April 17, 2025
The global rise in antimicrobial resistance (AMR) – where microorganisms do not respond to antimicrobial treatments – has contributed to a decline in the effectiveness of medications used to treat common infections. In Côte d’Ivoire (Ivory Coast) in 2021, there were 4,277 deaths directly attributable to, and 19,598 deaths associated with, bacterial AMR. To combat AMR, Côte d’Ivoire has implemented a national antimicrobial stewardship strategy and a National Multisectoral Action Plan (2021 to 2025) that prioritizes multisectoral coordination, antimicrobial stewardship, and strengthened infection prevention and control.
However, bacterial infections are not the only types of infections becoming harder to treat. Despite a decrease in malaria-related mortality from 3,222 in 2017 to 1,316 in 2020 in Côte d’Ivoire, the mosquito-borne illness still kills four people, primarily young children, every day and accounts for the majority of hospital consultations. According to the World Health Organization (WHO), 94 percent of the 597,000 malaria deaths worldwide occurred in Africa, with 76 percent of these deaths among children under the age of 5 years old. Efforts to eradicate malaria in the country have been hindered by the growing resistance of Plasmodium falciparum, the parasite that causes malaria, to currently available anti-malarial drugs. In a move that promises to reverse this trend, Côte d’Ivoire was the first nation to introduce the novel R21 malaria vaccine in July 2024, marking a significant milestone in the country’s fight against malaria.
The Global Antibiotic Resistance Partnership (GARP) is a network of experts from Africa and Asia that provides a forum for developing practical policy recommendations to mitigate antibiotic resistance. Currently, GARP teams focus on the development and dissemination of cross-disciplinary evidence outlining the effects of vaccinations on mitigating AMR in country-specific contexts.
In the battle against AMR, vaccination is an essential and multifaceted tool that prevents infections, both drug-sensitive and resistant, reduces the need for antimicrobials, including antibiotics and antimalarials, and slows the emergence and spread of resistant pathogens. Although extensive evidence exists regarding the impact of vaccination on reducing drug resistance, many countries have yet to fully utilize this tool in their efforts to combat AMR. Teams from the One Health Trust and the Centre de Diagnostic et de Recherche sur le SIDA et Autres Maladies Infectieuses, CHU de Treichville (CeDReS – CHU de Treichville), convened a workshop in Abidjan, Côte d’Ivoire, to discuss this subject.
The in-person workshop of the Global Antibiotic Resistance Partnership—Côte d’Ivoire working group took place in Abidjan on March 25, 2025. I was delighted to represent OHT and connect with Ivorian professionals from academia, pediatrics, economics, pharmacy, microbiology, veterinary medicine, immunology, and public health who participated in the workshop. The interdisciplinary nature of the group fostered a holistic discussion, as each attendee made insightful contributions based on their unique backgrounds, expertise, and experiences.
The Global Antibiotic Resistance Partnership – Cote d’Ivoire Working Group
After introductions, Prof. Timothee Ouassa, Professor of Microbiology and a Clinical Biologist at the University Hospital of Treichville, provided a brief background on the importance of vaccines in mitigating AMR. He emphasized the role of vaccines in disease prevention, which reduces the need for antimicrobial use and ultimately slows the development of resistance. He used pneumococcal and Haemophilus influenzae diseases as examples.
I presented the impact of vaccines on AMR using evidence from Côte d’Ivoire. I started with our previous and ongoing AMR projects at the One Health Trust, summarized the GARP initiative, and discussed the effectiveness of current vaccines in reducing disease incidence. I also explored potential future vaccines and their expected impact. During the Q&A session, attendees inquired about potential vaccines, the One Health approach to mitigating AMR, and the effects of climate change on AMR.
OHT’s Dr. Oluwatosin Ajayi during her presentation
Prof. Andre Inwoley, a Professor of Immunology and Head of the Immunology Laboratory at the Faculty of Pharmaceutical Sciences at Felix Houphouet Boigny University in Abidjan, presented on the principles and implementation of vaccinology. He talked about the history of vaccines, dating back to Edward Jenner in 1789 and Louis Pasteur in 1885. He also discussed the mechanisms of the body’s defense system, the different types of vaccines, and the national immunization program. The sessions provided attendees from diverse fields with an understanding of how the body’s immune system and vaccines function.
After a coffee break, Dr. Richmond Djatchi of the CeDReS – CHU de Treichville discussed trends in AMR at the University Hospital of Treichville. He presented findings from a 7-year retrospective study conducted between 2012 and 2019. The study focused on the frequency of resistance to antibiotics among Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa strains isolated from patients at the hospital.
Dr. Richmond Djatchi during his presentation
Prof. Alfred Douba, a Professor of Public Health and Epidemiology at Felix Houphouët-Boigny University in Abidjan, presented the organization of the immunization program in Côte d’Ivoire. He emphasized the significant role of vaccination in disease prevention and highlighted the country’s priority target groups, such as children under one year old and pregnant women, along with the national coverage rate of some currently available vaccines. During the question-and-answer session, he addressed several challenges related to vaccine coverage in Côte d’Ivoire, including insufficient supply, the sale of vaccines that should be provided freely in some regions, and the fear of vaccine side effects among women. Following the session, there was a lunch break.
The audience during Prof. Alfred Douba’s presentation
After the lunch break, Prof. Bi Tah N’Guessan opened the floor by presenting the economic benefits of vaccines in combating AMR. He emphasized the cost-effectiveness of vaccination and how money spent on vaccination brings greater returns in savings due to avoided healthcare expenses. He ended the presentation by saying, “We can conclude by agreeing with the WHO to say that for the fight against AMR, vaccination is a cost-effective strategy allowing substantial savings, especially in our developing countries where resources are scarce.”
The audience during Prof. Bi Tah N’Guessan’s presentation
After the discussion, participants reviewed a policy brief highlighting the impact of vaccines in combating AMR in Côte d’Ivoire. To conclude the event, we expressed our gratitude to all participants, and Prof. Ouassa delivered closing remarks.
The GARP-Côte d’Ivoire team looks forward to sharing a policy brief in the near future on how vaccines can be leveraged in the fight to control AMR to influence change and keep infections treatable.
The Workshop participants at the close of the event
(From left to right: Dr. Tolla Affoue Leticiae, Prof. Bi Tah N’Guessan, Dr. Kacou Alain, Prof. Inwoley Andre,Dr. Oluwatosin Ajayi, Dr. Richmond Djatchi, Prof. Timothee Ouassa, Dr. Wognin Affou Seraphin, Prof. Alfred Douba, Prof. Gbonon Nbengue Valerie)
