Nigeria has formally launched its first nationally representative survey on antimicrobial resistance (AMR), signalling a significant escalation in the country’s efforts to confront a growing global threat. The initiative, backed by the World Health Organisation (WHO) in collaboration with the Nigeria Centre for Disease Control and Prevention (NCDC) and the Federal Ministry of Health and Social Welfare (FMoH&SW), promises to deliver robust data to underpin national strategies, shape policy, and ultimately protect lives.
This milestone follows a five-day planning workshop during which government officials, scientists, and international partners finalised the technical protocol and operational strategy for the survey. The consensus reached during that workshop establishes the foundation for a rigorous nationwide undertaking, a first of its kind for Nigeria.
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By joining this endeavour, Nigeria becomes only the third country globally to partner with WHO on a national AMR survey, a recognition of the country’s strengthened commitment to AMR surveillance, anchored to its updated national action framework (NAP 2.0), and a reflection of its readiness to expand laboratory and data systems.
Understanding the Urgency
Antimicrobial resistance arises when microorganisms, bacteria, viruses, fungi and parasites evolve mechanisms to withstand previously effective treatments, rendering once-manageable infections increasingly difficult or impossible to treat.
According to WHO’s global analysis, in 2019, an estimated 263,400 deaths in Nigeria were linked to AMR, a figure surpassing the combined fatalities from enteric infections, tuberculosis, respiratory diseases, maternal and neonatal disorders, malaria, cardiovascular diseases, neglected tropical diseases and more.
As of 2025, the WHO indicates that AMR claims more than 60,000 lives in Nigeria annually. In 2021 alone, roughly 50,500 deaths were directly attributable to drug-resistant infections, with a total of 227,000 deaths associated with AMR that year, a statistic that underscores the disproportionate burden borne by vulnerable populations, including children under five.
On the international stage, the toll of resistant infections is even more palpable: in tertiary care environments worldwide, such infections can increase hospital stay by an average of 7.4 days and raise mortality risk by 84 per cent. Treatment costs per episode can range between US$2,371 and US$29,289.
These numbers frame AMR not simply as a clinical nuisance but a looming public health emergency, one that undermines decades of medical progress and threatens the effectiveness of essential medicines.
Scope, Design and Ambitions
The national AMR survey in Nigeria will span 12 to 15 months and is slated to cover between 40 and 45 randomly selected health facilities across the country. The selection of facilities aims to ensure representativeness across diverse regions and population groups.
The focus will be on patients suspected of bloodstream infections (BSIs), using standard global case definitions. Blood samples will be processed in quality-assured laboratories to isolate the most common pathogens. The survey aims to recruit approximately 35,000 patients suspected of BSIs, with the expectation of yielding around 800 microbial isolates for detailed analysis.
Data collection will be comprehensive. It will encompass all age groups and gather a spectrum of clinical, demographic, laboratory, financial, and outcome-based indicators. Patient follow-up will occur at discharge, at 28 days post-infection, and three months later to assess outcomes and long-term effects.
The broader objectives are ambitious yet essential: establish a national baseline on AMR prevalence to enable tracking of interventions; assess the geographic and demographic distribution of resistance, morbidity, mortality, DALYs (disability-adjusted life years), and cost; and strengthen routine surveillance, including diagnostics, sample referral systems and laboratory capacity.
The survey is also designed to contribute to the global aim of reducing AMR-related deaths by 10 per cent by 2030, a target aligned with the political declaration adopted at the 79th session of the United Nations General Assembly (UNGA) in 2024.
Building Capacity
Beyond data collection, the AMR survey represents a strategic investment in Nigeria’s health system resilience. The technical support from WHO will enhance the capacity of laboratories, strengthen diagnostic and referral systems, and provide a model for integrating science into public health decision-making.
Senior officials have underscored the importance of domestic ownership and multi-sectoral collaboration. By involving government bodies, healthcare institutions and international partners, Nigeria aims to weave AMR response into its broader health security agenda, advancing not only morbidity and mortality reduction but also supporting progress toward Universal Health Coverage (UHC).
The survey is also expected to strengthen Nigeria’s adherence to the “One Health” paradigm, recognising that AMR is not just a human health issue, but intersects with veterinary, environmental and agricultural domains. The expansion of surveillance beyond solely clinical settings will provide a more comprehensive understanding of how resistance emerges and spreads.
Implications for Patients, Policy and Global Health
For patients, the survey holds the promise of improved diagnosis, more effective treatments, and better clinical outcomes. It could reduce the frequency of treatment failures, long hospital stays, and preventable deaths. For policymakers, the evidence generated will enable informed decisions on antibiotic prescription guidelines, resource allocation, and national stewardship strategies.
At a global level, Nigeria’s participation enhances the collective ability to monitor AMR trends across Africa and beyond, pooling data to inform regional and international responses. As one of the first countries to adopt such a comprehensive, WHO-backed national survey, Nigeria positions itself as a potential leader in AMR surveillance on the continent.
A New Chapter in Nigeria’s Health Security
The launch of Nigeria’s first national antimicrobial resistance survey marks a critical juncture in the country’s public health journey. It reflects a shift from reactive treatment to proactive prevention, from fragmented data to coherent nationwide surveillance, and from isolated interventions to integrated health-system strengthening.
With rigorous design, broad scope and international support, the survey stands to deliver the evidence base necessary to counter AMR, preserving the power of essential medicines, safeguarding public health, and fortifying Nigeria’s resilience against future epidemics.
In a time when antimicrobial resistance threatens to unravel decades of medical progress globally, Nigeria’s bold step sends a clear signal: the fight is on, and this nation is determined not to be left behind.
