A continent-first simulation in Brazzaville
At dawn on 3 December 2025, the auditorium of the National Public Health Laboratory in Brazzaville was transformed into a war room. Screens streamed mock epidemiological alerts, while teams from the Ministry of Health, the Ministry of Livestock and the Armed Forces exchanged rapid-fire updates. The scenario, conceived with experts from the World Health Organization, postulated the emergence of a multidrug-resistant bacterium spreading simultaneously through a hospital ward in Makélékélé and a poultry farm on the outskirts of Dolisie. Within minutes the digital dashboard registered a spike in unexplained septic shocks, launching what officials described as the first full-scale antimicrobial-resistance (AMR) drill on the African continent (WHO, 2025).
Health Minister Gilbert Mokoki, welcoming observers from Cameroon, Gabon and the African Union, framed the exercise as “an investment in foresight”. He stressed that rapid detection and disciplined information-sharing are indispensable in a region where porous borders could allow a resistant pathogen to travel faster than paperwork.
Stress-testing laboratories and data flows
The core of the simulation lay in the laboratory network. Swabs collected at fictional patients’ bedsides were couriered to Brazzaville, Pointe-Noire and Owando, each facility racing against a six-hour clock to identify carbapenem-resistant Enterobacterales. False positives and power outages were deliberately introduced to mimic field conditions. According to the preliminary evaluation report, all three laboratories confirmed the pathogen within the allotted time, yet divergences in data formatting momentarily delayed aggregation at the national coordination centre.
These minor frictions are precisely what the organisers hoped to expose. The country is aligning its surveillance architecture with the Global Antimicrobial Resistance and Use Surveillance System, known as GLASS, which requires harmonised metadata and the secure transfer of anonymised patient information. “The technical capacity exists; the challenge is to make it speak the same language,” observed Dr Edith Boukaka, head of the national reference laboratory, during a debriefing attended by representatives of the World Organisation for Animal Health.
Embedding One Health into national vigilance
From the outset the designers anchored the exercise in the One Health framework, recognising that resistant pathogens circulate among humans, animals and the environment. Veterinarians tracing the poultry cluster exchanged antibiograms with clinicians treating the human cases, while environmental officers sampled effluents near the farm. The simultaneous data streams fed an integrated dashboard developed by Congolese software engineers with funding from the Central African Economic and Monetary Community.
The drill also clarified institutional mandates. The Ministry of the Environment will henceforth issue advisories on antimicrobial residues in watercourses, while the Ministry of Agriculture gains a formal seat in the Incident Management System during AMR events. Such codification responds to lessons learned from COVID-19, when early ambiguity over lead agencies magnified response times across the continent.
From exercise to enduring policy
Congo-Brazzaville adopted its national action plan against antimicrobial resistance in 2021, yet budgetary constraints and competing health priorities slowed implementation. Findings from the simulation are expected to unlock earmarked funds in the 2026 finance law, notably for uninterrupted reagent supply and electronic reporting tools in district hospitals. The ministry has already announced a schedule of quarterly tabletop exercises and a biennial nationwide drill.
International partners expressed confidence without complacency. Dr Mariângela Simão, WHO regional adviser, applauded “an encouraging display of operational maturity” while urging acceleration of community-level stewardship to curb over-the-counter antibiotic sales. Parliament’s Health Commission signalled support for a draft bill that would tighten pharmaceutical regulation in tandem with public awareness campaigns.
Regional implications and cautious optimism
Sub-Saharan Africa shoulders an estimated 1.14 million direct deaths annually from drug-resistant infections, with projections nearing two million by 2050 if corrective action falters (Lancet, 2024). By volunteering as a pilot country, Congo-Brazzaville positions itself to disseminate practical guidance across the Economic Community of Central African States. Observers noted that the simulation dovetails with the United Nations Political Declaration on AMR and the WHO Strategic Priorities 2025-2035, both of which emphasise field-tested preparedness.
For citizens, the exercise remained largely invisible—a deliberate choice to avoid undue alarm—but its implications are tangible. As Dr Boukaka remarked, “Preparedness is not a headline; it is an insurance policy.” The successful conduct of the drill suggests that Congo-Brazzaville is reinforcing that policy, proving that rigorous rehearsal is as critical to health security as the microscopes that first glimpse a lurking bacterium.