Africa has the world’s highest death rate from antimicrobial resistant infections – reported at 27 deaths per 100 000 – the health burden of which is far greater than HIV/Aids and of Covid-19, according to a policy brief by the Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) consortium.
However, says MAAP, for the first time, 14 African countries have taken a “critical step” towards controlling the deadly problem of superbugs – bacteria, viruses, parasites and fungi that are resistant to most antibiotics – by expanding their lab surveillance and reporting on antimicrobial drug resistance.
But only five out of 15 antibiotic-resistant pathogens most dangerous to people were being consistently tested in these countries that participated in the new research, mapping “the growing menace” of antimicrobial resistance across the continent.
And only 1% of the 50 000 participating laboratories were ready to do bacteriology testing and even fewer had the resources to detect antimicrobial resistance (AMR), the researchers found.
South Africa’s laboratory network and AMR surveillance, across state and private healthcare, is more developed than most African countries, and its 2021 report was the most comprehensive yet.
The public health sector used less than 8% of the total antibiotics procured, while both the public and private sector had a high usage of broad spectrum penicillin, it found.
About 40% of imported antibiotics in South Africa went to human use, while almost 60% was for animal use between 2018 and 2020, broadly aligned with other countries internationally, the report stated.
Dr Yewande Alimi, AMR programme co-ordinator for the Africa Centre for Disease Control and Prevention, said the reports put AMR on the map of Africa for the first time, and were a critical step to tackling the threat on the continent, reports Sunday Times.
The landmark study led by MAAP revealed that only four drugs made up the backbone of antibiotic use being used for two-thirds of treatments in healthcare settings, and only six countries had “reserve category antibiotics” that are vital to treat resistant pathogens.
The reports exposed “an alarming picture of antimicrobial consumption” in African countries, in which patients lacked access to the drugs and use was erratic.
Despite the dismal findings, the findings are “a unique resource for (those) working at reducing the burden of AMR in Africa”, said Pascale Ondoa, science director at the African Society for Laboratory Medicine, which co-published the reports with the Africa CDC.
Globally, 1.27m deaths are attributable to infections caused by resistant bacteria and this figure “could rise as high as 10m in 2050”, said the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (Charm).
Charm head Professor Nelesh Govender, based at the National Institute for Communicable Diseases (NICD), said: “Antimicrobial resistance affects everyone. AMR is not a single ‘disease’.”
The countries taking part in the MAAP research were Burkina Faso, Cameroon, eSwatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia and Zimbabwe.
More than 819 500 data records of antimicrobial resistance were collected from 205 labs between 2016 to 2019 for the reports, which will inform national action plans and policy in Africa.
Africa heads of states in 2020 committed to tackling the AMR threat across human and animal health and agriculture through the Africa Union Framework for Antimicrobial Resistance Control 2020-2025.
TimesLIVE article – Superbug menace across Africa mapped in landmark study (Restricted access)
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