In Shortage: Understanding Global Antibiotic Supply Chains Through Pharmaceutical Trade Fairs

Mingyuan Zhang

doi:10.18357/anthropologica65120232605

Authors

Mingyuan Zhang University of Toronto Scarborough https://orcid.org/0000-0001-8310-5470

DOI:

https://doi.org/10.18357/anthropologica65120232605

Keywords:

antibiotics, global supply chain, Active Pharmaceutical Ingredients, antimicrobial resistance, pharmaceutical trade fair, China

Abstract

Many countries have reported supply shortages of antibiotics in recent years. The COVID-19 pandemic has sparked interesting discussions among government officials, public health practitioners, and scholars on how to maintain the security of the global pharmaceutical supply chain and how to decrease dependency on countries such as China. This article discusses the experiences and initial findings of tracing global pharmaceutical supply chains through pharmaceutical trade fairs and events at multiple locations. I argue that the reasons behind antibiotic supply shortages are multifold. Although the geographical concentration of the production of key raw materials and Active Pharmaceutical Ingredients (APIs) in China is considered the main reason for the unstable and disrupted supply chain, it is also important to recognize that the same forces that have driven Western pharmaceutical companies to shift some of their less profitable manufacturing lines to China are also challenging Chinese pharmaceutical companies to adjust and reorient their strategies. As such, antibiotics are facing a conundrum in which the governance of excessive use is complicated by a shortage problem that hampers access to essential drugs.

Downloads

Download data is not yet available.

References

Baird, Theodore. 2017. “Knowledge of Practice: A Multi-sited Event Ethnography of Border Security Fairs in Europe and North America.” Security Dialogue 48(3): 187–205. https://doi.org/10.1177/0967010617691656. DOI: https://doi.org/10.1177/0967010617691656

Büscher, Bram. 2014. “Collaborative Event Ethnography: Between Structural Power and Empirical Nuance?” Global Environmental Politics 14(3): 132–138. https://doi. org/10.1162/GLEP_a_00243. DOI: https://doi.org/10.1162/GLEP_a_00243

Davies, Sarah R., Cynthia Selin, Sandra Rodegher. Carlo Altamirano Allende, Michael Burnam-Fink, Corinne DiVittorio, Cecilie Glerup, Cameron Keys, Mindy Kimball, Miao Liao, Chad Monfreda, and Brenda Trinidad. 2015. “Studying Emerge: Findings from an Event Ethnography.” Futures 70: 75–85. https://doi.org/10.1016/j.futures.2014.05.003. DOI: https://doi.org/10.1016/j.futures.2014.05.003

Desai, Darash. and Muhammad. H. Zaman. 2015. “Continuous Flow Microfluidic Solution for Quantitative Analysis of Active Pharmaceutical Ingredient Content and Kinetic Release.” Analytical Methods 7: 1914–1923. https://doi.org/10.1039/C4AY02884H. DOI: https://doi.org/10.1039/C4AY02884H

Duffy, Rosaleen. 2014. “What does Collaborative Event Ethnography tell us about Global Environmental Governance?” Global Environmental Politics 14(3): 125–131. https://doi.org/10.1162/GLEP_a_00242. DOI: https://doi.org/10.1162/GLEP_a_00242

Ecks, Stefan. 2008. “Global Pharmaceutical Markets and Corporate Citizenship: The Case of Novartis’ Anti-Cancer Drug Glivec.” BioSocieties 3(2): 165–181. https://doi.org/10.1017/S1745855208006091. DOI: https://doi.org/10.1017/S1745855208006091

Halliburton, Murphy. 2017. India and the Patent Wars: Pharmaceuticals in the New Intellectual Property Regime. Ithaca, NY: Cornell University Press. DOI: https://doi.org/10.7591/cornell/9781501713460.001.0001

Hardon, Anita and Emilia Sanabria. 2017. “Fluid Drugs: Revisiting the Anthropology of Pharmaceuticals.” Annual Review of Anthropology 46: 117–132. https://doi.org/10.1146/annurev-anthro-102116-041539. DOI: https://doi.org/10.1146/annurev-anthro-102116-041539

Modisakeng, Cynthia, Moliehi Matlala, Brian Godman, and Johanna Catharina Meyer. 2020. “Medicine Shortages and Challenges with the Procurement Process among Public Sector Hospitals in South Africa; Findings And Implications.” BMC Health Serv Res 20, 234. https://doi.org/10.1186/s12913-020-05080-1. DOI: https://doi.org/10.1186/s12913-020-05080-1

Monahan, Torin and Jill A. Fisher. 2015. “Strategies for Obtaining Access to Secretive or Guarded Organizations.” Journal of Contemporary Ethnography 44(6): 709–736. https://doi.org/10.1177/0891241614549834. DOI: https://doi.org/10.1177/0891241614549834

National Health Commission of P.R. China. 2020a. 国家短缺药品清单. [National List of Medicines in Shortage] http://www.nhc.gov.cn/yaozs/s7653/202012/f30aad8ec4ba48a9afa2e559f4d20e7c/files/97ced024ced74c99af03bc64b672927e.pdf. (accessed 30 November 2022).

