The supply chain lens of the burden of antimicrobial resistance in Sub-Saharan Africa

Antimicrobial resistance is a major global health threat, with Sub-Saharan Africa experiencing the highest mortality rates. This study highlights how weak pharmaceutical supply chains in the region significantly worsen AMR by limiting access to quality medicines, encouraging inappropriate antibiotic use, and undermining surveillance. Most countries rely heavily on imported antibiotics, while local production is limited to a few nations. Public supply systems are fragmented and poorly managed, private distribution is highly decentralized and prone to counterfeit medicines, and very few countries systematically monitor antibiotic consumption. Frequent shortages of essential first-line antibiotics force the use of broader-spectrum alternatives, accelerating resistance and increasing costs and treatment failures. The study concludes that strengthening pharmaceutical supply chains—through better coordination, digitalization, regulatory oversight, pooled procurement, and incentives for local manufacturing—is critical to improving access to effective antimicrobials and slowing the spread of resistance in Sub-Saharan Africa.