EPIDEMIOLOGY AND HEALTH DATA INSIGHTS
Review Article
Oct 04, 2025 8 2

Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective

Abdulgafar Onikoko Ahmad 1 * ,
Modinat Aina Abayomi 2,
Obinna Hilary Tony-Okpalaobi 3,
Faozyat Odunayo Odetola 4,
Ogechi Njoku 5,
Ndubisi Ubaka Edebeatu 6,
Alayande Opeoluwa Oluwatosin 7,
Valentine Uchenna Oluchukwu 8,
Dorothy Abimbola Antai 9
1 School of Medical Laboratory Science, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria2 Department of Biology, Boston College, Boston, MA, USA3 Department of Internal Medicine, Federal Medical Center Jabi, Abuja, Nigeria4 School of Graduate Studies, American National University, Salem, VA, USA5 Department of Laboratory Services, AIDS Healthcare Foundation, Benue, Nigeria6 Department of Medicine, Texila American University, Providence, Guyana7 Investigation and Design Department, Ogun-Oshun River Basin Development Authority, Ogun State, Nigeria8 Department of Medical Laboratory Science, University of Nigeria, Nsukka, Enugu State, Nigeria 9 Department of Medical Laboratory Science, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria* Corresponding Author
Epidemiology and Health Data Insights, 1(5), 2025, ehdi016, https://doi.org/10.63946/ehdi/17210
Publication date: Oct 04, 2025
Full Text (PDF)

ABSTRACT

Antimicrobial resistance (AMR) is a growing global threat, and sub-Saharan Africa (SSA) bears a disproportionate share of this burden. This narrative review examines how deficiencies in water, sanitation, and hygiene (WASH) contribute to AMR in SSA. It draws on peer-reviewed literature, institutional reports, and regional policy documents published between 2015 and 2025. Sources were identified through databases such as PubMed, Google Scholar, and WHO/UN databases using combinations of keywords including ‘AMR’, ‘WASH’, ‘Sub-Saharan Africa’, and ‘One Health’. We survey recent literature on the regional AMR problem, the role of inadequate WASH in propagating resistant infections among humans, animals, and the environment, and the relevance of a One Health approach. Key themes include the high AMR mortality in Africa, the persistence of antibiotic residues and pathogens in poorly managed water and sanitation systems, and how poverty-related WASH gaps drive frequent infections that require antibiotics. Evidence suggests that unsafe water and sanitation facilitate the environmental circulation of resistant bacteria and genes. The One Health framework is highlighted as essential for addressing these links, since AMR crosses human, animal, and ecological domains. We conclude that improving WASH infrastructure and practices, alongside integrated AMR strategies, is critical to curb resistance in the region. Focusing on WASH under a One Health perspective can reveal overlooked pathways of AMR spread and inform targeted interventions in SSA.

KEYWORDS

Antimicrobial resistance WASH One Health Sub-Saharan Africa Infection Prevention Environmental Health AMR Policy

CITATION (Vancouver)

Ahmad AO, Abayomi MA, Tony-Okpalaobi OH, Odetola FO, Njoku O, Edebeatu NU, et al. Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective. Epidemiology and Health Data Insights. 2025;1(5):ehdi016. https://doi.org/10.63946/ehdi/17210
APA
Ahmad, A. O., Abayomi, M. A., Tony-Okpalaobi, O. H., Odetola, F. O., Njoku, O., Edebeatu, N. U., Oluwatosin, A. O., Oluchukwu, V. U., & Antai, D. A. (2025). Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective. Epidemiology and Health Data Insights, 1(5), ehdi016. https://doi.org/10.63946/ehdi/17210
Harvard
Ahmad, A. O., Abayomi, M. A., Tony-Okpalaobi, O. H., Odetola, F. O., Njoku, O., Edebeatu, N. U., . . . Antai, D. A. (2025). Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective. Epidemiology and Health Data Insights, 1(5), ehdi016. https://doi.org/10.63946/ehdi/17210
AMA
Ahmad AO, Abayomi MA, Tony-Okpalaobi OH, et al. Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective. Epidemiology and Health Data Insights. 2025;1(5), ehdi016. https://doi.org/10.63946/ehdi/17210
Chicago
Ahmad, Abdulgafar Onikoko, Modinat Aina Abayomi, Obinna Hilary Tony-Okpalaobi, Faozyat Odunayo Odetola, Ogechi Njoku, Ndubisi Ubaka Edebeatu, Alayande Opeoluwa Oluwatosin, Valentine Uchenna Oluchukwu, and Dorothy Abimbola Antai. "Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective". Epidemiology and Health Data Insights 2025 1 no. 5 (2025): ehdi016. https://doi.org/10.63946/ehdi/17210
MLA
Ahmad, Abdulgafar Onikoko et al. "Water, Sanitation, and Hygiene (WASH) Gaps as Drivers of Antimicrobial Resistance in Sub-Saharan Africa: A One Health Perspective". Epidemiology and Health Data Insights, vol. 1, no. 5, 2025, ehdi016. https://doi.org/10.63946/ehdi/17210

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