Table of Contents
Nigeria Initiates Groundbreaking National Survey on Antimicrobial Resistance
Abuja, Nigeria has embarked on a pioneering effort to comprehensively assess antimicrobial resistance (AMR) across the nation. This landmark survey, supported by the World Health Organization (WHO) alongside key partners, aims to produce vital data that will inform policy decisions, enhance patient care, and fortify the resilience of Nigeria’s healthcare system.
Collaborative Planning and Strategic Framework
The Federal Ministry of Health and Social Welfare (FMoH&SW) and the Nigeria Centre for Disease Control and Prevention (NCDC), with expert guidance from WHO, recently completed an intensive five-day workshop. This gathering united representatives from government bodies, academic institutions, and international organizations to finalize the survey’s technical protocols and operational plans.
Nigeria stands as the third nation worldwide to collaborate with WHO on a nationally representative AMR survey. This selection reflects Nigeria’s demonstrated dedication to AMR surveillance, the recent update of its National Action Plan (NAP 2.0), and its preparedness to enhance laboratory and data management infrastructures.
The Critical Importance of AMR Surveillance
Antimicrobial resistance poses a significant health threat in Nigeria, which ranks 20th globally for age-standardized mortality attributable to AMR. In 2019 alone, approximately 263,400 deaths were linked to resistant infections-surpassing fatalities from enteric diseases, tuberculosis, respiratory illnesses, maternal and neonatal complications, neglected tropical diseases, malaria, and cardiovascular conditions combined (Global Research on Antimicrobial Resistance – GRAM, IHME, University of Washington, 2023).
Worldwide, resistant infections in tertiary healthcare settings impose substantial economic burdens, with treatment costs ranging from US$2,371 to US$29,289 per patient episode. These infections also prolong hospital stays by an average of 7.4 days and increase mortality risk by 84% (Poudel AN et al., PLoS One, 2023).
AMR arises when microorganisms such as bacteria, viruses, fungi, and parasites adapt to evade the effects of antimicrobial drugs, complicating treatment efforts. Systematic surveillance is indispensable for monitoring resistance trends, pinpointing priority pathogens, and directing targeted public health interventions.
Survey Goals and Methodology
The national survey is designed to:
- Establish a comprehensive baseline of AMR prevalence to evaluate the effectiveness of ongoing and future interventions.
- Analyze the geographic and demographic distribution, disease burden-including morbidity, mortality, disability-adjusted life years (DALYs), and economic costs-and diversity of AMR across Nigeria.
- Support the global objective of reducing AMR-related deaths by 10% by 2030, aligning with commitments made at the 79th United Nations General Assembly in 2024.
- Enhance routine AMR surveillance capabilities, including diagnostic services, sample referral networks, and laboratory infrastructure.
Employing WHO’s standardized protocols, the survey will span 12 to 15 months and involve 40 to 45 randomly selected healthcare facilities nationwide. Patients suspected of bloodstream infections (BSIs) will be identified using established case definitions, with blood samples processed in accredited laboratories to ensure data quality.
Data collection will encompass all age groups and include clinical, demographic, laboratory, financial, and outcome variables. Follow-up assessments will be conducted at hospital discharge, 28 days, and three months post-infection. The survey aims to enroll approximately 35,000 patients suspected of BSIs to isolate around 800 samples of the most prevalent pathogens.
Enhancing National Expertise and Infrastructure
Dr. Pavel Ursu, WHO Representative in Nigeria, emphasized the significance of this initiative: “Nigeria is making a decisive move to tackle AMR through a data-driven, scientific approach that promises measurable impact. This survey will illuminate the path toward smarter policies, robust surveillance, and improved patient outcomes. It lays the groundwork for a resilient health system that safeguards lives, builds public trust, and preserves the effectiveness of essential medicines for future generations.”
Adding to this, Dr. Laetitia Gahimbare, Technical Officer at WHO’s Regional Office for Africa, stated, “Strengthening surveillance systems empowers Nigeria to detect and respond swiftly to AMR threats, thereby enhancing patient care, bolstering health security, and fostering a sustainable healthcare framework.”
Professor Babatunde Ogunbosi, a Pediatric Infectious Diseases expert at University College Hospital, Ibadan, highlighted the broader implications: “This survey transcends data collection; it is a catalyst for building national capacity in research, diagnostics, and policymaking, integrating scientific evidence into public health strategies.”
Contributing to Global Health and Universal Health Coverage
AMR is a pressing global health concern, and Nigeria’s active participation strengthens regional and international efforts to monitor resistance patterns and coordinate effective responses. The survey aligns with the One Health framework, acknowledging the interconnectedness of human, animal, and environmental health sectors.
By advancing diagnostic capabilities, reinforcing laboratory networks, and promoting judicious antimicrobial use, this initiative aims to reduce treatment failures and accelerate Nigeria’s progress toward Universal Health Coverage (UHC), national health security, and the objectives outlined in the National Health Sector Renewed Investment Initiative.
Unified National and International Commitment
Recognized as a top priority by WHO, AMR demands concerted action. Nigeria’s collaboration with WHO, NCDC, the National Agency for the Control of AIDS (NACA), and the Global Fund exemplifies strong national leadership and multisectoral cooperation.
Through evidence-based strategies, partnerships, and scientific rigor, Nigeria is establishing a robust foundation to protect public health, preserve the potency of vital medicines, and foster a healthier future for all citizens.
