Dr George Kimathi
Director – Institute for Capacity Development, Amref Health Africa
Dr Fuysa Goma
Animal Health Focal Point and Assistant Director, Zambian Ministry of Fisheries and Livestock
No single sector can solve Africa’s antimicrobial resistance (AMR) challenge on its own. Only a One Health response — uniting human, animal and environmental health — can curb AMR and protect communities.
All 47 WHO African Region countries have AMR National Action Plans framed around One Health. Yet, coordination between human, animal, agriculture and environmental sectors remains limited. Veterinary, health and environmental systems often operate in silos, with poor data sharing and weak sub-national collaboration. Five key steps are needed to strengthen this response.
1. Improve AMR awareness and understanding across sectors
The fight against AMR starts with awareness. Farmers, health workers, pharmacists, veterinarians and communities all influence how antibiotics are used. Many countries have awareness strategies in place, but we still lack a clear picture of what people actually know or do. Recent Amref Health Africa research showed huge variations in AMR awareness and knowledge among community members, human health workers and animal health workers surveyed in Burkina Faso, Cameroon, Ethiopia, Kenya and Zambia.
Without that awareness baseline, campaigns risk missing their audience. Amref is working with the Africa CDC to implement an AMR regional messaging framework. This will mobilise schools, clinics, community groups and agricultural networks to deliver clear, practical information about the dangers of antibiotic misuse and the importance of responsible use.
2. Integrate surveillance and research
Surveillance systems form the backbone of any AMR response, yet in many African countries, laboratories are poorly equipped, health facilities are under-resourced, and data rarely flows between human, animal and environmental sectors. This leaves dangerous blind spots in detecting resistant strains or understanding how they spread.
A One Health approach builds integrated surveillance that captures data from hospitals, veterinary clinics, farms and water sources. Research partnerships linking universities, ministries and agriculture departments — such as the collaboration between The Kenya Medical Research Institute, Wellcome Trust and Kenyan Ministry of Health to research AMR emergence and resistance patterns of selected infections in Kenya — can strengthen evidence and ensure it shapes national and regional decision-making.1
Every infection we prevent reduces the need for antibiotics and slows resistance.
3. Prevent infection
Every infection we prevent reduces the need for antibiotics and slows resistance. Infections spread rapidly where clean water, sanitation and hygiene are lacking or where health facilities fall short on infection prevention and control. Policy documents recognise this link, but evidence tying WASH and AMR remains weak.
One Health connects the dots. It pushes for investment in water and sanitation for households, health facilities, schools, farms and markets. Breaking the chain of infection matters as much in barns and fields as in hospitals. This is critical for Africa, which carries the largest global burden of communicable diseases.
4. Optimise the use of antimicrobials
Antimicrobial stewardship is gaining ground in human health systems, but animal health often falls behind. Livestock use accounts for 70% of antibiotic use worldwide.2 Farmers still use antibiotics in livestock (mostly without laboratory tests or prescriptions), fuelling resistance that spreads back into human populations.
While many countries have policies to regulate use, enforcement is weak. A One Health approach closes this gap. It develops stewardship programmes that apply equally across hospitals, pharmacies and veterinary practices. Training health workers and farmers side by side on correct prescribing, dosing and alternatives creates a culture shift that reduces misuse.
5. Build the economic case for investment
Financing ties these efforts together. Yet, too often, AMR work relies on short-term donor funding, leaving it vulnerable to the tectonic shifts caused by the cuts to global health funding. Africa needs a compelling economic case that shows the cost of inaction and the shared benefits of action.
Investment must support not only new medicines and diagnostics, but also the systems — labs, surveillance, education, stewardship — that allow them to work. The One Health framework makes this case clear: smart investment protects lives, food systems, livelihoods and economies.
Collaboration across human, animal and environmental health isn’t optional; it’s the only path to a safer, healthier future.
[1]KEMRI-Wellcome Trust Research Programme. Antimicrobial resistance.
[2]The Fairr Initiative. 2024 Protein Producer Index. Key antibiotics and animal health findings.
