Although antimicrobials have been used for decades to fight against infectious diseases, their effectiveness is increasingly undermined by antimicrobial resistance (AMR). AMR is the ability of microorganisms, including bacteria, viruses, parasites, and fungi, to develop resistance against the effects of drugs used to fight them. It is a widespread problem that affects people from all walks of life, regardless of age and sex.

Africa tops the global chart, having the highest burden of death linked to AMR, with 27.3 deaths per 100,000 people. United Nations projections indicate that, by 2050, AMR will account for over 10 million deaths globally, matching the number of lives lost to cancer each year and US$1 trillion in additional healthcare costs worldwide.   

The growing threat of AMR remains a great concern as standard treatments continue to fail against antimicrobial-resistant infections. This does not only endanger lives but also poses a risk to medical breakthroughs, making once-treatable diseases harder to combat.  

A major, often overlooked, driver of AMR is the widely misuse and overuse of antimicrobials. In many parts of the world, such as Nigeria, the unregulated sale of antimicrobials by street drug hawkers fuels this crisis. The drug hawkers provide easy access to antibiotics without prescription, creating a potential platform for the spread of antimicrobial-resistant infections. It’s particularly alarming that many Nigerians prioritise drug hawkers over hospitals for healthcare services, despite the danger they pose. 

This dangerous trend not only accelerates AMR but also exposes individuals to substandard and counterfeit medications, further compounding the public health crisis. “There are many fake medicines in circulation, often smuggled in illegally; these substandard drugs contribute to resistance”, stated Dr. Sati Ngulukun, Director of the National Veterinary Research Institute (NVRI), Plateau State, Nigeria. The misuse of antimicrobials over time renders them less effective for the individuals receiving treatment.   

While Nigeria’s National Drug Policy (NDP) classifies antimicrobials as prescription-only medicines, enforcement remains abysmal. The policy provides guidelines for drug distribution and stipulates that antimicrobials should be dispensed only with valid prescriptions.

In line with the NDP implementation policy, the National Agency for Food and Drug Administration and Control (NAFDAC), a health regulatory agency in Nigeria, is actively working to ensure antimicrobials are used responsibly within hospitals and pharmacies. NAFDAC provides regulatory oversight, ensuring antimicrobials are procured and distributed in authorised channels. The agency, through its antimicrobial stewardship programs, educates healthcare professionals on appropriate prescription practice and antimicrobial use. This reinforces the importance of individuals seeking medical advice from licensed healthcare providers instead of relying on street drug hawkers for safe and effective treatment.

Without stringent enforcement and regulatory oversight, AMR will continue to spread unchecked. Every unjustified antimicrobial use increases the chance of resistance and puts the next generation at risk.