Time to tame TB is now

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As Nigeria joins the rest of the World to mark this year’s World Tuberculosis Day (WTBD) scheduled for 24 March, the occasion presents a momentous opportunity for the Nigerian government to finally rise to the challenge of ridding the nation of this world’s deadliest infectious killer disease, in line with the 2019 World TB Day theme “IT’S TIME”.

Currently, the TB burden in the country is anything but encouraging. According to the 2017 Global TB report, Nigeria has a huge TB burden and is ranked 7th among the 30 high TB burdened countries in the world. Nigeria also has the second highest incidence rate in Africa and records about 432 TB-related deaths daily.

These worrisome statistics clearly present TB as a major public health challenge in Nigeria, with its attendant devastating health, social and economic consequences. Taming it therefore requires more than mere rhetoric and emergency palliative measures; it should be a major health intervention project.

While it is gratifying that the government is aware of the TB challenge as evidenced by the Health Minister, Prof. Isaac Adewole, pledging late last year that the federal government would increase allocation to TB control in the 2019 health budget, the real challenge over the years has been inability of government to walk the talk.

It is noteworthy that in the same address at the national summit on Public Private Mix (PPM) in which the health minister made the pledge of increased funding towards the fight against tuberculosis, he also disclosed that the health ministry had earlier established the National TB Control Programme. According to him, managers of the programme had developed a National TB Control Strategy 2015-2020 framework to address the country’s TB burden.

He however curiously added that the framework, which was in line with the World Health Organisation (WHO)’s End TB Strategy and had incorporated the most recent internationally recommended diagnostic and treatment strategies, was expected to help stamp out TB from Nigeria by 2030.

That the Nigerian government decided to shift the goalpost for TB eradication from 2020 to 2030 means that a lot more must be done to ensure national health programmes are properly implemented to ensure pre-determined timelines are kept to ensure that public health objectives are achieved.

The burning issues surrounding TB control in Nigeria are the challenges of multi-drug resistant TB, the HIV/AIDs pandemic, as well as the large number of undetected TB cases, which serve as a reservoir for the continuous transmission of the disease. Experts have said each case of undetected TB has the potential of infecting between 10 and 15 persons in a year.

There is an apparent need to scale up enlightenment campaign and educate Nigerians on this condition as a lot can be achieved in terms of prevention and control of TB when more people are aware of what to do when they have the disease or suspect someone close to them has it.

While we commend Global Fund which has committed about 246 billion dollars to TB control response in Nigeria since 2005, we also urge the Nigerian government to devise ways to work better with all stakeholders, especially the private sector, to drive TB out of the nation.

It must however be emphasised that while getting more out of collaborations with stakeholders is crucial for TB control, the government must take the lead in ensuring the control programmes are well-funded. This can be achieverd by making the necessary adequate budgetary provisions, as most of the challenges of TB control in this clime have to do with poor funding.

The time to take these important measures, as the 2019 World TB Day theme states, is now.