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Nigeria in urgent need of TB agency?

By Hassan Zaggi

Currently, in Nigeria, an estimated 156,000  people die as a result Tuberculosis (TB) every year. This, therefore, indicates that every hour, an  estimated 18 people die of TB. By extension, 432 people die of TB every day. This is, indeed, tragic.

Findings also revealed that Nigeria is among the 30-high burden countries for TB, TB/HIV and Multi Drug Resistant TB (MDR-TB).

Sadly, however, Nigeria is said to rank 6th among the 30-high burden countries globally and number one in Africa.

On the other hand, Nigeria accounts for 11 per cent of the global gap between TB incidence and notified cases and out of the 452,000 estimated new TB cases in Nigeria in 2020, only 138,591 were notified to the National Tuberculosis and Leprosy Control Programme (NTBlCP) with only 30 per cent treatment coverage.

However, for the first time in the history of the country, in 2020, Nigeria recorded 50 per cent increase in TB notification from 138,591 TB cases to 207,785 cases.

Regrettably, Direct Observation Therapy (DOTs) clinics  are only available in 44 per cent of health facilities in Nigeria. Only 9 per cent of them have TB diagnostic services.

In another twist, TB is the leading  cause of death of people with HIV and a major contributor to antimicrobial resistance.

The issues around TB in Nigeria are complicated and multifaceted. According to experts, the disease is infectious and thrives among the poor. In fact, it is called the disease of the poor who are the majority. It spreads when a person with active TB disease in his/her lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.

Nigeria’s situation is more worrisome because, over the years, TB programme has not gotten the required funding to make the needed impact.

Therefore, the success recorded in the fight against the disease is minimal.

The disease is fast spreading, but due to lack of the required funding, the case detection rate is low. This, therefore, means that many people who are having the disease in the communities across the country cannot be detected.

Another revelation about the TB in Nigeria is that it is spreading fast among pupils in primary and students in secondary schools.

This, therefore, calls for urgent government’s attention to ensure the spread is halted to prevent TB from becoming one of the worst epidemic to be witnessed in Nigeria. If the disease is allowed to spread among children in schools, it means it is going beyond control.

Just few days ago, the United States Agency for International Development (USAID), raised the alarm that TB is on the rise among students of primary and secondary schools in Nigeria.

The Lead TB and Research Mobilisation of United States Agency for International Development (USAID), Dr. Temitayo  Lagundoye Odusote, who raised the concern in Abuja  called on critical stakeholders to join hands to ensure that students at both primary and secondary schools are screened of TB.

She called on governments at all levels, lawmakers, philanthropic organizations including the private sector to invest in an effort to end TB in Nigeria.

“We urge Nigerians to continue to be there brothers’ keepers to refer, take by the hand, our neighbours, family members with chronic cough, weight loss, prolong fever, children that are just not gaining weight, failing to thrive, to take them to TB services close you.

 “We urge private businesses and education institutions to join in the fight against TB.

 “Incidentally we are finding an epidemic of TB in primary and secondary schools.

“We all have a role to play even if it means screening all our students for TB including x-rays and verbal screening. We encourage screening and testing for TB,” Dr. Odusote said.  

Currently, the fight against this dreaded disease is being coordinated by the National Tuberculosis and Leprosy Control Programme (NTBlCP)- a small unit under the Federal Ministry of Health.

In fact, the unit is fight the disease with almost zero funding. Funding for the fight against TB in Nigeria mostly comes from foreign donors. This is unacceptable. We must take responsibility for the health of our people.  The amount that comes from the government is meagre.

To say it clearly, the fight against TB in Nigeria needs funding. At the moment, Nigeria has 70 per cent funding gap and equally, 70 per cent gap in TB case finding. This further clearly shows that if there is more resources, more missing cases will be uncovered. .

This is the more reason why the NTBLCP unit under the Federal Ministry of Health should be made a full flagged agency. This will enable it have its own autonomy, source for its funding and confront TB to finish in Nigeria.

We commend the members  of AIDS, Tuberculosis and Malaria (ATM) Committee at the House of Representatives, under the leadership of Hon. Abubakar Sarki Dahiru, for initiating  a move to come up with a bill that will make the NTBLCP a full autonomous agency.

At a recent gathering in Abuja, Hon. Dahiru, said: “One of the things that we as legislators are trying to do is that by the grace of God, we have already started with the secretariat  and our consultant to make sure that from the National Assembly the issue of TB is headed by an agency which should be independently autonomous because of issues of funding so that a certain allocation will go to that agency and by that I am sure that the issue of TB will  be ended by 2030.”

Indeed, for Nigeria to move forward in the fight against TB, there must be a deliberate effort by the government at all levels. Also, for the fight against the disease to be more fierce and brutal, there must be an agency of government that is autonomous to take charge of the process.

The agency, when created, apart from the funding from the government, will mobilise its resources and take the fight to all nooks and crannies of the country, especially, among the rural poor where the disease is more prominent.

Other members of the National Assembly need to support this initiative and allow it see the light of the day to ensure that Nigeria has an agency that is in charge of TB.

Nigeria, indeed, needs a TB agency if we must end the deadly disease by 2030.

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