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The Lead Britons are facing some of the "most severe" shortages of NHS medicines on record including common painkillers, epilepsy drugs and HRT, health leaders have warned, even forcing some patients with impaired digestive systems to skip meals. Record-Breaking Shortages of Critical Medications The National Pharmacy Association (NPA) has warned that medicine shortages pose a "serious risk to patient safety." The Royal College of GPs has also raised concerns about the impact medicine shortages have on patients, GPs and pharmacists. Both have highlighted long-lasting supply issues affecting Estradot, a hormone replacement therapy (HRT) for menopausal women, and Creon, a drug taken by people with pancreatic cancer and cystic fibrosis to help them digest food. Both medications have had serious shortage protocols (SSPs) in place for between one-and-a-half (Estradot) and two years (Creon) – a new NHS record – and SSPs were recently extended by the NHS until 10 July. Impact on Patient Health and Wellbeing Pharmacies say this is forcing some patients to ration medication and, in some instances, even skip meals because they have been unable to obtain supplies. Bryony Thomas, 48, from Stroud, Gloucestershire, describes herself as a pancreatic cancer survivor. Along with other survivors, she expects to rely on Creon for the rest of her life because her pancreas does not produce the enzymes to digest food. She said she had been affected by the shortages for the past two years and has had to ration the drug, most recently nine months ago. "There was a three-month window where I couldn't get hold of my enzymes [Creon], so I had to reduce what I was eating. You'd have a much smaller meal, you eat less protein, you eat less fat," Thomas said. "If I get anything down to under a month [of supply] I start to panic." Systemic Causes of Medicine Shortages The Middle East conflict has made supply chains more volatile although it is not the only factor driving shortages, the NPA said. Lack of ingredients, manufacturing disruption, the UK's smaller medicines budget compared with other EU countries, and in the case of HRT, changing prescribing habits all play a part. Prices of some drugs, such as paracetamol and cetirizine for hay fever, have increased as a result. Pharmacies have also been struggling to source a number of commonly dispensed medicines, including Ramipril, used to manage high blood pressure, along with painkillers such as low-dose aspirin and co-codamol. Call for Government Action The NPA, which represents 6,000 independent community pharmacies in the UK, wants the government to convene an urgent taskforce including medicine manufacturers, wholesalers and clinicians to tackle the issues. More than 1,000 GPs and pharmacists will meet in Birmingham at a new conference organised by the NPA this weekend to discuss, among other things, improved information sharing about medicines. Olivier Picard, a pharmacist who chairs the NPA, said: "Medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients." He called on the government to amend legislation that prevents pharmacies from making substitutions to a prescription, where a safe alternative is in stock. Official Response A Department of Health and Social Care spokesperson said: "The overwhelming majority of medicines licensed in the UK are in good supply and patients should know that when visiting the pharmacy, their prescriptions will be available. "Ensuring there is robust supply of medicines is vital and this government is making significant investments in the UK medicine manufacturing industry to strengthen it."

The Rise of Nigeria's Digital Herbal Marketplace In Abuja, Nigeria, Oke Bola thought a fertility supplement she found online might help her conceive. Instead, within days of taking it, she struggled to breathe. Her experience reflects a growing online trade in unverified herbal remedies promoted across social media platforms. Bola, who is in her early 40s and has never had children, bought the supplement earlier this year and increased the recommended dosage, hoping for quicker results after hearing about it from friends and family. "I recognised the symptoms of asthma; the wheezing sound at night was familiar," she told Al Jazeera. "When I checked online, I realised it could be from the herbal medication." Her experience is not isolated. Across Nigeria, doctors and pharmacists report a surge in social media-driven self-medication, particularly involving unverified herbal products. This trend is worsening health outcomes, delaying treatment, and adding pressure to an already strained healthcare system serving about 230 million people. Nigeria's young, hyperconnected population increasingly uses digital platforms for health information and advice. But that access has also created what Dr Isaac Kolawole and Dr Fidelis describe as an "algorithmic apothecary" – an unregulated online marketplace where influencers and anonymous sellers promote remedies directly to consumers with little or no scientific backing. Health Impacts of Unverified Herbal Remedies Within this ecosystem, herbal remedies, long part of Nigeria's medical and cultural landscape, are increasingly repackaged as miracle cures, sometimes with dangerous consequences. Doctors report more patients arriving at hospitals only when their conditions have significantly worsened, often after prolonged use of unverified treatments. A consultant nephrologist at the University College Hospital in Ibadan, Dr Yemi Raji, said herbal medicine continues to play a role in kidney disease cases in Nigeria. "When you take herbal medication, you are taking both the good and the bad," he said. "Patients often arrive late, when treatment is more difficult and expensive." Dialysis alone can cost between 50,000 and 100,000 naira ($36-72) per session, several times a week. Studies link herbal use to kidney and liver disease cases across Africa, including findings that about 46 percent of liver disease admissions in one Nigerian hospital involved herbs or roots. A 2022 study found that 76.65 percent of participants had used herbal medicine, with more than a third combining herbal and conventional treatments while 82.44 percent did not inform their doctors. The Algorithmic Amplification Effect On a smartphone screen, relief is just a click away: fertility tonics, eye drops promising restored