TAMING THE TB SCOURGE
Eniola Olakunrin writes on the need to do more to curb the curable disease
Recently, the chief executive officer of Aurum Institute, a South African based public benefit organisation - Dr Andrew Titterton - in conjuction with officials of National Tuberculosis and Leprosy Control Programme (NTBLCP) led by its Co-ordinator, Dr Adebisi Lawanson, paid visits to some key government institutions in a bid to soliciting their support in halting Tuberculosis (TB) spread in Nigeria. Even though TB is treatable, Nigeria still adds a minimum of 600,000 new cases every year due to the societal stigma attached to the deadly disease. This in turn, drives sufferers underground thereby inhibiting them from seeking treatment.
For emphasis, Nigeria is the highest carrier of the disease in Africa and to underscore the need to roll back the terrible menace of TB, here are some quick facts as encapsulated by NTBLCP :
Nigeria and just one other country account for 43 per cent of the Global TB deaths (WHO 2016 Global TB Report.)
The Giant of Africa with five other countries also account for 60 per cent of the estimated 10.4 million new TB cases worldwide (WHO 2016 Global TB Report.) Only 17 per cent of the estimated TB cases in Nigeria report for assessment and treatment leaving a burgeoning 83 per cent undetected, thereby raising serious health implications for the larger population. One untreated TB sufferer can infect 10 to 15 persons per year given the fact that the disease is air borne.
It is the need to address this latent TB threat to the larger community that the current Health Minister, Professor Isaac Folorunsho Adewole, in his characteristic wisdom, declared 2017 as the year of “accelerating case finding for TB.”
Due to the fact that most cases are unreported, even though treatment is free, it behoves on the NTBLCP to run with the mandate given by the minister to seek means of identifying and getting TB sufferers treated. Aurum Institute, a non-governmental and a non-profit health organisation with almost 20 years experience is a leader in the response, treatment and research efforts aimed at eradicating TB and HIV in South Africa and by extension, the entire Africa. With offices in the United States, United Kingdom, Ghana, Mozambique, The Gambia, Tanzania and Nigeria (in view), the 1,400-peopled organisation is poised to bringing its wealth of experience (in tandem with that of the NTBLCP) to bear in locating the elusive or hitherto unreachable sufferers, leaning on strategies adopted in South Africa.
As a start off, NTBLCP and Aurum identified four major Nigerian governmental institutions namely, Federal Ministry of Education, Ministry of Mines and Steel Development, The Nigerian Prisons Service and The Nigeria Police Force as veritable grounds for the kick-off of the planned strategies of containing TB, easily more contracted in confined spaces.
The enthusiasm shown by the four institutions identified towards partaking in the programmes aimed at curtailing TB was remarkable and quite commendable. Whilst Permanent Secretary, Ministry of Mines and Steel Development, Alhaji Mohammed Abbas affirmed the support of the ministry for any quest by NTBLCP in arresting the TB spread, it was also soothing that the Ministry of Education is planning to inculcate TB control mechanism in the National School Health Policy presently under review. For The Nigerian Prisons Service, The Controller of Prisons, Alhaji Ja’afaru Ahmed said the service welcomes any collaboration which reduces the risk of the spread of the dreaded disease in their 244 prison formations nationwide, as staff manning these facilities, are also exposed to the same risks as the entire 71,000 incarcerated inmates.
The Deputy Inspector General of Police (Medical), Dr. K. Ahmadu echoed the position of the prisons helmsman and said the 370,000-strong Nigeria Police Force has 115 clinics nationwide which are open to policemen, their families and even the community where these clinics are located. In effect, the Police too are exposed to the spread of TB given the harsh conditions in which they work, their interactions with detainees as well as exposure of their health workers to various form of hazardous conditions. The DIG, therefore, welcomes any collaboration with the NTBLCP and affirmed the readiness of the police to partake in any programme deemed fit for TB eradication.
Titterton also lauded the cooperation of the identified government institutions and spoke on the need to getting the concept note and road map geared towards sieving sufferers ready and on time. The two documents once approved by the Ministry of Health, will form the ready plank to be deployed in seeking cases and fighting the TB scourge head-on.
Perhaps one area that is burdensome and worrisome is the increasing prevalence of multi-drug resistant TB. This is more common among patients who abandon their medicine intake midway when they started noticing improvements in their health. This conundrum presents a special challenge to the whole TB fight as it costs as much as One million naira to treat every such patient excluding other ancillary costs. It is therefore imperative that patients adhere to and run through the course of their treatment regime. Constant training and re-training of health workers are important in this all-important fight so that when a staff is transferred, no vacuum is left in the (health) facilities handling TB control. Detainees/prisoners are also expected to be screened before they are allowed to mingle with others in detentions/prisons, and the screening is also expected to be repeated after the determination of their cases or after serving their sentences before they are released to the population at large.
Generally, TB is preventable and curable. The general public should note and encourage themselves, their friends, loved ones and colleagues to get tested in the nearest hospital for TB if they are experiencing the following: persistent cough for onwards of two weeks; night sweats; fever; unexplained weight loss.
Again, for emphasis, the diagnosis and treatment are free. Interested parties are also enjoined to call the Help Line: 0800 225 5282 (free of charge) if so required. From an interested observer’s point of view, one needs to salute the enterprise, commitment to duty and rapid response make-up of the officials of the NTBLCP led by the indefatigable and dependable Dr. Adebisi Lawanson. This writer at various times did commend the work ethic of the entire staff which he finds comparable to (if not better) than most serious private companies and multinationals. The question of their exemplary and unusual work attitude (at least in this clime, for a government institution) was put to the administration head of NTBLCP, Alhaji Usman Mustapha. His reply was one word: ‘Passion’. He said once a staff is posted to the programme, Dr Adebisi’s first question was always about if the new addition has the passion for what NTBLCP does. If not, such a fellow is respectfully asked to seek an alternative work place.
This writer has always advocated that the template on NTBLCP work ethic should be a work study circulated and embraced by other Nigerian civil servants. Anyone in doubt should visit the NTBLCP office in Abuja to see things for him/herself. This reminds one of what the ruler of Dubai, Sheik Mohammed Al Maktoum stated in his best seller, ‘My Vision’, published in 2012: “Unlike the private sector, the public sector was known for its slow response, bureaucracy, low efficiency, and poor achievement but it’s efficiency is now better than that of many companies in the private sector....there is a new commitment in the public sector with regard to the need for discipline, professionalism and in dealing with the public in a civilised manner”
In short, people’s attitude is amenable to change given the right leadership, work environment, encouragement, gusto and commitment. Who knows, the work template of NTBLCP could just be the catalyst needed to revolutionise the way civil servants work in Nigeria.