AMR in Ghana: The Silent Economic Threat Undermining the Nation’s Long-Term Prosperity

Antimicrobial resistance (AMR) poses a growing challenge to Ghana’s health and economy. Observed annually from September 18 to 24 during World Antimicrobial Awareness Week, this issue highlights how drug-resistant infections strain resources and hinder development. This article breaks down AMR’s mechanisms, its disproportionate effects on Ghana, economic costs, and evidence-based solutions.

Introduction

Every year, World Antimicrobial Awareness Week draws global attention to antimicrobial resistance (AMR) in Ghana and beyond—a phenomenon where bacteria, viruses, parasites, and fungi resist medications designed to eliminate them. In Ghana, AMR transcends health concerns, emerging as a silent financial danger that burdens the healthcare system, households, and overall economic growth.

What is Antimicrobial Resistance?

AMR occurs when microorganisms evolve to withstand antimicrobials like antibiotics, antivirals, and antifungals. Simple infections that once responded to standard treatments become prolonged and life-threatening, leading to extended hospital stays, higher treatment costs, and increased mortality. The World Health Organization (WHO) ranks AMR among the top 10 global public health threats due to its role in nearly 4.95 million deaths in 2019, including 1.27 million directly attributed to bacterial resistance.

Analysis

This section examines AMR’s prevalence, causes, and specific impacts in Ghana, drawing from verified data sources.

AMR Statistics in Ghana

Data from the Institute for Health Metrics and Evaluation (IHME) reveals that in 2019, AMR directly caused approximately 5,900 deaths in Ghana, with an additional 25,300 deaths associated with it. This positions Ghana 36th globally in AMR mortality rates per 100,000 people, underscoring its vulnerability.

Key Drivers of AMR in Ghana

Over-the-counter availability of antimicrobials without prescriptions is a primary factor fueling misuse in Ghana. This easy access promotes self-medication and inappropriate use, accelerating resistance. As first-line drugs fail, reliance shifts to pricier alternatives, often scarce in local markets.

Healthcare System Strain

A prospective study in two major public teaching hospitals in Ghana quantified the burden: patients with drug-resistant infections stayed 5 extra days, incurring additional costs of US$823–$946 per admission. Annually, these hospitals faced US$650,000 in extra expenses. Patient-level costs reached US$1,300 per case, totaling US$1–1.4 million yearly across both facilities, factoring in lost productivity.

Summary

Antimicrobial resistance in Ghana represents a multifaceted crisis: a public health emergency driving 5,900 direct deaths and 25,300 associated deaths in 2019, alongside massive economic losses. Hospital costs escalate by hundreds of dollars per patient, while global projections warn of trillions in economic shrinkage by 2050 without intervention. Ghana’s high AMR ranking and OTC antimicrobial sales amplify risks, diverting health budgets and exacerbating family financial hardships.

Key Points

Practical Advice

Combating AMR in Ghana demands coordinated efforts across sectors. Here’s a step-by-step guide based on evidence.

Government and Policy Actions

Enforce existing regulations banning non-prescription antimicrobial sales. Invest in diagnostic labs and national surveillance to track resistance patterns. Boost infection prevention in hospitals, schools, and public spaces to reduce antimicrobial needs.

Healthcare Professionals’ Roles

Doctors should prescribe based on evidence, resisting patient pressure. Pharmacists must deny sales without prescriptions and educate users. Nurses enforce hygiene to curb hospital-acquired infections. Labs provide rapid, accurate diagnostics. Establish antimicrobial stewardship committees to monitor usage.

Public and Community Steps

Never self-medicate or share antimicrobials. Complete full courses when prescribed. Practice handwashing, safe food handling, and vaccinations to prevent infections. Media should amplify awareness through stories and campaigns.

Agriculture and One Health Approach

Collaborate across human, animal, and environmental health to curb antimicrobial overuse in livestock, a major resistance driver.

Points of Caution

Unchecked AMR risks catastrophic consequences for Ghana. With health spending projected at GH₵17.8 billion in 2025, resistant infections could siphon funds from prevention and infrastructure. Families face heightened catastrophic costs, widening inequalities. Prolonged hospital stays block beds, straining capacity. Economically, AMR threatens productivity losses and positions Ghana in global downturn scenarios, impeding growth in health, jobs, and income.

Household Financial Risks

Extra US$1,300 per AMR case erodes savings, forcing debt or delayed care, disproportionately affecting low-income groups.

Comparison

Ghana vs. Global AMR Burden

Globally, AMR contributed to 4.95 million deaths in 2019, dwarfing Ghana’s 31,200 total impact but highlighting per-capita severity—Ghana’s rate ranks 36th worldwide. Economic projections from the World Organisation for Animal Health (WOAH) estimate current global costs at US$66 billion, potentially surging to US$159–325 billion by 2050 under business-as-usual, shrinking GDP by US$1.7 trillion.

Optimistic scenarios show promise: universal quality care and new antimicrobials could yield US$97 billion healthcare savings, US$960 billion GDP growth, and US$680 billion health gains by 2050—benefits Ghana can access through targeted actions.

Legal Implications

In Ghana, regulations already prohibit over-the-counter antimicrobial sales, yet enforcement lags, enabling misuse. Strengthening compliance through inspections, penalties for illegal vendors, and mandatory reporting of usage/resistance data is legally mandated. Policymakers must update national treatment guidelines reflecting local resistance data, enforceable in public and private facilities. Non-adherence risks legal liabilities for providers, including malpractice claims from treatment failures. A One Health framework legally integrates human, veterinary, and agricultural oversight to curb resistance spread.

Conclusion

AMR in Ghana is a preventable economic threat demanding immediate, collective action. By enforcing laws, enhancing surveillance, promoting stewardship, and educating the public, Ghana can mitigate health losses, safeguard budgets, and secure long-term prosperity. During World Antimicrobial Awareness Week and beyond, every stakeholder—from government to individuals—must prioritize responsible antimicrobial use to protect the nation’s future.

About the Author: Dr. Harry Amoaning Okyere, PharmD, is a pharmacist, epidemiologist, and researcher with over 10 years of experience. He serves as Deputy Executive Secretary and Strategic Planning Lead at the Pharmaceutical Society of Ghana.

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