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.
The delay in implementing President Bola Tinubu’s directive for zero customs duty and value added tax on food imports is unacceptable and highlights a concerning lack of urgency within the Federal Ministry of Finance and the Nigerian Customs Service. Over two months after the announcement, the policy remains stalled, despite the President’s clear intention for immediate enforcement. This prolonged delay, especially given the policy’s temporary nature (July – December), is inexplicable and detrimental to a hoi polloi already grappling with a severe economic crisis.
While the Comptroller-General of Customs attributes the delay to the Ministry of Finance finalising details, this explanation is insufficient. The dire need for food relief demands swift action, especially in the face of soaring fuel prices, rampant inflation, and skyrocketing food costs. The President’s promise of subsidised rice at N40,000 per 50kg bag remains elusive as well, pushing many Nigerians further into hardship. Accusations of deliberate slowdowns motivated by the government’s revenue goals are alarming and warrant serious investigation.
A circular from the Presidency has clarified the approved food items eligible for duty exemption, specifically maize, millet, rice, wheat, husked brown rice, grain sorghum, and beans. This strategic move aims to alleviate the financial burden on consumers and enhance food security. Previously subjected to import duties between five and 30 per cent, these commodities will now be more accessible, potentially stabilising prices in the local market.
It seems the execution of the policy is encountering obstacles due to bureaucratic processes. If the government fails to address this crisis with comprehensive and effective measures, the consequences could be catastrophic. The simmering discontent amongst Nigerians could easily boil over into widespread protests and social unrest, further destabilising an already fragile nation. Ignoring the cries of its citizens and the looming threat of social upheaval would be a grave mistake with potentially devastating ramifications.
Public officials insulated by privilege and detached from the everyday struggles of the people, have fostered a dangerous disconnect. For too long, they have failed to truly understand the harsh realities faced by the majority of Nigerians, the daily grind of poverty, the constant battle for survival, and the crushing weight of economic hardship. However, the current multifaceted crisis, with its clear manifestation of suffering, should serve as a jarring wake-up call, even to the most arrogant and out-of-touch.
The government’s ill-conceived and draconian policies, implemented without adequate consideration for the people, have created an intolerable situation that can no longer be swept under the rug or dismissed with platitudes. The widespread suffering is a stark indictment of their negligence, demanding a fundamental shift in perspective and a renewed commitment to the welfare of the Nigerian people.
The recent #EndBadGovernance protests serve as an obvious reminder that disregarding the plight of the people is a dangerous gamble. When basic needs like food and security are unmet, and the cries for change are silenced, the simmering discontent inevitably boils over. Escalating hunger and desperation create a fertile ground for unrest, a truth tragically illustrated by the protests. If the government continues to turn a blind eye to the suffering of its citizens, more widespread and possibly violent demonstrations are not only likely, but inevitable.
Furthermore, attempting to quell dissent through intimidation and persecution of protesters is a recipe for disaster, as it only serves to further inflame tensions and breed resentment. The path to stability lies not in suppression, but in genuine engagement with the concerns of the people and a commitment to addressing the root causes of their suffering.
The Federal Ministry of Finance, led by Olawale Edun, has a crucial role to play in improving the image of this government. Minister Edun and Customs Comptroller-General, Wale Adeniyi, must prioritise the fight against hunger by expediting the zero duty policy. This policy will allow the importation of food at a reduced cost and ease the burden on struggling families.
Officials must accord precedence to the well-being of citizens over bureaucratic processes. The current economic hardship is undeniable, and the callous indifference displayed by those in power, who seem shielded from the harsh realities ordinary Nigerians face, is deeply troubling. The government must act decisively to expedite this critical policy and provide the much-needed relief to a population struggling with hunger, poverty, and misery. Continued delay is a betrayal of Tinubu’s promise and a grim reminder of the disconnect between those in power and the suffering Nigerians.
The delay in implementing President Bola Tinubu’s directive for zero customs duty and value added tax on food imports is unacceptable and highlights a concerning lack of urgency within the Federal Ministry of Finance and the Nigerian Customs Service. Over two months after the announcement, the policy remains stalled, despite the President’s clear intention for immediate enforcement. This prolonged delay, especially given the policy’s temporary nature (July – December), is inexplicable and detrimental to a hoi polloi already grappling with a severe economic crisis.
