Viral hepatitis remains one of the deadliest infectious diseases in the world, quietly claiming 1.3 million lives annually—second only to tuberculosis, according to the World Health Organisation (WHO). Yet, in countries like Nigeria, the disease continues to fly under the radar, especially in the country’s correctional facilities where conditions are ripe for transmission and healthcare services remain overstretched.
Nigeria’s National AIDS, STIs and Hepatitis Control Programme (NASCP) estimates that 8.1% of adults aged 15–64 live with hepatitis B, while 1.1% live with hepatitis C. Alarmingly, over 80% of infected individuals are unaware of their status. This silent epidemic thrives in settings where people live in close quarters, share personal items, and lack access to routine screening and treatment—particularly within prisons.
Behind Bars, Beyond Help
Malam Musa Danladi, 34, never imagined that a prison sentence would lead to a life-altering medical diagnosis. Sentenced in 2022, he was unexpectedly diagnosed with hepatitis B during a routine health check inside Kuje Medium Security Custodial Centre.
“They called me to the clinic one morning; I was confused. The nurse said I had hepatitis B. I didn’t even know what that meant,” Danladi recalled.
Like many inmates, Danladi had unknowingly shared razors, clippers, and toothbrushes—common vectors for hepatitis transmission. “Nobody told us we were at risk,” he said. Today, he lives with the disease but also with a new mission: raising awareness.
“Incarcerated people face a triple burden: poverty, stigma, and disease, with few resources or pathways to care,” he said.
A New National Drive: Project 365
In response to the growing crisis, Nigeria launched Project 365 in July—a year-long national campaign aimed at testing, treating, and vaccinating millions of Nigerians, including those behind bars. The campaign’s unveiling coincided with World Hepatitis Day, themed: “Hepatitis Can’t Wait – Test. Treat. Eliminate.”
Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, described the campaign as both a public health and economic imperative, noting that Nigeria loses between ₦10.3 trillion and ₦17.9 trillion annually to hepatitis-related productivity and healthcare costs.
“Project 365 is about saving lives and saving our economy,” Pate stated.
Key components of the campaign include:
- Screening all 360 federal constituencies
- Delivering curative treatment for hepatitis C
- Expanding vaccination for hepatitis B
- Establishing the Viral Elimination Fund (VEL) to ensure sustainable financing
- Scaling testing and treatment in prisons, IDP camps, and rural areas
- Supporting local production of diagnostics and medications
Taking Hepatitis Testing to the Prisons
At Kuje Correctional Centre, a pilot hepatitis programme screened 830 inmates between December 2024 and June 2025 under the Viral Hepatitis Action in Correctional Services initiative. Dr Ibrahim Ehizogie, a prison clinician, noted that many inmates were infected prior to incarceration, but the lack of early detection and treatment worsens outcomes.
The programme is now expanding to cover all six geopolitical zones, with a goal of reaching every one of Nigeria’s 300 custodial centres. Yet experts caution that this progress will stall without long-term investment, legislation, and public education.
Global Standards, Local Challenges
The 2024 INHSU Global Guideline on the Elimination of Hepatitis C in Prisons affirms that incarcerated people have the same right to healthcare as everyone else. The guideline recommends that testing and treatment for hepatitis begin within seven days of incarceration and stresses:
- Harm reduction services (e.g., safe injection tools, drug therapy)
- Peer-led education and outreach
- Continuity of care post-release
Dr Mya Ngon, WHO’s Team Lead for Communicable and Non-Communicable Diseases, praised Nigeria’s commitment but emphasised that efforts must link screening with sustained care.
“Treatment must be connected to continuity of care, even after prison,” Ngon said.
Life After Diagnosis: The Stigma Lingers
Since his release, Musa Danladi has become a local advocate for hepatitis awareness and reintegration. He speaks openly about his journey, urging others to get tested.
“I didn’t die in prison, so I want to use my voice,” he said. “You can treat it; you can live. But stigma remains. Some people say I brought prison sickness home; some won’t even shake my hand.”
Danladi now works in his community to promote health education, especially among ex-inmates and low-income residents, and is calling on the government to widen its outreach to these populations.
The Gaps Still Loom Large
Despite the momentum of Project 365, several systemic gaps persist:
- Women and pregnant inmates are frequently excluded from routine screening
- Youth offenders and first-time detainees often receive no preventive education
- Harm reduction services like sterile injection equipment are mostly unavailable
- Continuity of care after release is rarely guaranteed
- No national prison hepatitis registry exists to track data or treatment outcomes
Prof. Taiwo Lateef, a public health expert and Africa Lead for Lifeline International, stressed that without harm reduction and data-driven strategies, Nigeria’s hepatitis elimination plans could fall short.
Dr Adebola Bashorun, NASCP’s National Coordinator, echoed this sentiment, urging the government to embed legal protections, data systems, and community partnerships into the response framework.
A Call to Action
Dr Titilola Munkail of Africa CDC summed it up plainly: “You can’t talk about ending hepatitis while ignoring people behind bars. Prisons are not outside public health. They are central to it.”
As Nigeria pushes toward the WHO’s 2030 elimination target for hepatitis, experts say success will hinge on political will, intersectoral collaboration, and the moral imperative to treat every life—free or incarcerated—with dignity and care.
Hepatitis can’t wait. Neither should we.