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Forgotten stories of antimalarial drug resistance and its relation to AMR in Africa

My name is Olayinka Fakorede. As a Nigerian-trained medical doctor and someone who has experienced the challenges of malaria firsthand, I can personally relate to the looming threat of malaria resistance in Nigeria and other countries where malaria is endemic.

Malaria is an infectious disease transmitted by mosquitoes which are parasites. Malaria is treated with antimalarial medications, otherwise known as antiparasitics. Antiparasitics fall under the greater umbrella of antimicrobial medicines.

Growing up, whenever illness struck, my parents would swiftly whisk me off to the hospital, and often, it was a bout of malaria that had me bedridden. Over time, I became all too familiar with the recurring symptoms and subsequent need for antimalarial treatment.

As the years passed, something troubling began to happen. First-line medications, once a trusted ally in my battle, lost their effect. I was experiencing resistance to the antimalarials. I later learned first-line medications were also losing their effect on the broader population. I wasn’t the only one.

Unknowingly contributing to antimalarial drug resistance

At one point, I was old enough to purchase medications on my own, but I was also navigating the demanding journey of medical school. My days were a whirlwind of lectures, practicals, and the myriad responsibilities that came with being part of national and international medical student associations. Traveling for conferences were not uncommon either and stress became a constant companion.

As I soon discovered, stress can trigger the reactivation of dormant malaria parasites in the liver, making me a recurrent victim of the disease. In my haste to regain my health and keep up with my demanding schedule, I began to overuse antimalarial medications. Unknown to me, I was unwittingly contributing to the development of malarial resistance.

I had just returned from a conference, having taken two different antimalarial medications over two weeks, and remained unwell. While complications from malaria are less common in adults from endemic regions due to acquired immunity, this persistent illness was a stark reminder of the evolving threat.

Desperation led me to a second-line medication, and finally, I began to recover.

Knowledge empowered me

This experience was a profound wake-up call. I realised that I couldn’t continue down this path, and I couldn’t bear to see others suffer the same fate. Armed with knowledge about antimalarial resistance and antimicrobial resistance (AMR), I embarked on a personal mission to advocate for change.
My international position in medical associations gave me a platform to raise awareness about AMR and antimalarial resistance, and I seized the opportunity.

But did this ordeal end my battles with malaria? Unfortunately, not. However, I learned to manage my stress better and implemented various preventive measures. I surrounded myself with insecticides, insect repellents, and insecticide-treated nets, yet malaria would still find its way into my life.

Being a medical doctor undoubtedly gave me an advantage. I recognised the need for testing and confirmation of malaria, refusing to jump to conclusions and self-medicate. Instead, I engaged with colleagues who could admit me to the hospital and administer the antimalarial treatments appropriately.

My story, though personal, is just one among millions of Nigerians who have unknowingly misused antimalarial drugs due to inadequate awareness about AMR, lax government regulations, and poor access to diagnostics. I’ve witnessed patients battling antimalarial resistance, and my medical knowledge has allowed me to assist them effectively.

Antimalarial drug resistance is part of antimicrobial resistance (AMR)

 

Antimalarial resistance is considered a part of antimicrobial resistance (AMR) because it’s a special type of resistance, but specifically against medications used to treat or prevent the parasites (mosquitoes) that cause malaria.

Just like how bacteria can become resistant to antibiotics, the parasites that cause malaria can become resistant to the medicines used to fight them. This happens when these parasites change in a way that makes the medications less effective against them. So, just as we need to be careful with antibiotics to prevent the spread of resistant bacteria, we also need to watch out for antimalarial resistance to make sure the medications we use to fight this deadly disease keep working well.

Malaria remains a persistent burden in Nigeria and various parts of the world, affecting individuals regardless of their socio-economic status. The risk of mosquito bites and the disease’s relentless impact knows no boundaries, particularly affecting communities with limited resources.

Without effective antimalarials this deadly disease will claim thousands of lives.

As I continue to advocate for AMR awareness, my hope is that Nigeria will embrace comprehensive strategies to combat this growing threat, ensuring that medications for malaria remain effective. Through education, regulation, and accessible healthcare, we can secure a healthier future for all.

Disclaimer: This story is shared with the permission of the individual(s) involved and is intended for educational and awareness purposes only. It does not represent medical advice and should not be used as a substitute for consultation with qualified healthcare professionals. While we encourage you to share the story in its original format, all rights are reserved by The AMR Narrative. Please do not reproduce, modify, or use any part of this story without prior written consent from The AMR Narrative. To request permission, please contact us here.

Olayinka Fakorede

Olayinka Fakorede

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Olayinka Fakorede is a medical doctor from Nigeria with an interest in infectious disease and antimicrobial resistance. She has led youth organisations like the World Health Students’ Alliance (WHSA) to organise an Antimicrobial Resistance (AMR) Conference, as well as to write policy documents on control of infectious diseases and AMR and has also led AMR Advocacy Working Groups.

