Editorial
Ending TB Mortality Rate In Nigeria
Last Friday, the 24th of March 2023, commemorated World Tuberculosis Day 2023 to raise awareness about the deadly infection. The World Tuberculosis Day, one of eight global health campaigns marked by the World Health Organisation (WHO), is observed to build public awareness about the global epidemic of tuberculosis and efforts towards the eradication of the disease.
WHO proclaimed the day World Tuberculosis Day in 1882, when Dr Robert Koch of the University of Berlin’s Institute of Health announced to the scientific community that he had discovered the cause of tuberculosis. He explained the aetiology of the deadly disease and pioneered the diagnosis and avenues of treatment. Tuberculosis, also known as TB, is a contagious respiratory infection caused by the bacterium mycobacterium tuberculosis, which attacks a patient’s lungs.
Before Koch’s discovery, tuberculosis not only ravaged Europe and the Americas, killing one in seven people, but was wrongly thought to be hereditary.
Tuberculosis remains one of the world’s deadliest infectious killers, spread by inhaling tiny droplets produced when an infected person coughs or sneezes. Although a serious infectious disease, with proper treatment, it is not only preventable but also curable.
This year is critical for all who are engaged in TB work and should be championed as the ‘year of hope’ to get full support, attention, and energy for a collective ‘YES! We Can End TB’. There are several key areas to focus on, such as funding needs to scale up implementation and accelerate development of new tools, including new TB vaccines, access to new rapid molecular diagnostics and new shorter and more effective treatment regimens, TB prevention, childhood TB, strengthen and fund the community.
The world is grappling with this contagious and devastating disease. WHO’s commemoration of it is the means by which it highlights its impact on national life and the need to work together to eradicate it. The annual themes in this global fight have reflected the various and cumulative aspects of the fight. For example, the theme in year 2000, “Forging New Partnerships to Stop TB,” emphasized the need for a collaborative effort in the fight.
In 2001, it was DOTS: TB Cure For All, and while in 2010 it was “Innovate To Accelerate Action” and “It’s Time To End TB” in 2020. The theme for this year, “Invest To End TB. Save Lives”, conveys the urgent need to invest resources to ramp up the fight against TB and achieve the commitments to end TB made by global leaders.
This is especially critical in the COVID-19 pandemic that has put ‘End TB’ progress at risk, and to ensure fair access to prevention and care in line with WHO’s drive towards achieving Universal Health Coverage. WHO estimates that each day, over 4,100 people lose their lives to TB and close to 28,000 people fall ill with this preventable and curable disease.
Unfortunately, WHO states that the COVID-19 pandemic has reversed years of progress made in the fight to end TB. According to the WHO Global TB Report 2021, which includes data from over 200 countries, approximately 1.5 million people died from TB in 2020, up from 1.4 million in 2019. Worldwide, the WHO estimates that 9.9 million people fell ill with TB in 2021, but 4.1 million of those infected were not diagnosed or reported to national authorities. That’s up from 2.9 million in 2019.
It is instructive that this is the first increase in global TB deaths in more than a decade. Furthermore, WHO attributes the increase in deaths and decline in diagnoses and notifications to the COVID-19 pandemic and resulting lockdowns, which have reduced countries’ capacity to provide TB services and interfered with people’s ability to get diagnosed and treated.
This year’s theme reiterates the understanding that more investment in the fight against the disease will save a million more lives, prevent its spread and speed up the eradication of the TB epidemic. Despite significant progress over the last decades in the fight against the disease, regrettably, TB continues to be the top infectious killer worldwide.
Unfortunately, Nigeria ranks fourth in the world and first in Africa among countries with high prevalence of this killer disease. The Acting Board Chair, Stop TB Partnership Nigeria, Dr Queen Ogbuji declared in Abuja at the Pre-World TB Conference that over 156,000 Nigerians die of tuberculosis annually. This, she said, translates to 18 Nigerians dying of tuberculosis–related disease every hour and 432 daily.
This high fatality from a disease that is not only treatable, curable but preventable also, should not be allowed to continue on this dangerous curve. As usual in our environment, plenty of factors ranging from ignorance, poor environment, inadequate medical facilities, late diagnosis, cultural biases to poor budgetary provision and actual fund release accounts for this high fatality rate of the disease.
All tiers of government must commit to investing more in the health sector and in the fight against TB. Sadly, most Primary Health Centres (PHC) that ought to be the first point of call for TB patients are in comatose. Since TB thrives in poor environments and enhanced by population congestion, most times, those affected resort to presumptuous self-medication, hence giving rise to drug resistance at a later stage.
