Africa put on alert!

•Drug-resistant infections surge amid limited new treatments

By Doris Obinna

Africa is facing a worsening crisis of drug-resistant infections as the global pipeline for new antibiotics continues to shrink, threatening the ability of health systems to treat common diseases, a new report has warned.

The 2026 Antimicrobial Resistance (AMR) Benchmark, released by the Access to Medicine Foundation, highlights growing concerns that antimicrobial resistance is spreading faster than the development of new treatments, particularly in low- and middle-income countries.

At the launch of the report on Tuesday, during a webinar meeting, the organisation said infections resistant to existing medicines are already causing widespread deaths across Africa and placing enormous strain on fragile health systems.

Chief Executive Officer, Access to Medicine Foundation, Jayasree Iyer, said Africa now carries a disproportionate share of the global burden of antimicrobial resistance. She cited a 2024 report by the Africa Centres for Disease Control and Prevention (CDCP), which found that drug-resistant infections now kill more people on the continent than HIV/AIDS, Tuberculosis and Malaria combined.

“In parts of sub-Saharan Africa, nearly half of babies dying from neonatal sepsis are linked to drug resistance because standard antibiotics no longer work,” Iyer said, warning that a “silent pandemic” of resistant infections such as Gonorrhea is also spreading rapidly.

The report further revealed that drug-resistant infections have become one of the most serious threats to global health. According to the benchmark, more than one million people die every year directly from drug-resistant infections, while antimicrobial resistance contributes to more than four million deaths annually.

If urgent action is not taken, according to experts, the number of deaths linked to antimicrobial resistance could rise dramatically by 2050.

Despite these alarming projections, experts say the crisis is not insurmountable. “We can tilt the battle against superbugs in humanity’s favour. Our findings show practical approaches that can ramp up progress on all fronts,” Iyer said.

Declining innovation pipeline

The benchmark, first launched in 2017, evaluates how pharmaceutical companies are tackling antimicrobial resistance by examining their research pipelines, manufacturing practices, stewardship efforts and access to medicines in low and middle income countries.

Five years after the previous assessment in 2021, the latest report shows that the number of antibiotic projects in development by large pharmaceutical companies has fallen by 35 per cent.

Also, Director of Research, Access to Medicine Foundation, Claudia Martínez, noted that although a few promising medicines are in late-stage development, the overall innovation pipeline remains dangerously thin.

“More than one million people die every year from drug-resistant infections, yet the number of new antibiotics being developed continues to decline,” she said.

The report assessed 25 pharmaceutical companies, including major research-based firms, generic medicine manufacturers and biotechnology companies.

While the antimicrobial pipeline is shrinking, the benchmark identified seven innovative late-stage medicine projects that could help combat resistant infections if they reach the market and are made accessible to patients.

These projects are being developed by companies including GSK, Otsuka Pharmaceutical, Shionogi, BioVersys, F2G, Innoviva and Venatorx Pharmaceuticals.

One of the drugs highlighted is gepotidacin, a new antibiotic developed by GSK to treat urinary tract infections. It also highlighted that about 150 million people globally develop urinary tract infections each year, and more than half of women will experience one during their lifetime.

Children at greater risk

The report also revealed significant gaps in treatments for children. “Only five antimicrobial projects in the global pipeline specifically target children under the age of five, most of them adapted from adult medicines and being developed by just three companies.

Even where child-friendly antibiotic formulations exist, they often fail to reach countries that need them most.”

The benchmark found that in 17 countries across sub-Saharan Africa, none of the companies assessed had registered paediatric antimicrobial formulations.

It further indicates that this poses a major risk for children, who are more vulnerable to infections and may receive incorrect doses when suitable medicines are unavailable.

Among companies producing paediatric antibiotic formulations, five firms; Aurobindo Pharma, GSK, Hikma Pharmaceuticals, Sandoz and Teva Pharmaceutical Industries were identified as performing better than their peers in registering child-friendly antibiotics in low- and middle-income countries.

However, major access gaps remain in parts of sub-Saharan Africa.

Manufacturing and environmental risks

The benchmark also examined manufacturing practices that could contribute to antimicrobial resistance through antibiotic pollution.

It found some progress in controlling antibiotic waste released into the environment. Compliance with environmental discharge limits among suppliers has doubled since the last benchmark in 2021, particularly among generic medicine manufacturers.

Nevertheless, experts warn that Africa’s limited laboratory capacity, weak surveillance systems and poor access to diagnostics continue to drive the misuse and overuse of antibiotics.

Self-medication and the sale of antibiotics without prescriptions remain widespread in many countries.

Call for action

Health experts say tackling antimicrobial resistance will require coordinated action from governments, pharmaceutical companies and international health organisations.

The Access to Medicine Foundation urged African governments to strengthen national action plans on antimicrobial resistance, invest in laboratory infrastructure, regulate antibiotic sales and improve access to accurate diagnostics.

It also called for stronger regional procurement systems and financing models to ensure new antibiotics reach African markets.

“From research and development to manufacturing, access and responsible use, companies can take stronger action across the pharmaceutical value chain,” Martínez said.

For countries such as Nigeria, experts say strengthening regulation of antibiotic use and improving access to appropriate treatments will be critical to preventing antimicrobial resistance from becoming an even greater public health crisis.

“If innovation does not reach patients in Africa, infections that are treatable elsewhere will continue to be fatal,” Iyer warned.

Without urgent global and regional action, she added, routine infections, surgeries and even childbirth could once again become life-threatening as antibiotics lose their effectiveness.