Reducing the burden of tuberculosis and HIV in Nigeria
The inauguration of a multidrug-resistant tuberculosis (MDR-TB) treatment center in Nigeria in March 2012 symbolized continued progress in the fight to control MDR-TB. The treatment center, which has state-of-the-art digital X-ray capabilities, is located at Mainland Hospital, Yaba, Lagos State. The new center was built under the Global HIV/AIDS Initiative Nigeria (GHAIN) project — a project funded by the U.S. Agency for International Development (USAID) and managed by FHI 360.
The opening of this treatment center is particularly significant in Nigeria, which ranks 10th among the high-burden TB countries in the world, according to the World Health Organization (WHO). By the end of December 2011, nearly 3.5 million people were living with HIV. With TB recognized as the leading cause of death in people with HIV, thousands of Nigerians are believed to be living with a multidrug-resistant form of the disease.
Rates of MDR-TB in Nigeria are estimated at 2.2 percent among new TB cases and 9.4 percent among re-treatment cases (WHO report, 2011). Because drug-resistant TB does not respond to the first-line drugs that typically treat the disease, doctors must treat patients with second-line drugs, which are far less effective and have more toxic side effects.
The Mainland Hospital treatment center builds upon FHI 360’s extensive work in addressing MDR-TB in Nigeria. In 2010, FHI 360 provided technical support and capacity building for the opening of a biosafety level-3 laboratory at the Dr. Lawrence Henshaw Memorial Hospital in Cross River State. This laboratory addresses the threat that TB and MDR-TB pose to Nigerians, especially those who have HIV, by performing TB cultures, drug susceptibility testing and species identification. These are critical tests for diagnosing, treating, monitoring, researching and controlling drug-resistant TB.
FHI 360 staff have also contributed to the development and review of TB/HIV guidelines, strategic plans and tools at the state and national levels. Under GHAIN, FHI 360 integrated TB treatment in 186 health care facilities in Nigeria's 36 states and trained 3,386 health care workers in TB/HIV collaborative activities in 2005–2010.
In order to sustain these interventions, FHI 360 has engaged the host government through a subagreement mechanism and a memorandum of understanding. These initiatives have led to budgetary commitments from the host government.
Today, FHI 360 continues to work with local and national governments across Nigeria to reduce the burden of TB and HIV. Under TB CARE I, a project funded by USAID and the Royal Dutch Chemical Association (KNCV), FHI 360 is working to expand access to TB and MDR-TB treatment, improve the coordination of TB/HIV programs and strengthen health systems to ensure quality care.