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Tuberculosis: Nigeria’s Raging Silent Killer

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…Kills 268 Nigerians daily   About 40% of cases remain undetected 

…Over 50% of Nigeria’s LGAs still lack GeneXpert machines

…  US’s suspension of funding expected to increase problems     

  ….As mortality rate remains high

In spite of concerted partnerships to stamp out tuberculosis (TB) in Nigeria, stakeholders are worried it still kills thousands in the country.According to the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP), the disease, discovered 143 years ago, claims 71,000 lives annually in Nigeria, accounting for 18 percent of TB-related deaths in Africa.Disturbingly, Nigeria has the highest tuberculosis burden in Africa.

“The disease kills 268 people in the country every day,” says the World Health Organization, WHO. “Yet TB cases are under-reported, increasing the high risk of transmission. It is estimated that one missed case can transmit TB to 15 people in a year.”

According to provisional data, over 361,000 TB cases were reported in Nigeria in 2023, nine per cent of these in children. Overall, this marked a 26 per cent increase in the number of cases compared with 2022.

”When the late Malam Ibrahim Yusuf, a 32-year-old mechanic in No Man’s Land, Fagge Local Government Area, Kano State, first developed a persistent cough, he dismissed it as a minor infection.

His wife, Mrs Safiya Ibrahim, recounted how his condition deteriorated over time. “By the time we finally visited the health facility, he was diagnosed with tuberculosis (TB) in its advanced stage.”Despite undergoing treatment, my husband died three months later, leaving behind me and our three children,” she narrated.

According to the World Health Organisation (WHO), TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis.It primarily affects the lungs but can spread to other organs such as the brain, spine and kidneys.

TB spreads through the air when an infected person coughs, sneezes, speaks or sings.Experts say there are two types of TB– Latent TB, where the bacteria remains inactive, causing no symptoms and making the person non-contagious, and Active TB – where the bacteria multiplies, leading to a persistent cough, weight loss, night sweats, fever and fatigue.

The latter is contagious and requires immediate treatment.Medical professionals say TB is curable with a six-month course of antibiotics, including drugs like isoniazid and rifampicin.They say the BCG vaccine offers partial protection, especially for children, while early diagnosis through tests like GeneXpert and sputum microscopy is crucial in preventing transmission.Despite medical advances, TB remains a major public health crisis in Nigeria.

Ibrahim’s story is just one among thousands in Nigeria, where TB remains a leading cause of death despite being preventable and curable.In 2023 alone, 499,000 Nigerians were diagnosed with TB—five people every minute.

However, only 60 percent of cases were detected, meaning hundreds of thousands remain undiagnosed, posing a risk of further transmission.Nigeria is also battling a rise in Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB).MDR-TB occurs when TB bacteria become resistant to first-line drugs like isoniazid and rifampicin, making treatment longer, more expensive and less effective.

According to WHO, no fewer than 21,000 Nigerians develop MDR-TB each year, but only about 2,600 receive proper treatment due to funding shortages, limited diagnostic tools and inadequate second-line medications.

Dr Adesigbin Clement Olufemi, Head of the Programmatic Management of Drug-Resistant Tuberculosis (PMDT), NTBLCP, provided insights.”Many patients start treatment but struggle to complete the regimen due to side effects, stigma or financial hardship,” he said.According to Olufemi, without urgent intervention, MDR-TB will become even harder to control.

Dr Shehu Labaran, NTBLCP Director, explained that although more than 50 percent of Nigerian health facilities provided TB treatment, access remained a major challenge, especially in rural areas.”Only 48 percent of Local Government Areas (LGAs) have GeneXpert machines, the recommended rapid diagnostic tool for TB,” Labaran said.

By the aforementioned, 371 LGAs are left without advanced TB detection, leading to delays in diagnosis.Dr Patricia Chinedu, a pulmonologist, said that many patients sought treatment from traditional healers or chemists first, losing valuable time before receiving proper care.”By the time they reach a hospital, the disease has progressed to a life-threatening stage,” Chinedu warned.

Despite free TB treatment in Nigeria, the financial burden on patients is crippling.NTBLCP reports that 71 percent of TB-affected households face catastrophic costs, spending more than 20 percent of their income on transportation, nutrition, and other indirect expenses.For Mrs Maryam Usman, a resident of Karmajiji, Abuja Municipal Area Council (AMAC), Federal Capital Territory (FCT), her husband’s TB diagnosis forced her to make heartbreaking sacrifices.

“I had to stop my children’s schooling because we could not afford transport to the facility where my husband is undergoing TB treatment,”Usman said.In many Nigerian communities, TB is still linked to curses, witchcraft or divine punishment.This stigma prevents people from seeking early treatment, increasing the risk of transmission.

“My family stopped visiting me when they heard I had TB,” recounted Mr Adamu Peter, a recovered TB patient from Waru community, FCT.Dr Queen Ogbuji-Ladipo, Acting Board Chair of Stop TB Partnership Nigeria, underscored that awareness campaigns like “Check Am O!”were helping, but more work was needed.

Ogbuji-Ladipo said that the global End TB Strategy aimed to reduce TB deaths by 90 percent by 2030, but Nigeria still faced major hurdles.The Nigerian Government, in collaboration with WHO, USAID and the Global Fund, had unveiled several initiatives.

