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Africa's fight against antimicrobial resistance

Eunice Wanjiru
September 30, 2024

Antimicrobial resistance is linked to more than 1 million disease-related deaths in Africa, according to a report by the Global Research on Antimicrobial Resistance Project. What's behind the statistics?

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Bacterial transduction - Illustration of bacterial transduction, a horizontal gene transfer mechanism that can lead to antimicrobial resistance.
Illustration of bacterial transduction, a horizontal gene transfer mechanism that can lead to antimicrobial resistance.Image: Science Photo Library/IMAGO

Sub-Saharan Africa accounts for a disproportionate share of global antimicrobial resistance deaths. A recent groundbreaking report by Global Research on Antimicrobial Resistance (GRAM) Project forecasts that between 2025-2050, more than six million deaths will be directly attributed to AMR in sub-Saharan Africa.

According to the World Health Organization (WHO), Antimicrobial Resistance known as AMR for short, occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. Infections then become harder to treat, increasing the spread of disease, severe illness and death.

"AMR is a shared global problem. However, the highest burden, which means the highest number of deaths, is in Sub-Saharan Africa and in Southeast Asia," research lead of the Drug Resistant Infections for the Welcome Trust in London, Janet Midega, told DW.

This rapidly growing threat is a major concern for the future of global health and modern healthcare. It is projected that over 39 million people could die from antibiotic-resistant infections by 2050.

The global threat of antimicrobial resistance

Factors contributing to the rise of resistance include lack of access to clean water, sanitation and hygiene, related to both humans and animals. Also a lack of infection and disease prevention measures in homes, healthcare facilities and farms plays a role, as well.

Global commitment

A high-level meeting on AMR was held during the UN General Assembly at the end of September to discuss how to reduce human deaths from AMR by 10% by 2030.

World leaders met inNew York and agreed upon a list of global targets to control the antimicrobial resistance crisis.

"Today's political declaration shows the global commitment to collective action to control AMR," said Dr. Hans Henri P. Kluge, World Health Organization Regional Director for Europe. "With this clear target and the commitments made, we can accelerate progress and make sure less people die and suffer. This political declaration gives us the opportunity to strengthen investment in AMR control and partnerships, as well as increase solidarity and mutual accountability between countries."

AMR is recognized by the World Health Organization as one of the top ten global health threats. It is directly responsible for 1.3 million deaths a year.

The first Global Research on Antimicrobial Resistance (GRAM) study, published in 2022 in the Lancet, found that global AMR-related deaths in 2019 were higher than those from HIV/AIDS or malaria, directly causing 1.2 million deaths, and playing a role in a further 4.95 million deaths.

What does the new UN 'Pact for the Future' mean for Africa?

Action taken to stop AMR

Without urgent intervention, antimicrobial resistance will cause severe social, and economic consequences, say experts.

"As a multi-faceted problem, AMR requires action from different sectors of the economy, politics, the healthcare system, and policymakers in order to solve it," Janet Midega of Welcome Trust London said.

She added that reports about deaths in Africa attributed to AMR, mentioned not only resistance, but critically, lack of access to  antibiotics.

"One of the most important things for governments to do is to work on infection prevention and control, so that infections can be prevented before they occur… governments could (also) enhance water sanitation and hygiene services," Midega told DW. She added that vaccines should be more widely available, such as the pneumococcal conjugate vaccine. But the most important aspect, she added, is "to ensure that there is access to antibiotics."

Antimicrobial medicines play an important role in modern healthcare. The spread of drug-resistant pathogens threatens the ability to treat common infections. In addition, drug-resistant infections impact the health of animals and plants, reduce productivity in farms, and threaten food security.

In the  political declaration, heads of state and governments  committed to strengthening governance mechanisms for the response to AMR, using a One Health approach, which according to the World Health Organization is an "integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems."

"What we need now is for leaders to speed up what they've begun — speed up awareness, effective prevention; speed up the management of AMR at the national, regional and global levels. We have to stop antimicrobials from leaking into nature," Inger Andersen, Under-Secretary-General of the United Nations and Executive Director of UN Environment Program, said at the recent UN meeting on AMR.

Edited by: Sarah Hucal