According to WHO, Tuberculosis is the world’s most infectious deadly killer with about 4500 lives lost per day. Nigeria currently ranks 7th in the world and 2nd in Africa among the 30 countries with the highest burden of TB, TB/HIV, multi-drug resistant TB. TB has remained a major challenge despite the efforts of stakeholders to fight the disease. Although Significant progress has been made, what is needed to win the war against this curable disease remains huge. The emergence of multidrug-resistant TB (MDR TB), the high prevalence of TB among people living with HIV, which complicates these efforts, and the difficulty in finding and treating TB patients, complicates these efforts.
WHO reports that about 2 million people die from TB yearly and 10.4 million new cases of TB were reported in 2016, with seven countries accounting for 64% of the burden comprising of India, Indonesia, China, Philippines, Pakistan, Nigeria and South Africa.
Many of these people affected by TB are poor and disadvantaged people (about 152m Nigerians living below poverty line) who live in impoverished communities with remote access to healthcare and because TB infected persons also experience stigma and discrimination, many TB cases go untreated.
The Africa Center for Health Leadership supports national efforts to address this national challenge in line with NTBLCP to “save Nigerian lives, reach zero TB deaths and reduce the burden and impact of TB, drug-resistant TB and TB/HIV in Nigeria.” NTBLCP has set a goal to achieve a 50% reduction in the TB prevalence rate and a 75% reduction in TB mortality (excluding HIV-related TB) rate in Nigeria, compared to 2013 figures, by 2025. Through its 2015-2020 National Strategic Plan, NTBLCP has established 11 key objectives, including increasing case detection from 57.3/100,000 population (2013) to 287/100,000 population by 2020. In addition, it aims to scale up diagnostic capacity, develop new strategies to improve services for childhood TB, provide access to integrated services for all people co-infected with TB and HIV, and increase access to drug-resistant tuberculosis (DR-TB) diagnostics. Populations particularly vulnerable to TB in Nigeria include contacts of active TB cases, children, people living with HIV and AIDS (PLHIV), nomadic populations, migrants and internally displaced people, prisoners and slum dwellers. To improve case detection, NTBLCP seeks to actively target services for these populations and to engage patent medicine vendors (PMVs), community pharmacists (CPs), traditional healers, and religious leaders, who are often the first point of contact for people with TB symptoms, in TB control initiatives. The programme also seeks to expand the engagement of FBO and PFP health facilities in providing TB services.
Previously, ACHL collaborated through an MOU with Health Alive Foundation to implement the Global Fund Round Multi-drug Resistance Tuberculosis Program in the FCT, – supported the treatment, care and support of TB patients in the FCT and also implements a community TB prevention program in the area councils. It built the capacity of treatment supporters through the program and successfully concluded the treatment and rehabilitation of a number of patients. It organized treatment supporters’ meetings, community sensitization events and implement other collaborative activities with the area councils.
In summary, the main area of work for ACHL is to find the missing cases of TB, put them on treatment, support adherence through follow up, community education, and support of patients, building the capacity of treatment supports and health workers including empowering community members with relevant skills and knowledge in prevention including contact tracing.