Editorial
Confronting High TB Burden
Today, March 24, 2021, is observed as World Tuberculosis (TB) day by the United Nations, with the theme: The Clock Is Ticking. The day is commemorated every year since 1982 to raise awareness and educate the public about the impact of the deadly disease around the world. The UN designated the date in memory of Dr Robert Koch who announced his discovery of Mycobacterium tuberculosis, the organism that causes tuberculosis on March 24, 1882. At a time when TB killed one out of every seven persons in the United States and Europe, Dr Koch’s discovery became the most important step that opened the way towards diagnosing and curing this disease.
However, nearly 150 years after, TB has remained one of the world’s deadliest infectious killers, claiming nearly 4,000 lives and close to 28,000 people falling ill on a daily basis. The Mycobacterium tuberculosis, the TB bacteria, usually attack the lungs, and any other part of the body such as the kidney, spine, and brain, and though not everyone infected with TB bacteria becomes sick, if not properly treated, the disease can be fatal.
The TB bacteria are spread when a person with TB disease of the lungs or throat coughs, speaks or sings with nearby persons breathing in these bacteria and become infected. Symptoms of the disease in the lungs include a bad cough that lasts for three weeks or more; pain in the chest; coughing up blood or sputum; weakness or fatigue; weight loss; loss of appetite; chills; fever; sweating at night.
Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk with over 95% of cases and deaths occurring in developing countries. The risk of active TB is greater in persons suffering from other medical conditions that impair the immune system with people who are infected with HIV being 18 times more likely to develop active TB.
Worldwide, TB is one of the top 10 causes of death and the leading cause from single infectious agent. In 2019, an estimated 10 million people fell ill with tuberculosis, comprising 5.6 million men, 3.2 million women and 1.2 million children, while a total of 1.4 million people died from the disease (including 208,000 people living with HIV).
In same 2019, the 30 high TB burden countries accounted for 87% of new cases of the disease while eight countries including India, China, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa account for two thirds of the total burden.
Nigeria is the country with the highest TB burden in Africa and the 5th in the world with children, women of reproductive age and people living with HIV the hardest hit. Not less than 400,000 people contract TB while more than 150,000 lives are lost to the disease each year in the country. This is in addition to 63,000 people living with HIV that get it annually.
Tuberculosis incidence in Nigeria is said to have risen from 418,000 cases in 2017 to 429,000 cases in 2018, and deaths also rose from 155,000 to 157,000 within the same period while treatment coverage for the disease remained stagnant at 24%.
On the heels of the first global ministerial conference on TB hosted by the WHO and the Russian government in November, 2017, followed by the UN’s first ever high-level meeting on TB which elevated the discussion about the status of the TB epidemic and how to end it to the level of heads of state and government on September 26, 2018, leading to the political declaration agreed by all UN member-states, in which existing commitments to the Sustainable Development Goals (SDGs) and WHO’s End TB Strategy were reaffirmed and new ones added, on this year’s World TB Day, the global health body calls on everyone to keep the promise to:
Accelerate the End TB Response to reach the target set in Sustainable Development Goals, WHO End TB Strategy, the Moscow Declaration to: End TB and political declaration of the UN High-Level Meeting on TB; diagnose and treat 40 million people with TB by 2022, including 3.5 million children and 1.5 million people with drug-resistant TB; reach 30 million people with TB preventive treatment, including 24 million household contacts of TB patients – 4 million of whom are children under 5 – and 6 million people living with HIV; mobilise sufficient and sustainable financing to reach $13 billion a year to support efforts to end TB; invest in TB research to reach at least $2 billion a year for better science, better tools and better delivery.
As a member-state of the UN and particularly, as a country that is so heavily impacted, The Tide expects Nigeria to be committed to the vision and mission of the WHO in its effort to reverse the negative narrative of TB. To this end, we urge government at all levels in the country to muster the political will and strike right partnership with relevant stakeholders –and strengthen existing ones where necessary – to achieve the desired objective.
Government must also step up continuous sensitisation and advocacy to women and children, especially in the rural areas. Training and retraining of health workers to build and strengthen their capacity in order for them to be able to deliver quality services to the people must be taken seriously. In this regard, efforts must be made to ensure industrial harmony and stability in the primary health care sector in particular and the health sector in general. Continuous and sustainable community engagement and good data collection are as well pivotal to achieving desired results beyond clinical treatment.