While the Comptroller-General of Customs attributes the delay to the Ministry of Finance finalising details, this explanation is insufficient. The dire need for food relief demands swift action, especially in the face of soaring fuel prices, rampant inflation, and skyrocketing food costs. The President’s promise of subsidised rice at N40,000 per 50kg bag remains elusive as well, pushing many Nigerians further into hardship. Accusations of deliberate slowdowns motivated by the government’s revenue goals are alarming and warrant serious investigation.
A circular from the Presidency has clarified the approved food items eligible for duty exemption, specifically maize, millet, rice, wheat, husked brown rice, grain sorghum, and beans. This strategic move aims to alleviate the financial burden on consumers and enhance food security. Previously subjected to import duties between five and 30 per cent, these commodities will now be more accessible, potentially stabilising prices in the local market.
It seems the execution of the policy is encountering obstacles due to bureaucratic processes. If the government fails to address this crisis with comprehensive and effective measures, the consequences could be catastrophic. The simmering discontent amongst Nigerians could easily boil over into widespread protests and social unrest, further destabilising an already fragile nation. Ignoring the cries of its citizens and the looming threat of social upheaval would be a grave mistake with potentially devastating ramifications.
Public officials insulated by privilege and detached from the everyday struggles of the people, have fostered a dangerous disconnect. For too long, they have failed to truly understand the harsh realities faced by the majority of Nigerians, the daily grind of poverty, the constant battle for survival, and the crushing weight of economic hardship. However, the current multifaceted crisis, with its clear manifestation of suffering, should serve as a jarring wake-up call, even to the most arrogant and out-of-touch.
The government’s ill-conceived and draconian policies, implemented without adequate consideration for the people, have created an intolerable situation that can no longer be swept under the rug or dismissed with platitudes. The widespread suffering is a stark indictment of their negligence, demanding a fundamental shift in perspective and a renewed commitment to the welfare of the Nigerian people.
The recent #EndBadGovernance protests serve as an obvious reminder that disregarding the plight of the people is a dangerous gamble. When basic needs like food and security are unmet, and the cries for change are silenced, the simmering discontent inevitably boils over. Escalating hunger and desperation create a fertile ground for unrest, a truth tragically illustrated by the protests. If the government continues to turn a blind eye to the suffering of its citizens, more widespread and possibly violent demonstrations are not only likely, but inevitable.
Furthermore, attempting to quell dissent through intimidation and persecution of protesters is a recipe for disaster, as it only serves to further inflame tensions and breed resentment. The path to stability lies not in suppression, but in genuine engagement with the concerns of the people and a commitment to addressing the root causes of their suffering.
The Federal Ministry of Finance, led by Olawale Edun, has a crucial role to play in improving the image of this government. Minister Edun and Customs Comptroller-General, Wale Adeniyi, must prioritise the fight against hunger by expediting the zero duty policy. This policy will allow the importation of food at a reduced cost and ease the burden on struggling families.
Officials must accord precedence to the well-being of citizens over bureaucratic processes. The current economic hardship is undeniable, and the callous indifference displayed by those in power, who seem shielded from the harsh realities ordinary Nigerians face, is deeply troubling. The government must act decisively to expedite this critical policy and provide the much-needed relief to a population struggling with hunger, poverty, and misery. Continued delay is a betrayal of Tinubu’s promise and a grim reminder of the disconnect between those in power and the suffering Nigerians.
All looks set for the conduct of the Rivers State local government election scheduled to take place tomorrow in the 23 local government areas of the state. A total of 18 political parties will vie for various council positions in the polls to be conducted on Saturday. The Rivers State Independent Electoral Commission (RSIEC) had initially listed 19 political parties for the election, but the Peoples Democratic Party (PDP) discontinued the contest. Chief Emeka Beke’s faction of the All Progressives Congress (APC) has said that it will participate in the ballot.
Ahead of tomorrow’s council election, various lawsuits have resulted in conflicting rulings about how the election should be conducted. A recent judgment by a Federal High Court in Abuja has prohibited the Independent National Electoral Commission (INEC) from providing the voters register to RSIEC and instructed the police to withdraw security for the ballot. Similarly, the court has barred RSIEC from getting the voters register from INEC. However, in a counter ruling, a High Court in Port Harcourt has mandated that the state electoral commission continues with the election, requiring INEC to hand over the voters register and ordering police protection for the event.
