While global health headlines focus on pandemic preparedness and disease outbreaks, a slower but far larger catastrophe is unfolding across Africa: antimicrobial resistance, or AMR, is now killing more people on the continent than HIV, malaria, or tuberculosis individually, and the toll is climbing steeply.
A feature published by France24 this week placed AMR squarely in the spotlight, drawing on data from the World Health Organisation and African health ministries that paint a deeply alarming picture. In Africa, drug-resistant infections already claim an estimated 1.27 million lives annually — more deaths than all the continent’s major infectious diseases combined. By 2050, if current trends continue unchecked, AMR could cost Africa 00 billion in economic losses and push 28 million more people into extreme poverty.
The crisis has multiple roots. Overuse and misuse of antibiotics in human medicine is one part of the problem. But in Africa, the drivers are more complex: antibiotics are frequently sold over the counter without prescription, a practice that is commonplace across much of the continent’s enormous informal healthcare sector. In livestock farming, antibiotics are routinely used as growth promoters and preventive medicine, a practice that creates vast reservoirs of resistant bacteria that can jump to humans through food, water, and direct contact.
Poor sanitation and inadequate infection control in hospitals amplify the problem dramatically. In many African healthcare facilities, hand hygiene supplies are unreliable, clean water is not always available, and patients recovering from surgery can acquire drug-resistant infections they never had before they were admitted. The rise of multi-drug resistant tuberculosis — already a crisis in its own right — shows how quickly resistant strains can spread when they take hold.
What makes AMR uniquely dangerous is its invisibility. Unlike a flood or a war, it does not produce images that move the world to action. It kills quietly, in hospitals and nursing homes, often in patients whose underlying conditions are already serious. By the time a resistant infection is identified, it has typically already spread beyond the original patient.
Global health leaders gathered in France this week for a One Health summit that was meant to address the AMR crisis with renewed urgency. But African health advocates say the commitments coming out of such forums have consistently fallen short of what the scale of the problem demands. Funding for AMR surveillance, laboratory capacity, and the development of new antibiotics — or alternatives to them — remains minuscule compared to the threat.
Africa is not waiting for the world to act. Several countries, including Kenya, Ghana, and Nigeria, have developed national action plans on AMR. But implementation is hampered by a lack of diagnostics, a shortage of trained microbiologists, and weak regulatory enforcement around antibiotic sales. The gap between having a plan and executing it is, in many African nations, a chasm.
The antibiotics that once transformed medicine — that made surgery safe and turned deadly infections into manageable ones — are losing their power. For Africa, which has the world’s youngest and fastest-growing population, the stakes of losing them are higher than anywhere else on earth.