Global Medicine Shortages: Public Health Challenges and Policy Responses

Medicine shortages have emerged as a persistent global health challenge, affecting both high-income and low- and middle-income countries. This study analyzed the prevalence, duration, recurrence, systemic drivers, and coping strategies associated with shortages in Mexico, Colombia, and Peru, situating the findings within the international context. Using a cross-sectional design with 1,250 participants, results revealed that shortages were most frequent among antimicrobials, oncology agents, insulin, and anesthetics. These shortages not only lasted longer and recurred more often than in other therapeutic categories but also disproportionately affected low-income and rural populations. Coping strategies included therapeutic substitution and private purchasing, but also riskier responses such as resorting to informal markets and treatment abandonment. Participants identified manufacturing failures, import dependence, and procurement weaknesses as the main systemic drivers, consistent with international evidence. The findings highlight that medicine shortages are not isolated events but structural failures embedded within fragile pharmaceutical systems. Addressing them requires proactive, resilient, and equity-focused policies, including early warning systems, resilient procurement models, diversification of supply chains, and targeted protections for vulnerable populations.