Antimicrobial Resistance (AMR) is fast becoming one of the gravest health threats of our time. Around the world, drug-resistant infections are on the rise, undermining decades of progress in modern medicine. Nowhere is this crisis more acute than in Africa, where AMR is fuelling a surge in preventable deaths and overwhelming fragile healthcare systems.
In response, global institutions such as the World Bank are stepping in through major health investment programmes like REDISSE (Regional Disease Surveillance Systems Enhancement) and HEPRR (Health Emergency Preparedness, Response, and Resilience). These initiatives champion a One Health approach, recognising the interconnectedness of human, animal, and environmental health. By funding AMR surveillance, health workforce training, and the development of local pharmaceutical capacity, these programmes aim to strengthen Africa’s ability to contain resistance and promote more sustainable, resilient health systems. But as the threat escalates, coordinated global and regional action is no longer optional; it is imperative.
READ ALSO: The Future of Healthcare in Africa: Can Tech Solve the Doctor Shortage?
Globally, AMR contributes to approximately 4.95 million deaths annually, with over 1.27 million directly attributed to drug-resistant infections. Projections indicate that, without effective interventions, AMR could cause up to 10 million deaths per year by 2050, surpassing the current mortality rates of cancer. This silent pandemic threatens to undermine decades of medical advancements, rendering common infections and minor injuries potentially lethal.
According to the World Health Organisation, AMR has significant economic costs. The World Bank estimates that AMR could result in US$ 1 trillion in additional healthcare costs by 2050 and US$ 1 trillion to US$ 3.4 trillion in gross domestic product (GDP) losses per year by 2030.
Africa bears a disproportionate burden of the AMR crisis. The continent experiences the highest mortality rate from AMR, with 27.3 deaths per 100,000 people, surpassing the combined death toll from HIV/AIDS, tuberculosis, and malaria. In Nigeria alone, over 64,000 deaths in 2019 were linked to AMR, highlighting the severity of the issue.
Several factors contribute to this crisis in Africa. The misuse and overuse of antibiotics in human medicine and agriculture accelerate the development of resistant strains. Additionally, inadequate access to clean water, poor sanitation, and limited vaccination coverage exacerbate the spread of infections. The prevalence of substandard and falsified medicines further compounds the problem, undermining treatment efficacy and fostering resistance.
The One Health Approach
Addressing AMR requires a comprehensive strategy that recognises the interconnectedness of human, animal, and environmental health, a concept known as the One Health approach. The World Bank has been instrumental in promoting this strategy through programmes like the Regional Disease Surveillance Systems Enhancement (REDISSE) and the Health Emergency Preparedness, Response, and Resilience (HEPRR) Programme.
REDISSE, initiated in the aftermath of the 2014–2016 Ebola outbreak, has engaged 16 countries in West and Central Africa, benefiting nearly half a billion people. The programme focuses on strengthening disease surveillance systems, enhancing laboratory capacities, and fostering regional collaboration. HEPRR, with funding of $1.5 billion, extends these efforts to Eastern and Southern Africa, aiming to bolster health emergency preparedness and response capabilities.
These initiatives emphasise the importance of integrated planning, robust regulatory frameworks, and sustainable financing to combat AMR effectively.
The Role of Health Champions
Community engagement is pivotal in the fight against AMR. In Nigeria, organisations like the DRASA Health Trust have pioneered the Health Champions initiative, training individuals from diverse backgrounds to advocate for responsible antimicrobial use and educate their communities about the dangers of AMR.
These health champions, including government officials, students, and religious leaders, undergo participatory training sessions to enhance their technical knowledge and communication skills. By leveraging peer-to-peer learning and community-led initiatives, they promote best practices in disease prevention, such as hand hygiene and immunisation, thereby reducing the reliance on antibiotics. Currently, DRASA Health Trust has mobilised over 2,000 AMR ambassadors across 30 secondary schools in Nigeria, demonstrating the impact of grassroots movements in addressing public health challenges.
Strengthening Surveillance and Diagnostic Capacities
Effective surveillance and diagnostics are critical for monitoring AMR trends and informing policy decisions. However, many African countries face significant challenges in this regard. A joint study by the Africa CDC and the African Society for Laboratory Medicine revealed that only 1.3% of microbiology laboratories in 14 African Union member states can test for key AMR pathogens.
To address this gap, the Africa CDC’s Pathogen Genomics Initiative (Africa-PGI) is working to enhance genomic surveillance capacities across the continent. By providing training in next-generation sequencing and bioinformatics, the initiative aims to detect and monitor the spread of resistant strains, such as the hypervirulent Klebsiella pneumoniae, which poses a significant threat to neonatal health.
Furthermore, the WHO’s Global AMR Surveillance System (GLASS) supports 43 African countries in strengthening laboratory capacities, improving data collection, and fostering data-driven decision-making.
Investing in Local Pharmaceutical Manufacturing
Reducing dependence on imported medicines is essential for ensuring access to quality antimicrobials and mitigating the spread of resistance. The HEPRR programme emphasises the development of regional pharmaceutical and vaccine manufacturing capacities, coupled with strong regulatory ecosystems and reliable market infrastructures.
By investing in local production, African countries can improve the availability of effective antimicrobials, reduce the circulation of substandard medicines, and enhance their resilience to health emergencies.
Global Commitments and the Path Forward
Recognising the urgency of the AMR crisis, world leaders have committed to reducing superbug-related deaths by 10% by 2030. This target, established at the UN General Assembly, underscores the need for coordinated efforts across healthcare, agriculture, and environmental sectors.
Achieving this goal requires substantial financial investment. The Africa CDC estimates that $2–6 billion is needed annually to combat AMR effectively in Africa. However, current funding levels remain only a fraction of what is allocated to other major diseases, highlighting the need for increased resource mobilization.
AMR represents a challenge that threatens global health security. Embracing the One Health approach, empowering communities, strengthening surveillance systems, investing in local pharmaceutical manufacturing, and securing adequate funding, can turn the tide against this silent health emergency. The time to act is now, as the future of public health in Africa depends on the collective resolve to confront AMR head-on.
