Antibacterial resistance in sub-Saharan Africa: an underestimated emergency

Ann N Y Acad Sci. 2014 Sep;1323(1):43-55. doi: 10.1111/nyas.12380. Epub 2014 Mar 14.


Antibacterial resistance-associated infections are known to increase morbidity, mortality, and cost of treatment, and to potentially put others in the community at higher risk of infections. In high-income countries, where the burden of infectious diseases is relatively modest, resistance to first-line antibacterial agents is usually overcome by use of second- and third-line agents. However, in developing countries where the burden of infectious diseases is high, patients with antibacterial-resistant infections may be unable to obtain or afford effective second-line treatments. In sub-Saharan Africa (SSA), the situation is aggravated by poor hygiene, unreliable water supplies, civil conflicts, and increasing numbers of immunocompromised people, such as those with HIV, which facilitate both the evolution of resistant pathogens and their rapid spread in the community. Because of limited capacity for disease detection and surveillance, the burden of illnesses due to treatable bacterial infections, their specific etiologies, and the awareness of antibacterial resistance are less well established in most of SSA, and therefore the ability to mitigate their consequences is significantly limited.

Keywords: antibacterial resistance; bacterial pathogens; sub-Saharan Africa.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology
  • Drug Resistance, Microbial
  • Humans


  • Anti-Bacterial Agents