N14bn needed to control spread – Expert
Five-year national eradication plan fails to achieve objective
Act on your commitment to accelerating progress, WHO tells Buhari
As Nigeria joined the global community to commemorate the 2019 World Tuberculosis Day, fresh indications have emerged that the country’s national Action Plan on TB Eradication 2015-2020, being pursued by the Federal Government will end next year without achieving its set objectives. This is coming as 420 Nigerians still die everyday from the deadly infectious disease.
Though President Muhammadu Buhari, during a High Level Meeting on TB at the United Nations General Assembly Headquarters, New York last September , told the world that the National Action Plan on TB Eradication 2015-2020 was being pursued with renewed vigour by his administration, indications have emerged that the epidemic is far from being tackled in Nigeria.
Figures gathered by The Point from the National Tuberculosis and Leprosy Control Programme indicate that 420 Nigerians die everyday due to tuberculosis popularly called TB.
The figures also show that over 154, 000 TB deaths are recorded every year even as about 300,000 undiagnosed TB patients pose public health risk.
Confirming the figures, the Coordinator, National Tuberculosis and Leprosy Control Programme, Dr. Adebola Lawanson, noted that of the 105,000 cases diagnosed in 2017, 63 per cent were between the productive ages of 15 to 44 which no doubt calls for concern.
Less than one year to the expiration of the five-year TB eradication action plan, Lawanson revealed that Nigeria was one of the countries with the highest burden of TB and HIV just as the country is also the seventh highest in the world, and second in Africa.
She said N14.4 billion was needed to control the spread of the disease which also kills 18 Nigerians every hour despite being both curable and preventable.
The World Health Organisation, in one of its reports in 2018, disclosed that TB was one of the top 10 causes of death globally and killed an estimated 1.6 million people worldwide in 2017.
Lamenting the staggering statistics ,National Professional Officer in charge of TB at the WHO, Dr Ayodele Awe, decried the high burden of TB in Nigeria particularly the number of missing cases.
He said, “We have been on this business for a long time. I have been working on TB in Nigeria for 30 years and we kept getting same report. We are meant to be detecting 400,000 TB cases yearly but we are only reporting 100,000, meaning we are missing 300,000 cases, each year.
“ Every TB case not detected can be a risk to 10 to 15 persons. TB causes ill health for approximately 10 million people each year.”
Awe further added, “TB is diagnosable, treatable and curable, but the burden of the disease in Nigeria is further fuelled by the huge number of missing cases, which serve as a pool of reservoir for the continuous transmission of the disease. The only way to arrest them is when they present themselves to the health facilities for treatment.”
At the current death rate and missing cases , experts say there is very little prospect of the country ever meeting the target of 2030 set by both the United Nations Sustainable Development Goal and the World Health Organisation for ending the global TB epidemic.
Experts are worried that the government has not demonstrated commitment to tackling TB spread based on the country’s dependent on international donors for funding for its TB programmes, revealing that 60 per cent of TB funds used in the country were donated by international partners.
The national Action Plan on TB Eradication 2015-2020 being pursed by the Federal Government has five overarching priorities. These are : Detection of TB in adults and children; Improving treatment in specific geographic areas that are under-performing; Integrating TB and HIV services; Building capacity for diagnosing and treating drug resistant TB; and creating strong and sustainable systems to support these achievements. Findings however , showed that these five priorities will be a mirage by 2020 is next year.
During the High Level Meeting on TB at the United Nations General Assembly Headquarters, New York last September , President Buhari promised the General Assembly that his administration would fight TB which so far has become a mere talk based on available evidence.
His words, “We are exploring the possibility of establishing a financial institution dedicated to providing financial lifelines for free, comprehensive and qualitative medical treatments. The aim is to mitigate financial burden on victims and to also ensure that we continue to save lives and create favourable conditions for economic and social development.
“ Let me pledge Nigeria’s continued commitment to the eradication of TB in Nigeria. We remain resolute in efforts to address institutional and societal challenges, through the enhancement of strong multi-sectoral mechanisms. Let me therefore seize this opportunity to call on the global community to demonstrate renewed commitment to today’s declaration.”
The President’s pledge since last year has not in anyway translated into action as TB deaths in Nigeria continue to soar .
Evidence shows that while global mortality rate and incidence have fallen by three per cent and two per cent respectively, Nigeria is still grappling with the basics of how to detect new cases. Hence, five in every six TB cases in Nigeria are undetected, which poses a serious problem for the treatment and control.
This is why stakeholders, including the WHO , are calling on the government to intensify efforts to discover most of the undetected cases, stressing that apart from helping in the containment of the disease, early detection offers higher chances of cure.
WHO says TB remains the world’s deadliest infectious killer.
The World TB Day is commemorated on March 24 every year to raise public awareness about the devastating health, social and economic consequences of TB, and to step up efforts to end the global TB epidemic. The day presents a unique opportunity to secure a commitment from heads of state and governments for a coordinated global response to end the epidemic.
The theme for this year’s commemoration is, “ It’s Time to End TB”.
In a statement to commemorate this year’s event , WHO’s Director-General, Dr Tedros Ghebreyesus, in his speech, called on all heads of state who came together and made strong commitments to end TB at the first-ever UN High Level Meeting in September 2018 including President Buhari to fulfill their commitment by translating it into action.
“We’re highlighting the urgent need to translate commitments made at the 2018 UN High Level Meeting on TB into actions that ensure everyone who needs TB care can get it.
“Since 2000, 54 million lives have been saved, and TB deaths fell by one-third. But 10 million people still fall ill with TB each year, with too many missing out on vital care”, he said.
Ghebreyesus said WHO had issued a new guideline to improve treatment of multidrug resistant TB by recommending a shift to fully oral regimens to treat people with MDR-TB. This new treatment course he said, is more effective and is less likely to provoke adverse side effects.
He explained, “WHO recommends backing up treatment with active monitoring of drug safety and providing counselling support to help patients complete their course of treatment. The recommendations are part of a larger package of actions designed to help countries increase the pace of progress to end tuberculosis . The WHO package is designed to help countries close gaps in care ensuring no one is left behind. This is a set of pragmatic actions that countries can use to accelerate progress and act on the high-level commitments made in the first-ever UN High Level Meeting on TB last September.”
TB, a bacterial infection that most often affects people’s lungs, is caused by Mycobacterium tuberculosis. Personal contact is not necessary for infection to occur, as merely inhaling the air polluted by the sneeze, cough or spit of an infected person is enough. Signs and symptoms of active TB include: Coughing that lasts three or more weeks, Coughing up blood, chest pain, unintentional weight loss, fatigue, fever, among others .
Recommending other way forward, Awe called for more media awareness on TB in Nigeria in other to find most of the missing
cases.
He added: “We need the media to rise up to the task of raising awareness and enlightenment on TB in Nigeria. Most people do not know the symptoms of the disease. This has also affected their health seeking behaviour. “
To further tackle the TB burden, other stakeholders are calling for more involvement of private sector in TB control programmes, noting that available data shows that only 14 per cent of private health institutions are collaborating with the national TB control programme.
