Audu Obaje, 51, died three weeks after his diagnosis with tuberculosis in October last year. He had suffered from cough for almost a year before he went to hospital.
He had taken sweets and bitter kola as treatment during the first few weeks of the cough. But with time his friends suggested he tried herbal medicine, his wife, Jummai narrated.
She said when he didn’t get better, he bought pain relief medicines and cough syrups occasionally from a patent medicine shop in their neighbourhood.
Obaje later went to a health post in his community. The community health worker said the cough may be linked to his hypertensive condition. No test was done as it lacked laboratory facilities. She prescribed cough medicines and he went home hoping the cough would go away with time.
‘There’s 69% funding gap for TB control in Nigeria’
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By the time Obaje was rushed to the general hospital in another town some months later, he was in serious pain, had already lost weight considerably, and was very weak. There he was diagnosed of tuberculosis, and treatment commenced before he died three weeks later.
Obaje is one of many Nigerians dying daily from tuberculosis, also known as TB, in spite of the fact that the disease is both preventable and curable.
An estimated 15 Nigerians die each hour due to TB, equivalent to about 347 deaths daily, 10,417 monthly and 125,000 in a year.
Medical experts say people should not take any cough that exceeds two weeks lightly. They say persistent cough for two or more weeks could be tuberculosis, and advise that the only way to get the right diagnosis is by visiting a health facility for test or seeing a qualified health care provider.
Joyce Seember, a TB survivor and advocate, said TB is deadly but also curable. She said, “I have experienced the pains and discomfort that come with TB and religiously had my treatment for six months and today, I am TB-free.”
TB is an air-borne disease caused by a germ known as mycobacterium tuberculosis which mainly affects the lungs and other parts of the body. It is the number one infectious killer disease in the world and among the top 10 causes of death worldwide.
Some symptoms of tuberculosis include cough lasting longer than two weeks in normal individuals, and any current cough in People Living with HIV and AIDS, weight loss, night sweats, and persistent fever.
Dr Morenike Alex-Okoh, the Director, Public Health, Federal Ministry of Health, said TB remained a major public health problem in Nigeria, adding that the burden was further fuelled by the huge number of undetected TB cases which serves as a pool of reservoir for the continuous transmission of the disease in communities.
Findings revealed gaps in domestic funding of TB programme have continued to stall efforts towards eliminating the disease in Nigeria. Experts say there is a 69 per cent gap in the funding required for TB control in the country.
Others include poor knowledge about the disease, stigma, missed cases, inadequate human resources for health, and poor access to testing and treatment facilities among others.
Many Nigerians don’t know where to access care and that treatment is free.
As the country joins the rest of the world to commemorate this year’s World TB Day, experts have called for improved and concerted efforts towards addressing the challenges.
They say it is in our collective power to end TB by 2030 and reach the Sustainable Development Goals (SDGs). The theme for this year’s World TB Day is “Yes! We Can End TB.”
Data from the National Tuberculosis and Leprosy Control Programme (NTBLCP) of the Federal Ministry of Health and Stop TB Partnership Nigeria show that the country has a high triple burden of TB, Drug Resistant-TB and HIV-associated TB. It is also one of the 10 countries that contribute the highest number of missing TB cases globally.
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.
Also, whereas Directly Observed Treatment short course (DOTs) clinics for TB treatment and care are available in up to 50 per cent of health facilities in Nigeria, only nine per cent of these have facilities for laboratory diagnosis of TB infection and disease.
Dr. Chukwuma Anyaike, National Coordinator, NTBLCP, said Nigeria has the highest TB burden in Africa and ranks 6th in the TB burden in the world.
Anyaike, said there is still poor awareness about tuberculosis in the country, adding that, “tuberculosis is not caused by witchcraft nor transmitted by shaking hands and hugging’’.
“We need to do much awareness creation. So as the number one principle of primary prevention, awareness creation comes in, we need to make much noise and it shouldn’t be just on an annual basis.”
“At the end of 2022, we were able to notify above 285,000 missing TB cases in Nigeria and that is 60 per cent of the missing cases. It is a huge milestone, but we have not gotten there.
“The remaining 40 per cent is still causing havoc in the communities. If you, multiply the remaining 40% by 15, you will notice that we still have a lot to do. These people are with us in the communities and the worrisome aspect is that our children are also coming down with TB”, he said.
The Executive Director, KNCV Nigeria, Dr Odume Bethrand, said funding for TB had remained a key challenge to support programme activities towards closing the TB treatment coverage gap which stands at 66 per cent as of the end of 2021.
Odume, who is also the Chair, 2023 National World TB Day Planning Committee said, “We need to intensify advocacy to the government and the organized private sector to increase funding for TB programmes in the country. At 69 per cent funding gap, and over-reliance on external donor agencies for funding, sustaining the TB programme in Nigeria will continue to remain a challenge.”
The acting board chair, Stop TB Partnership Nigeria, Dr Queen Ogbuji, said in line with this year’s theme of the World TB Day, ‘Yes! We can end TB’, Nigeria can end TB if everyone gets involved.
She said “We all have roles to play in ending TB in Nigeria; from the community stakeholders, the civil society organisations, the state and national programs, academia, media, private sector and government at all levels.
She called on government to increase funding for TB to address the huge funding gap and reduce the burden in Nigeria.
She said out of the 31% of TB funding available for TB control in Nigeria, 24% is from donors.
The World Health Organisation (WHO) country representative in Nigeria, Dr Walter Kazadi Mulombo, said HIV and Drug Resistant TB further complicate the reduction of the disease in Nigeria.
“TB control projects are drastically underfunded. This is a major setback, as many are pushed into poverty when they contract TB due to catastrophic costs. There is a need to increase funding for TB,” he said.
The Minister of Health, Dr Osagie Ehanire, said findings of the mid-term review of the Tuberculosis National Strategic Plan 2021-2025, show that the Nigerian TB Programme has made significant progress, but that there are areas the country needs to improve on.
He said in 2020, the National Tuberculosis, Leprosy and Buruli Ulcer control programme, took a bold step to address the low TB case detection by developing the National Strategic Plan for the Control of TB 2021-2025 with the main goal of accelerating efforts at ending TB epidemic in Nigeria by ensuring access to comprehensive and high-quality-patient-centred and community-owned TB services for all Nigerians.
Joyce Seember, the TB survivor and advocate said advocacy is key to ending TB in Nigeria.
“Yes, we can end TB, by getting involved. No matter the amount of funding we get ,if we don’t go out there for advocacy it is nothing.
“We should get involved by pushing human and non-human resources in communities, especially in rural communities where people living with tuberculosis are because of their lifestyles which act as a catalyst for the spread of the disease.”
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