Nigeria's Tuberculosis Control Under Threat from Persistent Challenges
As nations observe World Tuberculosis Day, health experts in Nigeria are raising alarms that significant obstacles, including a severe funding shortfall, low public awareness, malnutrition, and pervasive stigma, are endangering recent achievements in tuberculosis control and the long-term sustainability of the country's response efforts.
Alarming Statistics and Global Rankings
According to the World Health Organisation, Nigeria has seen a 63% reduction in TB deaths between 2015 and 2024. However, incidence rates have not declined overall, indicating ongoing community transmission despite improved treatment outcomes. In 2024, the country recorded an estimated 510,000 new TB cases, equating to an incidence rate of 219 per 100,000 population.
TB, an airborne disease caused by Mycobacterium tuberculosis, remains the world's leading infectious killer and ranks among the top ten causes of death globally. Although preventable and curable, approximately 1.9 billion people, or one-quarter of the global population, carry the bacterium in a dormant state.
Data from the Knowledge Network for Disease Control and Vigilance Nigeria reveals that the country faces a high triple burden of TB, drug-resistant TB, and HIV-associated TB. Nigeria is among the ten nations with the highest number of missing TB cases worldwide, ranks first in TB burden in Africa, and sixth globally, accounting for about 4.6% of the global TB burden.
An estimated 15 Nigerians die from TB every hour, translating to roughly 360 daily deaths, 10,417 monthly, and 125,000 annually.
Critical Funding Gap and Resource Shortages
Nigeria confronts a severe tuberculosis funding gap, with approximately 73% of its 2025 national TB budget remaining unfunded. Information from the Federal Ministry of Health and Social Welfare indicates that while $405 million was required for comprehensive TB treatment and services in 2024, only 27% was secured, leaving a 73% deficit.
The Federal Government has allocated about N73.4 billion for procuring TB drugs and medical commodities to prevent potential stock-outs nationwide. Reliable sources suggest that without significant domestic funding for TB medicines, Nigeria may experience shortages between May and June 2026.
At the Directly Observed Treatment centre in Asokoro, Abuja, TB focal person Mrs Blessing Onuoha reported that drugs are currently sufficient for patients. "For now, we don't have a problem with drugs. Drugs are very much available," she stated. However, she highlighted a previous scarcity following U.S. aid cuts, which increased TB spread. Onuoha also appealed for a functional X-ray machine, as patients are often referred to other facilities for imaging.
A patient at the Lagos University Teaching Hospital DOT centre confirmed that treatment and tests remain free but expressed concerns about the long-term sustainability of TB programs amid donor funding shortfalls.
Stigma and Discrimination as Major Barriers
For TB survivor Justice Ejiga, stigma and discrimination pose serious obstacles to care, often preventing individuals from seeking diagnosis, adhering to treatment, and reintegrating into society. Ejiga lost his banking job after returning from four months of TB treatment, with his employer fearing transmission to other staff.
"I suffered stigmatisation, and it was a deadly blow," he recounted, emphasizing that such fears are unfounded since patients on treatment quickly become non-infectious. "No one deserves to die. No one deserves to be stigmatised for a disease that is curable and treatable," he warned, noting that stigma discourages testing and treatment, exacerbating TB spread.
The WHO identifies stigma and discrimination as major barriers to ending the TB epidemic. Stakeholders argue that eliminating stigma would facilitate early diagnosis, encourage treatment-seeking, improve medication adherence, and reduce community transmission.
Government and Stakeholder Responses
Acting Board Chair of Stop TB Nigeria, Queen Ogbuji-Ladipo, emphasized the need for increased domestic resource mobilization and sustained budgetary support. With declining global health financing, she stressed that Nigeria must generate in-country resources to bridge the 70% funding gap.
Ogbuji-Ladipo also highlighted stigma as a key challenge, noting that the Tuberculosis Anti-Discrimination Bill 2025 has passed its first reading in the House of Representatives, aiming to hold accountable those who stigmatize TB patients.
She reported progress, including First Lady Oluremi Tinubu's donation of N2 billion for TB control, used to procure diagnostic tools distributed across all 36 states and the Federal Capital Territory. "We are also engaging the private sector, and some have built DOT centres in health facilities," she added.
Dr Urhioke Ochuko, Deputy Director at the National Tuberculosis and Leprosy Control Programme, outlined predisposing factors for TB in Nigeria: malnutrition contributes about 50,000 cases, diabetes 31,000, and HIV 21,000 in 2024. He confirmed drug availability but identified stigma and low awareness as major challenges, urging media efforts to dispel myths.
Ochuko detailed government initiatives, including a $200 million release to cushion funding cuts and the inauguration of a Technical Working Group for AIDS, Tuberculosis, and Malaria to transition from donor dependency. "The model being built is such that the government leads and donors follow," he explained.
Professor Ibrahim Kolo of Ibrahim Badamasi Babangida University commended the operational DOT schedule in many centres but warned that continuity depends on sustained government support. He expressed hope for meeting 2030 TB targets but cautioned about low awareness, delayed diagnosis, and drug resistance due to poor treatment adherence.
"Many patients discontinue medication once symptoms subside, despite needing at least six months of treatment," he said, contributing to resistant strains that are more difficult and costly to treat.
