Marijn Verhoef, Director of Operations and Research at the Access to Medicine Foundation examines the interconnected challenges of drug shortages and antimicrobial resistance. Verhoef urges decisive and urgent action from the pharma companies that manufacture lifesaving antibiotics and antifungals to ensure that patients can get the right medicine when they need it most.


A few weeks ago, I felt a sense of relief when I picked up amoxicillin from my local pharmacy for one of my children who was ill. As a trained pharmacist living in a high-income country, I could not have imagined having this feeling some years ago. Being able to fill an amoxicillin prescription was a non-event – and something you would take for granted.  Firstly, with so many manufacturers of amoxicillin, availability of this essential antibiotic was not something that was considered an issue just a few years ago. Secondly, I am lucky enough to live in a country where drug shortages were not commonplace; access to the latest innovative medicine or generic drug is not something I have had to worry about for most of my life – as a pharmacist, patient, or parent.

The reality is that today, drug shortages are increasing worldwide while antimicrobial resistance (AMR) is spreading at devastating rates. What makes this current situation even more alarming is that more and more patients around the world are now battling drug-resistant infections or ‘superbugs’, many of which can no longer be treated with existing medicines like amoxicillin, for example

Fortunately, I was still able to access the paediatric formulation of amoxicillin for my child’s infection. For people living in low- and middle-income countries (LMICs), where on top of drug shortages, the burden of drug-resistant infections is disproportionately high, that sense of relief never arrives. In many LMICs, existing treatments remain out of reach – let alone newer treatments that are effective against the most severe drug-resistant infections.

That is why it is so critical for pharmaceutical companies that produce lifesaving and essential antibiotics and antifungals to prioritise access and stewardship of these drugs in LMICs. Failure to make these medicines available – and ensuring their responsible use – in LMICs will inhibit ongoing global efforts to tackle drug resistance. Planning ahead for this is especially important for the handful of promising antibiotic and antifungals medicines that are currently in clinical development.

At the same time, the development of new antibiotics and antifungals by pharmaceutical companies is failing to keep pace with deadly superbugs, which is why the Access to Medicine Foundation’s latest AMR report on R&D focuses on key late-stage R&D projects that target pathogens that cause some of the deadliest drug-resistant infections. If even only these handful of projects result in newly developed drugs making it to every single patient who needs them, at least 160,000 lives could be saved annually. In the fight against a global health threat that claims over a million lives every year, every effort counts.

This report comes hot on the heels of the World Health Organization’s updated bacterial priority pathogens list and tracks projects from GSK, F2G, Pfizer, Innoviva Speciality Therapeutics and Venatorx Pharmaceuticals which target some of these deadly pathogens. The findings and recommendations in the report clearly show that by implementing advance access and stewardship planning during R&D, these companies can provide patients with much-needed medicines to treat drug-resistant gonorrhoea, urinary tract infections, intra-abdominal infections, respiratory infections and invasive fungal infections. While these diseases and syndromes affect a wide range of patients globally, women and children – especially those living in LMICs – are disproportionately affected.

Curbing AMR is a massive undertaking and there is no single solution that can solve its unprecedented spread. But, as the work in our AMR Programme and this latest report shows, without decisive and urgent action from the companies that manufacture lifesaving antibiotics and antifungals, too many patients will face the reality of not getting the right medicine when they need it most.

It is critical to act now and make sure the few antimicrobials are made available to patients on the frontlines of drug resistance, because as a pharmacist there is no worse feeling than not to be able to deliver the right medicine at the right time for the right patient.