Background: Antimicrobial resistance (AMR) is a growing public health threat, particularly in Africa, where it increasingly poses a greater risk than HIV/AIDS, tuberculosis, and malaria. Despite global efforts through initiatives like the Global Antimicrobial Resistance Surveillance System (GLASS) and the Global Action Plan (GAP), Africa continues to face significant surveillance and implementation challenges. This study aims to explore AMR surveillance trends, identify persistent challenges, and propose actionable recommendations. Methods: A comprehensive review of both published and grey literature was conducted using databases including PubMed, Google Scholar, and WHO AMR resources. Additionally, data from the Tracking AMR Country Self-Assessment Survey (TrACSS) were analysed to evaluate the progress of AMR surveillance systems in Africa. Results: By 2024, 96% of African countries had developed National Action Plans, with 74% initiating implementation. However, only 47% had functional multisectoral and One Health coordination mechanisms. While 95.7% of countries could perform antimicrobial susceptibility testing (AST) for critically important bacteria, only 51.1% had capacity for fungal AST. Furthermore, 10.6% lacked a national surveillance system for AMR in humans, and AMR surveillance in animals remains significantly underdeveloped. Key challenges include inadequate laboratory infrastructure, insufficient funding, fragmented data systems, a shortage of skilled personnel, and weak intersectoral collaboration. Conclusion: Despite notable progress, major gaps hinder effective AMR surveillance and control in Africa. Strengthening laboratory systems, improving data collection, enhancing workforce capacity, enforcing supportive policies, and fostering sustained regional collaboration and funding are essential to mitigate the growing threat of AMR across the continent.
