The overuse and misuse of antibiotics in Africa is fueling a surge in antimicrobial resistance (AMR), threatening health progress and putting millions of lives at risk.
Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist medications—including antibiotics, antivirals, antifungals, and antiparasitics—that were once effective.
A report by the Africa Centre for Disease Control and Prevention (Africa CDC) highlights the urgent need to strengthen surveillance, laboratory capacity, and data-sharing systems to combat this crisis.
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Antibiotics have long been the foundation of modern medicine, saving countless lives. However, their widespread misuse in healthcare, farming, and livestock has accelerated the rise of resistant microorganisms.
In 2019, AMR caused an estimated 23.7 deaths per 100,000 people in Africa, surpassing the combined toll of HIV/AIDS, tuberculosis, and malaria. AMR also threatens food security, economies, and livelihoods across the continent, according to the Africa CDC.
Africa faces many challenges in addressing AMR, including weak laboratory systems, limited surveillance, and gaps that allow resistant microorganisms to spread. Poor hygiene, counterfeit antibiotics, and weak infection control exacerbate the problem, undermining policy efforts.
Alarmingly, only 16% of 37 countries perform regular AMR checks in animals, even though resistant bacteria have been found on farms.
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The Africa CDC’s Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) study revealed that only 1.3% of microbiology labs in 14 member states can test for critical AMR pathogens, exposing a serious lack of diagnostic tools.
Another study published in The Lancet found that only 1% of 53,770 labs in 14 countries can test for bacteria, leaving over 136 million people without access to antimicrobial testing.
Only 23% of labs met ISO15189 accreditation standards, and automated diagnostic tools were rare, highlighting the urgent need for investment in National Action Plans (NAPs).
Top private and not-for-profit labs performed better than government labs.
However, NAPs allocated less than 20% of their budgets to addressing these issues.
Experts recommend expanding bacterial testing to cover 80% of the population, decentralizing services, improving lab certification, and using electronic data systems with sentinel sites for better monitoring. Strengthened lab systems are essential for timely actions and public health protection.
In response, Africa CDC has initiated several projects, including the Africa Pathogen Genomics Initiative (PGI), to equip countries with tools for real-time AMR tracking and response.
These efforts aim to enhance lab diagnostics, microbiology, and genomic monitoring across the continent. Training programs are also preparing skilled workers to handle research, surveillance, and interventions.
The global community is increasing its focus on AMR. In September 2024, the second High-Level Meeting on AMR during the 79th United Nations General Assembly adopted a political declaration to reduce AMR deaths by 10% by 2030.
This declaration, backed by $100 million in funding, includes commitments to ensure water, sanitation, and hygiene (WASH) in healthcare facilities, adhere to WHO infection prevention standards, and reduce antibiotic misuse in farming.
The Jeddah Commitments, introduced at the fourth Global High-Level Ministerial Conference on AMR in Saudi Arabia, emphasise sustainable funding and equitable access to antimicrobials.
Simple measures, such as improving WASH and infection prevention in healthcare facilities, could prevent up to 20% of AMR-related deaths each year in Africa.
Africa CDC has championed these priorities in its Continental Landmark Report, ensuring African challenges are included in global efforts. These commitments aim to strengthen Africa’s ability to combat AMR and contribute significantly to the global response.
Malawi offers a promising example of fighting AMR through its Antimicrobial Resistance Coordinating Committee (AMRCC), established within the Ministry of Health. The committee’s One Health approach integrates human, animal, and environmental health sectors.
Strong laws and political backing have been key to its success, which includes regular training for health workers, robust monitoring systems, and collaboration with stakeholders.