Antimicrobial resistance, AMR, is a growing concern in Nigeria, posing a risk of increased morbidity and mortality, threatening the control of emerging and increasing range of infections that result from microorganisms.  

It arises from the overuse and misuse of antibiotics and other antimicrobial agents. It occurs when microorganisms such as bacteria, fungi, viruses and parasites become resistant to the antimicrobial agents that are commonly used to combat them. When antimicrobial resistance sets in, active antimicrobial agents that include antibiotics, anti-fungals, anti-virals and anti-parasitics, no longer show preventive activity against the corresponding microbes.

As a result, erstwhile effective medicines become ineffective against the targeted pathogens and infections become difficult or impossible to treat. This development is worsening existing infections and increasing illness and death rates.

In recent years, Nigeria has faced this formidable and escalating public health threat that is leading to longer hospital stays, higher medical costs, and increased mortality rates.

It is compromising the ability to treat infections effectively, endangering lives and burdening an already strained healthcare system. The malady is amplified by factors such as self-medication, lack of regulation, and inadequate healthcare infrastructure.

The World Health Organisation, WHO, rates Nigeria as having the 20th highest age-standardised mortality rate per 100,000 population associated with antimicrobial resistance across 204 countries. Fatalities caused by antimicrobial resistance in the country are higher than recorded from fevers, respiratory infections and tuberculosis.

The ease of accessibility of antibiotics without prescriptions allows misuse. Quite often, people take antibiotics for viral or fungal infections against which they are ineffective. Worse still, the incomplete courses of treatment contribute to the survival of partially resistant strains, which proliferate and spread.

The problem is worsened by a generally low awareness and poor understanding of AMR in the country. This is evident in the pattern of use of available antimicrobials which are mostly obtained over-the-counter, facilitating irrational use and enhancing the exposure of microbes to non-lethal doses.  

Weak regulations, chaotic distribution and unrestricted access are also enhancing the problem, just as a lack of formal antimicrobial stewardship and support for effective management of antibiotic use is worsening the problem. To reduce the overuse and misuse of antimicrobials, the Federal Government launched an action plan, several years ago, to focus on the healthcare, animal agriculture, and environmental sectors. This Action Plan must be revisited.     

Consistent dispensing of antimicrobial agents as prescription-only medicines is a major means of curbing inappropriate access and potential antimicrobial resistance.  

Since misuse and overuse of antimicrobials is a major source of antimicrobial resistance in the country, effective communication and targeted messaging by pharmacists and other medical personnel, including proper regulation, will promote rational use. The menace of antimicrobial resistance desires conscious and effective attention of healthcare providers and other stakeholders for its control. Combating the problem requires responsible antimicrobial use and improving healthcare delivery.  

Public awareness campaigns are crucial in educating the populace about the dangers of antimicrobial misuse even as healthcare professionals must adhere to stringent guidelines for prescriptions, and ensuring they are only used when absolutely necessary.  

Strengthening regulations around the availability and access of antimicrobials can help curb their misuse and prevent the development of resistant strains. 

Antimicrobial resistance is a clear and present danger to public health in Nigeria. It demands immediate and concerted action.  

By promoting responsible antimicrobial use and strengthening healthcare systems, Nigeria can mitigate the impact and protect its citizens from this growing threat. It is a battle that requires vigilance, education, and a commitment to sustainable health practices.