According to the World health Organization, an estimated 26 million Nigerians are living with viral hepatitis.
As a result of the staggering number, the World Health Organization (WHO) in 2016 set a target for the elimination of viral hepatitis as a public health threat by 2030 and provided a Global Health Sector Strategy (GHSS) on viral hepatitis for 2016–2021 which has since been adopted and endorsed by 194 countries of the world.
Subsequently, Nigeria joined the league of other nations to sign up to the GHSS and was among the few countries in Africa to develop firm goals towards the elimination of viral hepatitis, DailyTimes gathered.
The goals were mapped out in a comprehensive framework that includes the National Viral Hepatitis Strategic Plan 2016-2020, National Policy for the Control of Viral Hepatitis, and National Guidelines for the Care and Treatment of Viral Hepatitis.
However, despite the efforts made, there has been very little financial assistance or investments by the government at the subnationals towards the elimination of hepatitis.
The obvious challenges include low awareness fueled by myths and misconceptions, lack of available information on hepatitis, poor systems of health, high cost of diagnostic testing and out of pocket expenses for viral hepatitis treatment.
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Others are low capacity of health care providers, and the proliferation of substandard treatment centres across Nigeria poses a challenge to the elimination goal of hepatitis in the country.
In Keffi, Community members lack information on Hepatitis B
In Dadin Kowa community of Keffi Local government, among the seven residents, few residents know about Hepatitis B and how deadly the virus is.
Rifkatu Musa, a resident of the community in an interview with this reporter said she has not heard about Hepatitis and what it means.
Speaking in Hausa language, she said “I don’t know the sickness means because here what we only know is malaria and when we feel sick, we go to the nearest clinic and they give us medicine,”
She added that “As for me, I don’t know what I will go to hospital and do if I don’t feel ill,”
Another resident, Hamisu Kabir of Ungwan Dadi community said he has heard of Hepatitis B at a function once but don’t know about it and what it means.
“I remember sometimes in 2020, I was at a wedding and we sat with some set of people on the table where they said they want to wash their spoon before eating because they don’t want to catch hepatitis.
“That was the first time I was hearing about it and I was wondering what kind of sickness is that. Since then I haven’t really heard or know much about it,”
Another resident of Angwan Lambu Village, Bashir Kwande said his neigbour had onced encouraged him to have get Hepatitis B testing but said he didn’t get proper explanation on it.
“During the Christmas period last year, I was having a chat with my neigbour and she was telling to go and have hepatitis test to know my status because the sickness is even more deadly than HIV Aids and I was wondering.
“Although I have not done the test, I plan to do it soon,” he added
However, another resident in Angwan Kare community said she is fully aware of the ailment and its effect on the human body.
“I am aware of Hepatitis B and I have done the test which turned out negative. What is remain now is the vaccine. Just like Covid 19 many people in this community don’t believe about the sickness, just few that have gone to test,” she added.
Although she said people encouraged to go for testing, only few are complying.
Primary Health Care only Conducts Testing
In a visit to some Keffi communities, majority of the primary health care centers does not conduct hepatitis test while the few that do, they refer them to either the general hospital or the Federal Medical Center.
A matron at Primary Health Care center in Dadin Kowa community, Ladi Jospeh said they only conduct testing as they don’t have the capacity to treat patients.
She said “You know this health care center is small so we don’t have the drugs and treatment facilities. What happens is when we test you and it is negative, then we can advise you take the vaccine, but if you are positive, we refer you to general hospital Keffi or the Federal Medical Center”
Asked about the turn out people coming for test, she said “truly the turn out is low and I won’t blame them because some of them do not even know what the sickness means and how deadly it is, which is why we are calling for increased advocacy at Nasarawa state ministry of health to ensure state governments prioritize hepatitis
What CSOs are Doing
Speaking on their efforts in curbing the spread of Hepaptitis B, Danjuma Adda Adda who is the Executive Director and Founder of Chagro-Care Trust (CCT), a non-profit dedicated to helping hepatitis patients in Nigeria said more needs to be done in the area of testing and treatment.
On the efforts of his organization, “In my own organisation, Chagro-Care Trust (CCT),we run free hepatitis screenings and the prevalence we estimate is quite alarming and far higher than the official national figures.To further compound this problem, less than 4% of the infected population know their status and less than 2% have access to treatment.
“In 2016, the government of Nigeria developed a strategic plan to eliminate hepatitis by 2020. In the paper, national goals are for 50% of persons infected with Hepatitis B & C virus to know their status and for50% of all eligible persons infected with either virus to receive treatment by 2020,” he said.
He however called for the implementation of the Policy.
“It’s a beautiful policy but it’s not being fully implemented, except for the birth-dose vaccination and screening of blood for donations and blood banks. Unfortunately, the allocation of healthcare resources, including workforce, is skewed towards secondary and tertiary health institutions, where only a negligible number of people access services.
“Over 65% of the population reside in semi-urban or rural communities where they can only access primary healthcare institutions such as clinics but over 80% of hepatitis healthcare is provided at secondary and tertiary institutions.Even in terms of equipment, there is a need for good diagnostic technology at the primary healthcare centres.
“Also, there is also a need for highly-trained specialists as these are the people that have the highest level of training and knowledge on hepatitis.
“At CCT, we go out and provide free testing to people in remote areas but there is only so much we can do. I have a register of more than 10,000 people in rural communities who have tested positive for hepatitis B & C but are not able to access treatment.
“The disconnect between the communities and where the services are available is the main challenge we need to overcome as Nigerian society if we are to defeat hepatitis B & C.If we work together, the elimination of these diseases can become a reality,” he further explained.
Proposed Solutions
To boost advocacy, the engagement of private institutions to invest in the hepatitis prevention is crucial.
Another public health expert, Musa Ibrahim said “An increased domestic financing is needed by state governments towards the elimination of viral hepatitis in Niger
“Secondly, as The World Hepatitis Alliance (WHA) UK is partnering with CSOs/Patient groups to build advocacy efforts for hepatitis C financing, there is a need for the engagement of state governments and private sector players to invest in elimination projects across Nigeria towards the elimination of this disease and surpass the WHO target.
He added that “In order to attract support from partners around the world including pharmaceutical companies, the government of Nigeria must make a bold commitment and investment in addressing the challenge of viral hepatitis for its citizens.
“The government of Nigeria must take the first step by making the financial commitment towards provisions for prevention, testing and treatment programs in the country by launching a pragmatic and ambitious Viral Hepatitis Elimination Project with clear targets to reach each year on prevention and treatment, including harm reduction strategies,”.
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