Antimicrobial resistance is becoming one of Africa’s most serious public health threats, but the continent faces a problem that extends beyond the growing number of resistant infections: in many places, there is simply not enough reliable data to understand the scale of the crisis.
AMR occurs when bacteria and other microorganisms evolve in ways that allow them to survive medicines designed to eliminate them. As resistance increases, infections that were once relatively easy to treat can become more difficult, expensive or even impossible to cure.
A Lancet analysis 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 has also reported that roughly one in five laboratory-confirmed bacterial infections in its African Region was resistant to antibiotics in 2023.
But those figures tell only part of the story.
Many Resistant Infections Are Never Properly Recorded
The biggest weakness in Africa’s AMR picture is that laboratory-confirmed cases represent only infections that have actually been tested.
The WHO reported that 48% of countries did not submit resistance data to its Global Antimicrobial Resistance and Use Surveillance System in 2023. Even among countries that did provide information, around half lacked systems capable of consistently producing reliable data.
That creates a significant blind spot for health authorities.
Where infections are treated without laboratory confirmation, there may be no record showing which organism caused the illness or whether the prescribed antibiotic was effective. Without those details, national surveillance systems struggle to identify emerging resistance patterns.
Doctors Often Have to Treat Without Laboratory Confirmation
The shortage of diagnostic evidence also affects everyday clinical decisions.
The Nigeria Centre for Disease Control and Prevention has reported that one in two hospitalised patients receiving antibiotics is prescribed more than one antibiotic.
Research in Nigeria has also documented widespread empirical prescribing, meaning treatment is started before laboratory testing establishes the organism responsible for an infection or identifies the most appropriate medicine.
This does not necessarily mean clinicians are deliberately ignoring antibiotic stewardship.
When diagnostic services are unavailable or results take too long, doctors may have little choice but to make decisions based on symptoms, experience and the information available at the time.
Dr Ifeyinwa George, a pharmacist and AMR programme manager at DRASA Health Trust, has identified limited laboratory capacity as one of the barriers to detecting and monitoring resistant pathogens.
Africa’s Laboratory Capacity Remains Uneven
The scale of the laboratory challenge becomes clearer when looking at data from individual countries and regional studies.
An Africa CDC-led assessment covering 14 countries found that only 1.3% of approximately 50,000 laboratories within the participating networks performed bacteriology testing.
The study also found that 88% of roughly 187,000 samples tested for resistance did not contain clinical information such as the patient‘s diagnosis or previous antibiotic exposure.
Kenya has faced similar challenges. A survey involving 219 health facilities found that 61.6% did not provide bacterial culture testing, while only 16.9% conducted antimicrobial susceptibility testing.
For health professionals, the consequences are straightforward: without testing, it becomes much harder to know which antibiotics remain effective.
As Ghanaian AMR researcher Prof Beverly Egyir has put it, the absence of testing leaves clinicians effectively “flying blind.”
Even Available Tests Can Take Too Long
Having laboratory capacity does not automatically solve the problem.
At Cape Coast Teaching Hospital in Ghana, researchers found that laboratory results took an average of 3.4 days from the arrival of a sample to its upload into the electronic health system.
For some infections, that delay can influence treatment decisions.
The challenge therefore involves more than building laboratories. Health systems also need efficient processes for processing samples, analysing results and delivering clinically useful information to doctors while patients are still receiving treatment.
Digital systems can play a role by reducing the gap between a laboratory finding and the clinician who needs to act on it.
Poor-Quality Medicines Add Another Layer to AMR
Antimicrobial resistance is not only about how antibiotics are prescribed or whether infections are tested.
The quality of medicines entering the health system also matters.
In 2025, Ghana’s Food and Drugs Authority reported finding counterfeit pharmaceutical products valued at GH₵42 million, equivalent to about $3.6 million.
Nigeria has also faced persistent concerns over substandard and falsified medicines. The National Primary Healthcare Development Agency has previously cited estimates that around 70% of medicines distributed in the country were substandard or counterfeit.
