Critical Condition: Securing Europe’s Fragile Antibiotic Supply Chain

The report warns that Europe’s supply of key, system-critical antibiotics is increasingly fragile, due to over-emphasis on lowest-cost procurement, dependence on a small number of non-European suppliers and under-investment in regional manufacturing; it calls for urgent policy reforms including smarter public-procurement mechanisms, stronger local sourcing capacities and public-private partnerships in order to secure access, support stewardship and mitigate future risks from antimicrobial resistance (AMR).

Major Findings:

1. The supply-chain for critical generic antibiotics in Europe has become highly fragile, primarily because of an over-emphasis on lowest-cost procurement, coupled with consolidation of manufacturing into few sites (often outside Europe) and reduced regional production capacity. 

2. Europe’s dependence on a small number of non-European suppliers (especially in Asia), and limited investment in “sunrise” production of active pharmaceutical ingredients (APIs) and finished generics in Europe, poses a strategic risk—especially given recurring supply disruptions of penicillins and other system-critical antibiotics.

3. Without policy intervention, this structural weakness threatens not only access to existing antibiotics but also undermines efforts to combat antimicrobial resistance (AMR), because shortages force clinicians to use broader-spectrum or less-appropriate agents, which may accelerate resistance.

Key Policy Recommendations:

1. Reform public procurement frameworks and reimbursement mechanisms so that they reward supply-security (e.g., regional manufacturing, diversification of sources, quality of supply) rather than purely lowest cost. For example, allow higher unit prices when a product is made in Europe or from diversified suppliers.

2. Increase investment in European manufacturing capacity (for APIs, intermediates and finished generics), strengthen regional-value-chains, and incentivise public–private partnerships and regulatory simplification to bring back or keep critical antibiotic production in Europe.