Leveraging a people-centred approach to combat antimicrobial resistance in Africa

This commentary argues that antimicrobial resistance (AMR) in Africa is not only a medical problem but deeply rooted in social, economic, and structural inequalities that disproportionately affect marginalised communities. While current responses focus heavily on technical solutions like stewardship and surveillance, the authors stress that AMR is driven by poverty, limited education, gender inequality, weak governance, poor access to healthcare, clean water, diagnostics, and reliable medicine supply chains. They call for a people-centred, community-driven approach that strengthens primary healthcare, ensures affordable and quality-assured antimicrobials and diagnostics, and engages local stakeholders to promote awareness and culturally relevant behaviour change. Embedding AMR efforts within universal health coverage, expanding preventive measures such as vaccination, and tackling systemic barriers are essential to reduce reliance on antibiotics. Overall, the commentary advocates a coordinated One Health response rooted in equity, community ownership, and cross-sector collaboration to ensure that AMR control efforts benefit everyone, especially the most vulnerable.