NAIROBI – Kenya is grappling with a severe public health crisis as antimicrobial resistance (AMR) renders common antibiotics ineffective, leading to increased deaths and healthcare costs. According to the Institute for Health Metrics and Evaluation, an estimated 28,500 deaths in Kenya were associated with AMR in 2021, with 6,670 directly attributable to it. This growing threat jeopardizes the core of modern medicine, potentially returning the world to a pre-antibiotic era where routine infections could once again be fatal, a concern repeatedly highlighted by the World Health Organization (WHO).

The primary driver of this crisis is the widespread misuse and overuse of antibiotics in both human and animal health. In Kenya, it is common for individuals to purchase antibiotics over the counter without a prescription, often for viral illnesses like the common cold, which do not respond to such treatment. A recent surveillance study presented during World Antimicrobial Resistance Awareness Week in November 2025 revealed alarming resistance rates in Kenyan hospitals. For instance, Klebsiella pneumoniae, a common cause of infections in newborns, now shows 70-80% resistance to frequently used antibiotics. Similarly, Escherichia coli (E. coli), a primary cause of urinary tract infections, exhibits 60-70% resistance. Experts warn that even last-resort antibiotics are losing their effectiveness.

National and Global Response

In response to this escalating threat, Kenya developed a National Action Plan (NAP) on Prevention and Containment of AMR for 2017–2022, aligning with the WHO's 2015 Global Action Plan (GAP). The plan was formulated through a 'One Health' approach, recognizing the interconnectedness of human, animal, and environmental health. Key objectives include improving awareness, strengthening surveillance, reducing infection incidence through better sanitation and hygiene, optimizing antimicrobial use, and securing sustainable investment. A second iteration of the plan, NAP 2.0, now guides efforts from 2023 to 2027.

Progress has been made under this framework. A National Antimicrobial Stewardship Interagency Committee (NASIC) was established to coordinate efforts, and 22 surveillance sites now submit data to a central warehouse. However, significant challenges persist, including funding gaps, reliance on foreign donors, and difficulties in implementing policies at the county level. Limited diagnostic capacity in many health facilities means antibiotic prescriptions are often empirical rather than based on evidence, exacerbating the problem.

The East African Context

The challenge of AMR is not unique to Kenya but is a pressing issue across East Africa. Factors such as poor sanitation, inadequate healthcare infrastructure, the prevalence of counterfeit medicines, and the unregulated use of antibiotics in livestock contribute to the regional problem. In many pastoralist communities, self-medication of animals is common due to a lack of veterinary services, further fueling resistance. The high burden of infectious diseases in the region, coupled with limited surveillance capacity, means the true scale of resistance is likely under-reported.

The Way Forward: A Multi-pronged Approach

Addressing AMR requires a concerted, multi-sectoral effort. Experts are calling for stricter control over antibiotic sales, enhanced antimicrobial stewardship programs in hospitals, and significant investment in laboratory capacity for accurate diagnosis and surveillance. Public education on the appropriate use of antibiotics is also critical to shifting cultural norms of self-medication.

Globally, the pipeline for new antibiotics is alarmingly thin. A 2025 WHO report indicated a decrease in the number of antibacterial agents in the clinical pipeline, with very few being innovative or effective against the most critical drug-resistant bacteria. This innovation gap highlights the need for increased investment in research and development. New technologies, including artificial intelligence, are being harnessed to accelerate the discovery of next-generation antibiotics. For Kenya, the effective implementation and sustainable funding of its National Action Plan are paramount. Without immediate and harmonized action, the gains made in public health over the last century are at risk of being undone by the silent pandemic of antimicrobial resistance.