The World Health Organization and the African Union have reached a historic milestone by signing the first binding antimicrobial governance framework for the African continent. Adopted at the AU Extraordinary Summit on Health in Addis Ababa in March 2026, this framework establishes minimum standards that all 55 member states commit to upholding regarding antimicrobial regulation, surveillance, and use. The framework rests on four fundamental pillars: regulation of antibiotic sales (ban on over-the-counter sales by 2028), integrated AMR surveillance (mandatory reporting of antimicrobial susceptibility data to Africa CDC), hospital antimicrobial stewardship (mandatory establishment of stewardship committees in all referral hospitals), and reduction of antibiotic use as growth promoters in livestock production. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, described this agreement as "a decisive moment in the global fight against AMR." He emphasized that "Africa is showing the world that it is possible to build strong political consensus around antimicrobial governance, even in resource-limited settings." A peer review mechanism, inspired by the African Peer Review Mechanism (APRM), will be established to monitor framework implementation. Countries that fail to meet the set deadlines will be subject to public recommendations, creating positive diplomatic pressure. The first evaluation cycle is planned for 2028.