Apps, chatbots, and data dashboards are helping doctors and patients in Sub-Saharan Africa fight infections, promote antibiotic stewardship, and drive much-needed changes in healthcare delivery.
The result is a new antibiotic stewardship model that looks very different from stewardship programs in the Global North, said the director of a global-health advocacy network leading the initiative at the 2026 IDWeek conference in Washington, DC.
Mirfin Mpundu, the African regional director of ReAct, described the $1.5 million, three-year program, ASPIRE (Antibiotic Stewardship Programme through Innovation, Research, and Education), and outlined some midstream results. [1]
Antimicrobial resistance is bad news globally, but even more dire in his region, Mpundu said. “In Sub-Saharan Africa today, the leading cause of death is the consequences of AMR. It has surpassed deaths from tuberculosis and malaria.”
The situation grew tougher when the US effectively shuttered its major foreign-aid agency, the Agency for International Development (USAID), in early 2025. “We see a lot of deaths and predicament here,” he said. His assessment is bolstered by research published in July in BMJ Public Health, which found that the aid freeze disrupted the delivery of reproductive health services and HIV treatment and caused mental health crises in Kenya, Colombia, and Nepal. [2]
But as the situation got tougher, the African group got creative.
Hurdles to Stewardship
The 2026 Updated WHO Global Action Plan calls for a 10 percent reduction in AMR-associated deaths by 2030, relative to 2019. It also calls for using targeted, narrow-spectrum antimicrobials as first-line treatment for infections at least 70 percent of the time. [3] This goal avoids overuse of broad-spectrum antibiotics that drive drug resistance.
In Sub-Saharan Africa, a lack of timely diagnostic data on a patient’s infection often has African clinicians reaching instead for broad-spectrum drugs.
“One of the things that the hospitals struggle with is having functioning microbiology, having a steady supply of antibiotics, and having a trained workforce,” Mpundu said.
Another challenge the region faces is the ease of antibiotic access for patients, which undermines stewardship. “It’s not like in this country where I [must] walk into CVS or Walgreens and request an antibiotic,” Mpundu said. “In Africa, I can walk anywhere and come back with a bag full of all sorts of antibiotics, injectables, and the like.”
Together, these make antibiotic stewardship an uphill battle in the region, and they call for different approaches, Mpundu said.
A Digital Boost
The ASPIRE program, which began in 2024, is being piloted over three years in two hospitals in Kenya and two in Zambia.
“What we have done is develop a trustworthy program to strengthen clinical practice,” Mpundu says.
The group established stewardship teams, audited clinical practices, trained and mentored doctors, and used digital innovations to provide doctors with diagnostic information within the critical two- or three-day window when it’s needed. They’ve also digitized paper-based records to make it easier to track a patient’s history.
Digital tools helped both doctors and patients. Digital decision-support tools for doctors included data dashboards and AI-enabled clinical guidance. Doctors and patients can query AI-enabled chatbots trained on WHO guidelines, as well as on hospital and national guidelines where they exist, Mpundu said.
So far, the team has strengthened four hospitals — two in Kenya and two in Zambia—during the project’s pilot phase.
Community Involvement
“These digital innovation tools are coming at the right time,” Mpundu says. “We’re seeing a lot of utilization of chatbots by clinicians and by patients, even when they’re in the hospital unit.”
Involvement from community groups is proving essential, Mpundu says. This includes faith-based organizations in both Kenya and Zambia, as well as enrolling young people as partners through the African Youth AMR Alliance Task Force. [4]
Activities include group discussions, real-life examples, and a central focus on women’s voices and each community’s realities.
Future endeavors include AMR education for university students and aspiring healthcare professionals. “We are in conversation with universities to introduce AMR much earlier in their clinical programs.”
As the project progresses, the team will systematically evaluate the results. But on the ground, Mpundu says, they have a few success stories.
One patient had a perforated ulcer and had been in the hospital for more than a month. He had experienced peritonitis, septic shock, and a surgical site infection. The ASPIRE team reviewed the patient’s records, isolated the bacterium causing the infection, and tested it against a wide range of antibiotics, Mpundu says. A new drug was prescribed, and within five days, the patient went home.
