A combination of drug-resistant pathogens and poor hygiene protocols in some facilities can even mean that something as seemingly simple as a tooth extraction deteriorates into a lengthy and costly infection, she points out. “That especially affects patients in this part of the world where poverty is really a huge problem.
Yewande Alimi, antimicrobial resistance programme co-ordinator at the Africa Centres for Disease Control and Prevention, also highlights the lack of laboratories and surveillance systems. “For a long time, policymakers struggled to get to grips with what AMR is,” she says, welcoming the Lancet report as an important step. “AMR is like climate change. Until you experience it, it seems like something far away. The more we know about it and its medical and economic impact, the more we can begin to tackle it.” The causes of AMR, particularly in poorer regions such as west Africa, are well understood — if no easier to deal with for that. They include poor sanitation, inappropriate and excessive use of antibiotics in humans and animals, as well as an empty pipeline of new antibiotics from pharmaceutical companies focused on more profitable areas of research. In much of Africa, there is an additional problem: counterfeit medicines. In Idumota market, just back from the waterfront on Lagos Island in Nigeria, it is easy to find fake “branded” medicines among the thousands of lock-up shops. Customers go there to avoid costly medical consultations — particularly if they assume they need repeat prescriptions of medicines they have already taken. Unfortunately, counterfeits — locally produced or imported from China, India and elsewhere — are rife. The World Health Organization puts the value of fake medicines sold each year at an astonishing $200bn, equivalent to 10-15 per cent of the legitimate market. “Fake medicines are really a big concern across the continent,” says Alimi. “This drives antimicrobial resistance in our countries and we need effective legislation around drug production and drug importation.”
