Policy and regulatory interventions to address antibiotic shortages in low and middle-income countries

Table of Contents

• Acknowledgements 5
• Abbreviations 6
• Executive summary 7
• 1. Introduction 10
• 1.1 Context and objectives 10
• 1.2 Methods 11
• 2. Background: AMR and shortages of antibiotics 12
• 2.1 Threat of AMR 12
• 2.2 Global status quo of antibiotic shortages 12
• 2.3 Antibiotic shortages and AMR 12
• 2.4 Types of antibiotic shortages and their drivers 14
• 2.5 Stakeholders 16
• 2.6 Strengthening core NRA functions 22
• 3. Measures to address shortages 23
• 3.1 Scope of analysis 23
• 3.2 Framework of measures to address shortages 23
• 3.3 Summary of measures observed in HIC and LMIC 23
• 3.4 Typical roles and responsibilities in identified measures 35
• 3.5 In-depth analysis of measures 39
• 3.6 Country examples 55
• 4. Measures for addressing shortages of antibiotics in LMIC 69
• 4.1 Assessment of measures by impact and ease of implementation 69
• 4.2 Matching measures to the country context 71
• 4.3 Measures to be considered by countries 71
• 5. Implementation considerations and conclusion 74
• References 75
• Annexes 79
• Annex 1. Organizations that participated in expert interviews 80
• Annex 2. Types of shortages and identified measures 81
• Table A2.1 Types of shortages and identified measures 81
• Annex 3. Country profiles: measures by region and country 85
• Annex 4. Assessment of the impact of measures 97
• Table A4.1. Assessment of the impact of measures 97