Posted on: Tue 24-02-2026

Senior Researcher at the Nigeria Institute of Medical Research (NIMR), Dr. Emelda Chukwu, has warned that Nigeria may be edging toward a post-antibiotic era as drug-resistant infections rise sharply across hospitals in Lagos State.

Speaking during the institute’s February Media Chat in Lagos, Chukwu described antimicrobial resistance (AMR) as one of the country’s most dangerous and underestimated public health threats, with worrying levels of resistance now recorded against last-resort antibiotics.

“Antimicrobial resistance is the situation whereby microorganisms mutate in such a way that medicines originally meant to kill them can no longer do so. They evolve and boycott the drugs. We are now seeing an increase in resistance that is threatening to overturn decades of medical progress,” she said.

Reserve antibiotics losing potency

According to Chukwu, surveillance conducted across four selected hospitals in Lagos State revealed alarmingly high resistance to third-generation cephalosporins — a powerful class of broad-spectrum antibiotics reserved for severe infections that fail to respond to first-line treatments.

“These are reserve drugs. But we are now seeing that even these third-generation medicines are losing their effectiveness. That is a major red flag,” she said.

She explained that the findings demonstrate that resistance is no longer a theoretical concern but already entrenched in clinical cases across Lagos.

“When our reserve antibiotics begin to fail, patient safety is at serious risk. It limits treatment options and increases complications, prolonged hospital stay, and mortality,” she added.

Misuse, poor stewardship fueling crisis

Chukwu attributed the surge largely to widespread misuse and abuse of antibiotics.

“Human behaviour is a major driver. Irrespective of whether you use antibiotics correctly, if your neighbour does not, resistant organisms can spread. Resistance does not respect boundaries,” she warned.

Through a sentinel surveillance network, her team generated baseline data to guide national response efforts and supported hospitals in developing facility-specific antibiograms to improve empirical treatment decisions.

“About 80 percent of prescriptions are empirical. If doctors are guided by data from their own facilities, it can significantly improve outcomes,” she noted.

Wastewater surveillance uncovers hidden threats

Beyond hospital settings, Chukwu’s research identified another looming danger in Lagos’ wastewater canals.

Using environmental and wastewater surveillance across all 20 local government areas of the state, her team detected multiple pathogens of public health importance, including antimicrobial-resistant bacteria and cholera-causing Vibrio cholerae O1.

“Out of the 20 local governments surveyed, nine had Vibrio cholerae O1 incubating in their wastewater canals. That was extremely alarming,” she disclosed.

The findings prompted a policy advisory to Lagos authorities warning of a possible cholera outbreak. In 2024, cholera spread massively across the country, affecting 36 states with significant morbidity and mortality.

“Wastewater surveillance proved to be a reliable early warning system,” she said, adding that the approach offers a cost-effective tool for epidemic intelligence and pandemic preparedness.

“We do not know what the next pandemic will be. But this approach allows us to detect threats early and act before they spiral out of control.”

Environmental risks and behaviour gaps

The environmental survey also exposed risky behaviours fueling outbreaks. Residents were found to dump refuse and defecate directly into drainage canals, leading to blockages that overflow during the rainy season and contaminate homes and food sources.

“When the canals overflow, they carry pathogens back into people’s homes. It becomes a cycle of reinfection,” she explained.

Chukwu stressed that surveillance alone would not solve the crisis without behavioural change and stronger antimicrobial stewardship.

Her team conducted studies on knowledge, attitude, and practices among prescribers and the general public, identifying pressure on doctors to prescribe antibiotics and poor public awareness as key gaps.

“Even prescribers are under pressure to prescribe. The public believes antibiotics are cure-alls. These practices are fueling resistance,” she said.

She called for sustained public awareness campaigns, stricter antimicrobial stewardship programmes, and coordinated One Health interventions linking human, animal, and environmental health systems.

“Antimicrobial resistance is not a future threat. It is here with us. If we do not act decisively, we risk losing the gains made since the discovery of antibiotics in the 1920s. This is about national health security. The time to strengthen surveillance and change behaviour is now,” Chukwu warned.

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