NIGERIA’S RAGING TUBERCULOSIS CRISIS

The health authorities could do more to curb the rising incidence of tuberculosis

With about 600,000 cases of tuberculosis, as reported by the National Tuberculosis and Leprosy Control Programme (NTBLCP), the incidence of the disease is on the rise in Nigeria. That should worry the health authorities, as we cannot afford to add a TB epidemic to all the challenges that are already plaguing the nation.

According to the World Health Organisation (WHO), Nigeria ranks 10th out of the 22 over-burdened tuberculosis countries in the world. Just recently, the Kano State Commissioner for Health, Dr Kabiru Getso, lamented that the country is ranked first in tuberculosis cases in Africa. According to him, more than 500,000 people infected with tuberculosis in Nigeria “remain undetected and not placed on treatment. TB is treatable and curable if appropriate treatment commenced on time”.

Tuberculosis has been situated as a HIV co-infected disease by global health experts while its prevention, control and treatment is very often confined to the HIV/AIDS, tuberculosis and malaria programme. Over the years, this approach has guided government and health experts’ response to TB while questions remain as to its effectiveness.

Nigeria’s greatest plight in combating the disease is the prevalence of multidrug resistance tuberculosis (MDR-TB), especially considering that since 2013, there has been an increasing rise in the number such cases. This trend has compounded Nigeria’s drive to eliminate its prevalence. Added to that, Nigeria’s other challenge in fighting TB is rooted in poor diagnosis. Available reports indicate that many cases of TB were not diagnosed, and even when they were, they were not registered for tracking.

However, there are other challenges. To say the least, government efforts on research has also been peripheral ever since the disease became a heavy burden. Yet research ought to be a focal point in the fight to combat tuberculosis since with such efforts, a whole lot can be achieved in finding measures to prevent the disease. The Nigerian Institute of Medical Research (NIMR) should do more in that regard.

Also, Nigeria’s government funding mechanism has not been effective enough to contain high cases of the disease. Much of the funding for TB has been predominantly from foreign donors. The United States government, The Global Fund, WHO, Leprosy Mission in Nigeria, German Leprosy, Netherlands Leprosy Relief, Damien Foundation, the Canadian and UK governments remain the highest donors to tuberculosis-related programmes in Nigeria.

What that says very clearly is that the federal government has not shown enough commitment to fighting the disease. That perhaps explains why the Direct Observed Treatment Short Course (DOTS), a global method for treatment of the disease, has not been funded by the government. Also, availability of TB microscopy laboratory services is still in short supply, thereby weakening the preventive strategies set aside to tackle the disease. These are the existing gaps that have held back the elimination of TB for years in the country.

On the whole, there is need for government to wake up to its responsibilities in the fight against TB in Nigeria. A more workable plan should be set in motion that will address many of the gaps that have encumbered the fight against the disease. Focusing on prevention, diagnosis, tracking and treatment remain the key in that direction.

There is need for government to invest more on research on TB as a strategic way to put a stop to its raging spread. The NIMR could be empowered to go into advanced research on the subject that unravels the mystery surrounding Nigeria’s high incident cases. Government must take the challenge seriously.