By Eniola Akinkuotu
In the face of an ongoing global health crisis, antimicrobial resistance (AMR) has emerged as a stealthy, deadly epidemic—claiming more lives in Africa than malaria, HIV, and tuberculosis combined. Unlike these well-known diseases, AMR often goes undetected until it is too late, making it one of the most significant but invisible threats to public health in the 21st century.
What is AMR?
Antimicrobial resistance occurs when microorganisms—bacteria, viruses, fungi, or parasites—develop the ability to withstand the medications designed to kill or inhibit them. This resistance renders standard treatments ineffective, leaving infections to persist and spread unchecked. The World Health Organization (WHO) describes AMR as a “silent killer,” responsible for over 1.3 million deaths annually and contributing to an additional five million fatalities worldwide.
In Africa, where infectious diseases remain a significant public health burden, AMR compounds an already dire situation. The African Centre for Disease Control (CDC) reports that the continent has the highest mortality rate from AMR globally, with 27.3 deaths per 100,000 people.
A Personal Face to the Crisis
Isaiah’s Story
Fourteen-year-old Isaiah, a sickle-cell anaemia patient from Nigeria, has become resistant to common malaria medications. His condition exemplifies how indiscriminate use of antimalarial drugs has driven resistance in his community. For years, his family relied on a popular prophylactic antimalarial medication taken weekly—a practice common in Nigerian households.
When Isaiah fell ill in 2022, doctors prescribed a new antimalarial treatment. However, the drugs failed to alleviate his symptoms, leaving him in a constant cycle of illness. His recurring bouts of malaria have disrupted his education and dashed his dreams of becoming a lawyer.
The Tragedy of Kingsley Ogbonna
Isaiah’s plight mirrors that of Kingsley Ogbonna, a 62-year-old trader living with HIV. Despite accessing free antiretroviral therapies provided by the government, his condition worsened due to drug resistance. His inability to afford a $29 drug resistance test prevented timely intervention. Kingsley eventually succumbed to complications, leaving behind a legacy of sorrow and highlighting the socioeconomic barriers that exacerbate the AMR crisis.
Drivers of the Epidemic
1. Self-Medication and Drug Misuse
Self-medication is rampant in many African nations, including Nigeria, where antibiotics and other medicines are easily accessible without prescriptions. Many individuals discontinue treatment as soon as symptoms subside, unaware that incomplete courses of antibiotics fuel resistance by allowing surviving pathogens to adapt and thrive.
Additionally, unregulated traditional remedies—such as “agbo,” a herbal concoction often mixed with antibiotics—further contribute to the misuse of antimicrobial drugs. Consumers unknowingly ingest sub-therapeutic doses, which weaken the potency of these life-saving treatments.
2. Overuse in Agriculture
Antimicrobial agents are widely used in farming to promote growth and prevent disease in livestock. These practices introduce resistant bacteria into the food chain and environment, ultimately affecting human populations.
3. Environmental Contamination
Pharmaceutical wastewater and agricultural runoff containing residual antibiotics contaminate water sources, promoting the spread of resistant microbes. This environmental exposure compounds the AMR problem, creating a feedback loop that reinforces resistance across ecosystems.
Economic and Social Consequences
The financial burden of AMR is staggering. Testing for drug resistance in HIV patients can cost up to $180 in Nigeria, an insurmountable expense in a country where the monthly minimum wage is $45. This cost disparity denies access to critical diagnostic tools for millions, leaving them vulnerable to ineffective treatments.
Globally, AMR is projected to result in $100 trillion in economic losses by 2050, surpassing the financial impact of cancer. In Africa, where healthcare infrastructure is already strained, the repercussions could be catastrophic, further deepening poverty and inequality.
Addressing the Crisis
1. Strengthening Healthcare Policies
Efforts like Nigeria’s Second National Action Plan on Antimicrobial Resistance (AMR 2.0) aim to address the issue comprehensively. This initiative seeks to regulate drug usage, increase awareness, and enhance surveillance systems. However, the success of such programs hinges on robust funding and sustained political will.
2. Improving Access to Diagnostics
Subsidizing drug resistance tests and integrating them into universal healthcare schemes can ensure early detection and timely intervention. Investments in local manufacturing of diagnostics and treatments could reduce costs and improve accessibility.
3. Public Education Campaigns
Widespread educational initiatives are needed to promote responsible drug use. Communities must understand the risks associated with self-medication and incomplete treatments.
4. Global Collaboration
AMR is a global problem that requires international cooperation. High-income nations must support African countries through technology transfer, funding for research, and capacity building.
A Call to Action
Antimicrobial resistance threatens to dismantle decades of progress in global health. Without immediate and coordinated action, this silent epidemic will continue to devastate communities, economies, and healthcare systems worldwide. Africa, bearing the brunt of this crisis, must prioritize AMR in public health strategies and mobilize resources to protect its population from this invisible killer.
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