Antibiotic or antimicrobial resistance (AMR) occurs when bacteria evolve to survive antibiotic drugs. In Nigeria AMR poses a critical threat across human animal and environmental sectors seriously undermining efforts to treat common infections.
The One Health approach integrates these domains to better understand and respond to the crisis.
Which bacteria and resistance genes are most prevalent?
Systematic reviews in Nigeria show high prevalence of genes such as ESBL‑type bla_SHV (24%) bla_CTX‑M (23%) bla_TEM (18%) and carbapenem‑resistance genes like bla_KPC (33%) bla_NDM (21%) bla_OXA (11%) and bla_VIM (9%). mecA reaches 51% prevalence. Genes conferring resistance to tetracyclines sulfonamides macrolides and quinolones are also widespread. In a multi-country African surveillance resistance in Nigeria exceeded 70% for pathogens including Staphylococcus aureus.
Who are the key actors involved?
- Healthcare providers often overprescribe antibiotics including WHO Reserve drugs sometimes due to patient pressure or lack of diagnostics.
- Pharmacists and informal drug sellers frequently dispense antibiotics without prescriptions; studies show high rates of inappropriate dispensing.
- Patients and communities often self‑medicate even for viral illnesses due to inadequate awareness or healthcare access.
- Farmers and livestock industry often administer antibiotics for prophylaxis or growth promotion without veterinary oversight.
- Environmental sources such as sewage pharmaceutical effluent and agricultural runoff contribute to spread of antibiotic residues and resistance genes.
Where is the resistance emerging?
AMR is widespread across Nigeria’s geopolitical zones in hospitals community health centers animal farms food supply chains and environmental samples. Notably neonatal sepsis cases are increasingly resistant: up to nearly half of E. coli and 86% of S. aureus isolates in newborns show resistance to standard antibiotics. Houseflies in hospital wards have been found carrying resistant bacteria elevating concern over environmental vectors.
When has the problem intensified?
Nigeria launched its first National Action Plan (NAP 1.0) on AMR in 2017; subsequent data from 2018–2023 show high levels of resistance emerging in tandem with weak stewardship and surveillance infrastructure. Research in 2024 mid 2025 continues to highlight growing AMR prevalence among human animal and environmental domains.
Why is this happening (causes)?
- Over‑prescribing and empirical treatment without proper diagnostics
- Self‑medication and non‑prescription sales of antibiotics
- Inadequate regulation at pharmaceutical outlets and veterinary sectors
- Lack of public awareness and poor knowledge of antimicrobial stewardship
- Environmental contamination including antibiotic residues and resistant gene reservoirs in water and soil
- Weak infection prevention and control in hospitals compounded by vectors like flies spreading resistant bacteria
How is AMR affecting Nigeria? (Effects)
- Increased mortality particularly in neonates and hospitalized patients with sepsis
- Reduced efficacy of standard antibiotics forcing use of last‑resort or expensive alternatives
- Higher healthcare costs longer hospital stays and overwhelmed systems
- Threat to food safety livestock productivity and economic security
- Potential catastrophic economic and public‑health burden by 2050 consistent with global projections
Whose responsibility is it and what can be done?
Responsibility lies across multiple actors. Key strategies include:
- Strengthen antimicrobial stewardship (AMS) across hospitals primary care and veterinary sectors; use WHO AWaRe framework to limit Reserve drug use.
- Implement routine surveillance using culture and molecular diagnostics across One Health domains; enhance laboratory systems and data integration.
- Regulate drug sales enforce prescription‑only status and educate providers and pharmacists.
- Public education campaigns to discourage self‑medication promote adherence and understanding of AMR risks.
- Improve infection prevention control (IPC) in healthcare facilities including hygiene sanitation and insect control (e.g. screening to limit flies).
- Policy and One Health coordination: strengthen Nigeria’s NAP implementation leverage international support (e.g. Fleming Fund CDC) and participate in global panels such as the planned AMR science‑panel to launch late 2025.
- Invest in diagnostics and infrastructure so clinicians can prescribe appropriately and reduce empirical use.
Conclusion
Antibiotic resistance in Nigeria is worsening across human animal and environmental settings. Driven by over use weak regulations misuse and inadequate surveillance AMR threatens lives health systems and economic stability. However coordinated implementation of stewardship programs public education regulatory enforcement improved diagnostics and a robust One Health strategy offer a path forward. Continued global engagement including support from WHO international partnerships and Nigeria’s leadership is critical. With decisive action it’s possible to slow resistance trends and safeguard effective antibiotic drugs for future generations.