In the West African country of Ghana, rural health centers face severe water shortages but have a steady stream of antibiotics to treat infections often spread by unhygienic conditions, CNN reports.
About half the patients in Ghana's largest hospital receive antibiotics, compared to about a third in European hospitals.
Data is limited for rural health facilities in Ghana, but studies suggest the drugs are prescribed at even higher rates there. Only a handful of hospitals have labs to determine whether a patient needs antibiotics, and many patients buy them over the counter.
As bacteria become resistant to common drugs, stronger antibiotics are in short supply, and physicians can't treat the infections. The overuse of antibiotics has sped up this process, and experts warn of a looming global crisis.
In many developing countries, however, the crisis has arrived.
"When you have healthcare-associated infections from poor sanitation or poor infection control, you have all these readily available drugs given to patients to cure them. Now, when you have resistance to these drugs, there's nowhere to run," said Dr. Emmanuel Irek, a microbiologist at the Obafemi Awolowo University Teaching Hospital in Nigeria, who has studied resistant infections across Africa.
Ghana's health sector is working to improve sanitation and hygiene, part of larger plans to slow the growing superbug threat. Ghana is one of only two countries in West Africa to publish its action plan to tackle antibiotic resistance, a target set by the World Health Organization for all member states in 2018.