The recent report that about 138.9 million Nigerians need interventions against Neglected Tropical Diseases (NTDs) is alarming and must engage the immediate attention of the federal, state and local governments’ health authorities. NTDs are mainly prevalent among impoverished communities, women and children in tropical areas. GAVI organisation states that neglected tropical diseases are a group of communicable diseases found in tropical and subtropical regions of the world.
They are classified as “neglected” because they have received little or no attention in terms of prevention and control over the years. Most people affected by NTDs live in rural areas where houses are overcrowded and basic infrastructure such as water and toilet facilities are lacking. According to data from the World Health Organisation (WHO), Nigeria has the highest burden of NTDs in the African region and second globally after India.
The global health agency says that NTDs affect more than one billion people. However, the number of people requiring NTD interventions, both preventive and curative, is 1.6 billion. Some of the NTDs include onchocerciasis, schistomiasisi, lymphatic filariasis, soil-transmitted helminth infections and trachoma. Others are dengue fever, leptospirosis, trypnosomiasis, leishmaniasis, Buruli ulcer, leprosy and snake-bite envenoming.
More than 170,000 people die of NTDs annually, fewer than malaria with 627,000 deaths in 2020. Nigeria is among countries with heavy burden of NTDs. About a quarter of people affected by NTDs in Africa live in Nigeria. An estimated 100 million people in the country are at risk of at least one of the diseases, and there are several million cases of people being infected with more than one of them.
However, recent reports show that in Nigeria, about 138.9 million people require treatment for lymphatic filariasis; 48.7 million people require treatment for soil-ransmitted helminthiases and 43.5 million people require treatment for onchocerciasis, all through mass drug administration. The only NTD Nigeria has eliminated is dracunculiasis or guinea worm disease in 2013. It is also cheering that two states in Nigeria have eliminated onchocerciasis. All tiers of government must do more to ensure that Nigeria eliminates most of these neglected tropical diseases.
Available facts show that lymphatic filariasis impairs the lymphatic system and can lead to the abnormal enlargement of body parts, causing pain, severe disability and social stigma. It has been estimated that over 882 million people in 44 countries worldwide remain threatened by lymphatic filariasis and require preventive chemotherapy to stop the spread of the parasitic infection. The WHO says that lymphatic filariasis can be eliminated by stopping the spread of infection through preventive chemotherapy with safe medicine combinations repeatedly annually.
It states also that more than nine billion cumulative treatments have been delivered to stop the spread of infection since 2000. Onchocerciasis or river blindness is caused by the parasitic worm Onchocerca volvulus. According to experts, it is transmitted to humans through exposure to repeated bites of infected black flies of the genus simulium. More than 99 per cent of infected people live in 31 African countries.
To wage a relentless war against NTDs, the federal, state and local governments should concertedly invest not less than 15 per cent of their annual budget on health. This was the minimum benchmark agreed by African heads of government in Abuja some years ago. However, Nigeria has never for once reached that threshold. Nigeria cannot reduce its disease burden if the health budget continues to hover between five and seven per cent of the annual budget.
Since what happens in one sector affects the other, the government should in the same way increase the education budget to 15 or 20 per cent. The poor development of the country can be traced to poor funding of both the health and education sectors. The government should overhaul our primary health care system. Let there be functional primary healthcare centres in the 774 local government areas in the country.
There is no doubt that our disease burden is increasing because of absence of functional primary healthcare centres in some of the local government areas. The government should quickly reverse the trend and ensure that all Nigerians have access to affordable healthcare services throughout the country.