Universal access to key essential antibiotics—Recent amoxicillin global shortages mask a wider policy failure

The United Nations General Assembly on AMR in 2024 presents an opportunity to emphasize the importance of universal access to safe, effective, and affordable essential antibiotics. The European Union’s recommendations to prevent future antibiotic shortages for respiratory tract infections (RTI) include enhanced monitoring, increased regional production of selected Access and Watch antibiotics, and the development of an EU “critical medicines list.” Amoxicillin (+/− clavulanate) is the key oral antibiotic on the EU critical medicine list, as the first line recommended treatment for RTI in most European guidelines. The WHO AWaRe Book provides guidance on the choice of drug, dose, and duration for 35 infections in children and adults in both primary care and hospital settings. Ensuring the sustainable supply of amoxicillin is critical to meet future targets of increasing Access antibiotic use in both high-income (HIC) and low-and-middle income (LMIC) settings. Maintaining access to amoxicillin in an effective, quality, and affordable formulation is a key component of achieving SDG 3.8 (universal health coverage).