Africa’s Antimicrobial Resistance Response Held Back by Data and Laboratory Gaps

Africa’s efforts to track and respond to antimicrobial resistance are being limited by shortages in laboratory testing, incomplete clinical records, delayed reporting and weak systems for tracing medicines, according to a TechCabal Insights contributor report by Chinaza Esiaba.

Antimicrobial resistance occurs when bacteria and other microbes evolve to withstand medicines used to treat them. The report argues that digital health tools, including diagnostic and prescribing technologies, will depend on stronger laboratory, patient-record and surveillance infrastructure before they can make a meaningful contribution.

Limited testing leaves major gaps

A Lancet analysis cited in the report estimated that western sub-Saharan Africa recorded the world’s highest death rate attributable to bacterial antimicrobial resistance in 2019, at 27.3 deaths per 100,000 people.

The World Health Organisation estimated that one in five laboratory-confirmed bacterial infections in its African Region was resistant to antibiotics in 2023. That figure does not include infections that were never tested. The WHO also reported that 48% of countries did not submit resistance data to its GLASS surveillance system in 2023, while about half of reporting countries lacked systems capable of producing reliable data.

Dr Ifeyinwa George, a pharmacist and antimicrobial-resistance programme manager at DRASA Health Trust, said limited laboratory capacity remains a barrier to detecting and tracking resistant pathogens.

An Africa CDC-led study covering 14 countries found that only 1.3% of roughly 50,000 laboratories in participating networks performed bacteriology testing. Of approximately 187,000 samples tested for resistance, 88% lacked clinical information such as a diagnosis or details of previous antibiotic use.

In Kenya, a survey of 219 health facilities found that 61.6% did not offer bacterial culture testing, while 16.9% performed antimicrobial susceptibility testing. At Cape Coast Teaching Hospital in Ghana, laboratory reports took an average of 3.4 days from receipt of a sample to upload into the electronic health system.

“When we do not test, we are essentially flying blind,” said Prof Beverly Egyir, a Ghanaian antimicrobial-resistance researcher, according to the report.

Medicine quality and digital traceability

The report also links antimicrobial resistance risks to substandard medicines. Medicines containing too little active ingredient may expose bacteria to inadequate drug concentrations, potentially contributing to resistance.

Ghana’s Food and Drugs Authority found counterfeit pharmaceutical products valued at GH₵42 million, or $3.6 million, in 2025. Separately, Nigeria’s National Primary Healthcare Development Agency has said that about 70% of medicines distributed in Nigeria were substandard or counterfeit. The report presents that figure as an agency claim rather than an independently verified estimate.

Nigeria’s National Agency for Food and Drug Administration and Control operates a Mobile Authentication Service that allows consumers to check medicine codes by text message. The report says batch tracking, rapid alerts and shared records could improve the identification of falsified products.

It also notes that the WHO’s 2026 digital-transformation guidance encourages countries to replace fragmented, paper-based reporting on substandard and falsified medicines with interoperable digital systems.

Surveillance initiatives offer possible models

Several initiatives highlighted in the report are expanding the use of data. South Africa’s antimicrobial-resistance surveillance dashboard uses laboratory information to show which pathogens are developing resistance.

In Ghana, researchers have used whole-genome sequencing to study cholera isolates alongside samples from other African countries, examining resistance genes and relationships among strains. Kenya combines resistance, antibiotic-use and consumption data in a central warehouse and began submitting individual-level data to GLASS in 2025. Remaining work includes connecting hospital systems and completing missing patient fields.

According to the WHO’s account of the programme, a surveillance network that began with two model sites in 2017 had expanded to 32 sites across 27 countries.

The report cautions that technology by itself will not slow antimicrobial resistance. Infection prevention, vaccination, access to clean water and responsible antibiotic use remain essential alongside testing and surveillance.

An EU-backed ARILAC initiative is set to strengthen laboratory and data systems in eight countries over four years. At the initiative’s launch in July 2026, Africa CDC called for laboratory and data systems to be included in national budgets. Its 2026–2030 antimicrobial-resistance framework also identifies sustainable financing as a priority.