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.