Globally, antimicrobial resistance (AMR) has become a well-recognised public health threat in the recent years and interventions to reduce its burden have been launched worldwide. Like many countries, Nigeria is no exception to the challenges faced due to AMR. The emergence of multidrug-resistant organisms that have led to increased
mortality and economic burden have increased almost exponentially.

Thus, the prudent use of antimicrobial drugs cannot be more strongly emphasised than now. Nigeria, being the most populated country in West Africa has to take the lead in tackling antimicrobial resistance using the ‘One Health’ approach, which acknowledges the
links among humans, animals and the environment, as the cornerstone of its plan.

Poverty remains the major contributor to the worsening health status of Nigerians, with majority of the population surviving on or under $3.10 per day. Access to basic health services also vary especially in rural areas due topoor access to information leading to underutilisation of services and further health inequalities. Primary health care (PHC) services are the cornerstone of Nigerian health system but the problem of
poor funding has led to the persistence of user fees as a method of health financing thus increasing Out-Of–Pocket (OOP) expenses and exacerbating poverty. Health financing initiatives should be introduced to reduce the impact on the health status of Nigerians.

Prescription monitoring is poorly conducted and prescription only medicines (POM) including antimicrobials are routinely sold Over-The-Counter (OTC) in pharmacies and by patent proprietary medicines vendors (PPMVs). This has been worsened by the lack of confidence in the public health sector due to drug shortages and poor accessibility of medicine. Individuals are therefore driven to utilise the private health
care options and other access points to medicines. The government’s effort should be focused on equipping the public health facilities and improving access to services.

As regulations are loosely enforced with regards to the sale of POMs OTC, it is difficult to control overuse of antimicrobials in general. An important component of good clinical practice that promotes the efficacy of therapy is the rational use of antimicrobials. It will be prudent to implement quality-monitoring and regulation of drugs while engaging clinicians (in both public & private health sectors), pharmacists
and PPMVs on the importance of the rational use of antimicrobials.
This situation analysis report is based on the current situation in Nigeria and recommendations are made for immediate and long-term goals.

Where we go from here depends on good leadership, multidisciplinary approach, enforcement of regulations and public education on the importance of tackling the growing AMR problem. All effort should be aimed at reducing the misuse of antimicrobials and promoting the development of novel treatment options to sustain the health of Nigerians and the world in the future.