Nigeria is ramping up its battle against tuberculosis (TB), a long-standing public health menace. Spearheading these efforts is Professor Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, who aligns the campaign with President Bola Tinubu‘s Renewed Hope Agenda. This article explores Nigeria’s TB prevalence within the global landscape, highlights endemic hotspots, reviews historical control measures, and outlines essential strategies to eliminate the disease.
Professor Pate has reiterated Nigeria’s dedication to eradicating TB by 2030, consistent with the United Nations’ Sustainable Development Goals (SDGs). A significant milestone in this fight was the deployment of advanced molecular diagnostic equipment, funded by a generous N1 billion contribution from First Lady Senator Oluremi Tinubu. These cutting-edge machines facilitate swift and precise TB diagnosis, especially in underserved communities.
Efforts to embed TB services within primary healthcare frameworks aim to enhance the availability of diagnostics, medications, and trained personnel, ensuring equitable treatment access. The broader health sector revitalization initiative targets improvements in governance, population health metrics, healthcare supply chains, and health security-factors crucial to tackling TB’s root causes such as poverty and inadequate healthcare infrastructure. Globally, Nigeria ranks sixth among countries with the highest TB burden, reporting approximately 452,000 new cases in 2020 and a prevalence rate near 219 per 100,000 people in 2016, according to the Global Burden of Disease Study. When compared to India’s 188 per 100,000 and South Africa’s 513 per 100,000, Nigeria’s figures are moderate but remain a significant public health concern given its large population.
Within Africa, Nigeria shoulders the greatest TB load, accounting for 4.6% of global cases. High-risk areas include Enugu North, where TB and HIV co-infections are prevalent, and Kaduna State, which reports notable occupational TB among healthcare workers. Rural regions, particularly those inhabited by nomadic groups, face heightened vulnerability due to factors like malnutrition, overcrowding, and limited healthcare access.
Nigeria’s TB control journey has seen considerable progress since the establishment of the National Tuberculosis and Leprosy Control Programme (NTBLCP) in 1989. The adoption of the Directly Observed Treatment Short-course (DOTS) strategy has led to a substantial increase in case detection-from 106,533 notifications in 2018 to 361,000 in 2023, marking a 26% rise compared to the previous year.
Although the COVID-19 pandemic disrupted health services, innovative approaches such as door-to-door case finding and integrating TB screening with COVID-19 responses helped sustain notification rates. Nonetheless, challenges persist, exemplified by a 14,000-case detection shortfall in Enugu and a TB mortality rate of nearly 40% recorded in 2015, highlighting ongoing gaps in diagnosis and treatment.
To achieve complete TB elimination, Nigeria must focus on three critical priorities. First, boost investment to enhance laboratory infrastructure and broaden access to GeneXpert technology for early and accurate diagnosis. Second, address social determinants by expanding health insurance coverage in rural communities and combating malnutrition, especially among children. Third, adopt gender-responsive strategies, with particular attention to men, who represent 57% of TB cases.
With unwavering political commitment, coordinated stakeholder engagement, and these focused interventions, Nigeria is poised to become free of tuberculosis by 2030.