Nigeria grapples with rising antimicrobial resistance, prompting calls for prescription enforcement, public education, and market reforms.

World Antimicrobial Resistance (AMR) Awareness Week concludes, Nigeria faces an urgent public health challenge, with experts warning that antimicrobial resistance is already a daily reality undermining the nation’s healthcare system.

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According to biochemical researcher Opeyemi Fatunbi, AMR contributed to more than 260,000 deaths in 2019 alone, with infants and underserved communities particularly vulnerable.

Experts identify widespread, unregulated over-the-counter antibiotic sales as a major driver.

From pharmacies to informal markets, powerful antibiotics such as amoxicillin, ciprofloxacin, tetracycline, and metronidazole are easily accessible without medical oversight.

Despite NAFDAC classifying these medicines as prescription-only, enforcement gaps allow misuse and fuel resistance.

“Many Nigerians self-medicate for malaria, coughs, diarrhoea, or vague body pains, often stopping antibiotic courses prematurely,” Fatunbi explained.

“Sub-therapeutic exposure allows bacteria to adapt and develop resistance, creating a perfect storm for AMR.”

Hospitals report alarming resistance rates, including 67.8 per cent for methicillin-resistant *Staphylococcus aureus* and 28.6 per cent for carbapenem-resistant Enterobacterales, far above global averages.

An estimated 60,000 Nigerians die annually from AMR-related infections, straining healthcare resources and threatening decades of public health progress.

Fatunbi highlighted NAFDAC’s ongoing efforts, including market surveillance, public alerts on substandard drugs, and crackdowns in cities such as Lagos, Kano, and Onitsha.

Yet experts stress the need for a long-term, integrated strategy to close enforcement gaps.

Proposed measures include a national “Prescribe to Protect” campaign, a digital platform for real-time prescription verification, and tighter licensing rules for pharmacies and patent medicine vendors.

Compliance incentives, community-based monitoring units, and public education campaigns in local languages are also recommended.

“Shifting antibiotic access to regulated outlets, limiting open-market sales, and educating the public are essential to curb AMR,” Fatunbi said.

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“Bold action now is critical to protect Nigeria’s antibiotics and safeguard public health.”