Penetrating communities with effective antibiotics advocacy

BY ABUJAH RACHEAL

A 2025 study published in Globalisation and Health reveals that limited access to effective antibiotics is like a double-edged sword with inherent risks and downsides.

On one hand, patients suffer and die from treatable infections while misuse of low-quality or inappropriate drugs drives resistance.

According to the study, equity in access to effective antibiotics must be central to Antimicrobial Resistance (AMR) containment strategies.

Similarly, a 2023 paper on the ResearchGate appraising Nigeria’s response to AMR highlighted persistent gaps in regulation, financing, and public awareness, despite the existence of a national action plan.

In 2024, Nigeria unveiled its second National Action Plan on Antimicrobial Resistance (NAP 2.0), an upgraded strategy meant to tackle the gaps identified in the first plan (2017–2022).

The new plan prioritises expanding surveillance of resistant infections; ensuring antibiotics remain effective through stewardship programmes.

It also promotes research and innovation including local production of quality medicines, and strengthening community level access to effective drugs.

In Karshi, a rural community tucked away on the outskirts of the Federal Capital Territory (FCT), Mrs Ramatu Mairiga, a 28-year-old mother of two, sat quietly under the shade of a neem tree.

Her youngest child was coughing persistently, his frail body weakened by repeated bouts of infection. “I went to this roadside chemist last week and bought drugs, but my child did not get better.

“The man there told me to come back for a stronger medicine, but it was too expensive,” Mairiga said softly.

She said that the “stronger medicine” turned out to be an antibiotic that cost nearly half of her husband’s weekly income from farming.

With no functioning primary health centre nearby, she turned again to the local patent medicine store–the only accessible option for many residents in the community.

Just a few kilometres away in Kwaku, another village in the FCT, Mr James Sunday, a motorbike rider (Okada), recounted his struggle with a stubborn ear infection.

“I bought antibiotics from three different chemists, but the infection kept coming back.

“At the hospital in Gwagwalada, the doctor told me those drugs were not working because the bacteria had become resistant. “But the right drugs were unavailable there either,” Sunday narrated.

The experiences of Mairiga and Sunday highlight a growing crisis–the struggle of rural communities to access effective antibiotics, a challenge fuelling the dangerous rise of antimicrobial resistance (AMR) in the country.

According to the World Health Organisation (WHO), Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve and no longer respond to the medicines designed to kill them.

The result is that infections become harder, sometimes impossible, to treat.

Globally, AMR is already responsible for nearly 5 million deaths annually, with Africa projected to carry a disproportionate share of the burden.

In Nigeria, experts warn that weak health systems, unregulated drug markets, and poverty are accelerating the crisis.

Yet, as Mairiga and Sunday’s experiences show, policy often fails to translate into practice at the community level.

In villages like Karshi and Kwaku, the promises of NAP 2.0 remain distant. Health experts say access challenges cannot be separated from the broader realities of poverty and weak infrastructure.

Dr Sati Ndulukun, Director of Bacteriology, Parasitology & Virology at the National Veterinary Research Institute (NVRI), underscored the importance of cost.

“Most effective antibiotics are costly, and poor people simply cannot afford them.

“To make matters worse, these medicines are usually stocked in big pharmacies located in cities rather than in rural villages.’’

Ndulukun warned that the result was a dangerous reliance on sub-standard and fake antibiotics. “The risks are severe, from the spread of resistant strains to avoidable deaths.”

According to him, three urgent steps are needed; first, health insurance coverage should be expanded so that poor households can afford effective antibiotics.

“Second, community pharmacies must be strengthened to bring quality medicines closer to rural residents.