Undernutrition, HIV, diabetes fuelling TB cases – Minister

The Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, on Tuesday said the primary drivers of Tuberculosis in Nigeria include undernutrition, HIV, diabetes mellitus, smoking, and alcohol use, with the working-age group aged 15-44 years being the most affected.

Pate said this at the ministerial press briefing to mark the World TB Day themed, “Yes! We Can End TB: Commit, Invest, Deliver” with the Slogan: “We fit do am.”

Pate, represented by the Director of Port Health Services, Dr Nse Akpan, stated that Nigeria is also among the ten countries with the triple burden of TB, drug-resistant TB, and HIV-associated TB.

He said about 71,000 Nigerians succumbed to TB in 2023, but only one in four Nigerians had accurate knowledge about TB, according to the Knowledge, Attitude, Practice Survey of 2017.

“The primary drivers of TB in Nigeria include undernutrition, HIV, diabetes mellitus, smoking, and alcohol use, with the working-age group (15-44 years) being the most affected,” he noted.

The minister emphasised that eradicating TB remains a top priority for the government.

He mentioned that the Federal Ministry of Health, with the support of partners, has implemented several TB control interventions, including expanding the rapid molecular testing platforms for TB and treatment centres.

He stated, “Aligned with our National Strategic Plan for TB (2021-2026), our active case-finding efforts targeting key and vulnerable populations, as well as clinic and hospital attendees, are delivering positive outcomes. Routine TB screening for outpatients is now conducted in all tertiary and many secondary health facilities, along with over 500 high-burden primary health centres, contributing approximately 10 per cent to our 2024 TB notifications.

“We are prioritising the use of mobile digital X-ray units equipped with artificial intelligence, operated by trained radiographers, to enhance TB screening among key and vulnerable populations. Currently, around 400 mobile digital X-ray platforms are deployed across all 36 states and the Federal Capital Territory.

“This technology has significantly improved the sensitivity of our TB screening tools, allowing us to detect more cases—including asymptomatic TB—that might have otherwise been missed.”

He also mentioned a successful $50m bond raised for TB control, with half of the funds coming from the private sector, adding that community engagement is central to the strategy, with efforts to reduce stigma and encourage participation.

He said the financial burden on TB patients remains a significant challenge, with 71 per cent incurring catastrophic costs while seeking care, posing a major threat to ending the TB epidemic in Nigeria.

To address this, he disclosed that the National Leprosy and Tuberculosis Control Programme and other partners launched the Nigeria One Impact Free Skill Acquisition Programme in Lagos State to provide women and individuals affected by TB with essential skills to enhance their economic stability and support their recovery.

He said participants also receive startup resources to help them launch their businesses.

The Senior Communications Manager at the Institute of Human Virology Nigeria, Ms. Uzoma Nwofor, also acknowledged that the spread and persistence of TB in Nigeria are deeply intertwined with socioeconomic determinants.

Nwofor said, “Poverty, malnutrition, overcrowding, and inadequate access to healthcare continue to fuel the epidemic. The National Bureau of Statistics Multidimensional Poverty Index (2022) reports that 63 per cent of Nigerians (133 million people) live in multidimensional poverty, with factors such as poor housing, lack of clean water, and malnutrition contributing significantly to the spread of TB.

“Malnutrition, which weakens the immune system, affects over 45 per cent of children under five, making them highly vulnerable to TB infection and progression to active disease. Additionally, urban slums and congested housing, particularly in major cities, create conditions conducive to TB transmission due to poor ventilation and close human contact.

“Limited healthcare access exacerbates the problem, with less than five per cent of Nigeria’s GDP allocated to healthcare, leaving critical funding gaps in TB control efforts. Out-of-pocket expenditures remain high, discouraging many from seeking timely diagnosis and treatment, despite TB services being free. These socioeconomic realities make it imperative to implement targeted interventions that address both the medical and structural drivers of TB.”

She said the institute has played a pivotal role in expanding TB case detection through private healthcare provider engagement, rapid diagnostics and community-based interventions.

Also speaking, the World Health Organisation Country Representative, Dr Walter Mulombo, emphasised the need for a dedicated, fully funded budget to sustain TB control efforts in Nigeria, especially in light of the suspension of USAID funding.

Mulombo, who was represented by Mya Ngon, Team Lead for Communicable and Non-Communicable Diseases at WHO, noted that increased domestic investment would ease the burden on affected communities and ensure the availability of essential commodities for managing TB patients and their contacts.

“As a global health organisation, WHO will continue to provide normative guidance, mobilise resources for the TB response, and strengthen the capacity of the health system and the community, working in close collaboration with all stakeholders to end the TB epidemic.

“We must sustain the efforts, and the gains achieved in these past years to stop the spread of the disease and end the TB epidemic by 2035,” he said.