Analysis of international Antibiotic Guardian pledges with a focus on pledges from countries in Africa

Abstract

Background: Antimicrobial resistance (AMR) is a significant public health challenge. The Antibiotic Guardian (AG) campaign was developed in 2014 by Public Health England (now UK Health Security Agency) to raise increase engagement in personal actions to tackle AMR and promote responsible antibiotic use. The campaign expanded through collaboration with WHO Europe, Africa CDC, South African National Department of Health and the Ministerial Advisory Committee on Antimicrobial Resistance, as well as Belgian Antibiotic Policy Coordination Committee. This study aimed to analyse international AG pledges from 2014 to 2024 with a focus on pledges made on the Africa subpages. Methods: The AG pledge data was cleaned and sorted to exclude UK pledges. Pledges made on the Africa subpages, including the responses to the knowledge questions, were harmonized. Data sorting, cleaning and preliminary quantitative analysis tasks were performed using Microsoft Excel. Further analysis and visualization were conducted using Datawrapper. Results: The AG campaign has received 17 053 international pledges from 194 countries across the seven continents. The Africa subpages have cumulatively reached 3997 AGs across 40 African and 21 non-African countries. South Africa, Nigeria, Uganda, Kenya and Ethiopia had the highest pledges from African countries, with most pledges from healthcare professionals. Most AGs heard about the campaign through professional networks and social media. Nearly two-thirds of AGs (61.2%) answered all five knowledge questions correctly. Conclusion: The AG campaign has evolved into a global effort aimed at addressing AMR through behavioural change. Further promotion and audience-specific strategies are required to reach the most affected subpopulations and ensure pledges translate to reductions in the mis and overuse of antibiotics in Africa.