Tackling a Silent Epidemic
In northern Nigeria’s Nasarawa State, a sweeping five-year plan to eliminate viral hepatitis has shown promising results—particularly among people living with HIV (PLHIV). The initiative, launched in 2020, has not only reduced hepatitis B and C prevalence but also boosted routine immunisation and awareness efforts across underserved communities.
Viral hepatitis, dubbed a “silent killer,” claims 1.3 million lives globally each year. Nigeria alone carries a significant portion of this burden, with 8.1% of adults living with hepatitis B and 1.1% with hepatitis C. In Nasarawa, a proactive strategy aligned with WHO goals is helping to change that narrative.
Hope Rekindled Through Diagnosis and Treatment
For Rafatu Abdullahi, a middle-aged woman from Doma, life with HIV had become a grim routine of unanswered questions. Despite diligently taking her antiretroviral drugs, her viral load remained high—until a screening under the hepatitis elimination programme revealed a co-infection with hepatitis C.
Once treated for hepatitis C, Rafatu saw a dramatic turnaround: “After some months, I started seeing much improvement in the HIV treatment. My viral load has been going down steadily.”
Her story reflects a crucial intersection between hepatitis and HIV care—one that the Nasarawa programme is addressing head-on.
Reaching the Most Vulnerable
The hepatitis elimination plan, developed in partnership with the African Union and the Egyptian government, set out to treat 124,000 people over five years. So far, the state has made significant headway.
Dr. Akpan Nseabasi, the programme’s lead officer, said that over 16,000 PLHIV have achieved what he termed “micro-elimination” through screening, diagnostics, and access to treatment. Starting with six of the 12 target general hospitals due to funding constraints, the programme is scaling up across the state.
In tandem, village outreach efforts have screened more than 20,000 people and administered hepatitis B vaccinations, with the programme’s scope now extended to 2029 to reach more communities.
Community Impact and Lingering Challenges
While the initiative has brought relief to many, the benefits have not been evenly sustained. Salamatu Musa, a hepatitis B patient from Shabu, received free medication for two months before supplies ran dry. She now struggles to afford the treatment on her own, taking breaks when funds are scarce.
“Since then, I have been treating it out of my pocket,” she said. “I buy the prescribed drugs and go for check-ups periodically.”
Despite such setbacks, local leaders like Abdulkadir Abeh, head of Shabu’s ward development committee, are grateful. “Hepatitis is a silent killer, and people have been dying here. We see the programme as a messiah,” he said, recounting how he was cured of hepatitis C through the initiative.
Preventing the Next Wave
Experts stress that prevention remains the most sustainable solution. Professor Mustapha Shettima of Ahmadu Bello University warns that while hepatitis C has no vaccine, hepatitis B can be prevented through timely immunisation and safe practices.
“Blood should be properly screened before transfusion. People should avoid sharing sharp objects or engaging in unprotected sex,” he said, urging the government to boost vaccination access and public education.
Overcoming Geographic Barriers
One of the programme’s significant hurdles has been accessing people in remote, network-poor areas. Health workers often relied on community outreach and stipends for transportation to bring patients in for screening and care.
At Doma General Hospital alone, 280 PLHIV were screened, and 37 were found to be co-infected with hepatitis C—all of whom were successfully treated, according to laboratory head Donald Agondo.
Meanwhile, pregnant women are now routinely screened for hepatitis B, and their families are brought in for testing and vaccination—ensuring broader protection within households.
A Boost for Immunisation
Beyond hepatitis, the programme has indirectly improved childhood immunisation rates. Dr. Damila Adi, permanent secretary at the state Ministry of Health, noted that pentavalent vaccine coverage rose from 31% to 73% as a result of increased hepatitis awareness.
Clinicians like Salisu Habu at Shabu PHC confirmed a surge in participation: “People from neighbouring communities and states thronged to Shabu for screening. Mothers are bringing their children for vaccination as and when due.”
The Road Ahead
While Nasarawa’s hepatitis elimination initiative has made commendable strides, its future success hinges on sustained funding, drug availability, and expanded coverage. For communities that have already tasted its impact, the hope is that this momentum is not only preserved but scaled up—until hepatitis is no longer a quiet killer in the shadows.