ANTIMICROBIAL RESISTANCE IN AFRICA
Authors: Joseph Adegoke
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Abstract
This article is about the critical threat of Antimicrobial Resistance (AMR) in Africa, highlighting its causes, challenges, and potential solutions through improved healthcare systems, antimicrobial stewardship, and international collaboration to mitigate its global health and economic impacts.
Full Description
Antimicrobial resistance (AMR) is a top global health threat, projected to cause 10 million annual deaths by 2050 and reduce GDP by up to 3.5% if not urgently addressed. AMR arises when pathogens resist antimicrobial medicines, making infections harder to treat and increasing disease spread, severe illness, and deaths. In 2019, 4.95 million deaths were linked to bacterial resistance, with 1.27 million directly caused by it. LMICs face higher burdens due to prevalent infectious diseases. In Africa, AMR contributed to over 1 million deaths, particularly from lung, bloodstream, abdominal infections, and tuberculosis. AMR also threatens life-saving medical interventions like cancer treatments and surgeries.
The ESKAPE pathogens, including Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter species, and Pseudomonas aeruginosa, represent a critical public health challenge in Africa due to their association with severe infections and growing antibiotic resistance. These pathogens are responsible for conditions such as UTIs, pneumonia, sepsis, and bloodstream infections, with resistance mechanisms exacerbated by factors like biofilm formation and genetic diversity. Acinetobacter baumannii, for example, has alarmingly high multidrug resistance rates in intensive care settings across Africa.
Antibiotic resistance is driven by various factors, including inappropriate antibiotic use, gut microbiota imbalances, One Health dynamics, climate change, human mobility, improper waste management, and inadequate infection control practices. These drivers are amplified by systemic challenges such as the prevalence of substandard drugs, insufficient laboratory infrastructure, workforce shortages, poor coordination, scarce diagnostic supplies, reliance on donor funding, and inconsistent data reporting.
Efforts to combat antibiotic resistance have been guided by global initiatives like the WHO's Global Action Plan (GAP), which serves as a framework for national policies, emphasizing awareness, surveillance, and stewardship. Programs such as ReAct and GLASS foster collaboration, strengthen laboratories, and promote evidence-based policies, while campaigns like World Antimicrobial Awareness Week aim to educate and mobilize the global community. Addressing the complex and urgent issue of antibiotic resistance requires sustained and united efforts across sectors, regions, and communities to safeguard public health and ensure sustainable outcomes.