Every Nigerian at risk of blindness from Glaucoma

Associate Professor of Ophthalmology, Dr. Adeola Onakoya has called for increased awareness against Glaucoma, the second leading cause of irreversible blindness worldwide. Onakoya, who is the Head, Glaucoma Services and Acting Head of Department of Ophthalmology, College of Medicine/Lagos University Teaching Hospital, said it was necessary to sustain awareness about glaucoma and to encourage all Nigerians above the age of 30 to undergo regular screening for the common cause of blindness.
“It is a public health problem. Currently, 70 million people suffer from Glaucoma worldwide, with 10 million blind. It is anticipated that by 2020, sufferers would increase to 80 million and blindness from the disease will increase as well,” she noted in a statement.
Blindness from Glaucoma is 10 times higher in the developing world, with an aggressive clinical course in blacks, she noted that prevalence increases with age in 0.5-9 per cent of population over 40 years and increases to 15 per cent in population over 65 years.
“With ageing, the population of sufferers will increase. Population studies in Nigeria revealed that 5.02-6.9 per cent(1.8million) of people over 40 years suffer from Glaucoma with almost 360,000(20 per cent) of them blind in both eyes.”
Onakoya said the disease is asymptomatic and progressive with sufferers unaware until at an advanced stage when there is irreversible visual loss.
“Awareness is very poor with only 5 per cent of the Nigerian Glaucoma population being aware. Early detection and appropriate treatment of the disease seem to be the answer to the late presentation of sufferers and reduction of blindness from the disease.
“Education on the natural history of the disease will also improve the compliance and adherence to treatment in the diagnosed patients. Creation of awareness on the disease process and enlightenment programmes, backed up with case detection (through screening) will go a long way in reducing blindness.”
She said special attention should also be given to First Degree Relatives (FDR) of Glaucoma patients because of the heritability nature of the disease with the hope that the news can spread through word-of-mouth through at-risk groups.
“Every Nigerian is at risk of the disease but this is higher in the population over 30 years, so special attention must be paid to include every Nigerian above the age of 30 years as the disease tends to present a decade earlier in Africans.
In recognition of the importance of this common cause of blindness, the World Glaucoma Association (WGA) and World Glaucoma Patient Association (WGPA) declared March 12th of every year as World Glaucoma Day (WGD) 10 years ago.
Two years later, this was extended to a weeklong celebration (WGW). Mass Glaucoma screening and early treatment have been a cardinal aspect of the Rapid Response Initiative (RRI), one of President Mohammed Buhari’s nationwide quick-win thrusts in healthcare.
Onakoya argued that in pursuance of the same vision, the Lagos University Teaching Hospital has outlined a robust programme to educate the public on Glaucoma and also carry out case detection tests for the public.
This was done in conjunction with Glaucoma Patient Care Initiative in Nigeria, a registered glaucoma patients group and the ongoing RRI programme. The screening exercise commenced 14th & 15th March, 2017 at the Guinness Eye Centre, LUTH, in partnership with Pfizer Specialties and Novartis Ophthalmics.
A public lecture to sensitise the populace and impart knowledge held Thursday 16th March 2017 at National Sickle Cell Centre, co-organised with Ophthalmological Society of Nigeria, Mundi Pharma and Novartis Ophthalmics.

Investing in nutrition is an economic necessity in Nigeria

By Senator Lanre Tejuoso

Nigeria is in a state of double emergency. Chronic malnutrition, caused by poor nutrition over a long period of time, plagues one in three children under five. And in recent years, acute malnutrition has skyrocketed—particularly in the northeast—necessitating urgent, life-saving action. This widespread malnutrition crisis threatens the health and development of both individuals and the nation. Policymakers need to establish large-scale programs that treat and prevent malnutrition by funding interventions that target our most vulnerable, save lives and boost Nigeria’s long-term economic development.

Up until now, our response to the malnutrition crisis—both the emergency in the northeast and high rates of chronic malnutrition around the country—has not matched the severity of the problem. Of the 2.5 million children suffering from severe acute malnutrition each year, we only treat about 500,000 with the help of our partners, leaving a huge gap that calls for more commitment.

Chronic malnutrition rates which have remained fairly stagnant for the last 15 years also need to be addressed.  Eleven million children are malnourished in Nigeria. As a result, the lives, development and future productivity of 11 million children are all compromised. Yet to date, nutrition policies and programs have been chronically underfunded. The disconnect between what is urgently needed and current funding levels is deeply concerning.

Nigeria’s economic situation makes investments in nutrition all the more crucial. Even in the midst of a recession, nutrition needs to be prioritized. The toll that malnutrition takes on the economy cannot be ignored. Poor nutrition impedes cognitive and physical development, which translates to decreased learning ability, reduced productivity in adult years and increased healthcare costs. African countries lose an average of 8 percent of their annual GDP due to malnutrition. Micronutrient deficiencies alone result in a USD 1.5 billion loss in Nigeria each year. On the flipside, every dollar invested in nutrition in Nigeria has an average return of nearly USD 17. These figures leave little doubt of the economic potential of nutrition.  If Nigeria is to compete in the global economy—and supercharge the potential demographic dividend—, it will need to ensure its children are well nourished.

Progress is possible, and we now know what works. Targeting women and children—especially during the first 1,000 days of life—with interventions like food fortification and breastfeeding promotion, has proven to yield significant results and end the corrosive cycle of multi-generational malnutrition. Conversely inaction in those first 1,000 days likely means that any later interventions will be too little, too late, and too costly. Policymakers structured the National Food and Nutrition Policy on this knowledge—selecting and costing nutrition programs to maximize impact, all but guaranteeing a strong return on investment and improving the health of Nigerian’s population.

But investments in these interventions in Nigeria remain much too low and significantly lower than neighboring countries. Scaling up such proven interventions could help Nigeria reach the World Health Assembly (WHA) target of reducing stunting by 40 percent by 2025 and add USD 29 billion to our economy.  It is encouraging to note that rates of chronic malnutrition vary considerably between states in Nigeria, with some stunting rates among children at more than 50 percent and with several others with rates around 20 percent. This indicates that it is possible to address malnutrition even in the complex Nigerian environment.

Policymakers now need to marry the political will that gave rise to the National Food and Nutrition Policy with the actions needed to achieve impact. The recent high-level policy dialogue, “Nigeria’s Nutrition Crisis,” which I chaired, hosted by the Nigerian Senate Committee on Health and Federal Ministry of Health, resulted in a call for a USD 305 million (N1 billion) investment in nutrition in the 2017 budget at the very least, which closely aligns with the government’s costed plan to scale-up a set of effective nutrition programs across the country. The Senate Committee on Health will be on the lookout for this as we deliberate on the 2017 budget proposals. 

We can no longer afford to let policies gather dust on a shelf; government leaders must invest in and implement strong nutrition policies. Nigeria has an ambitious vision of becoming one of the largest economies in the world and establishing itself as a significant player in the global economic and political arena. This vision will not be realized unless we follow through on our commitments to improve nutrition. With increased leadership and action, Nigeria has the potential to make unprecedented progress that will be evident for generations to come – that is the change we promised. There is no time like the present.

Senator Lanre Tejuoso of the Federal Republic of Nigeria represents the Ogun Central Senatorial District which comprises of Abeokuta North, Abeokuta South, Obafemi/Owode, Odeda, Ewekoro and Ifo Local Governments. He also serves as Chairman Senate Committee on Health, Nigeria.