It is not untrue that there are many misconceptions about TB. While some believe that tuberculosis is caused by smoking and drinking, others believe that it is caused by witchcraft or even that it is hereditary. The result of such erroneous beliefs is that people ignorantly seek solutions where there are none and compound the problem when they resort to traditional fetish and religious rituals instead of accessing the tested, proven and reliable medical treatment.
Unfortunately, there are yet people who neither are aware of nor believe that tuberculosis testing and treatment are free in public health facilities in Nigeria.
It is the goal of the UN to eliminate tuberculosis by year 2030 and if an estimated 60 million lives were saved through TB diagnosis and treatment between year 2000 and 2019, the target is not unachievable with the right attitude, commitment and action. A TB-free Nigeria is as well possible in record time even as The Clock Is Ticking for ending a preventable and curable deadly disease.
Last Friday, the National Agency for Food and Drug Administration and Control (NAFDAC) destroyed fake, counterfeit and substandard drugs worth over N1 trillion in Awka, the Anambra State capital. Recall that for one month, NAFDAC shut the Onitsha Drug Market, restricting shop owners from coming to the market, barricading it with military personnel, while officials broke into and ransacked shops in search of fake drugs.
NAFDAC’s Zonal Director for South-East, Dr. Martin Iluyomade, revealed some of the drugs destroyed to include Analgin, Tramadol, and various paediatric pharmaceuticals, which had been stored in prohibited areas or were banned by the World Health Organisation (WHO). Iluyomade said the closure and raids of the markets where the drugs were confiscated was in response to public complaints regarding the prevalence of fake, substandard and counterfeit drugs in the South-East.
He said: “Many of these drugs are banned, such as Analgin and certain paediatric medications, and they were stored in places that violate WHO regulations. It is our responsibility to ensure that these products are safe and fit for human consumption. These drugs were transported in a 140-foot truck, valued at over N1trillion, and were supposed to be stored at specific temperatures. However, they were kept in markets that do not meet the required standards.
“The volume of drugs found in these two markets could destabilise the country, and many of these are narcotic drugs associated with criminal activities. People who consume these drugs are not only harming themselves but also using them to commit crimes, which contributes to the growing insecurity in our country.”
Unfortunately, that is the chilling reality of counterfeit drugs, and it is a problem NAFDAC is relentlessly fighting. This dramatic action underscores the monumental scale of the problem and the unwavering commitment of NAFDAC to protect public health. The massive destruction highlights the pervasive nature of the counterfeit drug trade and the resources NAFDAC dedicates to combatting it.
Counterfeit drugs are dangerous, even deadly. They can contain the wrong dosage, the wrong active ingredients, or even harmful substances. Imagine taking a pill you believe will cure your illness, only to find it contains something entirely different – something that could worsen human condition or even kill. That is the terrifying reality of the counterfeit drug market.
The insidious world of counterfeit medications poses a grave threat, as these fake drugs often harbour toxic fillers or entirely different, untested chemicals. The consumption of such substances can trigger a cascade of adverse reactions, varying from minor allergic responses to catastrophic organ failure, leaving vulnerable individuals severely harmed. In this critical battle for public health, NAFDAC stands as our frontline defender.
Through tireless monitoring, rigorous inspections, and decisive action against those who peddle these dangerous fakes, NAFDAC acts as a vital gatekeeper, ensuring the safety and efficacy of the medications we depend on. Supporting NAFDAC’s mission is paramount, as it directly equates to safeguarding the lives and well-being of our Nigerians by preventing the proliferation of these harmful and potentially lethal counterfeit medications.
Given the breadth and criticality of NAFDAC’s mandate – regulating everything from food and drugs to cosmetics and medical devices – it is imperative that the Federal Government bolsters the agency’s resources and capabilities. This monumental task, encompassing the entire lifecycle of regulated products from importation to usage, demands substantial investment in infrastructure, advanced technological tools, and a highly skilled workforce.
Under-resourcing NAFDAC risks compromising its ability to effectively monitor and enforce regulations, potentially leading to substandard or counterfeit products entering the market, with devastating consequences for public health and safety. Therefore, increased funding, enhanced training programmes, and optimised operational systems are essential to fortify the agency’s effectiveness and ensure it can continue to protect the Nigerian populace.
No doubt, NAFDAC currently faces numerous hurdles in fulfilling its mandate. These challenges range from inadequate funding and outdated equipment to a lack of personnel and poor training. Insufficient funding directly translates to limited capacity for effective inspection, testing, and enforcement. Imagine trying to police a vast country with only a handful of officers – the task becomes virtually impossible. This lack of resources allows substandard and even dangerous products to enter the market, posing serious risks to public health.
