FG ramps up AMR response amid declining donors support

The federal government is set to reactivate the national antimicrobial stewardship network to enable hospitals across States share lessons, provide mentorship (virtual and physical), and coordinate efforts in a unified way to combat antimicrobial resistance (AMR), it has emerged.

AMR occurs when germs become stronger than the medicines used to kill them which makes antimicrobial stewardship essential, ensuring antibiotics and other germ-killing medicines are used the right way, at the right time, and only when absolutely necessary.

To strengthen coordinated action against AMR, the Nigeria Centre for Disease Control and Prevention (NCDC) has called for AMS committee leads from implementing hospitals to join the national Technical Working Group on AMR, while urging broader participation from national and state ministries, the veterinary and environmental sectors, and professional associations such as the Pharmaceutical Society of Nigeria (PSN).

NCDC Director General, Dr Jide Idris, emphasized in Abuja on Wednesday during the close-out and sustainability meeting of the Commonwealth Partnership for Antimicrobial Stewardship (CwPAMS 2.5) organized by Global Health Partnership, in conjunction with the Federal Ministry of Health and Social Welfare, that the government’s move is necessary.

“This is because, under Nigeria’s first National Action Plan on AMR, stewardship performance was just below 40 per cent, and on closer scrutiny, effective implementation might be closer to 20 per cent,” he said.

He added that the move is further justified by the fact that only a few tertiary hospitals currently have functional antimicrobial stewardship programmes, despite widespread drug misuse and rising resistance.

“Because many antibiotics are consumed in the community, not just in hospitals, NCDC wants to engage community pharmacists and other community-level drug distributors to extend AMS beyond hospitals,” he said.

Represented by Dr Ridwan Yahaya, the DG urged the Federal Ministry of Health to make all tertiary hospitals AMS hubs , while calling on States to establish AMR governance structures to extend support to secondary and primary facilities.

“Stewardship cannot remain project-based, it must be institutionalised nationally with support from federal and state ministries, not just hospitals enrolled in CwPAMS 2.5,” he said. 

Pharm. Estelle Mbadiwe, Founding Partner at Ducit Blue Solutions, the in-country coordinator for CwPAMS, said antimicrobial stewardship is essential to keep medicines like antibiotics and antifungals effective as bacteria and other pathogens evolve, safeguarding healthcare quality and underscoring the imperative of harnessing domestic funding to tackle the challenge.

“Drugs that used to work are no longer effective, and that threatens quality healthcare. Antimicrobial resistance is captured as a silent pandemic, but I beg to differ. 

“We cannot be silent. We need to speak out and empower people to know the right actions,” she warned, rejecting the notion of AMR as a quietly unfolding crisis and stressing the need for deliberate, sustained measures to combat it.

She urged innovation-driven domestic financing, saying, “We need to look at domestic funding and look at the opportunities to innovate for the funding. At this event today, we are doing an AMR innovation marketplace to look at how stakeholders can innovate to address antimicrobial resistance”.

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While highlighting major gains of the CwPAMS programme across 17 health facilities, including five hub sites, which established models that Nigeria must now integrate nationally, Mbadiwe stressed the critical need for sustainable domestic financing.

“This programme has helped Nigeria build systems, skills, and strategies to combat resistance, while also creating platforms for bilateral learning with UK health institutions,” she said.

Looking ahead to the global high-level meeting on AMR next year, Mbadiwe stressed the need for mass public education, saying, “We want to ensure that the message on addressing antimicrobial resistance is at the lips of every single Nigerian. 

“We want them to understand what it means, we want them to understand their role and we want them to understand who the stakeholders are so they can ask the right questions and get results.”

Prof. Onyebuchi Chukwu, former Minister of Health and outgoing member of the United Nations Global Leaders Group on AMR, highlighted the urgency of sustained effort, noting that AMR remains one of the most serious public health threats in West Africa.

He recalled data from the Global Antimicrobial Surveillance System which showed the region as having the highest mortality. 

“It showed that West Africa, the West African sub-Saharan region, had the highest mortality related to antimicrobial resistance. That mortality slide, for every 100,000 people, 227 actually die as a result of antimicrobial resistance

“In 2021, the data shows that in Nigeria alone, 65,000 people died directly from antimicrobial resistance. 65,000 people. These are human beings,” he warned.

Chukwu, however, underscored Nigeria’s readiness to continue the fight and pointed to next year’s major international meeting as evidence of the commitment of Nigeria.

On funding concerns, he urged diversification and creativity, saying, “Even the Global Fund is also funding some aspects of this antimicrobial resistance pandemic. 

“So there are international funding mechanisms that can still be explored and utilised. But there could also be innovative domestic ways of funding it. We can also approach the private sector in Nigeria.”

Ms Oluwatoni Akinola, AMR and IPC Programme Officer at DRASA Health Trust, said the close-out of the CwPAMS programme marked a milestone in Nigeria’s fight against antimicrobial resistance.