Despite decades of awareness and free treatment, tuberculosis, an airborne infection, continues to spread across Nigeria, killing thousands every year. It remains one of the country's most persistent and underestimated public health threats. Patience IVIE IHEJIRIKA writes.
Despite being preventable and curable, tuberculosis (TB) remains one of the most persistent public health threats in Nigeria, silently infecting hundreds of thousands every year.
The World Health Organisation (WHO) ranks Nigeria among the countries with the highest TB burden globally and the highest in Africa. Each year, an estimated 510,000 Nigerians fall ill from TB, including 61,000 children and adolescents. And though the disease is preventable and curable, it continues to kill thousands, driven by gaps in detection, stigma, poverty, and weak access to healthcare.
TB is caused by Mycobacterium tuberculosis, a bacterium that primarily attacks the lungs but can affect other parts of the body. According health experts, TB's airborne nature makes it highly contagious; a single untreated infectious patient can transmit the disease to 12-15 people in one year.
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For decades, one of Nigeria's biggest challenges has been the large pool of undiagnosed cases. Although TB services are free in approved facilities nationwide, many Nigerians either do not know the symptoms, cannot easily access testing, or fear stigma.
According to WHO, Nigeria still carries a 175,000-case gap, people who are infected but undetected, silently driving community transmission.
The rise of drug-resistant TB (DR-TB) adds another layer of risk. These strains do not respond to standard treatment and require more complex, longer, and costlier therapies.
Although national TB notifications have increased in recent years due to improved testing, the country still struggles with a large "missing cases" gap.
A public health expert, Dr. Ntoyo Samson, said one of the greatest drivers of TB in the country is late diagnosis. "Many Nigerians with prolonged coughs turn to self-medication, prayer houses, or local pharmacies instead of visiting a health facility on time," he said.
Ntoyo also identified stigma as major challenge, stating that "For many, TB is associated with social shame, poverty, or HIV infection, causing people to hide symptoms or avoid seeking help until the disease becomes severe.
According to him, by the time many patients walk through hospital doors, they are already coughing blood, severely underweight, or dealing with complications that could have been avoided.
Beyond regular TB, Nigeria is also battling rising cases of drug-resistant TB. This form of the disease does not respond to the most common medications and requires long, expensive treatment that many patients struggle to complete.
According to WHO, most people with tuberculosis can be fully cured through a standard six-month treatment regimen, provided patients receive the right medicines and consistent medical support. However, the global health body said inappropriate or incorrect use of TB drugs continues to undermine successful treatment and fuel resistance.
WHO noted that factors such as the use of ineffective drug formulations, including single-drug therapy, poor-quality medicines, and improper storage conditions, contribute to the development of resistance, adding that premature interruption of treatment by patients increases the risk of drug-resistant TB, which is more difficult and costly to cure.
It explained that patients with TB of the lungs release infectious droplets when coughing, sneezing, or even talking.
This poses a major threat to national TB control efforts because it spreads just as easily as normal TB but is significantly harder to treat.
Despite major strides in detection and treatment, TB remains one of the country's deadliest infectious diseases, silent, airborne, and still spreading in many communities.
Though some states have made progress through mobile screening teams and community outreach, but many rural communities remain underserved. For families living hours away from the nearest TB treatment centre, treatment completion becomes an uphill battle.
Speaking further, Ntoyo told LEADERSHIP Weekend that children, people living with HIV, prisoners, miners, and internally displaced persons are among the most vulnerable. In crowded IDP camps, for example, TB spreads rapidly due to poor ventilation and overcrowding.
He said children face a double burden, they are harder to diagnose and more likely to develop severe forms of TB, yet pediatric TB remains under-detected nationwide.
Despite the challenges, Nigeria has recorded progress in recent years. Increased availability of GeneXpert machines has improved rapid diagnosis. Community health workers are increasingly being trained to identify symptoms early.
Recently, the Director of Public Health at the Federal Ministry of Health and Social Welfare, Dr. Charles Nzelu, revealed the federal government"s commitment of $54 million to secure tuberculosis medicines and prevent nationwide stock-outs.
The decision, he said, was prompted by projections that donor-supported TB drugs may run out in coming months.
"This is to ensure Nigeria does not experience any stock-out of TB medicines. We are already procuring commodities using part of the $200 million sector-wide allocation announced last year," he explained.
The government has also begun the national rollout of the Pluslife Mini Dock, a new near-point-of-care molecular testing platform. More than 1,000 units are being deployed, particularly to rural areas, to shorten the time between testing and diagnosis.
Nigeria's detection numbers have improved, as TB case notifications grew from 106,533 in 2018 to 405,324 in 2024. In the first three quarters of 2025 alone, the country reported 335,003 cases, with projections that Nigeria may detect up to 80 percent of estimated cases by year-end.
First Lady Senator Oluremi Tinubu has also deepened national advocacy through the Renewed Hope Initiative. She recently commissioned a batch of molecular TB diagnostic machines at the Dutsen Makaranta Primary Healthcare Centre in Dutse, FCT.
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She recalled her earlier pledge of N1 billion to support Nigeria's TB efforts, now being fulfilled through deployment of diagnostic equipment in underserved communities.
"Tuberculosis is curable, but too many Nigerians still die from it due to poor access to diagnostic tools," she said.
The machines also detect drug-resistant strains, helping break the chain of transmission.
WHO Representative in Nigeria, Dr. Pavel Ursu, acknowledged this progress but warned that the gains must not slow.
"These numbers are not just statistics, they are mothers, fathers, children, friends and colleagues. Too many patients suffer financially. Seventy-one percent of TB-affected households experience catastrophic costs," he cautioned.
Emphasising the need for innovation and private-sector participation,
Board Chair of Stop TB Partnership Nigeria, Dr. Queen Ogbuji-Ladipo,
said "Donor support alone cannot carry the burden. Ending TB requires sustained financing and stronger community structures," she said.
"Sustainable financing from government budgets, private sector contributions, and innovative financing mechanisms will be critical to sustaining TB programs and ensuring that no Nigerian is left behind in accessing TB prevention, diagnosis, and treatment services," she stressed.
According to her, communities remain central to the TB response, especially as the country rolls out new technologies like portable molecular testing devices, which will be deployed in more than a thousand locations to boost diagnosis in rural and hard-to-reach areas.
