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Antibiotic resistance in Africa: discerning the enemy and plotting a defense

This background piece to understanding antibiotic resistance in Africa is written in accessible language. It outlines the scale of the problem in Africa (bacterial infections cause 45 per cent of deaths) and the commonest types of infections — tuberculosis, respiratory illnesses and sexually transmitted infections.

It addresses problems of antibiotic resistance specific to African populations: the heavy burden of community-acquired infections; the limited range of first-line antibiotics and varying availability of second-line drugs (often vital against resistant bacteria); the hidden costs from longer hospital admission times and more expensive drugs needed to treat resistant pathogens.

The AIDS epidemic is linked to the problem – the HIV virus weakens people’s immune systems making them more susceptible to bacterial infection. In addition, antibiotics used prophylactically in AIDS patients to prevent opportunistic infections are also used for a wide range of bacterial infections, making it more likely that the pathogens will develop resistance.

Another problem is the sale of antibiotics by unsanctioned providers, who might give incorrect information about how to take the drugs. They frequently sell poor-quality or even counterfeit drugs that don’t cure the patient but encourage bacterial resistance.

Consumers need to be made aware of their own responsibilities, says the article, but ultimate responsibility lies with the healthcare providers in instituting and maintaining treatment programmes.