AS if the manifold problems that Nigerians are daily confronted with were not enough, Nigeria now ranks first in Africa in the tuberculosis disease burden. According to the Director of Public Health, Federal Ministry of Health, Dr. Evelyn Ngige, who made this known during the 2018 Annual Review Meeting of the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme organised by the Department of Public Health, Federal Ministry of Health in conjunction with the Anambra State government in Awka, the Anambra State capital last week, despite the gains made over the years in the fight against the three diseases, the country’s position in Africa and the world at large is totally unacceptable.
In March, while commemorating the World Tuberculosis Day, the country launched a new paediatric anti-tuberculosis formulation for the treatment of ‘drug-susceptible’ tuberculosis in children. Minister Of Health, Professor Isaac Adewole, speaking at a press briefing to mark the event in Abuja, said the new drug was both dispersible and flavoured and met the WHO “optimal dosing recommendations for all children.” Adewole stated that the major drawback of tuberculosis programmes in Nigeria was low case finding for both adults and children, “as there are lots of missing TB cases that were either not diagnosed or reported.” He pointed out that the tuberculosis burden in the country had been further compounded by the menace of drug-resistant tuberculosis (DR-TB) and the HIV/AIDS pandemic.
According to the minister, in 2017, 104,904 cases were detected out of an estimated 407,000 of all forms of tuberculosis cases expected to be detected. He said: “In the same year, the proportion of childhood TB was seven per cent of all forms of TB cases compared to 10 per cent recommended by the World Health Organisation. In addition, a total of 1783 DR-TB cases were notified out of the estimated 5200 DR-TB cases.” As the minister noted, the country had recorded a lot of progress in TB/HIV collaborative activity, as 96 per cent of tuberculosis cases and 82 per cent of presumptive tuberculosis cases knew their HIV status, while 84 per cent co-infected clients received anti-retroviral treatment (ART).
Tuberculosis remains one of the deadliest diseases in the world. In September, the WHO indicated that the world over, some 1.3 billion people are at risk of developing TB during their lifetime. According to the WHO, countries are not doing enough to end tuberculosis by 2030 in spite of the global efforts that averted about 54 million tuberculosis deaths since 2000. During the release of the latest Global TB Report, the organisation described it as “the world’s deadliest infectious disease.” It noted, however, that fewer people fell ill and died from tuberculosis in 2017. Globally, an estimated 10 million people developed tuberculosis in 2017. The deadly disease usually infects the lungs and is transmitted through the air. As the WHO noted, it is one of the top 10 causes of worldwide deaths, and is the leading cause of death from a single infectious agent, above HIV/AIDS.
Without doubt, Nigeria’s position as Africa’s tuberculosis capital is intolerable. Already, the populace is trapped in appalling economic conditions and the least the government can do is to ensure that it is not further bogged down by diseases for which treatment is readily available. Till today, tuberculosis diagnosis and treatment are free in public hospitals and treatment centres across the country. The problem seems to be inadequate sensitisation of the public in the treatment and management of the disease. Across the country, people still resort to self-medication in combating the disease, failing to take advantage of the facilities put in place by the government in the mistaken belief that they cannot afford the cost of treatment. In this regard, governments at all levels must heighten awareness and advocacy on the tuberculosis scourge. The airwaves must be suffused with relevant information. Among other things, people coughing for two weeks or more should be made to realise that they must visit the hospital for screening, rather than relying on the so-called herbal remedies that can only worsen their condition. The public must be told time and again that there is a toll-free line for further information on tuberculosis control in the country.
Even if the 7,389 tuberculosis drug centres across the country are inadequate, the very high burden of tuberculosis can still be significantly reduced if not completely eradicated when they are fully engaged. On its part, the Ministry of Health needs to site more drug centres across the country, while the state ministries of health should follow suit. Given Nigeria’s status as a federation, tuberculosis management ought to be the joint responsibility of the national and subnational governments in a very real sense.
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