Funding gaps, limited facilities threaten Nigeria’s TB progress – Health Minister

The Coordinating Minister of Health and Social Welfare, Muhammad Pate has warned that funding gaps and limited healthcare facilities pose significant threats to Nigeria’s progress in Tuberculosis (TB) control.

Mr Pate, a professor, disclosed this on Tuesday during the ministerial press briefing to mark the 2025 World TB Day in Abuja.

World TB Day is commemorated on 24 March annually to raise awareness of TB and to mobilise efforts, including political commitment to resources and healthcare financing towards TB elimination.

This year’s theme is “Yes! We can end TB: Commit, Invest, and Deliver.”

Represented by the Director of Port Health Services at the ministry, Nse Akpan, the minister noted that while Nigeria has made notable advancements in TB diagnosis and treatment, critical gaps remain in the country’s TB response.

He said that funding challenges have been exacerbated by the recent withdrawal of USAID funding, which previously supported nearly 50 per cent of TB case detection efforts in Nigeria.

He also highlighted limited health facility coverage as a major challenge, noting that only 56 per cent of healthcare facilities provided Directly Observed Treatment, Short-course (DOTS) services in 2023—approximately 23,000 out of 40,562 facilities nationwide.

Mr Pate, however, said there are coordinated efforts by the government through the Sector Wide Approach to address the funding gaps.

“To address limited health facility coverage, we are currently expanding diagnostic and treatment services through public and private healthcare facilities. Furthermore, we also leverage on other programmes to deliver TB services,” he said.

Tuberculosis, an infectious disease

TB, an airborne disease caused by a bacterium (mycobacterium tuberculosis), mostly affects the lungs. It is the second deadliest infectious killer disease (after COVID-19) and among the top 10 causes of death worldwide.

Globally, and according to the 2024 WHO global TB report, an estimated 10.8 million people developed TB in 2023, with 1.6 million people losing their lives and 12 per cent of the global burden affecting the most vulnerable – the children and young adolescents.

TB remains a leading cause of death in Nigeria, with the country ranking sixth globally and first in Africa.

Mr Pate said 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 reiterated that eradicating TB remains a top priority for the present administration government.

He explained that the government has significantly expanded rapid molecular testing platforms for TB to advance its Universal Health Coverage (UHC) agenda.

“The number of GeneXpert machines has grown from 32 in 2012 to 513 in 2024, while Truenat machines increased from 39 in 2022 to 372 in 2024, and TB LAMP equipment from 52 in 2022 to 275 in 2024,” he said.

Other challenges

Mr Pate also pointed to gaps in childhood TB detection, revealing that only 63 per cent of the estimated 59,000 childhood TB cases in 2024 were officially recorded.

Additionally, he raised concerns over low enrollment in Drug-Resistant TB (DR-TB) treatment, with just 3,500 cases treated out of an estimated 9,400 in 2024, representing a 37 per cent treatment coverage.

To address this, the minister said “We are deploying many innovations including the integration of childhood TB screening and treatment into Reproductive, Maternal, Newborn, Child, and Adolescent Health plus Nutrition (RMNCAH+N) programmes.”

He also said there is an ongoing DR-TB survey to determine its actual burden in the country.

“Moreover, we are improving access to DR-TB services through the engagement and capacitation of the LGA and community levels, thereby ensuring more patients receive timely care.”

Mr Pate noted that the financial burden on TB patients remains a significant challenge, with 71 per cent incurring catastrophic costs while seeking care.

He said this poses a major threat to ending the TB epidemic in Nigeria.

“Many patients face severe financial strain, often losing their jobs or sources of income, discouraging them from accessing treatment,” he said.

Speaking at the event, WHO Country Representative, 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.

Mr Mulombo, who was represented by Mya Ngon, Team Lead for Communicable & 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.

He added that too many people are pushed into poverty when they contract TB due to lost income, transportation costs, and other expenses.

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According to him, 71 per cent of TB patients in Nigeria and their households experience catastrophic costs related to the disease, further deepening economic hardship.

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

“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.”