Olayinka is currently completing an MPH in Global Health at the Harvard T.H. Chan School of Public Health. Her goal is to continue strengthening global health systems to tackle infectious diseases and AMR.

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Cameron Prior

Cameron Prior

BVSc MSc PgCert CertAVP DipECVIM-CA MRCVS

RCVS Recognised Specialist in Small Animal Medicine

Cameron is a European Diplomate in Small Animal Internal Medicine. Passionate about fungal disease, antimicrobial stewardship, endocrinopathy, and facilitating multiple studies to enhance the evidence base of veterinary medicine. Keen to build collaborative projects with colleagues across Europe and to promote clinical research in practice.

Abi Mc Alester

Abi Mc Alester

I am a graduate from the National University of Galway with an Honours BSc in Pharmacology, and a recent graduate from Maynooth University with a MSc in Immunology & Global Health. Throughout university, I was an active member of the Global Health Network, which was a student-led group focusing on health, equity, and international development. Here is where I became interested in the global impact of AMR and the multiple factors that influence its spread. I chose to focus my studies on the mechanisms behind resistance and vaccination design; however, I understand that in order to have a global impact, there needs to be global awareness.

The AMR Narrative provides lived experiences and stories from those affected by resistance, something I believe is so important and why I wanted to help share these stories on social media. Translating scientific knowledge into digestible and understandable language is critical for fighting resistance.

Nduta Kamere

Nduta is a global health pharmacist and AMR consultant recognised for her leadership in antimicrobial stewardship, One Health, and healthcare equity. She has shaped AMR strategies and advanced healthcare accessibility across Africa, with a significant portfolio that includes contributions to the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programmes. As Technical Lead, she oversaw the co-development of the Quadripartite Antimicrobial Resistance Toolkit for Youth Engagement, now used globally to drive advocacy and behaviour change.

Her expertise spans supply chains, pricing, and substandard and falsified medicines, and her research is published in the WHO Bulletin and peer-reviewed journals, informing regional and global AMR policy and practice.

Dr Marie-Anne Bouldouyre

Dr Marie-Anne Bouldouyre is an infectious diseases physician and hospital practitioner in Paris. Twelve years of clinical work in a suburban hospital shaped her understanding of access to care, patient relationships, and the daily reality of antimicrobial resistance.

Since 2022, she has led the Regional Antibiotic Stewardship Centre in Île-de-France and coordinates the national network, working with a multidisciplinary team to promote responsible antibiotic use and strengthen collaboration among healthcare professionals. She also continues to manage complex infections at Saint-Louis Hospital.

Convinced that antimicrobial resistance cannot be tackled by healthcare workers alone, she advocates for the active involvement of patients : understanding, questioning, and taking part in decisions about antibiotics. Their stories are essential to making this issue visible and concrete.

She is proud to collaborate with initiatives such as The AMR Narrative and hopes to foster similar projects in France to give patients a voice in this shared fight.

Dr Erva Cinar

Dr Erva Cinar is a London based paediatric resident doctor and clinical researcher with interest in infectious diseases.

She is currently completing a Master’s in Public Health at the London School of Hygiene & Tropical Medicine. Through the World Medical Association’s Junior Doctor’s Network (WMA-JDN) AMR Working Group, she engages in policy and advocacy on antimicrobial resistance and stewardship at global level.

Alongside her clinical and academic roles, she works with the Royal College of Paediatrics and Child Health (RCPCH) and the International Child Health Group (ICHG); leads on organising teaching resources and educational events to improve research skills for UK paediatric trainees and for global child health professionals.

Hamu Madzedze

Hamu Madzedze is a seasoned Zimbabwean journalist with over 15 years’ experience.

She previously worked for the Zimbabwe Broadcasting Corporation as a reporter and sub-editor, before establishing an independent website, 365HealthDiaries, which focuses on health and gender issues.

She holds a BA in Media Studies and a BA (Special Honours) in Communication and Media from the Zimbabwe Open University, as well as a diploma from the Christian College of Southern Africa.

Her work has been recognised with several awards, including the Global AMR Special Mention Award (2024), the Sexual Health Rights and Equity Fellowship Special Mention Award (2025), and the Merck Foundation Award (2024) for outstanding coverage of health issues, gender, infertility, and genital mutilation, where she achieved third position in the Online Category.

Hamu is passionate about addressing AMR through the media.

Jomana F. Musmar

Dr. Jomana Musmar is a distinguished global policy expert and proactive leader with over fifteen years of government experience in strategic planning, operational design, and policy execution. Renowned for simplifying complex topics with expertise and diplomacy, she has spearheaded innovative solutions to global health challenges, shaped impactful policies, and advanced national and international missions.

