End Tuberculosis, Now

The soaring prevalence of tuberculosis-related deaths declared in Nigeria annually makes it mandatory for exigent and unyielding response by the government to contain the spread of the disease.  There is barely anyone who venerates human life that would not cringe at the news that more than 250,000 Nigerians are extirpated every year by the deadly disease. Yet, it is preventable and, with the right medical intervention, curable.
While joining the rest of the world to mark this year’s World Tuberculosis (TB) Day yesterday, March 24, 2022, the disease has been rightly described as an epidemic, not only because of the deaths it causes in Nigeria but the peril it constitutes to the entire world. Nigeria is positioned seventh among the 30 high TB burden nations and second in Africa. The quandary of tuberculosis in the country has been worsened by drug-resistant TB and the HIV/AIDS epidemic.
As usual, the root of Nigeria’s poor showing is the lack of dedication by the government to fund the programme of detection and treatment of the ailment. The same attitude of nonchalance that has encumbered the fight against other lethal diseases has also been transposed to the TB containment, allowing the illness to take advantage of the apathy to burgeon in Nigeria even when the incidence has witnessed a global drastic reduction over the past 20 years.
Despite calls for enhanced funding for TB control, Nigeria has recorded a 69 per cent ($257.4 million) funding gap in 2020. Of the $373 million required for TB control in the nation in 2020, only 31 per cent was available to all the implementers of TB control undertakings in the country and only seven per cent of the 31 per cent was dispensed by the Nigerian government while 24 per cent of the funds came from donors.
This was divulged by the Stop TB partnership and the National Tuberculosis and Leprosy Control Programme (NTBLCP) at the 2022 pre-World TB Day press conference in Abuja. The partners called on world leaders, including governments at the national and sub-national levels to step up and triple or quadruple the funding to save lives and end TB by 2030.
Tuberculosis and HIV are strongly linked. Whereas people with healthy immune systems may not fall ill from latent TB infection (when a person has TB but does not have any symptoms), those living with HIV are much more impressionable to active TB (when TB infection leads to illness). The risk of developing active TB is estimated to be 20 times greater in people living with HIV than in persons who are HIV negative.
Worldwide, TB is the 13th principal cause of death and the second primary infectious killer after COVID-19. In 2020, approximately 10 million people fell ill with tuberculosis globally — 5.6 million men, 3.3 million women and 1.1 million children. The baneful ailment is present in all countries and age groups.
Tuberculosis is effectuated by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It stretches from person to person through the air. When people with lung TB cough, sneeze or spit, they impel the TB germs into the air. A person needs to inhale only a few of these germs to become infected. About one-quarter of the world’s population has a TB infection, which means people have been infected by TB bacteria but are not ill with the disease and cannot transmit it.
The Millennium Development Goal for tuberculosis is to discontinue the increase in incidence and halve the mortality of the disease between 1990 and 2015. This goal has now been reached on a global scale, although not in the most affected region of Africa. The new target is TB elimination, defined as one case of active TB per one million population per year, which is to be reached before 2050.
Tuberculosis is a malady that affects mostly the poor and low economic population in Nigeria, leaving the patient and households with pestilential financial loss. Many patients are unable to pay for treatment from their income alone but have to rely on loans or dispose of their assets to have sufficient means for treatment. We prompt the government and development partners to demonstrate strong support to the patients.
Following stigmatisation in Nigeria, many people with TB fail to come out candidly to seek treatment. It is for this reason that the World Health Organisation (WHO) recommends the directly observed treatment, short course (DOTS) strategy. The technique combines five elements of commitment with increased and sustained funding; case detection through quality-assured bacteriology; standardised treatment with supervision and patient support; effective drug supply and management system; and monitoring and evaluation system and impact measurement.
The DOTS strategy was expanded to all the states of the federation in 1993. About 969 TB microscopy centres were established in 494 local government areas, according to the National Strategy Plan for Tuberculosis and Leprosy Control. Sadly, these centres have largely remained moribund. They must be made to work to reduce infection and death.
WHO, in its World TB observation this year, chose “Invest To End TB. Save Lives”. This communicates the crucial necessity to invest resources to ramp up the fight against the menace and achieve the commitments to end it. Nigeria has to key into the global vision of ending TB by 2030, which is also a component of the Global Goals of Sustainable Development. Early detection and treatment are paramount to prevent spread.