Nigeria needs to do more in the fight against TB –Dr Odume

Dr Bethrand Odume is the Country Representative Officer, KNCV Nigeria. In an encounter with our Health Editor, HASSAN ZAGGI, at a 2- day brainstorming session with stakeholders on the KNCV TB Foundation Nigeria Local Organisation Network (LON) Grant Application, he explained what the governments at all levels and other stakeholders need to do to phase out Tuberculosis (TB) from Nigeria. Excerpt:

Looking at TB control in Nige­ria, are we making progress?
I will tell you; one, we are mak­ing progress but we need to do more. Take for instance, one case of TB that is not treated in a space of one year can infect 15 to 20 people. Last year, Nigeria de­tected over 100,000 cases of TB out of estimated 480,000 people. A gap in case detection is still enormous, over 70 per cent. If you look at that, you will say we are not making progress.

But for us to have detected over 100,000 cases and put them under treatment, we have actu­ally helped to limit the transmis­sion if those 100,000 were not treated. But we need to do more because a prevalence survey was done in 2012 that showed us that the gap is very enormous.
The knowledge gap is very wide. If you go to the commu­nities, a lot of people don’t even know that treatment of TB is free.

The health system is not strong, sometimes you get to the health facility, you may not even see who will offer you the care. When go to the DOTs Centres where people have been trained, but due to the issues around support, salaries, there could be strike and when they move to the private sector, it is profit driven even the drugs that are free are charged in the private sector and we know the level of poverty in this country.

For us to be able to confront this TB, it is multi sectoral ap­proach. The community, the government, some of us work­ing in the NGOs, all of must be on board because the gap is enor­mous.

We can talk about funding, the level of government commitment is not what actually is expected. When we talk about funding, people think it is only the federal government. We have three tier of government, the federal is do­ing its best. But what is happen­ing at the states and local govern­ments and the at the community. The issues are actually enormous.

Have NGOs like you been able to let the states and local govern­ments know about the need to in­tervene in the TB
Situation in the country?

One thing I am actually see­ing in the effort against TB is the role of the Stop TB partnership in Nigeria.

The Stop TB partnership is a Non Governmental Organisa­tion in Nigeria that is actually a forum where multi stakeholders meet. KNCV that I represent is a board member. There are some opportunities we have explored recently looking at the Governor’s Forum where they come and we were able to show them TB score card.

Across most of the states, the funding gap ranges from 76-100 per cent. There are some states that what the government brings on board for the control of TB is actually zero.

We think if the states and lo­cal governments can bring more money it will go a long way.

Everything about TB, the in­ternational agencies through the USAID have provided the drugs free, the reagents are free but you need to support the health sys­tem. It is not only the drugs and reagents that will do it, there must be structures.

These are some of the issues the states and local governments need to do more.

Why this 2-day stakeholders meeting and what do you want to achieve?

The KNCV International have actually been in Nigeria since ear­ly year 2000. Over these years they have been supporting the National TB Response in over 26 states in the country.

They started with their first project TBCTA, TBCAP,TBCARE1 and the one that ended December last year.

In early 2016, they have ac­tually helped to midwife the lo­cal KNCV, that is KNCV TB Ni­geria. In as much as this office is concern, we have the interna­tional arm and equally have the local arm that is coming up.

This is because the thinking of most funding agencies is to think home-indigenization. How do we used the people to do the work to ensure sustainability.
You know the TB we are fight­ing here is in Nigeria. Those af­fected are our relations, it could even be we ourselves. You know if we continue to depend on in­ternational agencies, people don’t even know that we can look in­ward.

There are some philanthropists here in Nigeria, government can also support some Non Govern­mental Organsations (NGOs) to do what some of these interna­tional organisations are doing. The funding landscape is chang­ing. People are looking more into working with local organ­isations to device local mecha­nisms through which this can be done within those local commu­nities.

Because of that thinking, that is why the international NGO-KNCV actually midwifed the local NGOs.

Now opportunities are com­ing up, there are some funding for TB control that US Agency for International Development (USAID) is looking at how they can engage some local organisa­tions. Not only that, we have in­terest in other funding opportu­nities, but what actually matters most is that nobody is an island when it comes to knowledge.

If you look at our meeting here today, you could see health journalists, people affected by TB, Civil Society Organsations (CSOs) and the National TB Pro­gramme and people came from local governments (supervisors).

The essence is, let us all brain­storm because there are issues around TB control in Nigeria. The gap in detection has been very enormous about 74-75 per cent over the years.

Now we felt we should come together, tap into knowledge, share experiences and what ac­tually are the best issues.

For us to be able to crystalize those gaps and challenges is not what we can stay here and say we have done over the years, that is why we went to look for core people within different areas, the journalists, people affected by TB and even people working on the field.

We are rubbing minds and the outcome of this meeting will ac­tually help us not only now but in any subsequent grant appli­cation that we may throw in the area of TB control.

What positive impact will this meeting make to an ordinary Nigeria?
The benefit of this meeting is that we are repositioning our­selves for opportunities. Being an NGO, what you use to do your work is the grants and for you to get the grants, you need to convince the funders that you have the strength to do it, you have the appropriate strategies and the systems to checkmate that if you are given one naira, you will be able to use it for what it is meant to do.

The essence of this meeting is that we are brainstorming what are the key issues around TB, what are the key challenges and the strategies that had worked.
You could see some Professors here from the academia we are looking at evidence and we are actually gathering these things as an organisations, once we see any grant application we tap in.

You could also see people here from different backgrounds even from the facility level. We are actually building a data base of knowledge that these are the key issues and the strategies to tack­le them.

As a local organization, any time we see any opportunity, we tap into it. You could see, we worked in groups and a lot of facts had actually been gen­erated.

Look at these things that actu­ally came from the three groups, they could address the issues around TB. What we are gener­ating here will help us going for­ward and I have told the team that this thing should be a con­tinuous thing.

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