The Federal Government must prioritise NAFDAC’s needs and take decisive action to support, equip, and empower this vital agency. NAFDAC is a cornerstone of public health in Nigeria and its health and economic well-being depend on its support. By providing financial, technological, and human resources, the government can strengthen the organisation’s capacity to protect Nigerians and contribute to national development. Tinubu’s administration must ensure that NAFDAC had the tools it needs to succeed. The lives of millions depend on it.
The Nigerian Meteorological Agency’s ominous forecast of severe flooding in nine states as the rainy season draws nearer serves as a reminder of the country’s vulnerability to environmental disasters. With coastal states like Lagos, Ogun, Delta, and Rivers particularly at risk, the immediate need for proactive mitigation measures cannot be overstated.
This warning demands swift and decisive action from state governments, including the activation of urgent environmental interventions and a concerted effort to encourage citizens residing in flood-prone areas to relocate preemptively. Nigeria’s history is unfortunately punctuated by the devastating impacts of floods, a recurring crisis often compounded by inadequate infrastructure, haphazard urban planning, and a frustratingly slow response to impending threats.
The devastating 2024 floods serve as a stark and traumatic reminder of the catastrophic consequences of neglecting proactive flood management. With over 300 lives lost and more than 1.2 million people impacted across 31 states, the scale of the disaster underscores the urgent need for decisive action.
The UN has allocated $5 million to Nigeria to enhance flood preparedness, aiming to strengthen early warning systems, support emergency response initiatives, and provide relief to vulnerable communities. However, the ultimate responsibility for implementing and maintaining effective flood management strategies lies with Nigerian authorities at all levels, requiring a shift from reactive responses to comprehensive preventative measures.
Nigerian governors should take urgent measures, such as alerting residents in flood-prone areas and removing illegal structures blocking waterways to offer a glimmer of hope. The pervasive complacency across some states remains deeply concerning. This reactive approach, waiting for disaster to strike before responding, has repeatedly resulted in devastating consequences and underscores a critical need for a paradigm shift in flood management plans.
Specifically, in states like Rivers which is surrounded by water, a multi-pronged approach is needed, including strengthening infrastructure, enhancing drainage systems, promoting community engagement, and implementing sustainable land-use planning, while also considering nature-based solutions and early warning systems.
The cyclical nature of flooding in the country is exacerbated by human activities. The dangerous practice of constructing buildings on natural waterways and the rampant issue of indiscriminate waste disposal into drainage systems directly contribute to the problem. These actions obstruct the natural flow of water, leading to overflows and ultimately, the widespread flooding that plagues the nation.
The government’s inaction regarding waste management and environmental upkeep is a significant contributor to the looming environmental crisis. The absence of efficient waste disposal systems, coupled with the lack of environmental projects and proper maintenance of vital drainages and waterways, breeds unsanitary conditions and ecological damage.
This negligence carries a high price, manifesting in public health risks, degraded ecosystems, and increased vulnerability to natural disasters. To reverse the trajectory, a comprehensive strategy is paramount. Importantly, regulatory bodies need to step up their enforcement efforts, ensuring strict adherence to environmental regulations and imposing meaningful penalties on those who violate them.
Such measures are vital not only to curb pollution and irresponsible practices but also to send a clear message that environmental accountability will be enforced. There is a pressing need for the government to overhaul waste management systems, ensuring efficient collection and disposal to prevent blockages in drainage channels.
To mitigate future disasters, National Emergency Management Agency (NEMA) and the National Orientation Agency (NOA) are urged to launch comprehensive awareness campaigns to educate the public about environmental degradation risks and promote personal responsibility in flood prevention. This will empower citizens to adopt sustainable practices, reduce flood risks, and protect vulnerable communities.
The September floodings in Borno State, resulting in the collapse of the Alau Dam, highlighted Nigeria’s vulnerability to disasters. To mitigate the impact, the government and citizens should work together to demolish structures obstructing natural waterways, dredge rivers and canals, and equip emergency response units to act swiftly in case of a flood.
Long-term strategies must focus on sustainable urban planning, the construction of dams, and continuous public education on environmental stewardship. Crucially, transparency and accountability of ecological funds are paramount to ensure that allocated resources effectively address the challenges at hand. Nigeria should draw valuable lessons from countries like Denmark and the United States, which have successfully implemented flood mitigation plans.