As the Executive Director of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria, she established and led the council’s operations, liaising with over 600 experts, worldwide, across government, industry, and academia. Her efforts culminated in the development of critical recommendations addressing antimicrobial resistance and interrelated One Health issues, influencing both domestic and global health strategies.

In her tenure as Deputy Director of Strategic Initiatives for the Office of Infectious Diseases and HIV/AIDS Policy, at the US Department of Health and Human Services, Dr. Musmar oversaw the formulation and implementation of national health strategies for vaccines and a range of infectious diseases including HIV/AIDS and viral hepatitis. Her leadership and technical expertise facilitated groundbreaking policies during national emergencies, including responses to the COVID-19 pandemic, and initiatives to combat congenital syphilis and childhood vaccination disruptions. Dr. Musmar holds a Ph.D. in Biodefense from George Mason University, a Master’s degree in Biomedical Science policy and Advocacy from Georgetown University, and is a Lean Six Sigma Black Belt. Fluent in English and Arabic, she is a sought-after speaker and advisor, having represented the United States at premier global health conferences.

Her published works on antimicrobial resistance, pandemic preparedness, and national health security underscore her reputation as a thought leader and innovator in public health and biodefense.

Chris Shaffer

Chris Shaffer was a music, special education teacher, and high school principal for 45 years. At the end of his educational career, he was thrust into the world of AMR infections when a number of abdominal surgeries left him with an E-coli infection which failed to respond to antibiotics. After doctors in the USA left him with little hope for a cure, diminishing health, and a bleak prognosis, he set out on his own.

Chris found success in phage therapy at the Eliava Phage Therapy Center in Tbilisi, Georgia. With phage therapy giving Chris his life back, he has dedicated his retirement years to advocating for and helping raise awareness of phage therapy used for AMR infections. He tells the story of his phage journey in a book titled, Finding Phage: How I Partnered with a Friendly Virus to Cure My Deadly Bacterial Superinfection. His website, phagetherpyusa.com helps others learn to understand the healing power of phage therapy.

Demi Christofi

Demi is an Associate Scientific Director at a medical communications agency, with a background in microbiology and a longstanding focus on antimicrobial resistance. She holds an MSc in Microbiology, where she first became interested in the global challenge of resistance and the need to bring scientific understanding to wider audiences.

Demi’s career has centred on a simple but powerful belief: that how we communicate science matters. Her work focuses on making complex data clear, engaging, and accessible – whether for healthcare professionals, policy makers, or the patients most affected by infection and resistance. She has contributed to a wide range of AMR-focused projects, including educational programmes, congress communications and stewardship initiatives.

A central thread in Demi’s work is the importance of the patient voice. She is passionate about making sure real-world experiences of treatment failure, recurrent infections, and the anxiety surrounding resistance are not lost in the data. She believes that listening to patients and involving them meaningfully is essential for shaping more effective, human-centred responses to AMR.

Demi is also a strong advocate of the One Health approach, recognising AMR as a complex, interconnected issue that spans human health, animal health, and the environment. She is particularly drawn to efforts that move beyond siloed thinking and focus on practical, joined-up solutions.

In 2025, Demi joined The AMR Narrative as an Independent Advisor, where she supports the charity’s mission to centre communication, community, and inclusion in the global AMR response.

Outside of work, she is a Girlguiding unit leader and a qualified yoga teacher. These roles reflect her commitment to care, learning, and creating supportive spaces for others.

Andrea Hartley

Andrea has worked in health communications and campaigning for 3 decades. She is committed to fighting AMR through timely and appropriate communications globally,.

Andrea set up Skating Panda, the creative social and environmental impact consultancy, over a decade ago and drives its impact and growth. Focused on original and lasting public interest communications as well as issue strategy and advocacy, the Panda team has a track record of prompting tipping points in the status quo that drive better social and planetary outcomes.

Andrea’s combination of commercial marketing and development experience with deep issue knowledge have been sought by decision-makers at global summits, corporate and NGO board members, and have enabled her to set up multi-million fundraising platforms and push through policies that change and save lives. 

Andrea is Vice Chair of mothers2mothers, the world’s largest employer of women living with HIV, and a Board Director of Maymessy, a food poverty social enterprise.

A lifelong advocate for gender equality, she played a key role in establishing the UK’s Women’s Equality Party.

Esmita Charani

Professor Esmita Charani is a pharmacist and researcher investigating how we use antibiotics in different cultural and social contexts. She works with teams in the UK, India, and South Africa to develop research programmes investigating all aspects of antimicrobial resistance in human populations with a focus in hospital settings.

She has experience in communicating her research with patients and the public through various media including animations, blogs, and educational videos.