As voters in the state prepare to head to the polls tomorrow, the conflicting rulings and legal battles have cast a shadow of uncertainty over the election process. With INEC and RSIEC at odds over claims regarding the issuance of the voters register by the former and security arrangements for the ballot, there is a need for clarity and resolution to ensure a free and fair election. The conflicting court rulings have added further complications to an already challenging situation, raising concerns about the integrity of the electoral process. As all stakeholders navigate these legal challenges, the focus remains on upholding the democratic principles and ensuring that voters are able to cast their ballots without interference.
Intense preparations have characterised Saturday’s polls. The election is expected to be conducted in line with the provisions of the Rivers State electoral laws. Speaking at a meeting with stakeholders, the RSIEC chairman, Justice Adolphus Enebeli (Rtd), hinted that the commission had complied with relevant sections of the law in all its preparations for the task. He implored political parties and politicians to ignore acts that could jeopardise the electoral process.
While we wholeheartedly endorse the move to ensure that democratic practice, norms and values always prevail at the local government level, we are truly elated by the level of earnestness and commitment exhibited so far by the Justice Enebeli-led commission to conduct credible, free and fair election in the 23 local government councils. Indeed, RSIEC can execute credible elections if it resists pressures from different quarters.
Despite the Federal High Court order, the state electoral commission’s parley with security agencies, especially with the police, and other stakeholders is, to say the least, heart-warming and reassuring. We expect this cooperation and partnership to continue even after the election. Going by Enebeli’s antecedents, we strongly believe that the commission will not fail to provide a level playing ground for political parties and politicians to test their popularity in a free, fair and tension-free contest.
The state electoral body must, therefore, strive to adopt an open-door policy where complaints would be entertained on their merit during and after the election. As anticipated, we hope the commission embarked on massive voter education and training of electoral and ad hoc staff that would man the 23 local government areas. It is advised that adequate preparations should be made for the security of sensitive and non-sensitive electoral materials, particularly given the tensed atmosphere in the state.
RSIEC is reminded that the success or otherwise of any election depends largely on the authenticity of the updated voter’s register which the commission has reportedly obtained ahead of the election from the Independent National Electoral Commission (INEC). The news that as many as 18 political parties in the state will participate in the council polls is cheering. The parties are urged to support and cooperate with the commission in ensuring a smooth and credible election.
It is expedient that Governor Siminalayi Fubara releases all the funds appropriated for the conduct of the local government election to the commission and ensure that he does not interfere in the workings of the RSIEC, or even influence the outcome one way or the other. Members of the commission should work harder to uphold the law without fear or favour; let or hindrance.
Incidents of missing ballot or result sheets, late arrival of materials and other logistics will only serve to discourage the electorate who already entertain a deep mistrust for the electoral process in the country. The lack of confidence in the system is largely responsible for the attitude of most Nigerians refraining from playing an active role of either voting for candidates of their choice or vying for political office. RSIEC must guard against those lapses.
Politicians, on their part, must understand that irrespective of their party affiliations, the common goal is the provision of good governance for the people. An election should never be a ‘‘do or die affair’’ and no aspirant is worth spilling blood for. Political positions are a call to service, not personal enterprises motivated by profits or bloody sports for which violent and fatal competitions are means. Experience has shown that arms provided for political thugs during elections, end up being tools for robberies and kidnappings after the election.
The idea of security agents acting the script of political actors should no longer amount to something in our polity. The nation currently faces perhaps its worst security challenges, and the police as well as other security agencies need the trust of Rivers people to enable them to carry out their duties effectively throughout the polls.
Law enforcement agents must protect both voters and election materials because it is their constitutional role to do so. The recent #Endbadgovernance protest, along with the violence that ensued, is a manifestation of the dissatisfaction of Nigerians with police operations. These security agencies must learn to commit themselves to their constitutional obligation and oath in the sustenance of democracy, rather than to any government official.
We must realise that ultimate power rests with the people, and the best way to exercise this power is through the electoral process. Hence, Rivers people must own the electoral operation, first by acquiring their permanent voters’ card, turn out en masse tomorrow to vote for candidates of their choice, and guarantee that their votes count. They have to elect responsible and responsive persons whose utmost interest will be the security and welfare of the people.