Weak policies stoke drug-resistant infections
When Amina Balogun (not real name) was admitted to Lagos University Teaching Hospital for systemic lupus erythematosus, she didn’t know it would become a fight against relentless infections.
She received multiple courses of antibiotics, including ceftriaxone, metronidazole, piperacillin/tazobactam, levofloxacin, meropenem, gentamicin, and amikacin, yet the infections remained relentless and more severe.
After about two months of admission, Balogun’s condition deteriorated and she developed severe sepsis that was unresponsive to even last-resort antibiotics such as meropenem and tigecycline.
Blood cultures later revealed Candida auris, a multidrug-resistant fungus increasingly reported in hospitals.
Despite intensive interventions, her body was overwhelmed by the superbug. Weeks later, Balogun died.
Her case is an illustration of the human cost of growing public health crisis in Nigeria, caused by antimicrobial resistance.
BusinessDay gathered that more patients are now losing their lives to bacteria that no longer respond to treatment.
Antimicrobial Resistance (AMR) occurs when infections become harder to treat as microorganisms such as bacteria, viruses, fungi, and parasites evolve, becoming resistant to drugs and developing the ability to survive treatments that once killed or inhibited their growth.
The World Health Organisation (WHO) warned in October 2025 that antibiotic resistance was accelerating at a concerning pace, faster than medical science could respond, and posing serious threat to global health.
In Nigeria, Muhammad Pate, minister of Health and Social Welfare, has expressed concerns that drug-resistant infections continue to rise, and has become a ‘silent pandemic.’
Also, according to the ‘Global Burden of Disease’ study by the Institute for Health Metrics and Evaluation, at least 50,000 deaths in Nigeria in 2019 were directly attributable to AMR. Also in 2021, 227,000 deaths were associated with resistant infections. The largest number was associated with AMR in 2021 occurring among those aged under-5 in the country.
The figures rank Nigeria among the world’s hardest-hit countries.
“For now, the country’s antibiotic crisis is worsening, fed by weak enforcement, fragile institutions and widespread misuse. Unless Nigeria moves swiftly from policy to law, the fight against drug-resistant infections may be lost before it truly begins” said Adaobi Onyechi, a public health expert.
Gatefield, a sub-saharan Africa strategy organisation, recently warned that drug-resistant infections, which now kill more Africans than HIV/AIDS or malaria, could claim 10 million lives annually by 2050 in Nigeria and the rest of Africa, surpassing cancer as the world’s leading cause of death.
Read also: Drug resistance killing Nigerians, experts warn
Weak laws, weaker enforcement
Despite these projections and grim statistics, the regulation of antibiotics consumption, a leading cause of these infections, remains weak in Nigeria, according health experts.
Although the Nigerian law classifies antibiotics as prescription-only medicines (POM), medications such as amoxicillin, ciprofloxacin, metronidazole, tetracycline, and every other antibiotic circulates freely and is sold without prescriptions, proper dosing instructions, or professional guidance.
Loosely supervised pharmacies serve as the primary sources of antibiotics for millions, according to the National Library of Medicine, even though Nigeria’s drug regulation structure mandates the National Agency for Food and Drug Administration and Control (NAFDAC) and the Pharmacy Council of Nigeria (PCN) to regulate the manufacture, importation and sale of medicines including POM.
Onyechi noted that laws and policies on antibiotics are not definite or punitive. She said Nigeria needs to enact a law abolishing the sale of antibiotics in Nigeria without prescription while prescribe penalties on offenders. She stressed that overuse and misuse of antimicrobials, particularly antibiotics, ramain major drivers of AMR.
Nigeria has also developed a few policy frameworks, which include the National Action Plan for Antimicrobial Resistance (2017–2022) and a National experts say implementation and enforcement largely ineffective.
The had NAP for AMR, which was launched in 2017 and ran until 2022, but a report by the WHO found the plan could boast only a 44 percent completion rate, while there were gaps, including weak involvement from sectors such as environment, agriculture and animal health.
The report added that the plan lacked specific milestones, targets and a clear budget, according to an official assessment.
Read also: Over 65,000 deaths linked to growing antimicrobial resistance in Nigeria – FG
Crisis of awareness and behaviour
While the misuse of antibiotics is widespread, surveys suggest public understanding of antimicrobial resistance remains shallow.
A 2023 national survey of the antibiotic use, self-medication practices, and knowledge of antibiotic resistance among graduates of tertiary institutions in Nigeria, 2023 found tha despite having tertiary education, 47.7 percent of respondents self-educated with antibiotics.
Another study published NLM in 2020 on antibiotic resistance found that only 8.3 percent of respondents surveyed had knowledge or understanding of AMR. Two-thirds of respondents reported taking antibiotics within the previous six months, and nearly one-thirds admitted doing so without doctors’ prescription.
Beyond its human cost, AMR also threatens Nigeria’s fragile economy. The World Bank has warned that by 2050, drug resistance could cause a 3.8 percent reduction in global GDP, hitting low-income countries hardest.
Nigeria, where a significant population lives below the poverty line, faces rising out-of-pocket healthcare costs as patients are forced to buy second- or third-line antibiotics. Analysts say unchecked AMR could undermine workforce productivity, strain already limited health budgets, and deepen inequality.
