The impact of socioeconomic disparities climate factors and antimicrobial stewardship on antimicrobial resistance in Africa

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Abstract
The issue of antimicrobial resistance (AMR) is of global significance, affecting both developed and underdeveloped nations. In the context of low- and middle-income countries (LMICs), in Africa and other regions confronted with worsening health inequities such as inadequate healthcare resources and infrastructure, and a rising burden of infectious diseases, the adverse impact of antimicrobial resistance is exacerbated. This narrative review delves into the difficulties encountered in tackling the effects of AMR, focusing specifically on LMICs in Africa, where the overlap of climatic factors, socio-economic disparities, and inequities in access to healthcare intensifies the problem. The themes that emerged from the review include the need for infection prevention and control strategies, the adoption of a One Health approach to combat AMR, and the need for surveillance and monitoring. Several challenges were identified, including organizational and governmental issues, and the absence of leadership commitment. The review also emphasized the need for public and professional education for healthcare professionals and patients to promote and influence behavioral change patterns, a central aspect of AMR issues in Africa. These initiatives should be in tandem with enhanced diagnostic capacity, effective AMR surveillance, and capacity building at all levels of the healthcare system. Sustaining antimicrobial stewardship programs in Africa presents considerable obstacles, ranging from financial constraints to the lack of political will and coordinated efforts. When countries and partners adequately address these challenges by implementing sustainable solutions, LMICs in Africa can mitigate the threat of AMR, safeguard public health, and promote the responsible use of antimicrobials for future generations.

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