System Inequalities in East Africa Drive Antimicrobial Resistance

The Covid-19 pandemic has exposed long-standing structural fault lines in societies - especially in health systems. These same inequalities drive another major global health concern - antimicrobial resistance.

The World Health Organization defines antimicrobial resistance as the process by which microbes change over time and no longer respond to medicines. This makes infections harder to treat. It also increases the risk of disease spread, severe illness and death. Resistance of bacteria to antibiotics is especially worrying.

Global deaths from antimicrobial resistance are projected to increase from the current 700,000 a year to 10 million by 2050. These losses disproportionately affect the world's poorest and most vulnerable populations in low- and middle-income countries. For example, across sub-Saharan Africa, rates of deaths due to antibiotic resistance are 24 per 100,000 people. In high-income countries, the death rate is 13 per 100,000.

The fight against antimicrobial resistance must proceed in a way that tackles, rather than reproduces, existing health inequalities. To do so, more voices need to be heard, writes Alicia Davis, Blandina Mmbaga, Stephen Mshana and Tiziana Lembo for The Conversation.