The global fight against Tuberculosis (TB) has hit a critical roadblock, with Nigeria among the nations significantly lagging behind the World Health Organisation's ambitious 2025 milestones. New data reveals that progress in reducing deaths and new infections is far slower than required, putting the ultimate goal of ending the epidemic by 2035 in serious jeopardy.
Global and National Targets Missed
The WHO's End TB Strategy, launched in 2014, set clear interim goals for 2025: a 75% reduction in TB deaths and a 50% cut in TB incidence compared to 2015 levels. The latest assessment paints a grim picture. By the end of 2025, global TB mortality had fallen by only 29%, while the incidence rate dropped a mere 12.3%. This stark shortfall underscores persistent failures in prevention, early detection, and treatment access worldwide.
In Nigeria, the situation remains particularly severe. The country carries a high burden, with the WHO estimating 510,000 new TB cases in 2024 alone. This translates to an incidence rate of 219 cases for every 100,000 people. While total TB deaths fell by 63% between 2015 and 2024, the rate of new infections has not seen a significant decline, indicating ongoing transmission within communities.
The Nigerian TB Landscape: High Burden and Catastrophic Costs
A closer look at Nigeria's TB data reveals both challenges and areas of resilience. Pulmonary TB made up 99% of reported cases, with 80% confirmed bacteriologically. Tragically, an estimated 56,000 HIV-negative people and an additional 5,800 people living with HIV died from TB in 2024.
Drug-resistant TB poses a major threat, with roughly 8,200 cases of multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) estimated in 2024. Alarmingly, only 3,090 people with confirmed rifampicin-resistant TB received treatment, highlighting a massive gap in care.
On a positive note, treatment outcomes in Nigeria are strong where care is accessed. Success rates reached:
- 94% for new or relapse TB cases
- 83% for TB patients living with HIV
- 76% for patients with rifampicin-resistant TB
However, the economic impact is devastating. A 2017 national survey found that 71% of TB-affected households faced catastrophic costs, exposing critical gaps in social protection and universal health coverage.
The Critical Funding Crisis
The primary obstacle to progress is a severe and chronic lack of funding. In 2024, only $114 million was available for TB prevention, diagnosis, and treatment in Nigeria, with a paltry 18% originating from domestic sources. The country's estimated national TB budget for 2025 stands at $405 million, yet a staggering 73% of this budget remains unfunded. This financial chasm raises grave concerns about sustaining even the current level of effort, let alone scaling up to meet targets.
Nigeria is one of the top eight countries driving the global TB burden, accounting for 4.8% of all cases worldwide. The WHO has warned that stagnating global funding and planned donor cuts starting from 2025 could lead to an additional 2 million deaths and 10 million new TB cases globally by 2035.
WHO Director-General Dr. Tedros Ghebreyesus stated, "Progress is not victory. The fact that TB continues to claim over a million lives each year, despite being preventable and curable, is simply unconscionable." The organisation is calling for a dramatic increase in domestic investment, expanded preventive treatment, stronger health systems, and unwavering political commitment to avoid further setbacks and achieve the 2030 End TB targets.
