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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