strive to the detriment or suffering of other people. “We got information that the Food and Drugs Control Service of America from 2000 to now have withdrawn up to 1200 dangerous medications from the American market. It is a big challenge for the entire world especially for the poor developing countries like ours where all drugs will have to be imported and we have both limited human and material resources to detect the problems,” he said.

He said upon the announcement of Acute Kidney Injury in The Gambia, alert around the world was increased and it has led to discovery of similar phenomenon in Indonesia with a mortality of 208.

“Distinguish Speaker and Honourable members, Indonesia is considered to be a middle-income country with facilities to detect Acute Kidney Injury and substandard medication, so the fact that they had to take a cue from us, and even consulted our team to share our experience in dealing with the crisis, means the team in the Gambia has put in our best,” he said. He added that a similar incident occurred in Haiti where 108 children passed away. “This is not by any means trying to justify what happened in our country. It is just to delineate on the challenges developing countries face, it is important to note that the identification of the problem and action that the government took to stop the problem are remarkable by international standards and it has potentially saved many other lives,” he said.

While announcing that the World Bank has agreed to construct a food and drugs testing laboratory for the Gambia, Samateh said the ministry has not reported any case of the AKI for the past two weeks.

The mover of the motion and NAM for Brikama North, Alhagie S Darboe said the idea behind the extraordinary session is motivated by the need for the Assembly to debate on an issue of national concern.

“I have to make clear that this is not a motion to politicise the situation of the AKI. It is only correct that the Assembly find time to discuss the lapses and weaknesses that led to the importation of these medicines. It is in this spirit that this session was called,” he said.

He commended all the MPs who played a role in ensuring that the session was called yesterday.

“If you look at the pattern of the debate all the members have extended their condolences to the families who lost their children but ironically some of them are praising certain authorities,” he said.

Honourable Darboe said a parliamentary inquiry should be constituted to ensure that somebody is held accountable for what happened. “This should not be buried under the carpet,” he said.

“I take note of a comment of a member who said we should not have a preconceived mind before the findings of the investigation but it is my view that we must not also praise anybody for doing a job he/she is paid to do,” he stated.

In India, NGOs donated critical medications and supported local procurement to address shortages for vulnerable populations .

Title:

Content: Africa's Vaccine Production Push Reshapes Global Health Landscape

4 December 2023

Lusaka, Zambia — The novel coronavirus pandemic laid bare the stark disparities in global access to essential medicines. The world's most vulnerable populations were often left behind in the scramble for life-saving vaccines, diagnostics, and therapeutics. This underscored the urgent need for a paradigm shift in global health security and local production as a pivotal step towards bolstering healthcare resilience and accessibility worldwide.

In February 2021, UN Secretary-General Antonio Guterres described vaccine equity as the "biggest moral test before the global community."

Despite the challenges, Africa's vaccine manufacturing future is looking more promising.

A new era of vaccine production is dawning

At the International Conference on Public Health in Africa (CPHIA) held in Lusaka, Zambia, high-level delegates and experts assembled to explore the pressing need for accelerated local vaccine manufacturing across the continent, aiming to address vaccine shortages and promote self-reliance.

In Africa, less than 1% of vaccines used are locally produced, with the vast majority being imported from private sector suppliers around the globe. However, over the past two years, Africa has made significant strides in the production of medical commodities, with a particular focus on vaccines. The African Union, Africa CDC, and various international partners have been involved in supporting infrastructure and capacity in vaccine delivery, as well as in facilitating engagement with the private sector and international organizations to expand vaccine manufacturing in Africa.

This continent-wide effort has the potential to reshape the relationship between local communities in Africa and the global health sector.

More than 30 new vaccine manufacturing initiatives are currently underway in Africa, signaling a significant expansion of the continent's vaccine production capacity. This effort is aimed at safeguarding Africa against future pandemics and disease outbreaks, as well as reducing the delays and challenges faced in accessing vaccines, as experienced during the COVID-19 pandemic.

Africa CDC Director General Dr. Jean Kaseya pointed to the critical role of local vaccine manufacturing in safeguarding the health and well-being of Africa's citizens. He added that achieving self-sufficiency in vaccine production is a cornerstone of the continent's journey towards comprehensive healthcare security. The Partnerships for African Vaccine Manufacturing (PAVM) is spearheading this ambitious endeavor, which recently received a significant boost with the backing of the global vaccines platform, Gavi," said Kaseya.

Dr. Kaseya said that the African Union, along with its members and partners, set an ambitious goal in 2021 to achieve at least 60% local production of vaccines by 2040. This initiative, driven by the COVID-19 pandemic, has underscored the urgent need to strengthen Africa's pharmaceutical manufacturing capabilities.

He acknowledged that Africa has faced challenges in the past, particularly in terms of infrastructure, logistics, and production capacity. However, he expressed his determination to overcome these obstacles and create a robust ecosystem for manufacturing vaccines and other medical products.

To address these challenges and advance the local manufacturing agenda, Dr. Kaseya announced the establishment of a Platform for Harmonised Africa Health Products Manufacturing (PHAHM).

"Therefore, I have decided to create a directorate that will lead this agenda and in a few days, I hope most African people will have the opportunity to send applications for all of the positions we are creating starting with the position to lead the platform that we are talking about," he said.

He urged all African citizens to apply for positions within the newly created directory that will oversee all aspects of local manufacturing.

