Medical experts specializing in respiratory conditions have expressed mixed reactions to the Federal Government’s efforts and commitment to ending tuberculosis (TB) in Nigeria. In separate interviews with HealthWise, pulmonologists disagreed on the government’s strategy for eradicating TB. While one expert praised the FG’s Stop TB programme, others questioned the sincerity of its implementation. The interviews were conducted in commemoration of World Tuberculosis Day 2023, themed “End TB!”. This WHO‑designated day, observed annually on March 24, aims to raise public awareness of the global TB epidemic and efforts to eliminate the disease.
According to a WHO statement released in 2022, TB caused 1.6 million deaths in 2021, including 187 000 among people living with HIV. Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID‑19, surpassing HIV/AIDS. In 2021, an estimated 10.6 million people fell ill with TB—six million men, 3.4 million women and 1.2 million children. The disease is present in all countries and age groups, yet it is both preventable and treatable. Nigeria, with its large population, bears the highest TB burden in Africa.
Consultant Pulmonologist Dr. Olusola Adeyelu of the Federal Medical Centre, Abeokuta, and Senior Lecturer/Honorary Consultant Physician‑Pulmonologist Dr. Alexander Akor of the University of Abuja Teaching Hospital offered contrasting views on whether the FG is doing enough to combat TB. Dr. Adeyelu alleged that, from the outset, the government has not invested any funds in TB eradication. He likened the situation to other high‑profile projects such as the second Niger Bridge and the national airline, suggesting that TB control funding is “destroying the lives of our people by hundreds of thousands.” He emphasized that different TB variants have varying transmission potentials, and that inadequate financing hampers effective control.
Dr. Adeyelu further claimed that Nigeria relies heavily on free drugs from Western partners because the government does not provide counterpart funding. He argued that this dependence has led to shortened treatment courses—from the previous nine‑to‑twelve months to just six months—compromising patient outcomes, especially for extrapulmonary forms such as bone or spinal TB. He criticized the national treatment algorithm for applying a uniform drug dose regardless of patient weight, highlighting systemic funding and dosing issues. “If anyone says they are funding TB, let them show us the counterpart funding,” he said, adding that Nigeria’s progress depends largely on foreign generosity.
Regarding solutions, Dr. Adeyelu stressed that proper funding of TB control is essential. He called for increased government investment, the training of more pulmonologists and specialized respiratory nurses, and the professionalization of community health workers rather than using them as a catch‑all nursing cadre. He also urged the government to support local manufacturing of TB drugs, which would reduce reliance on imports and counterfeit medicines. “We must manufacture our drugs, and before we can do that we must conduct research to identify the TB variants present here,” he explained.
In contrast, Dr. Akor praised the FG’s efforts, noting that the government has taken steps toward ending TB but still has room for improvement. He referenced the 2020 multi‑sectoral “Stemming the Tide of TB” initiative, acknowledging its contribution while emphasizing the need for stronger contact tracing and early treatment initiation. “Identifying at‑risk individuals and starting therapy promptly prevents patients from shedding bacteria into the community,” he said.
Dr. Akor highlighted additional challenges, such as insecurity that hampers outreach in certain regions and delays in diagnostic turnaround times. While mobile vans and bikes can collect samples from remote areas, the lack of timely analysis limits effectiveness. He advocated for deploying more rapid diagnostic machines and training personnel to improve turnaround. Moreover, he called for enhanced advocacy and government commitment to expand contact tracing, case identification, and community education.
He stressed that TB control must be a multi‑sectoral effort, with health experts using all media platforms to educate the public. Religious institutions—churches and mosques—could play a significant role, and messages should be translated into local dialects to increase reach. “The media has done a lot of good work, but scaling up interventions and tailoring communication will help,” Dr. Akor concluded.
A study by the Liverpool School of Tropical Medicine found that TB has caused more deaths in the past 200 years than any other infectious disease, yet it receives only one‑sixth of the funding allocated to HIV research. In 2013, an estimated 9.0 million people developed TB and 1.5 million died, including 360 000 HIV‑positive individuals. Another study reported that researchers have developed new technology for early TB detection, offering hope for improved diagnostic capabilities.
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