These initiatives include free testing and treatment programs, active case-finding campaigns in high-burden areas, and mobile clinic pilot projects to improve rural healthcare access.However, a huge funding gap persists.)Mr Tajudeen Ibrahim, Executive Country Coordinating Mechanism, Global Fund, disclosed that Nigeria required 404 million dollars to effectively deliver TB treatment and services in 2025.

Ibrahim warned that the country’s TB drug supply for 2025 was already under strain, as some medications allocated for the year had been used to meet 2024’s treatment demands.He said the 5 million dollars funding gap caused by the U.S. Government’s recent executive order, affected active case-finding in 18 states between January and March.*Given that 24 percent of Nigeria’s TB funding comes from external sources, with the U.S. contributing 22 million dollars, there are concerns that detection and treatment efforts will suffer if funding issues persist,” he said.

Meanwhile, Prof. Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare, dismissed concerns from international agencies about possible drug shortages.

Pate stated that government analysis showed no imminent stockouts and stressed plans for direct and emergency procurement.

He also suggested that Nigeria might source medical supplies from economically similar countries instead of relying heavily on external donors.

Reaffirming the government’s steadfast commitment, Pate urged caution against misinformation from global organisations that might misrepresent Nigeria’s healthcare landscape.As Nigeria marks World TB Day 2025, Yusuf’s story serves as a stark reminder that TB is not a disease of the past—it is a present day crisis.

Note, NTBLCP says Nigerians can access information and resources by calling the toll-free helpline at 3340 or by dialing *3340#.

What’s more, stakeholders say that the government needs to increase funding, expand diagnostic tools, strengthen awareness, integrate TB services into primary healthcare, encourage early testing and fight TB-related stigma. They say there is need to scale up TB programmes and push for policy change as well as ensuring that patients complete their treatment regimens.

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Stakeholders Applaud A360 Impact On Adolescent Health

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Stakeholders in Nigeria’s health and development sector say the institutionalisation and scale-up of the Adolescent 360 (A360) Amplify project have greatly improved adolescent sexual and reproductive health outcomes in participating states.

They made this known at a dissemination meeting on the project on Thursday in Abuja.

It was implemented by the Society for Family Health (SFH) and partners, and later adopted into government systems following documented successes.

Launched in 2020, the A360 project was designed to provide adolescent girls with access to sexual and reproductive health information, youth-friendly services and economic empowerment opportunities.

The programme was implemented in Kano, Jigawa, Kaduna and Nasarawa States using a human-centred design approach that engaged governments, communities and young people to improve uptake of family planning and maternal health services.

Dr Aisha Sadiq, Permanent Secretary, Kaduna State Ministry of Health, said institutionalising A360 had delivered measurable improvements in adolescent health indicators and community wellbeing.

She said Kaduna currently provides A360 youth-friendly services in 623 Primary Health Care (PHC) centres.

The Matasan Mata Arewa (MMA) initiative, she added, had reached 75 communities and empowered more than 15,000 girls with entrepreneurship skills and seed capital.

According to her, more than 60,000 girls have accessed contraceptives through the programme, with a reduction in discontinuation rates as more young women sustain use and transition to maternal and child health services.

“These changes have shown a marked reduction in maternal mortality among those communities. It has also reduced negative neonatal outcomes,” she said.

Sadiq recounted an elderly woman’s remarks from a programme community, calling them a strong reflection of the project’s success.

“These girls have spent their whole lives believing they will remain tolerable liabilities to the husbands they marry, but now they are realising the value of becoming appreciated assets,” she quoted.

Sadiq added that Kaduna’s 16 per cent health budget allocation and the integration of A360 activities into the state’s 2025 Annual Operational Plan demonstrated sustained political commitment.

Also speaking, Dr Omokhudu Idogho, Managing Director, SFH, said the four implementing states had successfully embedded A360 approaches into government systems, community structures and routine health practices.

He was represented by Dr Kenechukwu Erichalo, Deputy Managing Director, Project Delivery.

Idogho said the project had reached more than one million adolescent girls with family planning services and engaged over 500,000 others with comprehensive sexuality education messaging.

“We recorded more than 50,000 antenatal care visits, ensuring that girls received skilled care that saved lives, and supported over half a million girls to learn income-generating skills,” he said.

He said A360 pioneered the MMA and Niger Girls models, demonstrating that culturally sensitive, human-centred programmes can succeed even in conservative communities.

“Our most significant achievement is institutionalisation. Today, all 1,750 A360-supported facilities are fully government-led,” he added.

Mrs Roselyn Odeh, A360 Project Lead, said the initiative was developed in response to poor adolescent health indices in the country.

She said the programme ensured respectful, youth-friendly services at PHCs and supported school reintegration and entrepreneurship for girls.

She said the decision to scale the programme in northern states was based on data.

“When you look at maternal mortality among young people, you know the section of the country it is coming from. Data drove our decisions in alignment with government priorities,” she said.

Odeh identified challenges including weak PHC infrastructure, funding gaps, commodity shortages and the need to engage husbands in conservative communities.

“But creatively, we worked with governments to mobilise domestic funding through health revolving funds and the Basic Healthcare Provision Fund,” she said.

Mr Sagir Musa, Commissioner for Youth, Jigawa State, assured of continued commitment from implementing states to sustain and expand the project’s gains.

“This project may be nearing closure, but for us, it has just begun. We have gone beyond its life cycle to embed its approaches in the things we do,” he said.

The dissemination meeting brought together policymakers, community leaders, development partners and beneficiaries to review lessons learned and outline future priorities for scaling adolescent health interventions nationwide.

 (NAN)

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