Medicines containing insufficient quantities of active ingredients can expose bacteria to inadequate drug concentrations, potentially contributing to the development and spread of resistance.
Digital Tracking Could Help Regulators Follow Medicines
Improving medicine traceability is therefore another part of the wider AMR response.
Nigeria’s National Agency for Food and Drug Administration and Control has used its Mobile Authentication Service to allow consumers to verify medicine codes through text messages.
More comprehensive digital systems could go further by connecting batch information, alerts and regulatory records.
Such systems could help authorities identify suspicious products more quickly and trace medicines through supply chains before potentially dangerous products reach more patients.
The WHO’s digital-transformation guidance is also encouraging countries to move away from fragmented, paper-based reporting of substandard and falsified medicines towards interoperable digital systems.
Better Data Opens the Door to More Advanced Technology
Some African countries are already demonstrating what becomes possible when surveillance infrastructure improves.
South Africa’s National Institute for Communicable Diseases operates an AMR surveillance dashboard using laboratory information to monitor resistant pathogens.
In Ghana, researchers have also used whole-genome sequencing to examine cholera isolates alongside samples from other African countries. Such techniques can help researchers identify resistance genes and understand how bacterial strains are related.
But advanced technologies are most useful when there is a strong underlying system for collecting samples and maintaining accurate records.
Artificial intelligence, for example, cannot compensate for an infection that was never tested or a laboratory result that was never properly recorded.
Kenya Shows How Surveillance Networks Can Expand
Kenya provides an example of how investment in basic surveillance infrastructure can create opportunities for more sophisticated analysis.
According to the WHO, two model surveillance sites established in 2017 eventually developed into a network of 32 sites across 27 countries.
Kenya now brings together antimicrobial resistance, antibiotic-use and consumption data in a central warehouse. The country also began submitting individual-level data to the WHO’s GLASS system in 2025.
Susan Githii, Kenya’s GLASS focal person, has highlighted the value of the expanded information in understanding resistance trends and supporting public health decisions.
The country still faces challenges, including integrating hospital information systems and filling gaps in patient-level data.
The Health-Tech Opportunity Is Bigger Than AI
The AMR crisis presents an opportunity for health technology companies, but the most valuable innovation may not necessarily be another standalone AI diagnostic tool.
A more immediate need is for technology that makes existing laboratory evidence accessible and useful.
That could include systems that automatically deliver antimicrobial susceptibility results to clinicians, connect laboratory information between hospitals, consolidate surveillance data or help regulators track medicine batches.
Once those foundations exist, AI could potentially be used to identify unusual resistance patterns, support clinical decisions and help health authorities recognise emerging threats.
Without reliable underlying data, however, even sophisticated algorithms will have limited value.
Funding Must Continue After Pilot Projects End
Building the infrastructure is only part of the challenge. Keeping it operational may prove even more difficult.
The EU-backed ARILAC initiative is expected to strengthen laboratory and data systems across eight African countries over four years.
Africa CDC has also called for laboratory and surveillance systems to be incorporated into national budgets rather than relying indefinitely on temporary external funding.
Its 2026–2030 AMR framework identifies sustainable financing as an important priority.
Laboratories require regular supplies, functioning equipment and trained personnel. Digital systems likewise need maintenance, upgrades and staff who can use them effectively.
For investors and technology companies, that means a successful pilot project is not enough. There must also be a sustainable model through which health systems can continue paying for and using the technology.
Technology Cannot Solve AMR Alone
Better data and digital infrastructure are important, but they cannot replace the broader measures needed to slow antimicrobial resistance.
Infection prevention, vaccination, clean water and sanitation, effective laboratory services and responsible antibiotic use all remain central to the response.
The most important technological contribution may therefore be less about replacing healthcare workers with AI and more about giving them better information.
If clinicians can see which medicines are working locally, public health authorities can identify where resistance is increasing, and regulators can quickly detect poor-quality medicines, health systems gain a stronger foundation for responding to AMR.
For Africa, closing that information gap could become one of the most important steps towards turning antimicrobial resistance from a largely invisible threat into a problem that can be measured, monitored and addressed.