National Health Commission of P.R. China. 2020b. 国家临床必需易短缺药品重点监测清单.. [National Monitoring List of Key Clinically Essential Drugs Prone to Shortage] http://www.nhc.gov.cn/yaozs/s7653/202012/f30aad8ec4ba48a9afa2e559f4d20e7c/files/c5160c1a3f0542cea7d0aa6f56c224f6.pdf. (accessed 30 November 2022).

National Health Commission of P.R. China. 2022. 短缺药品监测品种及生产企业(制剂). [Drug Varieties and Manufacturers Under Monitor for Supply Shortages (Formulated Drugs)] https://www.gov.cn/zhengce/zhengceku/2022-08/09/5704755/files/b9cf31eca1d848418b416422f04f0fdb.pdf. (accessed 30 November 2022).

Peterson, Kristin. 2014. Speculative Markets: Drug Circuits and Derivative Life in Nigeria. Durham, NC: Duke University Press. DOI: https://doi.org/10.2307/j.ctv125jqnj

Petryna, Adriana and Arthur Kleinman. 2006. “The Pharmaceutical Nexus.” In Global Pharmaceuticals: Ethics, Markets, Practices, edited by Adriana Petryna, Andrew Lakoff, and Arthur Kleinman, 1-32. Durham, NC: Duke University Press. DOI: https://doi.org/10.2307/j.ctv11cw7qd.4

Podolsky, Scott H. 2015. The Antibiotic Era: Reform, Resistance, and the Pursuit of a Rational Therapeutics. Baltimore, MD: Johns Hopkins University Press.

Shafiq, Nusrat Avaneesh Kumar Pandey, Samir Malhotra, Alison Holmes, Marc Mendelson, Rohit Malpani, Manica Balasegaram, and Esmita Charani. 2021. “Shortage of Essential Antimicrobials: A Major Challenge to Global Health Security.” BMJ Global Health 6:e006961. http://dx.doi.org/10.1136/bmjgh-2021-006961. DOI: https://doi.org/10.1136/bmjgh-2021-006961

Sunder Rajan, Kaushik. 2012. “Pharmaceutical Crises and Questions of Value: Terrains and Logics of Global Therapeutic Politics.” South Atlantic Quarterly 111(2): 321–346. https://doi.org/10.1215/00382876-1548239. DOI: https://doi.org/10.1215/00382876-1548239

US Food and Drug Administration (FDA). 2019. Drug Shortages: Root Causes and Potential Solutions. https://www.fda.gov/media/132058/download (accessed 23 November 2022).

US Pharmacopoeia (USP). 2022. Supply Chain Vulnerabilities Exist for Antimicrobial Medicines: USP Medicine Supply Map Analysis. https://qualitymatters.usp.org/supply-chain-vulnerabilities-for-antimicrobial-medicines (accessed 31 October 2022).

Van Beusekom, Mary. 2022. “Doctors, Pharmacists Coping with Amoxicillin Shortage.” CIDRAP News. https://www.cidrap.umn.edu/news-perspective/2022/10/doctors-pharmacists-coping-amoxicillin-shortage (accessed 31 October 2022).

Valiquette, Louis and Kevin B. Laupland. 2015. “Antimicrobial Shortages: Another Hurdle for Clinicians.” Canadian Journal of Infectious Diseases and Medical Microbiology. 26(2): 67–68. https://doi.org/10.1155/2015/789369. DOI: https://doi.org/10.1155/2015/789369

World Health Organization (WHO). 2021. WHO Model List of Essential Medicines, 22nd List. (WHO/MHP/HPS/EML/2021.02). https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02

Zhang, Mingyuan. 2018. “Being Chinese” in Madagascar, PhD Dissertation, University of Western Ontario. https://ir.lib.uwo.ca/etd/5778.

Zhang, Mingyuan and Lise Bjerke. 2023. “Antibiotics “dumped”: Negotiating Pharmaceutical Identities, Properties, and Interests in China–India Trade Disputes.” Medical Anthropology Quarterly 37 (2): 148-163. https://doi.org/10.1111/maq.12757. DOI: https://doi.org/10.1111/maq.12757