The 24th of March annually is set aside by the World Health Organisation (WHO) to strengthen the fight against tuberculosis (TB) globally. This year’s World TB day is tagged ‘Invest to End TB. Save Lives.’ The theme emphasises the urgency to invest in the fight to eradicate the disease as the outbreak of COVID-19 jeopardised advancements in the End TB campaign.
Tuberculosis remains a threat to lives globally. It is rated the 13th leading cause of death in the world and the second leading infectious killer after COVID-19 and above HIV/AIDS.
In 2020, about 6 of every ten persons infected with TB were male. An estimated 10 million people (5.6 million men, 3.3 million women, and 1.1 million children) will be confirmed TB positive in 2020. A total of 1.5 million people were lost to TB in the year.
TB, which is caused by the bacteria Mycobacterium tuberculosis and affects the lungs of its victim, is curable and preventable. As an airborne disease, it spreads through cough, sneeze, or spit. The disease affects all age groups.
Thirty countries are considered high burden TB countries as they accounted for 86% of the new cases in 2020.
Eight of these thirty countries accounted for two-thirds of the total cases. India topped these eight countries, followed by China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa.
The continuous investment in the fight has seen global cases fall by 2% between 2015 and 2020. However, it is expected that $13 billion will be needed in 2022 to combat the scourge effectively.
The cost of treatment remains out of reach of those infected as one in two TB-affected households spends over 20% of their household income on treatment.
The situation seems worse in low and middle-income countries. Funding in these countries is tight and falls short of what is required despite the region accounting for 98% of reported cases of TB globally.
TB Situation in Nigeria
Nigeria is rated the sixth country in the world with high cases of TB in 2020. The total number of new and relapsed TB cases in Nigeria increased from 135,638 in 2020 to 204,606 in 2021, a 50.85% increase.
Laboratory tests are used to confirm cases and a breakdown shows that 54% of them were discovered through rapid diagnostic procedures.
Cases in Nigeria are attributed to five high-risk factors in 2020. Topmost of these risk factors is undernourishment. This is followed by HIV, diabetes, smoking, and alcohol and disorder.
Treatment coverage is poor in the country as just about 30% of TB cases were treated in 2020. This is a fall from the treatment success recorded in 2019, as it recorded an 88% treatment success rate covering 117,150 cohorts.
Thus Nigeria is among the ten countries with the largest gap between notifications of new and relapse (incident) TB cases and the best estimates of TB incidence.
The fight against TB in the country is slow largely due to low funding. A total of $409.11 million was budgeted for TB in 2018. After that, the total budget dropped to $278.35 in 2019. It increased to $383.99 in 2020 and then fell again to $372.64 in 2021.
A breakdown shows that the funding comprises national government budget and international donor funding. Analysis of the budget shows that total funding was estimated insufficient to carry out due diligence concerning TB effectively.
For four years, there is a consistent funding gap of $312.49 million in 2018, $167.92 million in 2019, $267.88 million in 2020, and $255.53 million in 2021. This gap is probably due to the national target for TB being less ambitious than global targets.
Putting an end to the TB epidemic in Nigeria, will help reduce the burden globally especially because Nigeria is among the top 6 countries with the heaviest burdens. To achieve this will require adequate government funding and setting national targets that are measurable to global targets. Again, investment in TB eradication nudges Nigeria forward in the achievement of the Sustainable Development Goal 3 which includes eradicating TB by 2030.