Potential activities to reduce the extent of substandard and falsified antibiotics across Africa and associated antimicrobial resistance

Tiyani Milta Maluleke¹Biset Asrade Mekonnen²Chukwuemeka Ubaka³Bene Anand Paramadhas⁴Mukhethwa Munzhedzi¹Aubrey C Kalungia⁵Ester Hango⁶Santosh Kumar⁷Brian Godman^1,8,9*Johanna Catharina Meyer¹

• ¹Sefako Makgatho Health Sciences University Faculty of Health Sciences, Pretoria, South Africa
• ²Bahir Dar University, Bahir Dar, Ethiopia
• ³University of Nigeria, Nsukka, Nigeria
• ⁴ministry of health botswana, Gabarone, Botswana
• ⁵University of Zambia, Lusaka, Zambia
• ⁶University of Namibia, Windhoek, Namibia
• ⁷Karnavati University, Gandhinagar, India
• ⁸Laboratory Medicine Clinical Pharmacology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Faculty of Science, University of Strathclyde, Glasgow, United Kingdom
• ⁹St George's University of London, London, United Kingdom

• Antimicrobial resistance (AMR) is a global public health threat exacerbated by inappropriate antibiotic use. This is particularly important in Africa • The availability of substandard and falsified antibiotics, particularly among African countries, contributes to this adding to the burden of AMR • Poor monitoring and regulatory controls among African countries increases the public health risks of these antibiotics. This is especially the case in the informal sector • Addressing Africa's battle against substandard and falsified antibiotics requires an integrated approach building on current WHO, Interpol and Pan-African initiatives • Activities include harmonizing regulatory activities across Africa, increasing monitoring as well as fines and sanctions for offenders. In addition, making the market considerably less attractive through reducing current high levels of inappropriate antibiotic use