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By Abujah Racheal (NAN)
Every day in Nigeria, millions of people squeeze into crowded buses, walk through packed markets, and share the same air in bustling streets and workplaces.
In those ordinary moments of daily life, an invisible threat travels silently from person to person, tuberculosis (TB).
TB is an airborne disease caused by the bacterium Mycobacterium tuberculosis.
Albeit being preventable and curable, it continues to spread quietly across Nigeria, claiming thousands of lives each year.
In Lagos alone, health authorities reported about 15,000 diagnosed TB cases in 2024, yet experts estimate that nearly 32,000 people may actually be living with the infection.
This means that almost 17,000 cases remain undetected, allowing the disease to move silently through communities.
Across Nigeria, the numbers are even more alarming.
The country recorded over 400,000 TB cases in 2024, the highest ever reported, with more than 71,000 deaths attributed to the disease.
Globally, TB has reclaimed its position as the world’s deadliest infectious disease, surpassing COVID-19, according to the World Health Organisation (WHO) Global TB Report 2024.
Yet, in spite of the scale of the problem, many Nigerians still perceive TB as a disease of the past, or as a condition that affects only the poor or people living with HIV.
However, data compiled by the KNCV Tuberculosis Foundation shows that TB remains one of the world’s most devastating infectious diseases.
Although it is preventable and curable, it continues to kill millions annually.
Globally, TB is the number one infectious killer and among the top 10 causes of death worldwide.
About 1.9 billion people, roughly one-quarter of the world’s population, carry the TB bacteria in a dormant or inactive state.
Each year, about 10 million people develop active TB, including 1.1 million children and 860,000 people living with HIV.
In addition, three million people miss care or treatment annually, while about 500,000 develop drug-resistant TB (DR-TB), with only one in three receiving proper treatment.
Nigeria mirrors many of these global challenges.
The country carries a triple burden of TB, DR-TB, and HIV-associated TB, ranking first in Africa and sixth globally, accounting for about 4.6 per cent of the global TB burden.
Estimates suggest that 15 Nigerians die every hour from TB, translating to about 347 deaths daily and roughly 125,000 annually.
Nigeria’s TB incidence rate is estimated at 219 per 100,000 population, with about 467,000 people believed to be living with active TB disease.
Nevertheless, a large proportion of cases remain undetected.
In 2021, the National TB, Leprosy and Buruli Ulcer Control Programme (NTBLCP) notified just over 207,000 cases, leaving more than half of infections unidentified.
Similarly, out of an estimated 21,000 drug-resistant TB cases, fewer than 3,000 were diagnosed, leaving more than 80 per cent undetected.
Children are especially vulnerable.
TB is often more severe in those under 15 years of age, especially those under five.
Yet, paediatric TB detection remains extremely low, accounting for only six per cent of notified cases nationwide, according to KNCV.
Compounding the challenge are significant funding gaps.
Of the 373 million dollars needed for TB control in 2020, only 31 per cent was available, leaving a funding shortfall of nearly 70 per cent.
Beyond the statistics are real lives disrupted by illness.
For Mrs Grace Enema, a civil servant in Abuja, TB began with what seemed like a harmless cough.
“I thought it was just the weather or stress from work,” she recalled.
Weeks passed. The cough worsened, night sweats began, and she began losing weight.
“A visit to Garki Hospital finally revealed the truth, tuberculosis, but treatment was not available there.
“I was referred to Nasarawa State, where I began treatment immediately and completed the six-month course successfully,” Enema said.
Her case represents what is possible when TB is detected early and treated properly.
However, not everyone is as fortunate.
Mallam Inusa Salisu, a 33-year-old gateman and resident of the Federal Capital Territory (FCT), believed he had defeated TB after completing treatment. Months later, the symptoms returned.
“Doctors diagnosed me with multidrug-resistant TB.
“The treatment became longer, harsher, and far more exhausting. I did not know TB could come back stronger,” Salisu said.
According to the WHO, drug-resistant TB often emerges when treatment is interrupted or incomplete, making adherence to medication critical.
Health experts say stigma continues to hinder Nigeria’s TB response.
Dr Chukwuma Anyaike, Director of Public Health (Rtd) at the Federal Ministry of Health and Social Welfare, said that beyond poverty and weak access to healthcare, stigma remains one of the biggest barriers to TB control in Nigeria.
Anyaike said that many patients delay seeking diagnosis out of fear of discrimination or social isolation.
