Global health organisations warned last week that the coronavirus (COVID-19) pandemic having seized the world’s attention since the last five months has diverted attention and resources from other pressing health issues which could lead to a second tragedy of mass deaths from other diseases. The World Health Organisation (WHO) reminded nations to maintain continuity of essential services – prevention, diagnosis, treatment and care for long-standing health problems and to continue to protect the lives of people with tuberculosis (TB) and other diseases and health conditions during the COVID-19 pandemic.
The Stop TB Partnership last week also released the results of its latest study with the Imperial College which demonstrates the impact of COVID-19 on tuberculosis, the world’s leading infectious killer disease. The new study was in collaboration with Avenir Health, Johns Hopkins University, with the support of the United States Aid for International Development (USAID). The study found that 1.4 million TB patient may die by 2025 as a result of the COVID-19 response from “lockdowns, limitations on diagnosis, treatment and preventative services.” It shows, therefore, the consequent increase in TB cases. Its analysis shows that under a three-month lockdown and a protracted 10 month restoration of services, the world would see an additional 6.3 million cases of TB between 2020 and 2025.
Indeed, Nigerian doctors have testified that since the coronavirus came to town and sucked all the energy out of our healthcare system, Nigerians have largely stayed away from hospitals and clinics, even for regular services like immunisations and check-ups. Dr. Akyala Ishaku said on Friday that consultation has dropped to about 50 per cent. In addition to their natural inclination to avoid coronavirus infection, it would also appear that some Nigerians think there is a stigma attached to COVID-19 infection or they are simply scared of going into 14-day quarantine. Whichever it is, the global health authorities are warning about the grave risks of ignoring endemic diseases like tuberculosis, malaria, HIV/AIDS each of which would fester and kill many more Nigerians if left unchecked.
The Global TB Report 2019 records that in 2018, 1.5 million people died of tuberculosis and among those 1.5 million were 251,000 who also had HIV. In 2018, a total of 10 million people were stricken with TB, 5.7 million were men, 3.2 million were women, and 1.1 million were children. The 2018 report has Nigeria on the list of eight countries which account for 87 per cent of the world’s new TB cases, including India, China, Indonesia, the Philippines, Pakistan and Bangladesh and South Africa. And this is a disease that had been eradicated more than a decade ago in many parts of the world,
Nigeria’s poor treatment of tuberculosis is sometimes difficult to understand. The WHO records Nigeria as having 429,000 carriers of the disease, which is curable and preventable. But we found that Nigeria’s TB budget for 2019 was $278 million. Only eight per cent of that budget was funded. International donors, charities, others brought in 32 per cent of that budget. The rest, the 60 per cent of that budget, went unfunded. This little bit of information becomes significant when it is remembered that the eradication of tuberculosis by 2030 is listed among the health targets of the UN Sustainable Development Goals, which Nigerian has sworn to attain.
The similarities of the symptoms of COVID-19 and TB are sometimes so uncanny. The pathogen that causes TB is air borne, transmitted from person to person in households and social space. People with TB spread it when they breathe. Only half of those with TB display symptoms allowing the deadly disease to spread undetected. The most vulnerable people are those with underlying conditions and people living in poverty. Thus, when we are fighting the COVID-19 pandemic, we must bear in mind at all times the warnings by health authorities, knowing that although the virus seems to have overwhelmed the world and drowned out all things, including diseases as deadly as the virus, the cost will be too high to pay.
We need to fund our healthcare system adequately. We need to invest in our people and the infrastructure they need to deliver health services. The pandemic is clearly a wakeup call, and we urge the Federal Ministry of Health to set in motion a programme of action to eradicate TB from Nigeria on or before 2030.