A case for the adoption of Phage therapy in Africa

Background

Antimicrobial resistance(AMR) is one of the greatest threats we face as a global community. An essential global public health objective is lowering the burden of infection-related mortality. Previous research has calculated the number of fatalities brought on by drug-resistant infections and sepsis and discovered that infections continue to be the world’s leading cause of mortality. The WHO has predicted that by 2030 (https://​​www.who.int/​​news/​​item/​​29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis), antimicrobial resistance could force up to 24 million people into extreme poverty.According to the UK Government-commissioned Review on Antimicrobial Resistance, AMR might result in the yearly death of 10 million people by 2050. It is predicted that 90% of these deaths will occur in Africa and Asia.

According to a recent report published in the Lancet, which estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 23 pathogens and 88 pathogen–drug combinations in 204 countries and territories in 2019. The study predicted that in 2019, there were an estimated 4·95 million (3·62–6·57) deaths associated with bacterial AMR including 1·27 million (95% UI 0·911–1·71) deaths attributable to bacterial AMR. Six leading pathogens for deaths associated with resistance (Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa) were responsible for 929 000 (660 000–1 270 000) deaths attributable to AMR and 3·57 million (2·62–4·78) deaths associated with AMR in 2019. The full report can be found here.

A case for sub-Saharan Africa

Based on the report, analysis based on regions of the world, Western sub-Saharan Africa had the highest burden, with 27·3 deaths per 100 000 (20·9–35·3) attributable to AMR and 114·8 deaths per 100 000 (90·4–145·3) associated with AMR, while Australasia had the lowest AMR burden in 2019, with 6·5 deaths per 100 000 (95% UI 4·3–9·4) attributable to AMR and 28·0 deaths per 100 000 (18·8–39·9) associated with AMR in 2019. In Nigeria, communicable diseases accounted for 66% of morbidity in 2015 There is an urgent need to address this problem in Sub-Saharan Africa.

Phages as an alternative to antibiotics

Phages have been proposed as an alternative to drug resistance. While phages have been used successfully in Europe, Australia and the USA. No report on phage therapy use in Africa. Phage research is neglected in Africa. A recent survey of phage scientists under the Africa phage forum showed that funding, lack of skill sets and infrastructure are the major setbacks preventing success in phage research in Africa.

To stimulate phage research as an alternative to antibiotics in Africa, I propose coordinated and strategic support. This support should focus on:

  1. Influencing policies that will allow for the adoption and use of phage therapy in Africa. No country within Africa has a framework for the adoption of phage therapy

  2. Address the infrastructure problem. This can be done by setting up phage banks in regions of Africa. In Nigeria, I am currently building a phage bank that can isolate, characterize and purify phages for use as phage therapy against the WHO priority pathogens. We can encourage this kind of phage banks across Africa. Funding has been a major challenge even for the phage bank in Nigeria.

  3. Training, Phages for global health have supported the training of phage researchers in Africa. They can be encouraged to do more