A one health perspective on antimicrobial resistance in Sub-Saharan Africa: synthesizing human, animal, and environmental evidence for integrated action

This review takes a One Health perspective on antimicrobial resistance (AMR) in Sub-Saharan Africa, showing that resistance is driven by interconnected factors across humans, animals, and the environment, while current surveillance and response systems remain fragmented and under-resourced. It highlights major gaps—especially in environmental and animal data—and identifies key drivers such as antibiotic misuse, poor sanitation, and weak health systems. The paper concludes that tackling AMR in the region requires integrated, cross-sector action, including stronger surveillance, antimicrobial stewardship, improved infrastructure, and coordinated policies tailored to local contexts.