Chijioke Iremeka
The battle against infectious diseases remains a priority on the global public health agenda, especially in Nigeria, consultant public health physicians have said.
They said that the Human Immunodeficiency Virus, viral hepatitis, and sexually transmitted infections will continue to inflict a heavy toll on human lives and underscored the urgent need for concerted action.
The consultants stressed the need for equitable delivery of health services for HIV, hepatitis, and STIs in all geographical regions of the country.
According to them, achieving equitable distribution is imperative if Nigeria is to effectively combat the rising tide of infectious diseases nationwide.
They also emphasised the importance of having the general public adhere to safety precautions and underscored the significance of testing, treatment, and vaccination to effectively address the triple menace of HIV, viral hepatitis, and sexually transmitted infections both within the country and at the global health level.
According to a recent report by the World Health Organisation, global HIV, viral hepatitis epidemics, and sexually transmitted infections continue to pose significant public health challenges, causing 2.5 million deaths each year and underscoring the urgent need for concerted efforts to address their spread and impact.
The WHO noted that HIV/AIDS, despite decades of progress in prevention, treatment, and awareness, remains a formidable global health challenge, pointing out that the virus has claimed millions of lives since its emergence.
WHO
The global health body stated that while advancements in antiretroviral therapy have transformed HIV into a manageable chronic condition for many, access to treatment remains uneven across regions and populations.
The new report indicated a major increase in sexually transmitted infections, amidst HIV and hepatitis burden.
PUNCH Healthwise reports that in 2022, WHO Member States established an ambitious goal of reducing the annual number of adult syphilis infections by ten-fold by 2030, aiming to decrease it from 7.1 million to 0.71 million cases.
However, contrary to this target, new syphilis cases among adults aged 15 to 49 years surged by over one million in 2022, reaching a total of eight million cases. The most significant increases in syphilis cases occurred in the Americas and African regions.
This surge, the report revealed, coupled with inadequate declines in new HIV and viral hepatitis infections, poses a threat to the achievement of the targets outlined in the Sustainable Development Goals by 2030.
The Director-General of the WHO, Dr Tedros Ghebreyesus said the rising incidence of syphilis raises major concerns but that there has been important progress on several other fronts including accelerating access to critical health commodities, diagnostics, and treatment.
WHO DG Dr Tedros Adhanom Ghebreyesus
“We have the tools required to end these epidemics as public health threats by 2030, but we now need to ensure that, in the context of an increasingly complex world, countries do all they can to achieve the ambitious targets they set themselves,” he assured.
Speaking on the increased incidence of sexually transmitted infections, WHO noted that four curable STIs – syphilis, gonorrhoea, chlamydia, and trichomoniasis, account for over one million infections daily.
The report notes a surge in adult and maternal syphilis (1.1 million) and associated congenital syphilis (523 cases per 100,000 live births per year) during the COVID-19 pandemic, indicating that there were 230,000 syphilis-related deaths in 2022.
New data also indicated an increase in multi-resistant gonorrhoea. As of 2023, out of 87 countries where enhanced gonorrhoea antimicrobial resistance surveillance was conducted, nine countries reported elevated levels (from 5% to 40%) of resistance to ceftriaxone, the last line treatment for gonorrhoea.
In 2022, around 1.2 million new hepatitis B cases and nearly one million new hepatitis C cases were recorded, with the number of deaths from viral hepatitis rising from 1.1 million in 2019 to 1.3 million in 2022 despite effective prevention, diagnosis, and treatment tools.
Speaking exclusively with PUNCH Healthwise in different interviews, public health physicians blamed the rising cases of these infections on programme implementation failures occasioned by poor funding and high dependence on donors.
A Consultant Public Health Physician at the University of Ilorin Teaching Hospital, Kwara State, Professor Tanimola Akande said for Nigeria to deal with these challenges, the government needs to implement well-funded policies and guidelines for the control of HIV, Hepatitis B, and STIs.
Professor Tanimola Akande
Akande also said awareness through health education and sensitisation of citizens needs to be increased.
He also stressed the need to create awareness of preventive measures to drive behavioural change among Nigerians
The don lamented that the implementation of control programmes targeting these diseases is heavily donor-dependent and advised the government to aim at improving funding.
Akande stressed the need for Nigerians to change risky sexual behaviours, ensure blood donors are well-screened and take advantage of screening for the listed infections for early detection and treatment.
The consultant, who was at various times Head of the Department of Epidemiology and Community Health, University of Ilorin, Kwara State, said most countries have adopted policies, programmes, and strategies to control these infectious diseases but there are challenges in their implementation.
He said, “These challenges vary from one country to the other. Some countries have programme implementation failures due to poor funding or dependency on donors.
“However, there are policies already in place in Nigeria to control these infections. The policies include universal precautions in workplaces like health facilities and policies on control of sexually transmitted infections.
“Early detection through screening, case management, contact tracing, and free treatment in the case of HIV will help curb the rising cases of these infections.”
He warned against some risk factors that include risky sexual behaviours, substance use, improper use and disposal of sharp objects and needles, use of contaminated blood for transfusion, mother-to-child transmission, and scarification among others.
Corroborating his views, another Public Health Physician and Medical Director, Federal College of Education, Akoka Medical Centre, Lagos, Dr Rotimi Adesanya said eliminating HIV, viral hepatitis, and STIs as public health threats ahead of 2030, requires collective efforts.
Dr Rotimi Adesanya
He recommended that drug prices be reduced substantially and hepatitis medicines included in the national health insurance scheme.
Adesanya further said Public–public-private partnership service delivery models should be rolled out.
He said, “The coverage of hepatitis services should expand more through domestic funding. The government should maximise opportunities for integrating services based on local epidemiology and context.
“These must include reproductive health services, HIV, viral hepatitis, TB services, and non-communicable diseases, and to decentralise integrated services to the primary healthcare level, among others.
“There is an urgent need to focus on inequalities and populations left behind – adolescent girls and young women, their male partners, people who inject drugs, sex workers, people in prisons, and all vulnerable populations.
“There must be equitable delivery of services for HIV, viral hepatitis, and sexually transmitted infections across the geographical zones. The masses should observe safety precautions at all times. They should go for testing, treatment, and vaccination.”
Adesanya advised that the country should leverage the resilience and innovation exhibited in the global response to COVID-19, noting that it would go a long way to help.
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