review · Toxicology Reports
Antimicrobial pollution and antibiotic resistance genes in East Africa are creating significant risks for public health, environmental integrity, and food security. Soil and water bodies act as reservoirs for these contaminants, exerting selective pressure that drives the development of multidrug-resistant pathogens. This trend impairs infection treatment in areas with limited sanitation and healthcare infrastructure. Furthermore, antimicrobial pollutants disrupt fundamental ecological functions such as nutrient cycling and organic matter breakdown, which in turn reduces soil fertility, water quality, and agricultural yields. Existing surveillance initiatives, including regional laboratory networks and global tracking systems, provide useful data but remain inadequate for the scale of the challenge. Addressing this crisis requires joined-up interventions that combine tighter antibiotic regulations, enhanced wastewater treatment technologies, and comprehensive environmental monitoring spanning public health, agriculture, and ecological management.
Antimicrobial resistance undermines modern medicine by making common infections harder to treat, particularly in areas with fragile healthcare systems. When antimicrobial residues contaminate soil and water, they also degrade farmland and water quality. Understanding these connected impacts helps policymakers, environmental agencies, and public health authorities design coordinated interventions that protect food production, ecosystems, and human health simultaneously.
The findings point to an urgent operational demand for advanced wastewater treatment technologies and comprehensive environmental surveillance tools. Potential users include municipal water utilities, environmental regulators, and public health bodies. However, because the study outlines regional challenges and requirements rather than evaluating proprietary prototypes or processes, commercial solutions addressing these specific East African contexts appear to be at an early, conceptual stage of deployment.
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The escalating burden of antimicrobial pollution in East Africa poses severe threats to public health, environmental integrity, and economic stability. Environmental compartments such as soil and water serve as reservoirs for these pollutants such as antimicrobials and antibiotic resistance genes, creating selective pressure that accelerates the emergence of antimicrobial resistance (AMR). These dynamic fosters the proliferation of multidrug-resistant pathogens, or "superbugs," complicating infection management and amplifying health risks in a region already challenged by inadequate healthcare and sanitation infrastructure. Furthermore, pollution by antimicrobials and antibiotic resistance genes critically disrupts ecological processes, such as nutrient cycling and organic matter degradation, diminishing soil fertility, water quality, and agricultural productivity, thereby threatening food security and overall ecological health. Current surveillance efforts, including the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the East Africa Public Health Laboratory Networking Project (EAPHLNP), have made strides in tracking AMR trends and guiding policy decisions. However, these efforts remain insufficient to address the growing crisis. This study highlights the urgent need for integrated strategies, including stringent antibiotic usage regulations, advanced wastewater treatment technologies, and comprehensive environmental surveillance. Therefore, there is a need to address the intersections of health, agriculture, and environment, to mitigate AMR and its far-reaching consequences to ensure public health safety and sustainability.
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DOI: 10.1016/j.toxrep.2025.101969
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