Tackling antimicrobial resistance across sub-Saharan Africa: current challenges and implications for the future

Area of Science:

• Global Health
• Infectious Diseases
• Public Health Policy

Background:

• Antimicrobial resistance (AMR) poses significant global health threats, increasing morbidity, mortality, and healthcare costs.
• Sub-Saharan Africa exhibits the highest rates of AMR globally, necessitating urgent action.
• Numerous international, Pan-African, and national initiatives, including National Action Plans (NAPs), have been established to address rising AMR.

Purpose of the Study:

• To document current NAP activities and persistent challenges across sub-Saharan Africa.
• To provide guidance for future efforts in combating AMR in the region.
• To build upon existing literature through a narrative review.

Main Methods:

• A narrative review of existing literature was conducted.
• Survey of National Action Plan (NAP) activities and implementation status across sub-Saharan African countries.

Main Results:

• All surveyed sub-Saharan African countries have developed NAPs, but implementation is variable.
• Countries like Botswana, Namibia, and Eswatini are in early stages of NAP implementation, while Cameroon shows some progress.
• South Africa demonstrates advanced NAP implementation, including antimicrobial stewardship programs and monitoring.
• Persistent challenges include limited personnel, expertise, capacity, resources, lack of focal points, and competing priorities.

Conclusions:

• Despite universal NAP development in sub-Saharan Africa, variable implementation and significant challenges impede progress.
• Addressing resource limitations, enhancing coordination, and establishing clear focal points are crucial for effective AMR reduction.
• Coordinated efforts are essential to overcome existing barriers and mitigate the growing threat of antimicrobial resistance.