By Rakiya A.Muhammad
As the world intensifies its battle against Antimicrobial Resistance (AMR), Nigeria finds itself at the forefront of this urgent crisis. The World Health Organization has labelled AMR as one of the most severe global public health and development concerns, underscoring the need for immediate and concerted action.
“The misuse and overuse of antimicrobials in humans, animals, and plants are the main drivers in developing drug-resistant pathogens,” WHO reveals.
“AMR puts many of the gains of modern medicine at risk. It makes infections harder to treat and makes other medical procedures and treatments—such as surgery, caesarean sections, and cancer chemotherapy—much riskier.”
Startling Numbers
The figures are alarming.The Institute of Health Metrics and Evaluation (IHME) report shows that 4.95 million people who died in 2019 suffered from drug-resistant infections, while AMR directly caused 1.27 million of those deaths. 1 in 5 of those deaths occurred among children under 5 years old.
It notes that in Nigeria, there were 64,500 deaths attributable to AMR and 263,400 deaths associated with AMR in 2019.
Among the 204 nations studied, Nigeria ranks 20th in the age-standardised mortality rate per 100,000 people due to AMR.
The Nigeria Centre for Disease Control and Prevention (NCDC), tasked with overseeing the preparedness, detection, and response to public health emergencies, explains the situation more..
“Low- and middle-income countries (LMICs), including Nigeria, bear the brunt of the burden, accounting for nearly 90 per cent of the direct death toll,” it notes.
“Sadly, over 99.5 per cent of AMR-related deaths are among children under five. Recent studies show that more people die directly from AMR than from HIV/AIDS, malaria, or any one form of cancer other than lung cancer.”
“In Africa, the burden of death attributed to AMR was highest in western Africa, at 27.3 deaths per 100,000, making it a super region for death due to drug-resistant pathogens.”
NCDC elaborates: “According to the World Health Organisation (WHO), there are 15 priority antibiotic-resistant pathogens causing the greatest threat to human and animal health, and 4 of them have been detected in Nigeria.”
It describes the enormous impact of AMR on the economy, health systems, and the attainment of sustainable development goals (SDGs).
“Up to US$100 trillion of global gross domestic product could be lost due to AMR by 2050, and the LMICs would be most negatively impacted,” NCDC reveals.
“Antimicrobial agents are essential for food security, as they are used to treat and prevent diseases in livestock and crops. The global consumption of antimicrobials is projected to rise by 70% by 2030 and will affect sustainable food production systems if nothing is done.”
Resisting the Resistance
Recognising the gravity of the situation, multiple stakeholders have joined forces. The Nigerian government, NGOs, and international organisations pool resources and expertise to combat this menace.
“Antimicrobial resistance is not only a public health threat; it has huge implications for global economic wellbeing and security, affecting developed and developing countries,” says Dr Iziaq Salako, Minister of State for Environment, at the recent inauguration of the National Antimicrobial Policy and Strategic Plan on Microbial Resistance (2023–2027) Environment Sector.
“Nigeria, as a responsible member of the global community, is committed to adopting a holistic approach to addressing AMR and ensuring all sector involvement.”
The minister continues, “To achieve this and protect public health, food security, and the environment, the recognition of the interconnectedness between human, animal, and environmental health in line with the One Health Principle is central.”
Dominique Koffy Kouacou Head of the Food and Agriculture Organisation (FAO) urges:”All sectors must address antimicrobial resistance, a health issue, and countries must implement measures to curb and manage the surge.”
“It is estimated that 10 million people will die annually by the year 2050, and the economies of nations will be negatively affected if this challenge is not mitigated,” he adds.
” For this reason, the FAO in 2022 supported the Federal Ministry of Environment to develop the AMR Policy and Strategic Plan (2023-2027).”
The FAO head emphasises the need to ensure all relevant environmental stakeholders are sensitised and participate in the fight against AMR in the environment, especially and generally at the animal-human interface.
Nigeria’s struggle against AMR depends on sustainable practices, continuous research, and international cooperation as it confronts this challenging landscape.
The country was one of the 17 participating nations in the Africa Centers for Disease Control and Prevention’s Pathogen Genomics Initiative (African short-term intensive courses to transform disease surveillance).
Dr. Yenew Kebede, head of the Laboratory Systems Division at the Africa Centre for Disease Control, underscores the urgency of the situation. “Strengthening laboratory diagnostics, microbiology, and genomic surveillance capacity for AMR across Africa is critical. We need to detect and elucidate the burden of AMR in Africa as soon as possible to address this silent pandemic.”
The Africa CDC, a leading authority in public health on the continent, acknowledges antimicrobial resistance as a significant public health concern and is actively involved in addressing this issue.
“Currently, there is limited epidemiological, laboratory, and genomic data to inform responses, which makes it critical to equip member states to ensure timely detection and response to AMR.”
For Nigeria, the NCDC reaffirms the nation’s dedication to combating the global threat of AMR, a battle that necessitates a One Health strategy and collaborations.
“Led by the Nigeria Centre for Disease Control and Prevention in collaboration with the tripartite sectors, there is now an AMR surveillance network, antimicrobial stewardship, and awareness programs across the country creating awareness of AMR among healthcare professionals, farmers, and the public,” it asserts.
“To effectively curb this menace, all sectors must join forces and encourage the prudent use of antimicrobials and preventive measures.”
