Slums, reason antimicrobial resistance amplifies — UNILAG VC

VICE Chancellor, University of Lagos (UNILAG), Professor Folasade Ogunsola, has said slums, a permanent fixture of African cities, needed to be given special attention in Nigeria’s drive to combat antimicrobial resistance, which she described as silent, deadly and relentless pandemic threatening to undermine gains made against infectious diseases since the advent of penicillin.

Professor Ogunsola, in the 2023 Horatio Oritsejolomi Thomas Distinguished Lecture, entitled ‘Cities, People, and Bugs: Perspectives on Combating Antimicrobial Resistance in Nigeria,’ delivered at the University of Ibadan, said factors that accelerate and amplify microbial resistance, including antimicrobial resistance disease-causing germs, are present and increased in slums.

The increasing size and number of slums in many low- and medium-income countries, including Nigeria, she declared will not make antimicrobial resistance go away, except slums are upgraded and special attention paid to their health issues.

According to her, the full impact of antimicrobial resistance is yet to be fully quantified, adding that 10 million people, including 4.1 million in sub-Saharan Africa, according to the World Health Organisation (WHO), are expected to have died from antimicrobial resistance organisms by 2050.

She added that countries across Africa could lose up to five percent of their gross domestic product (GDP) by 2050 if this silent, deadly and relentless pandemic, one of the top 10 global public health threats facing humanity, is not stemmed.

The UNILAG vice chancellor noted that antibiotics underpin modern medicine, adding that if they lose their effectiveness, it will be catastrophic.

She stated that antimicrobial resistance occurs when germs that previously responded to an antimicrobial no longer respond at the normal doses required.

According to her, rapid population growth, which led to uncontrolled urbanisation and the proliferation of slum settlements, ensures a perfect community environment for rapid transmission of germs between humans, animals and the environment and the amplification of infection in many slums due to factors such as overcrowding, inadequate access to clean water and sanitation services, and poor waste management.

Professor Ogunsola said, “Pit latrines in slums need to be revisited. In the context of overcrowding, they may contribute to the contamination of water sources. The approach to solving antimicrobial resistance must include the social determinants of health.

“Slum upgrades will be needed. We must solve the drivers of infection and ill health, whether real or perceived, that drive the consumption of antibiotics.

“Slum interventions should move away from destroying slums to upgrading slums, as destruction just creates the squeezed balloon effects, and they set up elsewhere. Antimicrobial resistance will not go away if slums do not. If we do not go back to the basics and ensure we address the social determinants of health, the high infection rates in slums will continue to fuel the pandemic.”

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