Move Against Cancer Africa | November 2025
Raphael, a 32-year-old man undergoing chemotherapy for lung cancer, develops what should have been a minor, easily treatable infection. But due to years of antibiotic misuse, the infection is drug-resistant. Standard treatments fail, his recovery slows, and the emotional and financial toll intensifies. This scenario reflects a growing, real threat: Antimicrobial Resistance (AMR) and its devastating impact on cancer care.
During this AMR Week, we join the global community to raise awareness about the silent crisis that undermines cancer treatment outcomes. For immunocompromised patients, even a single resistant infection can become life-threatening, turning hope into uncertainty.
The Growing AMR Crisis: Global to Nigerian Context
AMR causes an estimated 1.27 million deaths annually worldwide and continues to rise due to inappropriate antibiotic use, inadequate infection control, and weak regulation (WHO, 2023). In many African countries, limited access to diagnostics and widespread self-medication worsen the situation, with resistant pathogens responsible for up to half of all hospital-acquired infections (O’Neill, 2016; Laxminarayan et al., 2020).
In Nigeria, the situation is particularly alarming. Over-the-counter antibiotics, weak enforcement of policies, inadequate stewardship programmes, and poor infection prevention leave patients, especially those battling cancer, extremely vulnerable (Okeke et al., 2021). Drug-resistant infections delay chemotherapy cycles, prolong hospital stays, increase treatment costs, and significantly raise the risk of mortality.
Sign of Progress and Hope
Despite the growing burden of antimicrobial resistance, evidence from global cancer centres demonstrates that targeted interventions can significantly reduce resistant infections and improve outcomes for immunocompromised patients. Across high-income settings, oncology hospitals that have implemented comprehensive antimicrobial stewardship bundles, incorporating routine culture-guided therapy, rapid diagnostics, multidisciplinary antimicrobial review, and safe early de-escalation, have recorded reductions in mortality, shorter febrile neutropenia episodes, and fewer instances of inappropriate empirical antibiotic use (Gudiol et al., 2023).
Across Africa, antimicrobial stewardship (AMS) is expanding in hospitals despite resource constraints. Multifaceted interventions, including audit and feedback, education, and protocol development, reduce inappropriate antibiotic use and improve guideline adherence, though limited laboratory capacity and staffing remain barriers (Abubakar et al., 2022; Olumuyiwa et al., 2023). In oncology, antimicrobial resistance is particularly alarming, with high prevalence of resistant pathogens among cancer patients (Ntim et al., 2025). Diagnostic limitations, including scarce rapid molecular assays, hinder timely de-escalation and targeted therapy. In Nigeria, only 57% of healthcare professionals demonstrate adequate AMS knowledge (Akpan et al., 2024). These findings highlight the need for strengthened laboratory capacity, multidisciplinary training, and context-adapted AMS programs to protect vulnerable oncology patients.
Many countries in the Africa have developed national action plans. Several have national antimicrobial stewardship programmes that promote diagnostics-led decision-making, audit-and-feedback mechanisms, and clinician education. However, integration with oncology care remains limited. With coordinated leadership, improved diagnostic capacity and strengthened stewardship in oncology units, better outcomes for cancer patients are achievable.
Key challenges in African oncology care settings
- Low awareness of AMR among patients and caregivers
- Insufficient diagnostic capacity for culture testing
- Weak enforcement of antibiotic regulations
- Inconsistent training on antimicrobial stewardship
- Gaps in infection prevention and control in many oncology units
These challenges require practical, coordinated actions that can be implemented immediately.
Recommendations
To safeguard cancer patients from drug-resistant infections, five priority strategies are essential:
- Strengthen antimicrobial stewardship: establish stewardship programmes in oncology units and centers within hospitals to promote diagnosis, guided treatment where possible; and antibiotic prescribing practices are audited to improve accountability.
- Integrate AMR education into cancer care: include information on AMR counselling sessions during chemotherapy visits; sensitize the oncology health workers on early detection of resistant infections; and distribute patient-focused materials on proper antibiotic use.
- Improve access to rapid diagnostics: expand point-of-care tests and culture specimen facilities in cancer centres; ensure timely access to laboratory results for targeted therapy; and reduce out-of-pocket spending for diagnostics by patients.
- Enhance infection prevention and control: improve hygiene, sterilisation, and environmental cleaning; ensure access to PPE and isolation spaces; and conduct routine IPC training for oncology health workers.
- Promote responsible prescription and public awareness in the community: regulate over-the-counter antibiotic sales; run community education campaigns on the dangers of misuse; and empower cancer support groups to disseminate evidence-based messages.
Conclusion
For cancer patients, antimicrobial resistance impacts their survival. Strengthening stewardship, improving access to diagnostics, enhancing infection prevention, and empowering patients and the public with information can significantly reduce resistant infections and protect treatment outcomes.
MACA stands united with global efforts to raise awareness, advocate for stronger policies, and protect the lives of cancer patients during this World Antimicrobial Awareness Week. Cancer should never be a death sentence, and preventable infections should never steal the future of those fighting bravely.
#AMRWeek #CancerCare #PatientSafety #AMR #MACA #GlobalHealth #InfectionPrevention
Written by: Mrs Ogechukwu Akabuike
References
- Abubakar, I., Hamishehkar, H., Alli, J., et al. (2022). Impact of antimicrobial stewardship interventions to improve antibiotic prescribing for hospital inpatients in Africa: A systematic review and meta-analysis. Journal of Hospital Infection, 120, 67–79. https://pubmed.ncbi.nlm.nih.gov/35970382/
- Akpan, M. R., Jackson, I. L., Eshiet, U. I., Mfon, S. A., & Abasiattai, E. A. (2024). Knowledge of antimicrobial stewardship and the Access, Watch and Reserve (AWaRe) classification of antibiotics among frontline healthcare professionals in Akwa Ibom State, Nigeria: A cross-sectional study. BMC Health Services Research, 24, 1014. https://doi.org/10.1186/s12913-024-11428-8
- Olumuyiwa, A., Chukwu, O., & Adeyemi, A. (2023). Pharmacist-led antimicrobial stewardship programmes in Sub-Saharan Africa: A systematic review. Journal of Pharmaceutical Policy and Practice, 16, 34. https://pmc.ncbi.nlm.nih.gov/articles/PMC9584722/
- Ntim, O. K., Awere-Duodu, A., Osman, A.-H., & Donkor, E. S. (2025). Antimicrobial resistance of bacterial pathogens isolated from cancer patients: A systematic review and meta-analysis. BMC Infectious Diseases, 25, 296. https://doi.org/10.1186/s12879-025-10481-w
- Biological Procedures Online. (2022). Combating the menace of antimicrobial resistance in Africa: A review on stewardship, surveillance and diagnostic strategies. Biological Procedures Online, 24, 19. https://biologicalproceduresonline.biomedcentral.com/articles/10.1186/s12575-022-00182-y
