Tuberculosis (TB) is caused by bacteria called Mycobacterium tuberculosis which most often affects the lungs and is spread when people who are sick with TB expel bacteria into the air (e.g., by coughing). Even though TB is preventable, treatable, and curable, it remains one of the top 10 causes of death worldwide, and from a single infectious agent, and accounted for an estimated 1.4 million deaths globally in 2019. About 90% of the total number of people who develop TB each year are adults, with more cases among men than women with childhood TB shown to occur mostly among infants and young children aged <15 years. The disease typically affects the lungs (pulmonary TB) but can also affect other sites. Without treatment, the death rate from TB disease is high but with currently-recommended treatments, about 85% of people can be cured.
Nigeria, with a population of more than 200 million people, has the highest burden of the disease in Africa and is among the 14 high-burden countries for TB, TB/HIV, and multidrug-resistant TB (MDR-TB) with an estimated TB incidence of 219 per 100,000 in 2020. The biggest challenges with fighting TB in Nigeria are low case detection, funding gap, and multi-drug resistance; about 6% of new cases are drug-resistant TB. Evidence indicates that on average, an employee with TB loses 3-4 months of work per year, resulting in potential losses of 20-30% of his annual household income, as well as workers and their families losing 15 years of income from premature death. Thus, Critical to rapidly find and treat undiagnosed people infected with TB.
The private sector in Nigeria has a track record of supporting disease control/eradication efforts, such as in the fight against polio and malaria; achieving significant health gains. Therefore, leveraging on the gains; the private sector is well-positioned to expand demand for and access to TB services & improve the financing of TB services in Nigeria to support government efforts to achieve a healthier workforce through the demonstration of corporate social responsibility.
What Can the Private Sector Do?
Provide information, Education, and Communication (IEC) materials for sensitization and increased awareness of TB among employees and all stakeholders
Employers are enjoined to provide more support to employees to receive TB preventive and curative care and the mobilization for prevention and early detection and referrals for treatment.
Train Health and Safety Officers or other Occupational health physicians in the screening and referral of suspected TB cases to accredited health facilities for diagnosis and treatment.
Encourage passive case finding for TB at the workplace through (voluntary) periodic tests, entry screening, and cough surveillance.
Incorporate TB services in company health insurance plans.
Promote policy of non-discrimination and work accommodation for workers with TB through the protection and promotion of human rights and dignity.
Advocate for political commitment and greater investment in TB treatment and control.
Overall, multi-sectoral collaboration from both the public and private stakeholders is required to end tuberculosis in Nigeria just as obtained in other countries.
A category of TB awards was created at the 2022 Nigerian Healthcare Excellence Awards (NHEA). The NHEA award is designed to celebrate distinguished personalities and organizations who have contributed immensely to the growth of the Nigerian health sector and the TB awards at the event were given.to recognize the support received from the private sector through advocacy and control efforts for the disease and to encourage more support from other private sector stakeholders. The 3 awardees were:
Wellness HMO, a leading health maintenance organization (HMO), Verod Capital, a Venture Capital firm, Leadway Assurance Company – a foremost and leading insurance company in Nigeria
As part of advocacy measures, training of occupational physicians, health and safety professionals, and human resources in private companies on current diagnosis and treatment protocols for TB and sensitization sessions have been held with key professional associations such Association of Certified and Chartered Accountants (ACCA), the Nigerian Bar Association (NBA), the Institute of Capital Market Registrars (ICMR), the Association of Securities Dealing Houses of Nigeria (ASHON), the Association of Elite Human Resource Professionals (AEHRP), and the Nigerian Society of Engineers (NSE).
A high-level political commitment from the government such as obtained from the Lagos State Government is commendable and holds great promise for better control and eradication efforts. For instance, the Lagos State Government provides 69.4% of the annual TB operational budget with counterpart funding of 14.3% from development partners leaving a gap of 16.3% which private sector collaboration can provide. A realization of the huge support for TB control efforts in the State, the Executive Governor of Lagos State, Mr. Babajide Sanwo-Olu was recently appointed as Global TB Ambassador for Africa by the Stop TB Geneva. This appointment portends a lot of gains for ending TB because the political level will be actively involved in the fight against TB.
Anadach Consulting Limited in partnership with the Institute of Human Virology Nigeria (IHVN) has continued to implement the Private Sector Component of a United States Agency for International Development (USAID) funded Tuberculosis Local Network Organization Network (TB-LON3) Project.