Supply-chain factors and antimicrobial stewardship

Efficient and secure supply chains are essential for effective health services globally. In low- and middle-income countries, ensuring the accessibility, affordability, and availability of essential medicines, including antimicrobials, remains a significant challenge. Ineffective supply chains often result in antimicrobial shortages, leading to inappropriate use of alternative treatments and heightening the risk of antimicrobial resistance. These shortages, along with insecure supply chains, also facilitate the spread of substandard and falsified medicines, resulting in suboptimal treatment and further driving antimicrobial resistance. Addressing supply-chain challenges should be a core element of antimicrobial stewardship programs. The authors examined the relationship between medicine supply chains and antimicrobial use in seven focus countries—Kenya, Malawi, Nigeria, Sierra Leone, Uganda, the United Republic of Tanzania, and Zambia—analyzing national supply-system structures, policy documents, and global reports. The goal was to develop evidence-based strategies to improve the effectiveness and efficiency of supply chains in supporting antimicrobial stewardship initiatives.