Faith-based organisations help address antimicrobial resistance in Africa, closing a critical gap in cancer care

Across Africa, faith‑based organisations are frequently the first – and sometimes the only – healthcare providers available to people living in poverty or in remote areas. For this reason, faith-based organisations (FBOs) play a very active part in the response to antimicrobial resistance (AMR) in these regions.

AMR occurs when the medicines, such as antibiotics and antifungals, that are used to treat infections caused by microbes (bacteria, fungi, and parasites) stop working as intended. In practical terms, this means that infections which should be manageable become much harder to treat, last longer, or require more complex care. 

Cancer treatments place immense pressure on a patient’s immune system, making them more vulnerable to infection and thus making effective antimicrobials essential for cancer treatment and care.

Findings published last year in The Lancet Oncology found AMR among people living with cancer at rates of up to three times higher than among those without cancer. For such patients, infections that prove difficult if not impossible to treat can interrupt care, delay cancer treatment, and increase the risk of serious complications.

Africa, notably, is among the regions that bear a disproportionate burden of antimicrobial resistance. “We have weak, fragmented health systems,  and infection prevention control is nowhere near optimal,” said Dr Sherin Paul, medical doctor specialising in community medicine and palliative care, and Monitoring & Evaluation Manager at ReAct Africa.

Tracie Muraya, a pharmacist and public health specialist also working with ReAct Africa, added that limited access to diagnostics and unaffordable or unavailable quality antimicrobials are other overlapping factors that make Africa’s response to AMR challenging. 

For people living with cancer, these pressures intersect in ways that can delay treatment, prolong hospital stays, and increase financial strain on households already under pressure. “Some patients are forced to sell livestock to pay out of pocket for the needed tests or medicines, and that is their livelihood, further exacerbating their financial difficulties.”

The role of faith-based organisations

In several African countries, hospitals and clinics managed by FBOs provide an estimated 40–60% of health services. “These centres are not free but heavily subsidised,” explained Reverend Jane Ng’ang’a, who works in policy advocacy with the Ecumenical Pharmaceutical Network (EPN). “Subsidies are often covered through faith‑based systems’ own fundraising and contributions, which can make care more accessible for people who cannot afford private services.”

FBOs largely operate at primary health care level, complementing public services, according to Muraya. She noted that most are not equipped to provide advanced cancer care or manage hard‑to‑treat infections, however, and that their integration into national health systems varies widely by country.

“By and large, faith‑based organisations are often classified under the private sector, yet they are not private in the conventional sense,” Muraya said. “In some African countries they receive medicines or human resources through public systems. In others, they rely on separate mission‑based supply chains.”

For Rev. Ng’ang’a, the structural ambiguity surrounding the role of faith‑based organisations in the response to AMR means that faith‑based health systems are often absent from strategic health planning, despite providing care to large segments of the population, particularly in rural, marginalised, and fragile settings.

ReAct Africa and EPN work at different but complementary points in the response to antimicrobial resistance. While ReAct Africa focuses on policy advocacy, stewardship, and equitable access at national and regional level, EPN works within faith‑based health systems to strengthen pharmaceutical practices, supply chains, and the rational use of medicines.

Together, this combination of technical expertise and community‑rooted health networks illustrates how faith‑based providers can be engaged more effectively in AMR responses.

This approach is examined in a recent policy brief led by ReAct Africa and developed with faith‑based health networks, which highlights how organisations such as these remain under‑integrated in national AMR planning and decision‑making despite their extensive role in service delivery.

“It depends from country to country,” Rev. Ng’ang’a explained. “You will find, for example, in Kenya, the system is working very well, but in Cameroon faith‑based health services are not as well integrated into national systems. These differences affect how faith‑based facilities access medicines, financing, and national planning processes."

Rev. Ng’ang’a also highlighted the essential role of faith‑based providers in fragile and conflict‑affected settings. She pointed to facilities operating in parts of the Democratic Republic of Congo, where communities may have little or no access to government health services. In such contexts, she said, faith‑based providers often remain present when others withdraw, underscoring the need to strengthen these systems and ensure their contribution is properly recognised.

“In many countries, faith‑based organisations are not represented in technical working groups or financing frameworks,” she said, limiting their ability to contribute data, access funding, or influence policy. “Donor frameworks must also include the faith‑based health systems, and they should be prioritised as recipients of AMR funding.”

Both Muraya and Paul stressed that this lack of integration is rarely deliberate, but reflects how AMR policies are developed and disseminated. “You will go down to primary health care or faith‑based facilities and probably they’ve never even heard of the national AMR plan,” Muraya said.

Dr Paul added that many faith‑based organisations have historically focused on specific disease areas, such as HIV or maternal and child health. “For a condition like AMR, it requires a whole‑of‑system approach,” she said. “Often, the leaders making decisions may not have a medical background, so AMR is not prioritised.” 

Muraya pointed to lessons from the HIV response, where faith leaders played a central role in shaping public understanding and advocacy. “When we build capacity among religious leaders and then use their governance systems, right from leadership down to those delivering messages to congregations, we start getting understanding of AMR among the general community,” she said. 

This bottom‑up awareness, she argued, can complement top‑down policy efforts, creating demand for better stewardship and access – including for people living with cancer. “People understand pneumonia, but they don’t understand that it could be  a resistant infection,” Muraya said. “That is where faith leaders can help make the link.” 

The experiences shared by UICC members suggest a significant opportunity to better align cancer care and antimicrobial resistance responses. A more coordinated approach – bringing together faith‑based providers, cancer institutions and the cancer health workforce, infectious disease expertise, and policymakers – can help protect people living with cancer by driving behaviour change, preserving the effectiveness of existing antimicrobials, and reducing avoidable deaths by embedding AMR considerations more firmly within cancer planning and delivery.

Learn more about the impact of AMR on cancer care