Some common infections are increasingly failing to respond to the medicines that once treated them effectively, a trend experts link to the growing threat of antimicrobial resistance (AMR).
The World Health Organisation (WHO) describes AMR as “one of the leading global health challenges of the 21st century,” which occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines.
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As a result, infections become harder and sometimes impossible to treat, increasing the risk of severe illness, disability and death.
It said bacterial AMR was directly responsible for 1.27 million deaths and associated with 4.95 million deaths globally in 2019.
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A 2024 report by Africa CDC warns that AMR has now become a bigger threat to Africa than HIV/AIDS, tuberculosis and malaria combined, with a mortality rate of 27.3 deaths per 100,000 people, the highest in the world.
Failing treatment
Speaking with PT Health Watch, Zainab Dambazau, an epidemiologist and One Health and Public Health Consultant, explains that the rising treatment failures seen across Nigeria highlight a pattern of AMR spreading in communities, hospitals, and even the environment.
“We’re seeing a rise in common infections that no longer respond to treatment, not just bacterial infections, but also viral, fungal, and even parasitic ones,” Mrs Dambazau said.
“This is the bigger issue of antimicrobial resistance. It means the medicines we use to treat infections, antibiotics, antivirals, antifungals, antiparasitics, are becoming less effective or no longer work at all.”
Mrs Dambazau, who is also the publisher of the One Health Messenger newsletter, explained that urinary tract infections, pneumonia, wound infections, typhoid fever, malaria, and fungal infections, such as candidiasis, are becoming harder to treat in different parts of the country.
She noted that malaria is already showing signs of resistance in some regions, particularly where treatment is delayed or left incomplete.
“We’re also seeing treatment failures in tuberculosis and sexually transmitted infections like gonorrhoea, which now requires more complex drug combinations,” she added.
According to her, the worrying part is that resistance is no longer rare or limited to a few hospitals.
“Patterns are emerging in public and private health facilities across states, and we’re also seeing resistant organisms in animal farming and even water sources. This tells us that AMR is spreading beyond individual cases; it’s now a public health and environmental issue.”
Contributing factors
Mrs Dambazau noted that AMR is largely driven by how antimicrobials are used “across all sectors,” stressing that resistance does not develop by chance.
“In healthcare settings, antibiotics and other antimicrobials are sometimes used as a first response, without lab confirmation of the infection or whether it’s bacterial, viral, or fungal,” she said.
“In some cases, patients are treated for infections they don’t actually have, or the right drug is used at the wrong dose or for the wrong duration. This gives microbes a chance to adapt and become resistant.”
In households, she said, self-medication remains a major concern. Many people buy drugs without prescriptions, use leftovers from previous illnesses or stop treatment once they feel slightly better.
“In some cases, antibiotics or antimalarials are taken ‘just in case’ without a confirmed diagnosis. All these habits contribute to resistance.”
She linked rising resistance in animals and crops to the use of antimicrobials in agriculture.
Also, she noted that farmers routinely use antibiotics not just for treatment but for prevention and growth promotion. Over time, this creates resistant organisms that spread through food, direct contact or the environment.
She added that fungicides used on crops also contribute to antifungal resistance, while poor disposal of expired drugs and waste from hospitals and farms allows resistant organisms to contaminate soil and water.
Actions Nigeria must take
The epidemiologist stressed that Nigeria has reached a point where “action can no longer be delayed.”
She said “stronger regulation” of access to medicines, improved diagnostics, better support for farmers, public education and environmental controls are essential to preventing further treatment failures.
She emphasised that AMR must be treated as a One Health issue because human health is closely linked to what happens in animals and the environment.
Most vulnerable group
Mrs Dambazau further explained that “children, pregnant women, and older adults are naturally more vulnerable to infections, and when the drugs don’t work, they face a higher risk of complications or even death.”
She noted that some babies have been born with infections already resistant to available medicines.
Farmers and animal handlers, she added, are often exposed to resistant organisms through direct contact with animals or contaminated environments, especially where hygiene and biosecurity are poor.
Hospitalised patients, particularly those recovering from surgery, cancer treatment or intensive care, face higher risks in facilities where infection control systems are weak.
READ ALSO: PT Health Watch: Self-medication is a double jeopardy for patients — Expert
She also highlighted the vulnerability of people living with chronic illnesses such as diabetes, HIV or sickle cell disease, saying they are “more likely to fall ill and need antimicrobials, and if those drugs fail, the impact can be devastating.”
Way forward
“This is not just about doctors or pharmacists or farmers. This is about all of us,” Mrs Dambazau said.
“We’re already living in a time where some infections don’t respond to treatment. If we continue down this path, we could lose the ability to treat infections altogether, and that would change everything, from how we deliver babies to how we perform surgery, or even how we treat wounds and malaria.”
But she stressed that the situation can still be reversed. “The good news is: we can act now. We can improve how we use medicines, how we grow our food, and how we protect our environment. If we take the right steps today, we can stop AMR from becoming the next major health disaster.”
She added that “the solutions are known,” saying what is needed now is leadership, cooperation and public awareness.
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