An Unknown Burden – Drug resistance and lab capacity in Africa

Drug-resistant germs are hidden killers in more than one way. Not only are the microbes invisible to the human eye, in many places, they’re invisible because people simply are not looking for them systematically.

Doctors often do not know what infections their patients have and treat them based on best guesses, which allows for ineffective treatments and exacerbates drug resistance. Policymakers don’t know which infections are most common among populations and cannot make informed decisions about needed treatments or vaccines.

This is a major problem across Africa and a new report shows just how complex the problem is.

The Mapping AMR and Antimicrobial use Partnership (MAAP), which included the One Health Trust as well as the African Society for Laboratory Medicine; Africa CDC; the East, Central, and Southern Africa Health Community; Innovative Support to Emergencies, Diseases, and Disasters, a nonprofit focused on technology and communication;  the clinical research group IQVIA; and the West African Health Organization, collected data from laboratories from 14 countries in Africa (Burkina Faso, Cameroon, Gabon, Ghana, Kenya, Eswatini, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe). “The study revealed significant gaps in bacteriology testing capacities,” the group, whose work was paid for by the UK government's Fleming Fund, wrote in PLoS Medicine.

It's the biggest survey yet of testing for antimicrobial resistance – AMR or drug resistance – in Africa.

Among the gaps: too little testing overall, a lack of laboratory capacities, and poor coordination and analysis of records. Many records were kept only on paper, which made them almost impossible to access.

None of this surprises Dr. Sabiha Essack, South African Research Chair in Antibiotic Resistance and One Health and Professor in Pharmaceutical Sciences at the University of KwaZulu-Natal. 

In an ideal world, she says, a doctor, nurse or other professional should see a patient, test them to see what specific microbe is causing an infection, check to see which drugs will successfully fight that germ, and then treat the patient accordingly.

Cheap point-of-care tests should be available everywhere and the results of those tests should be entered into systems that officials can use to make policy decisions, she says. Listen as she tells One World, One Health host Maggie Fox other ways to improve our knowledge about the drug-resistant infections that lurk out there. 

Want to know more? You can find One World, One Health episodes on drug-resistant infections in cancer patients; superbugs and microplastics; the personal toll of antibiotic resistance; one woman’s antibiotic resistance nightmare; how to prevent drug resistance, and more.