Keyword: One Health

ABSTRACT: Antimicrobial resistance (AMR) is one of the most pressing global public health threats, compromising the effectiveness of antimicrobial therapies and increasing the burden of infectious diseases worldwide. Although AMR affects all populations, its impacts are disproportionately concentrated in resource-limited settings where poverty, inadequate healthcare infrastructure, poor sanitation, and limited access to quality medicines increase vulnerability to resistant infections. This narrative review examines the relationship between AMR and health equity, highlighting how social and structural determinants shape exposure, susceptibility, and health outcomes among disadvantaged populations. Literature published between 2015 and 2026 was identified through searches of PubMed, Scopus, Web of Science, and Google Scholar and synthesized using a thematic narrative approach. The review identifies poverty, inadequate water, sanitation and hygiene infrastructure, low health literacy, weak healthcare systems, limited diagnostic capacity, workforce shortages, and insufficient surveillance systems as major contributors to AMR vulnerability. Women, children, rural populations, refugees, migrants, and displaced communities experience disproportionate burdens due to overlapping social and healthcare disadvantages. A One Health perspective further demonstrates how human, animal, and environmental factors interact to accelerate resistance transmission. Addressing AMR requires equity-centered strategies that strengthen primary healthcare, improve access to diagnostics and treatment, enhance surveillance systems, expand water and sanitation infrastructure, and promote community engagement. AMR is not merely a biological phenomenon but a manifestation of broader social and structural inequities requiring integrated and sustainable public health responses.

ABSTRACT: Microbial biofilms represent a growing yet often overlooked public health concern, particularly in resource-limited settings where they exacerbate the burden of persistent infections and antimicrobial resistance (AMR). In Nigeria, fragile healthcare infrastructure, poor funding, and a continuous loss of skilled medical professionals compound the difficulty of managing biofilm-associated infections. These microbial communities, embedded in self-produced extracellular matrices, exhibit remarkable resistance to antimicrobials and host immune defenses, leading to chronic and recurrent infections that further strain an already overstretched health system. This review synthesizes evidence published between 2010 and 2025 to examine the burden, challenges, and opportunities surrounding biofilm control in Nigeria. Literature was systematically retrieved from PubMed, Scopus, and Google Scholar, complemented by reports from WHO and the Nigerian Centre for Disease Control. Findings indicate that biofilms not only complicate clinical treatment outcomes but also persist in environmental reservoirs, particularly water systems, serving as hidden amplifiers of resistance and infection transmission. To address these challenges, the review explores low-cost and context-appropriate strategies such as harnessing Nigeria’s biodiversity for the discovery of plant-derived antibiofilm compounds, implementing decentralized engineering solutions for water treatment, and promoting community-based infection prevention initiatives. It further emphasizes the importance of local innovation, interdisciplinary collaboration, and policy support within a One Health framework that integrates human, animal, and environmental health. By spotlighting the Nigerian experience, this review calls for urgent investment and global attention to biofilm-related infections in Low- and Middle-Income Countries (LMICs).