The global health landscape increasingly resembles a game of whac-a-mole — strike down one challenge, and two more emerge. As the world still grapples with pandemic aftershocks and anticipates Disease X, preventable outbreaks such as cholera and measles continue to be fuelled by conflict and misinformation. Concurrently, decades of sustained health investments are at risk as health financing shrinks and long-standing commitments weaken. Amid these, a particular health challenge has remained, sometimes termed ‘silent’, yet figuratively speaking volumes through untreatable common infections, extended hospital stays and economic burdens.
More wide-reaching than often understood, Antimicrobial Resistance (AMR), threatens planetary health, pulling the world back to a pre-antimicrobial period. Without decisive action, the next 10 years could see human life expectancies fall by an average of 1.8 and 2.5 years in some low- and middle-income countries. Termed by experts as the misuse of antimicrobials in animal and plant production to farmers it is simply them improving their profit and yield. Yet, the implications place our health and food security in jeopardy. Unfortunately, the Global South bears the heaviest burden, with South Asia expected to have the highest projected mortality at over 11 million deaths directly attributable to AMR, and sub-Saharan Africa at over 6 million.
As the Nigerian proverb says, “Whenever you wake up, that is your morning”, Africa is waking up to arguably, its most abundant resource — its youth. Over 70 per cent of Africa’s population are under 30, representing a major opportunity to strengthen our AMR response. Youth bring energy, creativity, digital fluency, a hunger for recognition, and the courage to challenge norms. The 2024 United Nations General Assembly High Level Meeting on AMR Youth Manifesto, Africa CDC Youth Advisory Team for Health,and Africa CDC Youth Engagement and Participation in Global Health Strategy (2025–2028) all signal increased space for young voices in high-level decision-making.
Ahead of the fourth Conference on Public Health in Africa in South Africa, the Youth Programmes Lead and Senior Technical Officer for Strategic Programmes at Africa CDC, emphasised youth as active participants in shaping and advancing public health on the continent. He noted that youth must move past being passive beneficiaries of health programmes, to becoming co-creators of solutions, driving innovation, accountability, and community-level action.
A powerful example of youth in action is the AMR school program driven by Ameyo Stella Adadevoh (DRASA) Health Trust. Supported by the World Health Organization (WHO) in partnership with Lagos and Osun State governments, DRASA established AMR Clubs in 30 public secondary schools across two states. In 2022 alone, 891 student ambassadors were equipped through interactive lessons and activities such as artwork, debates, essays, poetry, and inter-school competitions. These ambassadors reached 8,323 people in six months — teaching in assemblies, discouraging self-medication at home, and sharing hygiene and infection prevention and control messages in religious institutions. Through their boldness and creativity, they leveraged trust within their communities and translated AMR knowledge to action.
DRASA also partnered with the youth-led AMR Intervarsity Training Program to establish seven new AMR clubs in universities nationwide, and supported activities of 11 existing clubs. To mark World Antimicrobial Resistance Awareness Week (WAAW) 2024, the AMR on the Street project enabled students to reach 29,398 community members through awareness campaigns in farms, markets, religious institutions, health facilities and more. Beyond the numbers, these were lives equipped with knowledge to make better decisions a lesson underscored by the experience of AMR survivor, Pharmacist Mashood Lawal, (Member, WHO Task Force for AMR Survivors) whose kidney stone surgery resulted in a severe drug-resistant infection nearly costing him his life.
Yet, awareness efforts often face language barriers, and the abstract nature of AMR terminology is no exception. A 2023 paper by Krockow et al. highlights the low memorability and limited public resonance of existing AMR terms. Capitalising on the importance of effective communication of AMR, DRASA with the Nigeria Centre for Disease Control and Prevention, and other partners launched the SayAMR Language Hackathon to engage university students nationwide to translate AMR to four major Nigerian languages — Hausa, Igbo, Pidgin English and Yoruba. This pioneering initiative holds promise towards reaching previously overlooked audiences due to language exclusion. Across the ecosystem, youth-focused organisations like Ducit Blue Foundation and Alliance Against Antimicrobial Resistance (Triple A) continue to demonstrate the power of youth-led advocacy, communication and innovation.
Young people are assets in AMR prevention and control, but their involvement must be genuine not tokenistic. Inclusion must extend to national AMR and One Health governance structures for decision-making to be made with youth perspectives. DRASA and Alliance for Sustainable Livestock (ASL) in Nigeria are advancing this through the fellowship Youth for Pandemic Alliance (Youth PALLI), which is focused on capacity building on AMR, in preparation for their participation in national One Health decision-making to strengthen health security emergency preparedness and response systems.
Youth engagement is essential, but alone, is not enough. The challenge of our abruptly shifting financing landscape in global health remains. To sustain the youth momentum, there is a need for domestic financing to support the implementation of the National Action Plans on AMR — strengthening surveillance, infection prevention and control, governance, education and awareness, research and development, optimal antimicrobial use, through a One Health approach. At the recent continental meeting on the review of the African Union Framework on AMR Control convened by Africa CDC in Ethiopia, a key takeaway was the need for Africa to own the response and ensure context-specific, locally developed solutions.
A pathway to owning the AMR response and staying in the game amid the myriad of health challenges is to leverage on young voices. It must be done now, and it has to be done genuinely to protect our present and secure our future.
Oluwatoni Akinola is a public health professional driving health systems strengthening with a focus on antimicrobial resistance (AMR), health policy, and science communication
Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth