African health ministers today endorsed a regional strategy to ramp up action against antimicrobial resistance, which is estimated to have directly contributed to 1.27 million deaths in sub-Saharan Africa in 2019.

The region faces a high burden of antimicrobial resistance, which occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat. Globally, around 10 million people – including 4.1 million in the African region – are projected to die of antimicrobial resistance by 2050.

While most African countries have national action plans to address antimicrobial resistance, there is poor implementation due to lack of political commitment, inadequate antimicrobial surveillance, including insufficient laboratory capacity, limited capacity to ensure optimized antimicrobials use and promote awareness and understanding of the threat posed by antimicrobial resistance. Poor infection prevention and control measures, and inadequate water, sanitation and hygiene services also pose challenges.

“The growing threat of antimicrobial resistance requires scaled-up and sustained action by all – from governments to individuals and across all sectors,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “The commitment made today comes at a crucial time. WHO will continue supporting countries to reinforce measures for an effective response against antimicrobial resistance.”

The resolution adopted during the Seventy-third session of the WHO Regional Committee for Africa in Gaborone, Botswana, aims to strengthen coordination and governance of action against antimicrobial resistance, improve awareness and understanding, step up surveillance of antimicrobial resistance and antimicrobial use, and reinforce applicable national regulations and laws.

The regional strategy target that, by 2030, all countries will have a functioning “One Health” approach – encompassing human, animal and environment health – on priority antimicrobial resistance actions.

All countries should also have a monitoring and evaluation system, be conducting national awareness programmes, and have enrolled in a global portal for standardized approach to data collection, analysis, interpretation and sharing. Additionally, all countries should implement measures to optimize responsible use of antimicrobials in healthcare facilities by 2030.

In the African region, the burden of antimicrobial resistance is also exacerbated by lack of enforcement of prescriptions and selling regulations, misuse and overuse of antibiotics in human and in animal feed, leading to spread of antibiotic-resistant strains.

The inappropriate use of antimicrobials in human, plant and livestock increases the risk of infections with microbes that are resistant to available treatments, potentially resulting in severe illness and death.