Unexpected dimensions of the COVID-19 outbreak

By John Manton

On the face of it, the 2019-2020 coronavirus disease outbreak centred on Hubei Province in central China may seem tangential to concerns with antimicrobial resistance. COVID-19, a novel viral infectious disease in humans, currently has no vaccine or specific treatment, beyond therapeutic management of symptoms. It exerts no major direct pressures on antimicrobial stocks or stewardship. However, worries are beginning to surface about the potential impact of Chinese factory shutdowns and other capacity issues on global antibiotic supply chains.

US Senator Marsha Blackburn, writing in Stat News (a Boston Globe offshoot), notes the security dimensions of US reliance on Chinese-manufactured active pharmaceutical ingredients, among them various antibiotic agents. While this story is complicated by the trade politics of US-China relations, and worries around dependency and safety, both the UK government and Indian pharmaceutical industry representatives (quoted in the Financial Times, “Drugmakers braced for coronavirus disruption to China supplies”, 12 Feb, 2020 – paywalled) have commented on the potential risk to supply chains posed by manufacturing conditions and restrictions in key health-related industries in China.

UK and European sources point out that supply chain precautions taken in advance of the UK leaving the European Union may be able to help manage any disruption to supply caused by short term challenges in the production of active pharmaceutical agents in China. Inventory management, production, and circulation of a wide variety of pharmaceutical products, including antimicrobials will continue to absorb and propagate the shocks to global drug supplies in the coming months, though the implications for policy and practice are not yet entirely clear.


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