More and sustained investments are necessary to strengthen the health system at all levels, upscale our pandemic preparedness and end preventable deaths. Governments must get more involved in the campaign against the disease, especially to screen, as this will provide avenues for early detection, treatment and curbing its spread.
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Making Rivers’ Seaports Work
When Rivers State Governor, Sir Siminalayi Fubara, received the Board and Management of the Nigerian Ports Authority (NPA), led by its Chairman, Senator Adeyeye Adedayo Clement, his message was unmistakable: Rivers’ seaports remain underutilised, and Nigeria is poorer for it. The governor’s lament was a sad reminder of how neglect and centralisation continue to choke the nation’s economic arteries.
The governor, in his remarks at Government House, Port Harcourt, expressed concern that the twin seaports — the NPA in Port Harcourt and the Onne Seaport — have not been operating at their full potential. He underscored that seaports are vital engines of national development, pointing out that no prosperous nation thrives without efficient ports and airports. His position aligns with global realities that maritime trade remains the backbone of industrial expansion and international commerce.
Indeed, the case of Rivers State is peculiar. It hosts two major ports strategically located along the Bonny River axis, yet cargo throughput has remained dismally low compared to Lagos. According to NPA’s 2023 statistics, Lagos ports (Apapa and Tin Can Island) handled over 75 per cent of Nigeria’s container traffic, while Onne managed less than 10 per cent. Such a lopsided distribution is neither efficient nor sustainable.
Governor Fubara rightly observed that the full capacity operation of Onne Port would be transformative. The area’s vast land mass and industrial potential make it ideal for ancillary businesses — warehousing, logistics, ship repair, and manufacturing. A revitalised Onne would attract investors, create jobs, and stimulate economic growth, not only in Rivers State but across the Niger Delta.
The multiplier effect cannot be overstated. The port’s expansion would boost clearing and forwarding services, strengthen local transport networks, and revitalise the moribund manufacturing sector. It would also expand opportunities for youth employment — a pressing concern in a state where unemployment reportedly hovers around 32 per cent, according to the National Bureau of Statistics (NBS).
Yet, the challenge lies not in capacity but in policy. For years, Nigeria’s maritime economy has been suffocated by excessive centralisation. Successive governments have prioritised Lagos at the expense of other viable ports, creating a traffic nightmare and logistical bottlenecks that cost importers and exporters billions annually. The governor’s call, therefore, is a plea for fairness and pragmatism.
Making Lagos the exclusive maritime gateway is counter productive. Congestion at Tin Can Island and Apapa has become legendary — ships often wait weeks to berth, while truck queues stretch for kilometres. The result is avoidable demurrage, product delays, and business frustration. A more decentralised port system would spread economic opportunities and reduce the burden on Lagos’ overstretched infrastructure.
Importers continue to face severe difficulties clearing goods in Lagos, with bureaucratic delays and poor road networks compounding their woes. The World Bank’s Doing Business Report estimates that Nigerian ports experience average clearance times of 20 days — compared to just 5 days in neighbouring Ghana. Such inefficiency undermines competitiveness and discourages foreign investment.
Worse still, goods transported from Lagos to other regions are often lost to accidents or criminal attacks along the nation’s perilous highways. Reports from the Federal Road Safety Corps indicate that over 5,000 road crashes involving heavy-duty trucks occurred in 2023, many en route from Lagos. By contrast, activating seaports in Rivers, Warri, and Calabar would shorten cargo routes and save lives.
The economic rationale is clear: making all seaports operational will create jobs, enhance trade efficiency, and boost national revenue. It will also help diversify economic activity away from the overburdened South West, spreading prosperity more evenly across the federation.
Decentralisation is both an economic strategy and an act of national renewal. When Onne, Warri, and Calabar ports operate optimally, hinterland states benefit through increased trade and infrastructure development. The federal purse, too, gains through taxes, duties, and improved productivity.
Tin Can Island, already bursting at the seams, exemplifies the perils of over-centralisation. Ships face berthing delays, containers stack up, and port users lose valuable hours navigating chaos. The result is higher operational costs and lower competitiveness. Allowing states like Rivers to fully harness their maritime assets would reverse this trend.
Compelling all importers to use Lagos ports is an anachronistic policy that stifles innovation and local enterprise. Nigeria cannot achieve its industrial ambitions by chaining its logistics system to one congested city. The path to prosperity lies in empowering every state to develop and utilise its natural advantages — and for Rivers, that means functional seaports.
Fubara’s call should not go unheeded. The Federal Government must embrace decentralisation as a strategic necessity for national growth. Making Rivers’ seaports work is not just about reviving dormant infrastructure; it is about unlocking the full maritime potential of a nation yearning for balance, productivity, and shared prosperity.
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