When Antibiotics Are Sold Like Vitamins: A Woman’s Roadside Lesson in Global Health

On a recent road trip to Abuja, our vehicle stopped briefly at a roadside restaurant. As passengers stepped out to stretch their legs and buy refreshments, I noticed a woman standing  nearby selling medicines. She called out to customers,  advertising antibiotics such as Flagyl and Ciprotab with the same ease and enthusiasm one might use to promote multivitamins. 

Curious, I approached her and asked if she was a Patent and Proprietary Medicine Vendor. She confirmed that she was. I then asked a simple question: had she ever heard of  Antimicrobial resistance? 

She hadn’t. 

Some of the customers gathered around her also admitted they had never heard of it. In that moment, I  realised that what looked like a routine roadside interaction was a glimpse into one of the most pressing  global health challenges of our time. 

Standing there were two women occupying very different spaces within the health system. She was a  community drug vendor influencing what medicines people purchased. I was a public health professional  working in disease prevention programs. Yet both of us, in that moment, were shaping health decisions for  the people around us. 

I spent a few minutes explaining how frequent and unnecessary use of antibiotics can make infections  harder—and sometimes impossible—to treat in the future. We talked about why antibiotics should not be  taken casually or used as preventive medicine without proper diagnosis and prescription. The conversation  lasted only a few minutes, but it stayed with me long after we resumed our journey. 

As someone working in public health in Nigeria and preparing for doctoral research exploring antimicrobial  resistance among children, I am constantly reminded that many global health challenges are most visible in  everyday community interactions. While antimicrobial resistance is widely discussed in policy documents  and international forums, awareness at the community level often remains limited. 

Across many low- and middle-income countries, community drug vendors play a critical role in healthcare  access. For many families, especially in underserved areas, Patent and Proprietary Medicine Vendors and  community pharmacists are often the first point of care. Their influence on how medicines are used is  therefore enormous. 

Yet opportunities to strengthen their understanding of responsible antibiotic use remain limited. 

Reflecting on that roadside conversation, I was reminded of the immense opportunity that exists within  existing health programs. Thousands of community pharmacists and medicine vendors participate in  trainings focused on malaria, HIV, and other priority diseases. Integrating simple antimicrobial stewardship  messages into these platforms could significantly improve knowledge and dispensing practices among  providers who serve millions of people daily. 

Women are present across every layer of the health system—from community vendors and frontline  workers to program implementers and researchers. Because of this proximity to communities, women in 

Global health often witness firsthand how policies translate into practice. We see the small but critical  moments where health behaviours are shaped—in markets, pharmacies, clinics, and homes. 

Leadership in global health is not always exercised in conference rooms or policy dialogues. Sometimes it  begins with curiosity, a question, and the willingness to speak up in unexpected places. 

That brief roadside encounter reminded me that systems change often begins with awareness—one  conversation at a time. But when these moments are translated into broader advocacy, training, and policy  engagement, they can influence how health systems function. 

Sometimes leadership begins simply by noticing what others overlook, and sometimes, it begins on the side  of the road, when two women in different corners of the health system realise they are both shaping the  health of a community.