Increased awareness efforts have already resulted in a noticeable reduction in flood-related incidents in subsequent years, underscoring the efficacy of effective measures. State emergency agencies must collaborate, sharing resources and information to create a unified front against flooding. By embracing a culture of preparedness and environmental consciousness, Nigeria can safeguard its communities and build resilience against future natural disasters.
Governor Siminalayi Fubara has exemplified a proactive and resolute approach in steadfastly advancing the agenda of his administration, even in the wake of the Supreme Court’s ruling, which officially recognised Martins Amaewhule as the legitimate Speaker of the Rivers State House of Assembly. This unwavering commitment to governance and developmental progress underscores the Governor’s dedication to fulfilling his responsibilities to the people of Rivers State, regardless of the prevailing political and legal circumstances.
In meticulously orchestrating and initiating a broad spectrum of project inaugurations in multiple locations within Rivers State, Fubara articulates his resolute determination to honour the assurances given to Rivers people. His strategic focus on delivering tangible developmental projects not only highlights his determination to ensure the continued advancement of the state but also reinforces his vision of sustaining infrastructural growth, social welfare improvements, and economic empowerment.
This proactive stance can be viewed as a strategic move to showcase his administration’s competence and dedication to the public. Through the continuation of infrastructure endeavours and social initiatives, Governor Fubara aspires to reinforce public endorsement and effectively handle the complicated political situation resulting from the Supreme Court’s decision. The commissioning events serve as concrete evidence of the government’s initiatives and achievements, highlighting its commitment to progress.
The announcement of the projects generated widespread excitement throughout the state, with residents eagerly anticipating the institution of major infrastructure developments. The completion of these projects signifies an important milestone for the administration, demonstrating its dedication to fulfilling promises and investing in the state’s future. The Governor’s emphasis on the projects’ potential to drive economic growth, improve public services, and enhance overall quality of life, reflects his administration’s focus on delivering tangible benefits to the people.
The commissioning ceremonies are highly publicised events that attract considerable public attention and participation. This underscores the importance of the projects in enhancing the well-being and infrastructure of key areas in Rivers and Bayelsa States. The projects cover a wide range of sectors including housing, firefighting and emergency response, security, healthcare, education, and judiciary welfare, reflecting a comprehensive development approach essential for community progress.
The allocation of resources across various sectors demonstrates a deliberate strategy to address urgent needs and improve residents’ quality of life. In its efforts to foster safer communities, the government focuses on enhancing security and emergency response measures. Additionally, investments in healthcare and education underline a long-term commitment to human capital growth and well-being.
Among the projects scheduled for commissioning by the state government are the Government House Staff Quarters, the State Fire Service Headquarters with firefighting vehicles, the handover of a helicopter to the Nigerian Air Force, the Borikiri Fire Service Station, and the construction and furnishing of the palace and residence of the Akpor monarch. These projects address critical infrastructure needs and highlight the government’s dedication to enhancing public services and community welfare.
Other projects include the judges’ quarters, Bori General Hospital, Okrika Grammar School, as well as the furnishing, equipping, and electrification of the Nigerian Law School, Yenagoa Campus, and the Rumuodomaya Fire Service Station along with firefighting vehicles. Each of these projects plays a crucial role in improving the quality of life for residents and fostering development across key sectors in the region.
Governor Fubara’s actions speak volumes about his commitment to propelling Rivers State forward. The inauguration of diverse infrastructure projects is a tangible demonstration of his administration’s focus on progress and effective service delivery. This ardent approach extends beyond mere construction; it is a strategic investment in the future. Recall that in December last year, the Governor embarked on a schedule of projects commissioning and flag-offs to advance infrastructure and security across the state.
Through the prioritisation of key industries and allocating resources to essential sectors, the government is laying the groundwork for a more robust and prosperous Rivers State, offering its citizens enhanced opportunities and a higher quality of life. Through these initiatives, Governor Fubara is not just building roads and facilities; he is building trust, fulfilling his promises, and solidifying his leadership as a driver of sustainable development in the state.
The government is clearly committed to improving Rivers State. To say that Governor Fubara is rapidly transforming the state’s landscape with bold development initiatives is simply stating the obvious. In a short period, the Governor has turned the entire state into a vast construction site, with significant projects either underway or already completed — all in spite of the ongoing political challenges.
We join the good people of Rivers State, Nigerians, businesses, and individuals in commending and celebrating the Governor during this remarkable season of project commissioning and inauguration. The projects delivered so far reflect an extraordinary transformation, positioning the state as an attractive destination for investors. This progress stands as a testament to His Excellency’s commitment to leaving Rivers State far better than he found it.