Leaders in strategies to ensure a continuous supply of products to access countries


GSK, Mylan


Supply and shortages


GSK and Mylan lead in their activities to help ensure the supply of both new and 'forgotten antibiotics' — older, but still clinically useful antibiotics to access countries. Access countries are 102 low- and middle-income countries with a high burden of disease and high need for greater access to medicine.


e.g., Nigeria, Pakistan, Tanzania, Zambia

When antibacterial and antifungal medicines run short, or are of poor quality, antimicrobial resistance is likely to rise. For example, doctors often resort to using less optimal treatments, and this makes infections harder to cure, and creates opportunities for bacteria or fungi to adapt defences. To combat this, companies need to use various strategies that can contribute toward a continuous supply of products such as demand forecasting, shortage mitigation, preventing falsified medicines and supplying older, but still clinical useful antibiotics. Two companies stand out in this area: GSK and Mylan. 

How does GSK ensure the continuous supply of products? 
GSK is the only company to report multiple activities in all of the areas measuring supply operations, and demonstrates best practice. Activities include engaging in short-term and long-term forecasting, dual sourcing and monitoring of safety stock. When stocks of its antibiotic ceftazidime (Fortum®) grow low, it prioritises supply to emerging markets. It also works with partners such as the Tanzanian and Nigerian ministries of health to implement its mVaccination programme, improving coverage. With healthcare services group Zuellig Pharma, GSK delivers vaccines including Synflorix® and Infanrix Hexa® to access countries using a temperature-control packaging system (eZcooler). Among strategies to reduce supply of falsified medicines, GSK has security features, tamper-evident packaging, track-and-trace coding, warehouse auditing and fraudulent activity reviews. It also supplies the ‘forgotten antibiotic’ cloxacillin to two access countries: Pakistan and Zambia.

Why are 'forgotten antibiotics' still relevant?
Antimicrobial resistance is increasing, but the development of effective new antibacterial medicines is failing to keep pace. In this context, forgotten antibiotics, a group of 30 off-patent antibiotics, mainly produced for the first time during the 1950s to 1970s, have a useful role to play. They are no longer produced in large quantities, but are still effective in treating conditions caused by multidrug-resistant bacteria, such as pneumonia, meningitis and urinary tract infections. Companies that make and supply these antibiotics help to contain the spread of resistance. 

What makes Mylan stand out? 
Mylan, a generic medicine manufacturer, leads the way, producing 14 forgotten antibiotics and supplying six of these (chloramphenicol, flucloxacillin, nitrofurantoin, sulfamethoxazole/trimethoprim, teicoplanin and tobramycin) to access countries. Its medicines can be used to treat a range of diseases including infections of the eye, skin, chest, ear and urinary tract. 

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