vision, syrups claiming to "flush out" disease. The advertisements are polished, persuasive and constant, woven into TikTok, Facebook, Instagram and X feeds. "The platforms themselves amplify this effect," said Dr Egemba Chinonso Fidelis, a public health advocate known online as Aproko Doctor. "Their algorithms reward engaging content and push it to wider audiences." Even users who try to avoid such content often encounter it repeatedly, shaped by emotional storytelling, music and urgency-driven messaging. A 2025 Nigeria-based study on Jinja Herbal Mixture found it appeared safe for short-term use within tested dosage ranges, but researchers recorded biochemical changes at higher doses, including altered creatinine and sodium levels in test subjects, signs of possible kidney and liver stress. The study called for further research into long-term effects and interactions with conventional medicines. Regulatory Challenges in the Digital Age The National Agency for Food and Drug Administration and Control (NAFDAC) says it is working to track unregistered manufacturers, but enforcement remains difficult, especially online. "With the sheer volume of products online, enforcement has limited reach," said Isaac Kolawole, the southwest zonal director of NAFDAC. Many sellers use fake or incomplete addresses, making them difficult to trace. NAFDAC requires strict registration, testing and approval before herbal products can be sold or advertised, but regulation has not kept pace with online commerce. Fidelis argued that stronger regulation alone is not enough. "If there are no consequences for lying about healthcare online, people will keep doing it," he said. He noted that scammers have even used AI-generated versions of his image to promote fake products. "Real medicine does not promise to cure everything, and it does not rely on countdowns," he added. "Scammers do." Path Forward for Safer Digital Health As Nigeria's digital economy expands, the intersection of technology and healthcare will only grow more complex. Fidelis stressed that access to affordable healthcare must improve, public trust must be rebuilt, and digital platforms must take responsibility for the health content they amplify. Pharmacist Akinade Akinlolu noted that while conditions like diabetes and hypertension can be managed, online claims often suggest cures. "Economic pressure is also pushing people towards cheaper or 'miracle' alternatives," he added. "Without stronger safeguards," Fidelis warned, "the algorithmic apothecary will continue to grow and put more people at risk." The challenge for Nigeria's healthcare system is to harness the power of digital platforms while ensuring they promote evidence-based care rather than potentially harmful alternatives.

The Global Medicine Crisis UnfoldsThe United States and Israel's war on Iran has pushed up the price of nearly everything, with recent days seeing pharmacists note a spike in the price of medicines and contraceptives. In the United Kingdom, pharmacies are charging 20 to 30 percent more for over-the-counter medicines, while the common painkiller paracetamol has more than quadrupled in price. In India, chemists are reporting price rises of common painkillers of as much as 96 percent.Supply Chain Disruption Behind Medicine Price HikeSince the early days of the war, Iran has blocked the Strait of Hormuz, through which 20 percent of the world's oil and liquefied natural gas (LNG) supplies are shipped in peacetime. This has disrupted pharmaceutical supply chains, which are reliant on oil supplies. Pharmaceuticals are tied to petrochemical feedstocks, with many logistics routes between East Asia and Europe having important sea and air transhipment stops in the Gulf, particularly in Dubai.Furthermore, 35 percent of pharmaceuticals move by air, and about 90 percent of critical or life-saving pharmaceuticals and vaccines do so too. With the US-Israel war on Iran causing severe disruption for airlines, featuring widespread cancellations, airspace closures and a looming jet fuel crisis, approximately 22 percent of global air cargo flows are exposed to Middle East disruptions.Soaring Prices for Essential MedicationsPharmacies in the UK and India have noted significant increases in the price of paracetamol, a drug commonly used to treat headaches and the flu. In India, a former board member of the Visakha Chemists Association reported that paracetamol is rising by approximately 96 percent, with potential further increases of 30 to 40 percent due to spikes in raw material costs.In the UK, the price of paracetamol has also increased substantially. Olivier Picard, chair of the National Pharmacy Association, noted that the price he pays wholesalers for a pack of 100 500mg paracetamol tablets had jumped 41 pence to 1.99 pounds by the end of March, though it has since eased back to 1.09 pounds.Unequal Impact Across NationsThe impact of this pharmaceutical crisis varies significantly across different countries. The United States has domestic hydrocarbon and petrochemical supply, while China can source most of its demand from elsewhere. India, however, is a major producer of pharmaceuticals and depends on supplies from the Gulf, making it particularly vulnerable.The European Union has a 'solidarity mechanism' with stockpiling strategies including pharmaceuticals, with country-specific stockpiling requirements of two-10 months' worth of medicines. However, the problem is more acute for Global South countries, especially in sub-Saharan Africa, that have fewer or no stockpiles and limited financial resources to afford the price increases.Future Outlook for Global Medicine SupplyWhile the situation remains challenging, there are signs that some pharmaceutical supply chains may be stabilizing. The countries most likely to continue suffering are those directly touched by the conflict and regional disruption, including Lebanon, Palestine, and Iran. Fragile, aid-dependent countries that were already under severe pressure before this war also face significant risks.Import-dependent Gulf markets represent another conditional risk group, particularly for cold-chain and cancer medicines. However, in the Middle East region (excluding conflict zones), the situation remains more manageable than feared, with risks and delays rather than a generalized collapse. Pharmaceutical shipments continue to receive priority in air cargo due to their critical nature.

