Data Shortages Undermine Africa’s Fight Against Antimicrobial Resistance

Antimicrobial resistance (AMR) is emerging as a major health crisis across Africa, yet the continent lacks the laboratory data needed to monitor it effectively.

The Scale of the Threat and Data Gaps

A Lancet analysis placed western sub‑Saharan Africa at the top of the world for deaths attributed to bacterial AMR in 2019, with 27.3 deaths per 100,000 people.

The World Health Organization (WHO) estimated that in 2023, one in five laboratory‑confirmed bacterial infections in its African Region was resistant to antibiotics.

Because many infections are never tested, the WHO figure likely under‑represents the true burden.

In 2023, 48 % of countries worldwide failed to submit resistance data to the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS), and roughly half of the reporting nations lacked reliable data‑collection systems.

These gaps are especially acute in Africa, where laboratory capacity is limited and surveillance infrastructure is under‑developed.

Consequences for Clinical Practice and Policy

The Nigeria Centre for Disease Control and Prevention reports that half of hospitalised patients receiving antibiotics are prescribed more than one drug.

Antibiotics such as ceftriaxone, cefuroxime and ciprofloxacin dominate prescription patterns, amplifying selective pressure on bacteria.

Studies from Nigeria reveal high levels of empirical prescribing, meaning clinicians start treatment before laboratory results identify the causative organism or its drug susceptibility.

Dr Ifeyinwa George, pharmacist and AMR programme manager at DRASA Health Trust, highlights limited laboratory capacity as a core barrier to detecting and tracking resistant pathogens.

An Africa CDC‑led study across 14 countries found that only 1.3 % of roughly 50,000 laboratories in participating networks performed bacteriology testing.

Of about 187,000 samples examined for resistance, 88 % lacked essential clinical information such as patient diagnosis or prior antibiotic use.

A survey of 219 Kenyan health facilities showed that 61.6 % did not offer bacterial culture testing, and only 16.9 % performed antimicrobial susceptibility testing.

Prof Beverly Egyir, a Ghanaian AMR researcher, warned, “When we do not test, we are essentially flying blind.”

Even where testing exists, delays hinder timely decision‑making; at Cape Coast Teaching Hospital in Ghana, laboratory reports averaged 3.4 days from sample receipt to electronic upload.

Quality of Medicines Adds to the Blind Spot

Surveillance must also account for the quality of medicines patients receive, a factor often omitted from AMR data.

In 2025, Ghana’s Food and Drugs Authority seized counterfeit pharmaceutical products valued at GH₵42 million (approximately US $3.6 million).

Nigeria’s National Primary Healthcare Development Agency indicated that about 70 % of medicines distributed in the country are substandard or falsified.

These counterfeit drugs can contain insufficient active ingredients, fostering resistant strains while failing to treat infections.

The intertwining of poor diagnostic coverage, delayed results, and substandard medicines creates a feedback loop that fuels empirical prescribing and accelerates resistance.

Addressing the data gap therefore requires coordinated investment in laboratory infrastructure, electronic health record integration, and robust drug‑quality monitoring.

For governments and investors, the immediate opportunity lies in building these connections to generate reliable, timely evidence for clinicians and policymakers.

Why This Matters