Nigerians suffering from noncommunicable diseases urgently need cost-effective medications. Authorities seem to be turning to Western nations for assistance to reduce the burden of expensive medication on patients, despite their screening efforts. In this article, ODIMEGWU ONWUMERE explores recommendation focusing on embracing a balanced diet that includes a variety of nutrient-dense foods while controlling portion sizes and seasonings to improve overall health. By making thoughtful food choices, people in Nigeria can significantly reduce their risk of developing diabetes and hypertension.
With concerns over the rising prevalence of diabetes and hypertension, which had reached 90% and 50% for treatment and control rates respectively by December 2023, the Nigerian Health Commissioners Forum launched an initiative on Monday, October 14, 2024, to conduct screenings for hypertension and diabetes for 10 million Nigerians.
These concerns arose as specialists in 53 studies involving a sample of 78,949 Nigerians in 2020 calculated an age-adjusted hypertension prevalence of 8.6% in 1995, equating to 4.3 million individuals aged 20 years. The age-adjusted frequency increased to 32.5% (27.5 million people) in 2020.
In this context, what Nigerians suffering from noncommunicable diseases urgently need are affordable medications. Authorities appear to be looking to Western countries to mitigate the impact of high drug costs on patients.
Meanwhile, the sub-national health promotion initiative known as “Project 10 million—Know Your Number, Control Your Number,” aimed at raising awareness among Nigerians, was presented by NHCF Chairman Dr. Oyebanji Filani, who also serves as the Ekiti State Health Commissioner.
However, the specific strategies for ensuring access to affordable drugs were not clearly outlined. Dr. Filani stated, “NCDs, like high blood pressure and diabetes, present a significant health concern, accounting for around 27 percent of all yearly fatalities in Nigeria.” He emphasized the critical need for intervention, noting that the probability of mortality from these ailments between the ages of 30 and 70 is 17 percent.
“The initiative will prioritize marginalized communities, ensuring that at-risk demographics receive fair access to necessary healthcare services. Individuals can access any public healthcare facility or community outreach location for screening,” he added.
Experts have acknowledged the Merck Foundation’s program, which focuses on enhancing access to fair and high-quality cardiovascular, endocrinology, hypertension, and diabetes care in Africa, Asia, and Latin America. The program has gained recognition following the introduction of its Merck Foundation Media Recognition Awards for “Diabetes and Hypertension.”
High Cost of Medication
Despite these efforts, patients continue to face challenges in affording expensive medications. Hypertension, characterized by persistent elevated blood pressure, is the primary avoidable risk factor for heart disease and the leading contributor to mortality worldwide. Some patients have reported experiencing discrimination in the workplace and educational institutions.
Throughout Nigeria, the costs of most common medications required for health management have risen by more than 200 percent.
For instance, during our investigations, several individuals mentioned that a single hypertension pill they previously purchased for approximately N600 to N700 and a diabetes medication for a similar cost are now sold at a high rate of N5,000 per tablet.
Many of these individuals are retirees, and those who are employed earn less than $100 monthly.
Therefore, managing the illness has become a daunting challenge. This outcry has not gone unnoticed by certain health professionals who have advocated for improving the affordability of medications.
For example, Dr. Olubiyi Adeshina, a specialist in endocrinology at the Federal Medical Centre in Abeokuta, Ogun State, expressed significant concern regarding the escalating prices of diabetes treatment in Nigeria.
Speaking at the Talabi Diabetes Center 4th Annual Ogun Youth Diabetes Camp closing event at the Youth Development Centre, Olusegun Obasanjo Presidential Library in Abeokuta in August, he disclosed that an average individual with diabetes in Nigeria now needs between N70,000 and N100,000 per month for treatment, which exceeds many individuals’ monthly earnings. In 2023, the cost per tablet of medication was N5000.
Adeshina associated the dramatic increase in medication expenses with the recent devaluation of the naira, highlighting that insulin, formerly priced at approximately N6,000 to N8,000, now varies from N13,000 to N18,000, depending on the required dosage in 2024.
Health System Challenges
During the patients’ outcry, public presentations have highlighted that the primary obstacles to enhancing hypertension outcomes in Nigeria encompass health system difficulties such as insufficient funding for non-communicable diseases (NCDs), inadequate incorporation of NCD care into primary health services, recurrent shortages of medications, restricted health insurance accessibility, and a constrained workforce capacity for managing hypertension.