“Some hide their illness from family members or abandon treatment once symptoms improve,” he said.
He warned that such silence allows the disease to spread quietly within households and communities, making early detection and consistent treatment far more difficult.
Nevertheless, Nigeria has expanded its TB response in recent years.
Dr Adesigbin Olufemi, Head of the Programmatic Management of Drug-Resistant TB Unit at NTBLCP, said the number of health facilities providing TB services increased from about 9,000 in 2018 to more than 25,500 in 2024.
“Over 20,000 community pharmacies have also been mobilised to support case detection.
“Over 1,100 molecular diagnostic platforms have been deployed nationwide, and diagnostic coverage across Local Government Areas has improved from 48 per cent to 78 per cent.
“Portable digital X-ray units equipped with artificial intelligence are also helping health workers screen communities more quickly,” Olufemi said.
Similarly, Dr Temitope Adetiba, Senior Programme Manager at the Institute of Human Virology Nigeria (IHVN), highlighted additional results under the Global Fund–N-THRIP project (2024–2026).
“IHVN-supported facilities tested more than 3.5 million individuals in 2024, leading to the detection and notification of over 350,000 TB cases across Nigeria.
“More than 60 per cent of Nigerians initially seek healthcare through private providers, so we prioritised a Public-Private Mix strategy.
“Over 15,000 patent medicine vendors, traditional birth attendants, and other providers have now been mentored and linked to TB diagnostic and treatment facilities nationwide,” Adetiba said.
Meanwhile, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, said Nigeria is navigating a shifting global funding landscape.
“Through the Nigeria Health Sector Renewal Investment Initiative and the Sector-Wide Approach, the government is strengthening domestic health systems and reducing reliance on foreign aid,” Pate said.
He said tuberculosis highlights why this is essential.
“Despite being preventable and curable, the disease persists because it follows poverty, overcrowding, malnutrition, and weak access to primary healthcare.
“In the past five years, Nigeria has made significant progress; TB service delivery expanded from 9,000 facilities in 2018 to 25,500 in 2024, 20,000 plus community pharmacies mobilised.
“1,100 plus molecular diagnostic platforms deployed, LGA diagnostic coverage improved from 48 per cent to 78 per cent.
“400 AI-enabled portable X-ray units reaching communities nationwide. By the end of 2025, Nigeria had identified and placed about 82 per cent of its estimated TB burden on treatment, leaving 18 per cent still missing,” he said.
The minister added that the WHO’s recommendation for near-point-of-care nucleic acid amplification tests (NPOC-NAATs), battery-powered molecular tests providing results in under an hour, offers a scalable solution to close Nigeria’s diagnostic gap.
“After the Stop TB Partnership Board Meeting last year, a Nigerian delegation visited Pluslife in Guangzhou, China, to explore local manufacturing of WHO-recognised NPOC-NAATs.
“Local production promises technology transfer, skilled jobs, stronger supply chains, and lower costs, building a TB programme sustained by Nigerian systems, not imports,” he disclosed.
However, experts say diagnostics and treatment alone will not end TB.
Prof. Alash’le Abimiku, Executive Director of the International Research Centre of Excellence (IRCE), IHVN, said that ending TB in Nigeria requires broader systemic action.
Abimiku said there is a need for increased domestic financing to fill the 70 per cent funding gap and for community-based case finding, especially in underserved areas.
She said the country also needs integration of TB services into primary healthcare, expanded preventive treatment, especially for close contacts, and sustained political will and advocacy to reduce stigma and misinformation.
For Enema, tuberculosis is now a distant memory, for Salisu however, it remains a daily struggle.
For thousands of Nigerians who are still undiagnosed, the disease continues to lurk silently within communities.
Yet, experts say the tragedy is not the absence of solutions, but the failure to ensure that existing tools reach everyone who needs them.
Tuberculosis is preventable, treatable and curable, but it continues to claim thousands of Nigerian lives each year.
Achieving the global target of ending TB by 2030 will therefore require stronger community engagement, wider access to rapid diagnostics, sustained political commitment and increased domestic investment in the health sector.
Equally important is the need to confront stigma, expand case detection and ensure that treatment reaches vulnerable and underserved populations.
Nigeria, observers say, stands at a critical turning point.
With the right policies, resources and community participation, the country has the capacity to end the spread of tuberculosis.
The challenge now is to translate progress into universal access to care.
Only then can Nigeria finally consign a curable disease that has claimed too many lives to the pages of history.