Case Study for the GTBC Library - TB Prevention Briefing 2025

NIGERIA

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499,000	Number of people who fell ill with TB in Nigeria in 2023
4241%	Increase in TPT coverage between 2020 and 2024
29%	TPT coverage among household contacts of people with TB in 2023

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Dr Obioma Chikoke-Akaniro is Deputy Director and M&E Lead at Nigeria’s National TB, Leprosy and Buruli Ulcer Control Programme. She is an expert panel member for the Global TB Caucus’ new library briefing on TB prevention. Here, she outlines her team’s effort to expand access to TB preventive treatment in Nigeria, which is home to one of the highest TB burdens in the world. 

Understanding programmatic gaps 

Over the last 10 years, Nigeria has been able to significantly increase treatment coverage for people with TB disease. However, progress towards offering preventive treatment (TPT) to people who had been exposed but not yet developed TB disease was lagging behind. In 2020, under 10,000 people accessed TPT, which is less than 25% of the national target set on the basis of the commitments made at the 2018 United Nations High Level Meeting on TB. 

The TB programme quickly established one of the main hurdles to expanding access to TPT - the intervention was entirely passive. At the time, household contacts of people with TB disease could only access TPT if they travelled to healthcare facilities for assessment and treatment initiation. This resulted in major socio-economic barriers to care. 

Bringing TPT to people 

By the end of 2021, the National TB Programme operationalised active contact tracing, providing transportation stipends for healthcare workers to visit the homes of people who were diagnosed with TB disease. Having received comprehensive training, these outreach workers could identify people who would benefit from TPT, explain the risks and benefits of TPT, and initiate the treatment in the person’s home. 

With over 300,000 people being diagnosed with TB disease in Nigeria, the programme also deployed community TB workers to support initial contact tracing. Once individuals eligible for TPT were identified, they would then be referred to qualified healthcare workers to initiative treatment. 

This proactive outreach has proved highly effective. Following a more gradual increase in TPT coverage in the first year of the programme, the number of people accessing TPT has more than doubled each year. 

From donor pilot to national success - the role of parliamentarians 

Until now, the provision of travel stipend for home visits and a communication allowance for healthcare and community workers to reach out to households affected by TB was made possible through investment from the Global Fund to Fight AIDS, Tuberculosis and Malaria and the United States Agency for International Development (USAID). 

Now the intervention has proven to be so effective, the next step is to fully integrate TB prevention into the domestic budget. This is where parliamentarians play a crucial role, ensuring the domestic budget includes sufficient funds to cover these outreach services. 

Dr Obioma Chikoke-Akaniro underlines that in addition to helping deliver important national public health goals, this funding also helps reduce the catastrophic costs faced by TB-affected households. 

Earlier this year, Nigeria’s National TB Caucus helped push for an unprecedented increase to Nigeria’s health budget. While things are definitely moving in the right direction, more work is left to be done to ensure all eligible people can access TPT in Nigeria. 

This case study was developed to complement the new Global TB Caucus Library Briefing on TB Prevention. To find out more about why TB prevention matters,  and what parliamentarians can do to increase access to  these life-saving tools , click here.

The data presented in this case study was shared by the National TB Programme of Nigeria and drawn from the WHO Global TB Report.