Africa's pursuit of diagnostic and manufacturing self-reliance

Professor Abderrahmane Maaroufi, the Director of the Institut Pasteur Maroc (National Public Health Institute) added that Africa is steadily progressing towards self-sufficiency in diagnostics and manufacturing, with notable advancements achieved in recent years. The African Union has spearheaded several initiatives to foster local production of essential health products, and there is a burgeoning commitment among African nations to invest in this domain.

"Initiatives like the African Collaborative for Advanced Manufacturing of Vaccines and the establishment of Centers of Excellence are commendable," he said. "However, challenges persist, such as limited technology and distribution barriers hindering local manufacturing's full potential."

Maaroufi said that the advantages of local manufacturing of diagnostics and therapeutics are that it is both more cost-effective and efficient. He noted that Africa currently manufactures less than 2% of its required diagnostics and therapeutics, with a staggering 97% being imported from outside the continent. This reliance on external sources can hinder Africa's ability to effectively combat diseases.

Vaccine development and pandemic preparedness

Frederick Kristensen, the Deputy CEO of the Coalition for Epidemic Preparedness Innovations (CEPI), said that as we grapple with the lingering impacts of COVID-19 and confront other devastating outbreaks, the need for robust health security has never been more evident.

"We've witnessed devastating outbreaks, emphasizing the urgency of investing in health security. Climate change further complicates accessibility, amplifying the need for rapid response," he added.

"We're at a historic juncture where science, technology, finance, and political will converge, offering an unprecedented opportunity to enhance pandemic preparedness. African countries, through initiatives like the Africa CDC, are tackling these challenges collectively. Our contributions include supporting vaccine manufacturing capacity in Senegal and South Africa and aiding volunteers in developing an mRNA-based vaccine."

"The 100-Day Mission, endorsed by parties like the G7, aims to have vaccines ready within a hundred days of identifying threats," he said. "This shift from preparedness response necessitates global, locally-driven manufacturing for swift, top-quality vaccine production. Focusing on crucial factors among the myriad of infectious diseases could significantly expedite responses."

"Strengthening regulatory agencies and improving clinical trial protocols are essential to safely and efficiently evaluate countermeasures. Achieving this requires building capacity sustainably, leveraging existing research infrastructure, and fostering local expertise," he said. "In a significant step forward, we have partnered with the Medical Research Council of the Gambia and the International Vaccine Initiative to enhance clinical research capacity in West Africa. This initiative is already gaining momentum, and we aim to expand it to other regions, such as East Africa."

Global health architecture and partnerships

Echoing the sentiments of her fellow delegates, Heidy Rombouts, the Belgian Director General for Development Cooperation and Humanitarian Aid at the Belgian Ministry of Foreign Affairs acknowledged the glaring deficiencies exposed by the COVID-19 pandemic in global health systems, emphasizing the urgent need for a comprehensive overhaul of the international health landscape.

"The theme of 'Repositioning Africa in the Global Health Architecture' is undeniably compelling," she asserted. "It should resonate far beyond the continent, engaging the global community in a concerted effort. But what does this repositioning entail for us, as partners engaging with Africa and preparing for the next pandemic?"

Rombouts announced that Belgium would hold the EU presidency from January 1st for six months. "I have come to this conference with an open mind, eager to listen and learn more about what 'repositioning' means for us - for Europe, for the European Union, and our partnership with Africa," she remarked.

To strengthen partnerships in the health sector, Rombouts advocated for expanding collaboration to encompass a broader range of actors, including regulatory bodies, primary healthcare providers, market analysts, and market intelligence providers. She acknowledged that this may necessitate stepping out of comfort zones, forging new networks, and cultivating collaborative relationships with diverse communities. In addition, she emphasized the importance of enhancing communication strategies to effectively demonstrate how development finance institutions can support market initiatives and leverage investments in primary healthcare.

"Partnerships must extend beyond a single level," Rombouts asserted, echoing the adage "No one is safe until everyone is safe."

"We must engage at all levels, from local to regional, sub-regional, continental, and global. Technology can play a pivotal role in consolidating local information for faster decision-making at regional and sub-regional levels," she explained.

"Partnerships will be multi-layered," Rombouts said, citing Belgium's collaboration with Senegal and Rwanda to strengthen local health systems and regulatory bodies within the Team Europe approach as an exemplary model. This initiative aims to boost local manufacturing of vaccines, medicines, and health technologies in Africa, with a focus on creating an enabling environment for sustainable production and strengthening regulatory structures."

"Engaging in a mutual learning process and facilitating two-way learning through twinning arrangements are key aspects of this journey," she said.

 AllAfrica's reporting from CPHIA2023 is supported by the African Union and Africa CDC

AllAfrica publishes around 500 reports a day from more than 100 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.

Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica. To address comments or complaints, please Contact us.

Pharmacists in the UK and Texas transferred prescriptions between pharmacies and communicated with patients to find suitable alternatives during shortages .

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.”

**Summary of Global Trends and Lessons** Medication shortages between 2021 and 2024 were driven by a convergence of supply chain disruptions, demand spikes, manufacturing delays, regulatory challenges, and economic instability.

The impact on ordinary patients was profound, ranging from delayed or

The impact on ordinary patients was profound, ranging from delayed or

The impact on ordinary patients was profound, ranging from delayed or