MAP-AMRx

Nigeria Health Watch

MAP-AMRx

Empowering communities and decision makers with data to stop substandard antibiotics at the source

Abuja, Federal Capital Territory, Nigeria

NGA

Nonprofit

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Prevalence of substandard and falsified (SF) antibiotics contribute to antimicrobial resistance (AMR), and avoidable deaths. A UN study estimates that counterfeit drugs cause up to 500,000 deaths annually in sub-Saharan Africa, with falsified antibiotics used for childhood pneumonia accounting for 169,000. Despite efforts by Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC)—including deploying handheld drug-authentication tools and minilabs—systemic challenges persist. Porous borders, informal drug markets, and widespread poverty drive demand for cheaper, often unregulated medicines. Over 70% of Nigeria’s drugs are imported, many from countries with weak oversight, while NAFDAC lacks the granular, community-level data needed to detect SF antibiotic hotspots in real time. Current pharmacovigilance systems depend heavily on facility-based reporting and fall short of capturing realities in underserved areas where reliance on informal drug sellers is high. To achieve NAFDAC’s goals of reducing SF prevalence from 16% to 5%, there is an urgent need for scalable, community-informed surveillance models that complement regulatory efforts. This proposal seeks to explore how community-level data can be leveraged to estimate the prevalence and distribution of substandard and falsified antibiotics, using Kano, Cross River, Niger, Lagos, Ebonyi and Borno states as case studies.

The solution is a mobile-based community polling and surveillance platform designed to detect and monitor substandard and falsified antibiotics in underserved Nigerian communities. Building on Nigeria Health Watch’s existing community polling mechanism, adapted from our Health Misinformation and Community Health Watch Projects, the platform aims to empower everyday citizens and community health workers—especially those in rural areas—to report experiences with antibiotics purchased and administered respectively. Using a simple mobile interface, community members and health workers respond to structured surveys and open-ended prompts about drug availability, perceived effectiveness, side effects, and packaging anomalies. This data is aggregated and geotagged in real time through a digital dashboard accessible to regulators, policymakers, and public health actors. The system will also incorporate alerts to flag potential counterfeit clusters, supports trend analysis, and integrate GIS mapping tools to visualise distribution patterns. By leveraging low-cost, accessible mobile technology and trusted community engagement strategies, our platform provides an early warning system for substandard or falsified antibiotics, enhances pharmacovigilance, and supports targeted regulatory responses. It turns community voices into actionable intelligence, ultimately protecting lives and slowing the spread of antimicrobial resistance.

MAP-AMRx is designed to serve Nigeria’s most vulnerable populations—particularly rural communities—where reliance on informal medicine vendors is high, and access to formal healthcare is limited. These communities face disproportionate exposure to substandard and falsified antibiotics, often without awareness or recourse. The consequences are severe: treatment failures, prolonged illness, rising antimicrobial resistance, and, in some cases, preventable death. This solution also supports frontline health workers and informal drug sellers, such as Patent and Proprietary Medicine Vendors, by equipping them with tools to identify and report poor-quality antibiotics and access real-time safety insights—building a culture of shared accountability and stewardship. Lastly and importantly, the solution provides useful insights for NAFDAC, Nigeria’s drug regulator, to inform monitoring and regulatory activities, which are often undermined due to lack of resources and personnel to cover the country’s large population. By giving communities, a simple, accessible means to report their antibiotic experiences, MAP-AMRx transforms citizens into active participants in public health surveillance. Over time, this participatory model fosters safer medicine markets, reduces health inequities, and empowers people with the knowledge and tools to protect themselves and their families from harmful antibiotics.