Friday, 03 May 2024

Time For Nigeria To Win Fight Against TB

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The World Tuberculosis Day, one of eight global health campaigns marked by the World Health Organisation (WHO), is commemorated on March 24 to build public awareness about the global epidemic of Tuberculosis and efforts towards the eradication of the disease.

The day was so declared by the WHO to commemorate the day, in 1882, when Dr Robert Koch of the University of Berlin’s Institute of Hygiene announced to the scientific community that he had discovered the cause of tuberculosis.

 

Tuberculosis, also known as TB, is a highly contagious respiratory infection caused by the bacteria known as mycobacterium tuberculosis that attack mainly the lungs of its victims.

Spread through inhaling tiny droplets from the cough or sneeze of an infected person, TB is the number 1 infectious killer disease in the world and among the top 10 causes of death worldwide. Though a serious contagious disease, it is not only preventable but curable, with proper treatment.

Prior to this discovery by Dr Robert Koch, TB was not only ravaging Europe and the Americas, causing the death of one out of every seven people but was erroneously thought to be hereditary.

Its commemoration by the WHO is one of the means of bringing to the fore its impact on national lives and the need for a concerted effort towards its eradication.

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There has been a global effort aimed at tackling this contagious and devastating disease. For example, the theme in 2000, “Forging New Partnerships to Stop TB” emphasized the need for collaborative effort in the fight.

In 2001, it was “DOTS: TB Cure For All,” while in 2010 it was “Innovate To Accelerate Action” and “Time To End TB” in 2020.

The theme for this year: “Yes! We Can End TB”, is a continuation of the 2023 theme which aims to inspire hope and encourage high-level leadership, increased investments, faster uptake of new WHO recommendations, adoption of innovations, accelerated action, and multisectoral collaboration to combat the TB epidemic.

According to the World Health Organisation, without treatment, the death rate from TB disease is high (about 50%). However, with treatments currently recommended by WHO (a 4–6 months course of anti-TB drugs), about 85% of people with TB can be cured.

Regimens of 1–6 months are available to treat TB infection. Universal health coverage (UHC) is necessary to ensure that all people who need treatment for TB disease or infection can access these treatments.

The number of people acquiring infection and developing disease (and in turn the number of deaths caused by TB) can also be reduced through multi-sectoral action to address TB determinants such as poverty, undernourishment, HIV infection, smoking and diabetes.

The World Health Organisation estimates that every day, over 4,100 people lose their lives to TB and close to 28,000 people fall ill with this preventable and curable disease.

An estimated 15 Nigerians die every hour due to TB, equivalent to about 347 deaths daily, 10,417 monthly and 125,000 in a year.

Nigeria’s TB incidence rate is about 219 in a 100,000 population with an estimated total of 467,000 persons who have active TB disease. In 2021, the National TB, Leprosy and Buruli Ulcer Control Program (NTBLCP) notified 207,785 having a gap of 56% of the estimated cases unidentified.

Unfortunately, WHO states that the advent of COVID-19 pandemic in 2019 and its global health impact, has reversed years of progress made in the fight to end TB.

According to Report, global reductions in the reported number of people newly diagnosed with TB in 2020 and 2021 suggested that the number of people with undiagnosed and untreated TB had grown, resulting first in an increased number of deaths from TB and more community transmission of infection and then, with some lag-time, increased numbers of people developing TB.

This year’s theme reiterates the understanding that with more commitment and sustained campaign in the fight against the disease, the eradication of tuberculosis is possible, even in Nigeria. Such a feat will save million more lives, prevent its spread and accelerate the eradication of TB epidemic.

The Global Tuberculosis Report indicates that Nigeria has a high triple burden of TB, DR-TB and HIV-associated TB, and is one of the 10 countries that contribute the highest number of missing TB cases globally.

Nigeria also ranks first in Africa and sixth in the world, accounting for about 4.6% of the global TB burden.

In 2021, about 2,975 DR-TB cases were diagnosed out of an estimated 21,000 cases in the country, leaving out more than 80% of the resistant cases missing.

Whereas Directly Observed Treatment short course (DOTs) clinics for TB treatment and care are available in up to 50% of health facilities in Nigeria, only 9% of these have facilities for laboratory diagnosis of TB infection and disease.

This not too – cheerful statistics does not end there. Of the $373 million needed for TB control in Nigeria in the year 2020, only 31% was available to all the implementers of TB control. The 7% domestic contribution is mainly for personnel activities in Nigeria.

It was the consensus therefore that there must be a concerted effort towards addressing the 69% funding gap for TB and expanding diagnostic coverage in the country if the nation is to see a quantum leap on the impact of the fight against TB.

Recently, the Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate, declared that the country diagnosed over 300,000 TB cases in 2023, marking the first time in its history that such a high number is recorded.

According to the minister, at the 2023 UN High-level Meeting (UN HLM) on Universal Health Coverage (UHC), Nigeria reached about 70 per cent of its cumulative target and approximately 90 per cent of the 2022 target.

 

–Mohammad writes from Abuja.

 
 

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