The Geopolitical Ripple Effect on UK MedicineThe ongoing conflict in Iran is creating a significant ripple effect across the UK healthcare sector, driving up the cost of essential over-the-counter medications and threatening supply chains. Community chemists are reporting that the war has pushed up the price of widely used medicines, including painkillers and hay fever medication, leading to a crisis for both patients and pharmacists.The Surge in Over-the-Counter Medication CostsCommunity chemists are charging customers 20-30% more for paracetamol than they did in February, according to the National Pharmacy Association (NPA). Over-the-counter prices for cetirizine tablets, a common hay fever medication, have also risen by the same margin. Furthermore, many pharmacies have run out of certain strengths of aspirin and co-codamol, with some temporarily halting sales of aspirin altogether due to supply constraints.The Supply Chain Shock: Fuel and FreightThe jump in petrol and diesel prices since the war began nearly eight weeks ago has increased manufacturing and transport costs for medicine suppliers by 40-50%. The conflict has also doubled air freight costs, as one in five NHS medicines comes in by air. Additionally, supplies of petroleum derivatives from the Gulf, essential for making common medications like paracetamol and aspirin, have been strangled.Paracetamol Price Spike: Purchase price for a pack of 100 500mg tablets jumped from 41p to £1.99 before easing back to £1.09.Reimbursement Gap: The government reimburses only 49p for a prescribed 32-pack of paracetamol, often forcing pharmacies to sell at a loss.Pharmacy Closures: Over 1,400 community pharmacies have closed since 2020, with one or two closing per week.The Crisis for Community Pharmacies and the NHSManufacturers of generic off-patent drugs operating on low margins have started to increase their prices, driving up the NHS medicines bill. While suppliers have long-term agreements with NHS hospitals, they have more leeway over drugs provided to pharmacies. This has led to a record 230 items on the price concessions list in March, compared to 90 in the same month last year. However, popular items like paracetamol and cetirizine remain excluded, meaning pharmacies are absorbing the cost.Looming Shortages and Future Price HikesAs manufacturers move to replenish stocks, transportation costs have risen by 700%, and some chemicals are in very short supply. Mark Samuels, chief executive of Medicines UK, warned that if the conflict continues, rising prices or shortages of essential medicines could occur as soon as the next few weeks. Patients are also warned that allergy sufferers could face more price increases by May or June, the peak of the hay fever season.

Pet owners in Britain may soon be barred from purchasing flea‑control products for cats and dogs at local shops. The government has opened an eight‑week public consultation to consider restricting sales to veterinarians or pharmacists, arguing that professional oversight will ensure correct usage and reduce environmental harm. Current regulations allow these topical treatments—containing potent insecticides such as fipronil and imidacloprid—to be bought in any pet store. Once applied, the chemicals disperse into the animal’s fur, enter waterways through washing or swimming, and have been linked to songbird nest failures and massive bee mortality. Water minister Emma Hardy emphasized the government’s commitment to “restore nature and clean up our rivers,” noting that while the products are vital for pet health, their distribution should be limited to professionals who can advise on safe application. Research funded by the Veterinary Medicines Directorate (VMD) found that pet owners’ use of these treatments contributes to detectable levels of fipronil and imidacloprid in rivers and lakes. Environment Agency data reveal fipronil residues in 98% of water samples and imidacloprid in 66%, often exceeding toxicity thresholds for aquatic insects. One monthly flea treatment for a large dog contains enough imidacloprid to kill 25 million bees, underscoring the broader impact on pollinator populations. In the UK, fipronil is an ingredient in 66 veterinary products, while imidacloprid appears in 21. Abigail Seager, chief executive of the Veterinary Medicines Directive, acknowledged the dual role of these chemicals in protecting pets and people from parasites, but warned that “they are entering our waterways and may be having wider environmental impacts.” She called for diverse stakeholder input to balance medicine availability with ecological protection. The consultation follows a recent governmental pledge to ban imidacloprid and two other neonicotinoids—clothianidin and thiamethoxam—from agricultural use, reflecting a broader strategy to safeguard biodiversity.