Editorial

Combating TB In Rivers

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Rivers State, on March 24, joined the rest of humanity to mark the 2020 World Tuberculosis Day, with the major target to do everything possible, with its array of influential religious leaders and other stakeholders, to change her fifth high burden status among the 36 states and Abuja, with its current burden estimated at above 16,000 cases.
Speaking at an event to mark the day, the state Commissioner for Health, Prof Chike Princewill, noted that in 2019, about 3,728 persons were diagnosed and treated for TB in the state, adding that apart from the 12 approved rapid diagnostic machines for free TB diagnosis provided in Rivers State, key players should join hands with the government to provide additional 15 TB diagnostic machines for the state in order to reduce the health burden on Rivers people.
The WTBD, observed by member states of the United Nations each year, is designed to build public awareness about the global epidemic of tuberculosis and efforts to eliminate the disease. Proposed by International Union Against Tuberculosis and Lung Disease (IUATLD) as an official UN Observance in 1982, a century after its discovery, with the theme, “Defeat TB: Now and Forever”, WTBD was not officially recognised as an annual occurrence by WHO’s World Health Assembly and the UN until over a decade later.
Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It’s curable and preventable, and is spread from person to person through the air. People who are infected with HIV are 19 times more likely to develop active TB. The risk of active TB is also greater in persons suffering from other conditions that impair the immune system. Common symptoms of TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
In his message to mark World TB Day, WHO Director-General, Dr Tedros Adhanom Ghebreyesus, emphasized that, “COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives”.
The Director of WHO’s Global TB Programme, Dr Tereza Kasaeva, also echoed the same sentiment, saying, “As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organisations, health-care providers, donors, partners and the industry to unite forces and step up the TB response – notably for TB preventive treatment – to ensure no one is left behind. We stand in solidarity with those affected by COVID-19 and those at the frontlines of the fight to combat the infectious disease. We need to act with urgency to ensure that in line with our vision of Health for All, no one with TB, COVID-19 or any health condition will miss out on the prevention and care they need. The time for action is now.”
Despite that linkage between TB and COVID-19, among others, as some of the infectious diseases complications ravaging humanity, Rivers State has effectively prosecuted the fight against TB over the last two decades and half, and the result has been crystal clear. Although the state ranked 5th in 2019 in high burden in Nigeria, The Tide is glad that the treatment for TB has been exponentially high in the state, even as the major challenge still remains in identifying infected persons. We note that last year, over 3,728 people were diagnosed of TB and subsequently placed on treatment. We also reckon the good treatment outcome in Rivers State, where cure rate is high; and treatment success rate is almost 90%, even as the World Health Organisation (WHO) target for success rate is about 25%.
This year’s theme, “It’s Time”, is aimed at drawing attention to the urgent need to act, by ensuring equitable and people-centred TB response and increased access to prevention and treatment, reduce stigma and discrimination as well as build accountability. This is why we suggest innovative ways to increase access to TB treatment while emphasizing collaboration with private sector by engaging private health practitioners, patent medicine vendors and community pharmacists to scale up the fight. Health workers as key stakeholders are enjoined to be more painstaking in the discharge of their duties, by among other things, obtaining information about patients’ history of cough, and make effective use of modern diagnostic services.
With this year’s target aimed at mobilising religious leaders in the fight, we urge those with large congregants to be in the frontline and use their exalted positions to raise awareness at the various churches and mosques on the need to go for diagnosis, and subsequently be treated, which will ultimately lesson the infection burden on the state. We equally advise them to be part of the crusade against TB by encouraging their followers to visit health facilities for diagnosis and treatment, if need be, with a view to combating the scourge and reversing the spike in the state.
Even as Rivers State ranks 5th in high burden of TB among the 36 states and the FCT, Nigeria regrettably ranks first among TB burden nations in Africa, and sixth globally, with 300,000 cases missing in most communities. About 18 Nigerians die hourly from TB, while 49 develop active TB; seven of which are children. In 2012, approximately 1.4 million deaths were attributed to TB infection, and Nigeria ranked 10th of the 22 high burden TB countries, and recorded over 190,000 new cases and over 280,000 prevalent TB cases. In 2016, Nigeria ranked 4th out of the 22 high tuberculosis burden countries worldwide and had the highest burden of tuberculosis in Africa, with an estimated 407,000 cases.
As we mark World TB Day 2020, the disease remains the world’s top infectious killer. Each day, over 4,000 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. We join WHO, its partners, civil society and governments, especially Rivers State, in asking for support of major stakeholders, including religious leaders in scaling up the TB response, to achieve the Sustainable Development Goals targets of ending the TB epidemic by 2030.
As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that essential health services and operations are continued to protect the lives of people with TB and other infectious diseases or health conditions. Health services, including national and state programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19 while ensuring that TB services are maintained. We urge continued efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. At the same time, we suggest that programmes already in place to combat TB and other major infectious diseases can be leveraged to make the response to COVID-19 more effective and rapid.
We, therefore, challenge religious leaders, community leaders, policy makers, and the media community to join other stakeholders to collectively win the war against infectious diseases, including TB, COVID-19, and their likes. It is a task that must be done for the benefit of humanity. We urge leaders across all levels to put the accent on the urgency to act on the commitments made to: scale up access to prevention and treatment; build accountability; ensure sufficient and sustainable financing including for research; promote an end to stigma and discrimination, and encourage equitable, rights-based and people-centred TB response. We charge all to join forces under the banner “Find. Treat. All. #EndTB” to ensure no one is left behind. Let us unite forces in raising our voices for the millions suffering and dying due to TB, especially in the midst of the COVID-19 pandemic. It’s time for action. It’s time to end TB.

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