Table 2

Transportation, regulation and supply chain management as threats to product availability

Risks to availabilityNon-medical examplesMedical examples
Restrictions on the mobility of goods from the place of production to the place of consumption due to limitations on cross-border flows or transportation impedances17
  • Oil tanker stuck in Suez Canal blocked ships carrying PlayStation II to consumers for 2004 Christmas season42

  • Export bans, authorisations and related restrictions on critical supplies19

  • Grounding of commercial flights challenge global freight movement19

Restrictions on quality and availability in specific markets due to regulatory compliance failures: Relevant to industries regulated for public or consumer safety, for example, medical products, aviation, automotive, telecommunication18
  • Intentional contamination of milk with melamine identified in 2008, leading to health harms and food recalls43

  • Heparin recall in 2008 after deaths and adverse events due to manufacturing plant adulteration44

  • Multiple recalls of medicines containing valsartan in 2018 due to contamination risk45

Short-termism in sourcing activities: Sourcing activities that do not prioritise long-term supply reliability (eg, focus on upfront costs, sole sourcing, poor contract management)8
  • Retail sourcing emphasis on large-scale producers lead to severe vegetable shortages in Europe, winter 2016–201746

  • Risks from single vendor contracts (eg, Sprint Fidelis defibrillator lead recall of 200747)

  • Poor contract management leading to drug shortages48