What would you think if you learnt that over 16 million Nigerian children had a disease that can cause internal bleeding and social stigma – but that only a little over half of them were getting treatment?
You’d be outraged, of course, and expect the kids to be looked after.
But what would you then think if you knew that the cost of solving this problem was drugs that cost less than 200 Naira per person per year?
You would probably wonder why the treatment was not given to everyone as soon as possible.
The disease in question is waterborne Bilharzia, or, to give its scientific name, Schistosomiasis. It’s a parasitic affliction caused by a worm which enters the body via infected water. The worm lays eggs that damage vital organs.
Some people call it “snail fever” because waterborne snails carry it. It affects women and children, mostly, because it is mostly Nigerian women who fetch water or wash clothes in the river, with their children playing alongside.
If many cases, in women, the eggs lodge in the urinary or reproductive organs, causing what doctors call Female Genital Schistosomiasis. This form of Bilharzia can cause infertility and make women much more vulnerable to contracting HIV/AIDS.
But this is not another tale of doom about the poor health of Africans. It’s a story about opportunity. International organisations have now taken note of Bilharzia and a host of other tropical diseases that were largely ignored until a few years ago because they tend to affect the poorest, rural people.
A big coalition of governments (including many African ones), aid agencies and the US philanthropist Bill Gates have come together to tackle what the jargon calls “Neglected Tropical Diseases”.
Apart from Bilharzia, the neglected diseases include Elephantiasis (official name Lymphatic Filariasis) which causes extreme swelling of the lower limbs and is largely prevalent in Asia. Another cruel affliction is River Blindness (Onchoceriasis) which causes painful scratchy eyelids and can lead to blindness.
Borno State resident Mr Habu Garu is just one person who is glad the campaign is on. He received treatment for Bilharzia after he noticed blood in his urine:
“For nearly two years I was extremely traumatised”, he told a United Nations World Health Organisation researcher;
“My friends used to mock me about it, calling it ‘male periods’. I’m so glad it is all over now”.
The international coalition tackling these diseases goes by the title “Uniting to Combat Neglected Tropical Diseases”. It has made some progress. Recent statistics say a billion and a half people worldwide still need treatment for at least one of the diseases. But a billion people received treatment in 2016 alone.
In January of 2017 the anti tropical diseases coalition set an unlikely ‘Guinness World Record’. These are often obscure feats like the most chocolate bars ever eaten in a minute, but this World Record was rather more serious. It was for the worlds biggest mobilisation of donated drugs – over 207 million doses were shifted towards patients in a single day, January 30 2017.
The record was partly thanks to the coalition having persuaded international drug companies to donate life-saving drugs, which can cure some of the diseases, for free.
Some of the afflictions, including Bilharzia, can be cured by a combination of drugs, basic hygiene measures and a clean water supply. But another key weapon is raising awareness. Because Bilharzia has mainly affected the poorest, usually rural people, some medical professionals – still less ordinary people – do not understand the symptoms.
Women suffering from the genital version of Bilharzia, and some doctors, often think they are seeing symptoms of general infertility or sexually transmitted infections – so patients do not get properly treated. The plan is to get more information about Bilharzia and the other diseases into nursing and medical schools.
Another hurdle for those tackling the diseases is traditional suspicion towards modern drugs and, sometimes, a belief that the afflictions are divine punishment of some sort.
The Director of Neglected Tropical Diseases in the Federal Ministry of Health, Dr Chukwuma Anyaike, told Daily Trust that the main problems he saw in tackling Bilharzia were: the short shelf life (2 years) of the treatment drug, Praziquantel; the mild side effects of the drug if taken on an empty stomach; and the low number of aid groups working on treatment projects given the large size of the problem across Nigeria.
For its part the international coalition has two key recommendations to move matters forward: for the Federal Government to increase its budget for the diseases; and for better data management.
There is definitely room for optimism in the fight against tropical diseases in Nigeria. To know why, wind back to 2014, when something extraordinary occurred in the country.
When the words “Lagos” and “Ebola” were first mentioned together in 2014, it sent a shiver down the spine of anyone who had visited that megacity and who knew anything about the disease.
At the time I was reporting for the BBC on the Ebola epidemic in Sierra Leone, Liberia and Guinea. I have lived in Lagos. I love its vibrancy and the gutsiness of its people. But like many others, I feared that the arrival of Ebola there meant the disease was about to explode exponentially, on a truly world scale
I was wrong.
Nigeria used the expertise it had built up in previous years, to trace and tackle Polio cases, in its fight against Ebola. Nigerian epidemiologists surprised the world – including, I admit, myself – with their speed, professionalism and efficiency. The country was declared Ebola free in a relatively short time – an amazing achievement.
The tropical diseases mentioned in this article are not anywhere near as infectious or dangerous as Ebola. They are mostly diseases of poverty, often caused by poor hygiene. And they create poverty as well – unwell people are not dynamic economic actors.
But if Nigerians can tackle the raging beast of Ebola, and win, the sky is surely the limit.
Doyle Freelance Journalist and Consultant