Service du droit pour le développement

Tackling antimicrobial resistance in West Africa through legal frameworks


The Codex Alimentarius defines antimicrobial resistance (AMR) as “the ability of a microorganism to multiply or persist in the presence of an increased level of an antimicrobial agent relative to the susceptible counterpart of the same species” (Codex Alimentarius Commission, 2011, p. 4). AMR refers to microorganisms – bacteria, fungi, viruses, and parasites – that have acquired resistance to antimicrobial (AM) substances (FAO, 2016). It is one of the most complex and urgent issues facing the world today (FAO, 2021).

AMR can occur naturally through microbial adaptation to their surrounding environment. However, it has been observed that resistance to antimicrobials is exacerbated by inappropriate and excessive use of AM. Through the use, overuse, and misuse of AM, especially in the human health and agriculture sectors, more and more microorganisms have become (or are becoming) resistant to the drugs to which they were previously susceptible (FAO, 2016). The consequences of AMR include severe or prolonged illness, death, production losses and negative consequences for livelihoods and food security (FAO, 2016). The consequences on human health and the economic costs of AMR are estimated at 10 million annual human fatalities and a 2 to 3.5 percent decrease in global Gross Domestic Product, or 100 trillion USD by 2050 (O’Neill, 2014), although the real consequences of AMR remain unpredictable (Smith and Coast, 2013).

To tackle this trend and its harmful effects, it becomes essential to look at the possible means and measures that can be adopted to change human behaviours. With its highly technical and scientific backdrop, combatting AMR through legislative intervention is an area where the usefulness of the conventional role of legislation is revealed. Law can change behaviour through enforcing prohibitions or by creating legally-binding rules (Bilz and Nadler, 2014). For example, law can be used to regulate the practice of veterinary medicine, education or information, as well as create reporting obligations. Law also forms the backbone for appropriate frameworks to prevent the introduction and spread of pests and diseases in countries, contributing towards minimizing the need to use AMs.

The FAO Methodology for the analysis of AMR-relevant legislation in the food and agriculture sectors (FAO Methodology) confirms the importance of legislation for AMR. According to this Methodology, there is no need for the enactment of a specific piece of legislation on antimicrobial use (AMU) - nor on AMR - for AMR to be adequately addressed in legislation. Rather, the Methodology identifies the key legal areas, and the elements of these areas that can be revised for countries to tackle AMR effectively and under a One Health approach.

A request for technical assistance to assess the AMR regulatory framework of some countries in West Africa was introduced by the FAO Regional Office for  Africa (FAORAF). Following that request, between 2019 and 2022, the Development Law Service (LEGN) supported three regional organizations and fifteen countries in West Africa to collect and analyze AMR-relevant legislation, with a strong focus on information sharing. The three regional organizations participating in this activity were: the Economic Community of West African States( ECOWAS), the West African Economic and Monetary Union (WAEMU/ UEMOA), and the Permanent Interstate Committee for Drought Control in the Sahel (CILSS). The countries were both Members of FAO and of the three organizations.

The resulting analysis found that both ECOWAS and WAEMU/(UEMOA) have worked extensively on harmonising legislation in the areas of veterinary legislation and food safety. More specifically, in the area of veterinary medical products (VMP), both organizations have regional and sub-regional VMP registration systems that pay attention to the quality, safety, efficacy and residues of VMP. To obtain marketing authorization for a veterinary drug, a request must be made to the competent regional body (ECOWAS Commission in the case of ECOWAS and WEAMU Commission in the case of WAEMU). The regional-level VMP registration is effective and applicable in WAEMU Member States. A list of VMPs  authorized for marketing is updated quarterly and sent to Member States to serve as a basis for import and monitoring. The WAEMU regional VMP registration system is used as an example to follow by other regional organizations in Africa who are working towards creating similar systems. The reports also identified some opportunities to strengthen AMR-relevant legislation in ECOWAS and WAEMU, particularly in relation to the regulation and use of veterinary medicines.

The legal work at the national level focused on the collection and systematization of national legislation relevant to AMR, and the update and consolidation of the existing regional and national profiles in AMR-LEX. AMRLEX is a dataset of FAOLEX , the most comprehensive and up-to-date legislative and policy database and one of the world’s largest online repositories of national laws, regulations and policies on food, agriculture, and natural resources management. AMR-LEX compiles all the national and/or regional legislation relevant to AMR across the legal areas and elements identified in the FAO Methodology.

The above work also produced regional profiles for the three organizations: ECOWAS, WAEMU and CILLS.

As a next step, countries in ECOWAS and WAEMU are to continue working towards the implementation of this regional-level legislation into their national legal systems. Environmental legislation, pollution or water legislation, also relevant for AMR, are yet to be prioritized under regional harmonization efforts. Applying the widely endorsed One Health approach will be instrumental when this is done.

                                                                                                                                                         Sylvestre Yamthieu (FAO)