Australia’s penicillin crisis: How a single drug shortage exposes our medical manufacturing vulnerability

When a critical medication that protects Australia’s most vulnerable communities runs short, who pays the price? A new investigation reveals the shocking gaps in our pharmaceutical sovereignty. By Simran Gill.

In late February, Australia faced a crisis that few noticed but many felt: a serious shortage of benzathine benzylpenicillin G (BPG), an essential medication used to treat syphilis and prevent rheumatic heart disease. But this wasn’t just another supply chain hiccup—it was a stark reminder of how pharmaceutical dependency can literally be a matter of life and death.

Speaking on @AuManufacturing Conversations, three leading medical experts have revealed the true scope of this crisis and outlined a potential solution that could transform Australia’s approach to essential medicine manufacturing.

Dr Rosemary Wyber, a researcher focusing on Aboriginal and Torres Strait Islander cardiovascular health, explained the devastating impact: 

“We’ve been managing shortages of BPG in Australia for decades now. We’ve unfortunately become better and better at it, but at the end of the day, if we don’t have access to high quality product with reliable supply, we can’t do what it takes to tackle rheumatic heart disease and syphilis in Australia.”

The shortage disproportionately affects Aboriginal and Torres Strait Islander communities, who face higher rates of both conditions. This makes the supply crisis not just a manufacturing concern but a critical health equity issue that undermines national Closing the Gap targets.

Associate Professor Glenn Pearson, Director of First Nations Strategy at The Kids Research Institute Australia, emphasised the broader implications: 

“We can’t continue to turn up at the opening of each parliament of each new year, giving the next iteration of the closing gap targets which appear to be standing still with little increase or slow going backwards.”

The solution, according to the experts’ recent paper in the Medical Journal of Australia, lies in developing sovereign manufacturing capabilities for BPG in Australia. Dr Wyber believes this is “eminently feasible,” stating: “What it really takes is political will and commitment to make this happen.”

The case for local manufacturing has been strengthened by recent innovations developed by the Australian research team. Associate Professor Laurens Manning, an infectious diseases physician from Perth, revealed breakthrough delivery methods that could revolutionise treatment: 

“Instead of having a monthly intramuscular injection, we can deliver a high dose of subcutaneous BPG and it lasts for up to ten weeks. And similarly for syphilis, instead of having to come in for three visits, we can do the entire dose at a single visit.”

These innovations would differentiate Australian-made BPG from “pretty much every other product available in the world,” potentially making Australia a global leader in this essential medicine.

The experts point to successful precedents, including recent government commitments to scaling up domestic saline production and the work of Medicines Development for Global Health, an Australian not-for-profit that has successfully developed moxidectin for treating scabies and river blindness.

However, implementing sovereign BPG manufacturing would require significant steps. 

“The first step is having the political will to actually commit to embarking on this project,” Manning explained. 

“It’s clear that for BPG, we’re going to need a standalone facility… you can’t actually have product lines and penicillin adjacent to other product lines for other medications.”

Beyond BPG, the experts identified other essential medications facing shortages that particularly impact Aboriginal and Torres Strait Islander communities, including treatments for scabies, trachoma, and diabetes medications.

Dr Wyber delivered a clear message to policymakers: “It is absolutely possible for Australia to choose to make BPG available for communities in this country who need it, and to decide that we will be a regional and a global leader in producing this essential medicine. What it will take is an investment, political commitment and a choice by this country that this is important.”

The COVID-19 pandemic highlighted Australia’s pharmaceutical vulnerabilities, but experts argue the BPG shortage represents an ongoing crisis that demands immediate action. As Professor Pearson noted: “This is a global challenge and it has a critical Australian heart to it… the most vulnerable in the Australian community are the ones who are paying the prices of that indifference.”

In this episode of @AuManufacturing Conversations, Simran Gill learns about Australia’s pharmaceutical manufacturing challenges and the experts’ detailed proposals for sovereign medicine production.

Main picture: supplied

Further reading

Call for homegrown medicine production as penicillin imports dry up

The federal government wants to boost productivity. Science can help