Furthermore, the World Health Organization’s (WHO) core technical package offers strategies for health systems to enhance cardiovascular health care in primary healthcare facilities, but Nigeria has not followed suit. Dating back to 2012, the prevalence of non-communicable diseases (NCDs) has been escalating, with health professionals noting that Africa bears a disproportionate share of this upsurge.
In their assessment at that time, which has escalated to a critical level today, they stated that cardiovascular ailments and diabetes accounted for 48% (18.2 million) and 3.5% (1.33 million), respectively, of the 38 million deaths attributed to non-communicable diseases in 2012; regrettably, 28 million of these fatalities occurred in low- and middle-income nations.
Effects Of Urbanization
Investigations disclosed that with the progression of urbanization, altering dietary patterns, and aging populations, Nigeria has also experienced a rise in adults living with diabetes, from 209,400 in 2000 to 3.6 million in 2021—only South Africa exhibited a higher prevalence in 2021.
Diabetes accounts for approximately 4.5% of fatalities in individuals under 60 years old in Nigeria, leading to common issues such as hyperglycemic emergencies, diabetic foot ulcers, chronic kidney disease, and stroke.
One out of every five adult deaths under the age of 70 is attributed to non-communicable diseases (NCDs), with cardiovascular diseases and diabetes mellitus representing 7% and 2%, respectively, of the 2.08 million NCD-related deaths recorded in 2014.
Approximately 27% of fatalities in Nigeria can be attributed to diabetes, cancer, cardiovascular, and chronic respiratory ailments.
These four prominent non-communicable illnesses (NCIs) are the primary contributors to global mortality, with a significant number of fatalities taking place in low- and middle-income nations (LMIs). Per data, diabetes, defined by increased blood sugar levels, impacts 537 million adults (ages 20-79) globally.
The figure is projected to increase by 46% in 2045. However, initiatives to address non-communicable diseases in Nigeria were revived in 2021 after the Brazzaville statement on NCDs and the subsequent governmental proclamation at the 66th United Nations General Assembly on the prevention and management of NCDs.
These statements establish the foundation for the global WHO NCD Action Plan 2013-2020, which has since been prolonged until 2030, and the struggle could be losing its momentum.
Improving Health Outcomes With Diet
It is anticipated that government officials will reduce the price of medications. But, prior to doing so, there are recommendations indicating that diet has a vital impact on the prevention and control of these ailments, providing a potent instrument for enhancing health results.
Experts said that a nutrition plan abundant in fruits, vegetables, whole grains, and lean proteins is crucial for preventing and controlling diabetes and hypertension.
For example, consuming leafy vegetables such as ‘ugu’ and spinach, which are rich in potassium, can assist in controlling blood pressure. In the same vein, incorporating fiber-dense options like legumes, okra, and whole grains such as millet and local rice aids in controlling blood glucose levels.
As indicated in public discourses, in contrast to North America and Europe, the incidence of hypertension is increasing in West Africa. With a shift from natural foods to packaged foods in Nigeria, dietary choices serve as a primary catalyst for hypertension.
To address this issue, the national dietary recommendations in Nigeria were instituted; however, their conversion into practical resources for healthcare providers continues to pose a difficulty.
At present, there are no straightforward dietary evaluation instruments that are succinct and appropriate for integration into clinical practice without necessitating thorough data examination, yet still offering tailored dietary assistance to individuals.
Nutrition and Accessibility
In central and western Africa, a food and beverage company has committed to offering both children and adults the necessary nutrients required for optimal growth and progress.
In 2022, the company provided individuals in this area with 89.5 billion portions of goods enriched with a minimum of one of the four primary micronutrients individuals lack (iron, iodine, zinc, and vitamin A) to assist them in bridging the gaps related to micronutrient deficiencies, specifically iron deficiency.
The corporation’s recent launch of a milk and soya product in Nigeria forms part of the company’s dedication to providing improved nutrition at an affordable rate and enhancing accessibility throughout the area.
This demonstrates how cost-effectiveness can be incorporated into nutritional remedies, guaranteeing that crucial nutrients are accessible to everyone, irrespective of economic circumstances.
Acknowledging that accessibility also impacts affordability, the company utilizes locally obtained soybeans for the production of milk and soya product in Nigeria.
In this manner, the corporation not only backs local farming but also guarantees that the merchandise is easily accessible to customers in the area. This regionalized method of manufacturing and procurement decreases shipping expenses, reducing the cost of the item for the final customer.
Onwumere is Chairman, Advocacy Network on Religious and Cultural Coexistence (ANORACC).
