Nine years ago, countries started reporting shortages of benzathine penicillin G, or BPG. One of the world’s oldest and cheapest antibiotics, BPG is used to prevent and manage rheumatic heart disease and to treat syphilis. It’s particularly critical for pregnant people who have syphilis because it’s the only medicine that can cross the placenta and treat the fetus.
It took years for those earlier shortages to ease. But the underlying drivers of the stockouts — too few producers of the treatment and a lack of urgency from governments about the risks of BPG shortages — persist. Add to that exploding rates of syphilis since the COVID-19 pandemic, which has increased demand for the treatment in recent years, and there are clear warning signs of impending global shortages again, particularly in low- and middle-income countries.
The United States, Brazil, Australia, and countries in southern Africa are already reporting shortfalls of BPG, according to the World Health Organization. And experts warn there could be even more supply unavailability occurring in places where officials are not monitoring the situation.
About the authors
Andrew Green@_andrew_green
Andrew Green, a 2025 Alicia Patterson Fellow, works as a contributing reporter for Devex from Berlin.
Sara Jervingsarajerving
Sara Jerving is a Senior Reporter at Devex, where she covers global health. Her work has appeared in The New York Times, the Los Angeles Times, The Wall Street Journal, VICE News, and Bloomberg News among others. Sara holds a master's degree from Columbia University Graduate School of Journalism where she was a Lorana Sullivan fellow. She was a finalist for One World Media's Digital Media Award in 2021; a finalist for the Livingston Award for Young Journalists in 2018; and she was part of a VICE News Tonight on HBO team that received an Emmy nomination in 2018. She received the Philip Greer Memorial Award from Columbia University Graduate School of Journalism in 2014.
