Understanding antibiotic access in the WHO African Region

Overview

This report presents findings from a multi-country survey and stakeholder roundtables conducted to better understand antibiotic access challenges in the WHO African Region. Developed as part of SECURE, a global initiative led by the World Health Organization (WHO) and the Global Antibiotic Research and Development Partnership (GARDP), the work aimed to validate and refine an initial shortlist of priority antibiotics and identify barriers to their availability, affordability and appropriate use.

The survey went to all 47 Member States; 25 countries responded (53%). Respondents assessed six antibiotics: amoxicillin, nitrofurantoin, meropenem, vancomycin, ceftazidime-avibactam, and cefiderocol. Findings were discussed in roundtables with country representatives.

The findings show that amoxicillin and nitrofurantoin, both Access antibiotics, were widely seen as priorities. Amoxicillin faced fewer barriers, though some countries highlighted stockouts. Nitrofurantoin access was variable due to limited public sector availability, supply chain issues, and diagnostic constraints. By contrast, countries reported significant access challenges for Watch antibiotics meropenem and vancomycin, with high cost and supply chain issues identified as main barriers. The Reserve antibiotics, ceftazidime-avibactam and cefiderocol, were less recognized as priorities, reflecting unfamiliarity, lack of national registration, high cost, and low public sector availability.

Improving access requires solutions combining regulatory, procurement, and country actions. Suggested actions include rapid appraisals; accelerated registration for Watch and Reserve antibiotics; piloting pooled procurement; and support for country introduction plans including guideline updates, essential medicines list alignment, and prescriber training.