A recent milestone was the commissioning of new molecular diagnostic machines, purchased with support from a ₦1 billion donation by the First Lady, Senator Oluremi Tinubu. These machines are expected to significantly improve rapid detection and treatment of TB, particularly in underserved and rural communities.
Nigeria’s Global TB Burden
Globally, Nigeria ranks sixth among high-burden TB countries, recording an estimated 452,000 new cases in 2020. The country’s TB prevalence rate stands at about 219 per 100,000 people, according to the Global Burden of Disease Study. While this is lower than South Africa’s 513 per 100,000, it is higher than India’s 188 per 100,000, underscoring the scale of the challenge in Africa’s most populous nation.
Nigeria also carries the highest TB burden on the continent, contributing 4.6 per cent of global cases. Endemic zones are widespread but particularly severe in Enugu North, where TB-HIV co-infections remain stubbornly high, and Kaduna State, where healthcare workers face notable risks of occupational TB. Rural communities—especially nomadic populations—are disproportionately affected due to malnutrition, overcrowding, and poor access to healthcare facilities.
A Historical Battle
Nigeria’s formal fight against TB dates back to the establishment of the National Tuberculosis and Leprosy Control Programme (NTBLCP) in 1989. The programme adopted the Directly Observed Treatment Short-course (DOTS) strategy, which became the global standard for TB care. Over the years, this approach, combined with donor support and domestic reforms, led to remarkable improvements.
Case notifications, for example, rose from 106,533 in 2018 to 361,000 in 2023—a 26 per cent increase from 2022. Innovative interventions such as house-to-house case searches and integration with COVID-19 surveillance helped sustain detection during the pandemic, despite initial setbacks.
Yet, the gaps remain. In Enugu State alone, a 14,000-case notification gap was reported recently. The mortality burden is also striking: TB accounted for a 39.96 per cent mortality rate in 2015, making it one of Nigeria’s deadliest infectious diseases.
Critical Steps Toward Eradication
Experts argue that Nigeria’s pathway to TB eradication by 2030 hinges on three urgent priorities:
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Expand diagnostic capacity – Scale up funding to strengthen laboratory networks and increase access to GeneXpert machines, which detect TB early and accurately.
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Address social determinants – Improve health insurance coverage, reduce malnutrition, and expand outreach in rural and underserved communities. Malnutrition in particular fuels susceptibility to TB, especially among children.
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Adopt gender-sensitive interventions – Focus on men, who represent 57 per cent of TB cases, while also addressing barriers that prevent women and vulnerable groups from seeking timely care.
Political Will and Partnerships
Professor Pate has stressed that the integration of TB services into primary healthcare systems is key to improving access to diagnostics, drugs, and skilled personnel. This approach is part of Nigeria’s broader health sector renewal programme, which emphasises governance, population health outcomes, healthcare value-chain development, and health security.
He has also called for stronger multi-stakeholder collaboration—from local communities and civil society to international partners like the Global Fund and WHO—to close the remaining gaps in detection and treatment.
Looking Ahead
For Nigeria, the battle against TB is both a health and a development issue. By tackling the disease, the country not only reduces preventable deaths but also strengthens its overall health system.
If sustained political will, increased funding, and community-driven strategies are maintained, experts believe that Nigeria could achieve its goal of being TB-free by 2030—transforming a once-persistent scourge into a story of national resilience and recovery.