A silent and growing health crisis is unfolding in Malawi, where common infections are increasingly turning deadly due to the rise of antibiotic-resistant bacteria.

The Society of Medical Doctors in Malawi is sounding the alarm, warning that the overuse and misuse of antibiotics are rendering standard treatments ineffective, with urinary tract infections (UTIs) emerging as a key example of this dangerous trend.

The scale of the problem is staggering. A recent report from the Malawi -Liverpool Wellcome Programme estimates that drug-resistant infections are a significant contributor to the high maternal mortality rate of 225 deaths per 100,000 live births and an infant mortality rate of 29.4 deaths per 1,000 live births in the region.

“We are facing a situation where common infections that were once easy to treat are becoming more dangerous and, in some cases, even deadly,” said Dr. Victor Mithi, president of the Society of Medical Doctors in Malawi. “A significant driver of this is the fact that people can just walk into a pharmacy and buy antibiotics without a prescription. This leads to under-medication and the development of a heavy antimicrobial resistance burden.”

Local Research Confirms Widespread Resistance

The alarming national mortality data is corroborated by disturbing findings on the ground.

A study conducted by Mzuzu University at Zomba Central Hospital revealed that nearly half of the women presenting with UTI symptoms had infections resistant to multiple first-line antibiotics.

The research, which recorded a UTI prevalence of nearly 49 percent, found extreme resistance to common drugs.

For instance, 87% of bacterial samples were resistant to ampicillin and 77% to ceftriaxone. Even last -resort drugs showed signs of failing, with some pathogens displaying only moderate susceptibility.

Dr. Pizga Kumwenda, the lead researcher, stated that the findings point to systemic failures.

“This high level of drug resistance is a symptom of larger issues, including poor hygiene, limited access to proper healthcare, and the overuse of antibiotics without a proper diagnostic test to confirm the infection,” Dr. Kumwenda explained.

A National Pattern of Resistance

The problem extends far beyond a single hospital. A related national study, published last year in BMC Infectious Diseases, analyzed data from seven public health facilities between 2020 and 2024. It found that over half of all pathogen tests showed resistance to the antibiotics prescribed.

The study also flagged the concerning overuse of ‘watch’ antibiotics -a World Health Organization classification for drugs that should be carefully monitored due to their high resistance potential -and documented a high rate of multi-drug resistant infections across the country.

A Call for Urgent Action

Health experts agree that without immediate and coordinated action, the situation will continue to deteriorate, turning routine medical procedures and common illnesses into high -risk endeavors. The solution, they say, requires a multi-pronged approach.

Enforcing prescription -only dispensing of antibiotics is critical to stopping the dangerous practice of self-medication.

Concurrently, there is an urgent need to implement antibiotic stewardship programs in hospitals to ensure these crucial drugs are used responsibly. 

Furthermore, investing in and promoting culture and sensitivity testing before treatment is essential to ensure the correct antibiotic is prescribed from the start.

As Dr. Mithi starkly put it, “The miracle of antibiotics is being squandered. If we do not act now, we face a future where a simple infection could once again become a death sentence.”