• Africa bears a disproportionate burden of antimicrobial resistance despite limited surveillance coverage. • WHO GLASS data reveal major gaps in laboratory capacity and bloodstream infection surveillance across the continent. • Antimicrobial stewardship implementation remains weak at community, district, and tertiary care levels. • Misalignment with WHO AWaRe targets and widespread empirical antibiotic use accelerate resistance. Antimicrobial resistance (AMR) represents a growing public health threat in Africa, where surveillance capacity and antimicrobial stewardship remain limited. Using findings from the World Health Organization Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2025, this commentary highlights the disproportionate burden of resistant infections across the continent, major gaps in laboratory infrastructure, and incomplete national surveillance coverage. Weak diagnostic capacity, widespread empirical antibiotic use, and misalignment with WHO AWaRe targets further exacerbate resistance. Strengthening AMR surveillance, diagnostic and antimicrobial stewardship, and governance across all levels of the healthcare system is essential to mitigate AMR and advance Universal Health Coverage in low-resource settings.
Shimber et al. (Sun,) studied this question.