Nigeria has commenced its first nationally representative Antimicrobial Resistance (AMR) Survey, marking a significant milestone in strengthening the country’s public health response to drug-resistant infections. The initiative, supported by the World Health Organization (WHO) and key partners, aims to generate critical data to inform evidence-based policies, improve patient outcomes, and reinforce health system resilience.
The Federal Ministry of Health and Social Welfare (FMoH&SW) and the Nigeria Centre for Disease Control and Prevention (NCDC), with technical support from WHO, recently concluded a five-day planning workshop to finalize the survey’s technical protocol and operational strategy. The workshop convened stakeholders from government institutions, academia, and international partners.
Nigeria becomes the third country globally to partner with WHO on a national AMR survey, selected for its demonstrated commitment to AMR surveillance, the updated Nigeria National Action Plan on AMR (NAP 2.0), and readiness to expand laboratory and data systems.
Why AMR Surveillance Is Critical
Nigeria ranks 20th globally for age-standardized mortality associated with antimicrobial resistance. In 2019 alone, an estimated 263,400 deaths in the country were linked to AMR—exceeding the combined deaths from enteric infections, tuberculosis, respiratory infections, maternal and neonatal disorders, neglected tropical diseases, malaria, and cardiovascular diseases (GRAM, IHME, University of Washington, 2023).
Globally, resistant infections in tertiary healthcare settings cost between US$2,371 and US$29,289 per patient episode, prolong hospital stays by an average of 7.4 days, and increase mortality risk by 84% (Poudel AN et al., PLoS One, 2023).
AMR occurs when bacteria, viruses, fungi, and parasites evolve to withstand treatment, making infections more difficult to cure. Effective surveillance is therefore essential to monitor resistance patterns, identify priority pathogens, and guide targeted public health interventions.
“This planning workshop marks a significant milestone in Nigeria’s AMR response,” said Dr Tochi Okwor, Acting Head, Disease Prevention and Health Promotion, NCDC. “With WHO’s support, the survey will generate the evidence needed to safeguard public health.”
Survey Objectives and Methodology
The national AMR survey will:
- Establish a baseline on AMR prevalence to monitor the impact of interventions.
- Assess the distribution, burden, and diversity of AMR across regions and populations, including morbidity, mortality, DALYs, and costs.
- Contribute to the global target of reducing AMR-related deaths by 10% by 2030, in line with commitments endorsed at the 79th United Nations General Assembly in 2024.
- Strengthen routine AMR surveillance systems, including diagnostics, laboratory capacity, and sample referral networks.
Using WHO’s standardized methodology, the survey will run for 12–15 months across 40–45 randomly selected health facilities nationwide. Patients with suspected bloodstream infections (BSIs) will be identified using standard case definitions, with blood samples analysed in quality-assured laboratories.
Data will be collected across all age groups, covering clinical, demographic, laboratory, financial, and outcome indicators, with follow-up at discharge, 28 days, and three months post-infection. Approximately 35,000 patients suspected of BSIs will be screened to obtain around 800 isolates of the most common pathogens.
Strengthening National Capacity
WHO Representative in Nigeria, Dr Pavel Ursu, reaffirmed the organization’s commitment to supporting the initiative:
“Nigeria is taking a decisive, data-driven step to combat antimicrobial resistance. This survey will provide the clarity needed to shape smarter policies, enhance surveillance, and improve patient outcomes—laying the foundation for a resilient health system.”
Dr Laetitia Gahimbare, Technical Officer at WHO’s Regional Office for Africa, noted that strengthened surveillance will enhance Nigeria’s ability to detect and respond to AMR threats, reinforcing health security and system resilience.
Similarly, Professor Babatunde Ogunbosi, Paediatric Infectious Diseases Specialist at University College Hospital, Ibadan, emphasized the broader impact of the survey, describing it as a platform for building national research capacity, strengthening diagnostics, and integrating science into public health decision-making.
Advancing Global Health and Universal Health Coverage
AMR remains a global health challenge, and Nigeria’s participation strengthens regional and international efforts to monitor resistance trends and coordinate responses. The survey aligns with the One Health approach, recognizing the interconnection between human, animal, and environmental health.
By improving diagnostics, expanding laboratory infrastructure, and promoting responsible antimicrobial use, the initiative will help reduce treatment failures and support Nigeria’s progress toward Universal Health Coverage (UHC), national health security, and the National Health Sector Renewed Investment Initiative
As one of WHO’s top global health priorities, AMR demands coordinated action. Nigeria’s efforts supported by WHO, NCDC, the National Agency for the Control of AIDS (NACA), and the Global Fund reflect strong national ownership and multisectoral collaboration.
Through science, partnerships, and evidence-based action, Nigeria is laying a solid foundation to protect lives, preserve the effectiveness of essential medicines, and build a healthier future.