Antimicrobial Resistance in Northern Nigeria: A Growing Public Health Threat

Abstract

Antimicrobial resistance (AMR) has emerged as a rapidly intensifying global health threat, critically 
undermining the effectiveness of existing treatments and posing severe risks to public health systems 
worldwide. This growing crisis is fueled by the relentless evolution of drug-resistant pathogens and is 
particularly severe in low-resource regions such as Northern Nigeria—a vast area comprising 19 states 
and the Federal Capital Territory (FCT), spanning the North West, North East, and North Central 
geopolitical zones. The region faces unique and compounding challenges that accelerate the spread of 
AMR, including limited access to quality healthcare services, underdeveloped laboratory infrastructure, 
and insufficient regulatory oversight. This review explores the current epidemiological landscape of 
AMR in Northern Nigeria, examining its primary drivers and far-reaching implications. It highlights a 
complex interplay of systemic, behavioral, and environmental factors that contribute to the emergence 
and persistence of resistance. Key among these are the rampant misuse and overuse of antibiotics in 
both human and veterinary medicine, widespread practices of self-medication, weak antimicrobial 
stewardship, and the proliferation of counterfeit or substandard pharmaceuticals. Poor healthcare 
infrastructure and a lack of diagnostic capacity further hinder timely and appropriate treatment, often 
leading to empirical prescribing practices that exacerbate resistance patterns. Data synthesized from 
peer-reviewed literature, national and regional surveillance reports, and institutional records reveal 
troubling trends in AMR prevalence across the region. Compounding these issues is the low level of public 
awareness about the proper use of antimicrobials and the consequences of resistance, along with 
inadequate training and enforcement capacity among healthcare providers and pharmacists. The review 
emphasizes the urgent need for a coordinated, multisectoral One Health strategy that integrates 
human, animal, and environmental health perspectives. Strengthening AMR surveillance systems, 
improving diagnostic access, promoting public education, and enforcing regulatory frameworks are 
critical components of an effective response. Ultimately, the implementation of context-specific, 
culturally informed, and sustainable interventions is essential to curb the rise of AMR, protect 
therapeutic efficacy, and secure the health of populations in Northern Nigeria and comparable low
resource settings.