As Nigeria joins the rest of the World to commemorate the 2024 World Sickle Cell Day, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate CON,has said that government recognizes the huge burden of socio-economic and psychological effects of Sickle Cell Disease (SCD), and has instituted policies and several strategic Interventions to address the challenges of the disease.
Pate, who was represented by the Director Public Health, Dr. Chukwuma Anyaike, made this assertion at the Ministerial Press Briefing, with the theme “Hope through Progress: Advancing Care Globally”, which came about as a result of the recognition of the increasing Sickle Cell Disease global health impact, socio-economic, infant and child morbidity and mortality resulting from the disease, held on 19 June, 2024, in Abuja.
According to the Minister, available records show that SCD affects nearly 100 million people globally and is also responsible for over 50% of deaths, in those with the most severe form of the disease (Hb SS). It is the most prevalent genetic disease in the WHO African Region. In many countries of the region including Nigeria, 10%–40% of the population carries the sickle-cell gene resulting in estimated SCD prevalence of at least 2%.
The situation in the region also indicates that national policies and strategic action plans are inadequate; appropriate facilities and trained personnel are scarce; adequate diagnostic tools and treatments are insufficient, as well as synergy amongst various stakeholders and NGOs in the prevention and control of the disease.
In Nigeria, Sickle Cell Disease contributes significantly to both child and adult morbidity and mortality. Nigeria stands out as the most Sickle Cell Disease endemic country in Africa and globally, ahead of India and Democratic Republic of Congo, with an annual infant death of 100,000 representing 8% of infant mortality and those that manage to survive suffer end-organs damage which not only shortens their lifespans but also affects their quality of life across the life course. The 2018 NDHS report put the prevalence of the disease in the country at 1% while 25% of Nigerian are healthy carriers of the disease.
The Minister went further to highlight policies and several strategic interventions by the federal government to include; the development of the first national guidelines for the prevention and control of the disease and the Universal Newborn Screening policy adopted to ensure that all children born in Nigeria are screened for SCD; First national NCD survey was conducted in 1990 to include determining the prevalence of the disease in Nigeria and strategic plan of actions developed to address the disease; Primary Health Care (PHC) workers were trained for the implementation of the Universal Newborn Screening for SCD policy in the South-West geopolitical zone of Nigeria with ongoing plans to train the remaining geo-political zones of the country.
Other interventions are the development of a National Desk Guide and Standard Operating Procedure (SOPs) to provide step by step instruction for healthcare workers to perform newborn and infant screening for SCD and also to ensure quality outcome for the Universal Newborn and infant screening programme for SCD in Nigeria; the establishment of (6)centers of excellence for the control and management of SCD across Nigeria, one in each geo-political zone with each equipped with HPLC and other complementary equipment and staff to serve as a hub for newborn screening.
Government through the FMoH recently reviewed the first national guidelines for the prevention, control and management of SCD and protocol for newborn screening to include new findings and technologies that had been found to be game changers both in the management and screening for the disease among newborn and the general population; the Integration of the NCDs including SCD care and services into the primary healthcare services has been initiated, which is an ongoing initiative; Nigeria-PEN strategy, adapted from WHO-PEN included SCD for Nigeria taking into account genetic counselling, diagnosis, newborn screening and comprehensive care package for SCD within the primary healthcare level with inbuilt cost-effective referral system. The strategy has been piloted in FCT and plans are on to scale up to the states at subnational level.
The Multi-Sectorial Action Plan (MSAP) and its Technical Working Committees involving different stakeholders were established to address the prevalence of SCD and other NCDs in Nigeria; advocacy and mass mobilization for awareness creation on SCD and the importance of genetic counselling and testing for Hb genotype commenced in some parts of the country, this is an ongoing initiative and the adoption of the Point of Care Screening method as the primary screening method for SCD to ensure improved access to quality screening and early identification of the disease.
Earlier, Permanent Secretary FMoH, Daju Kachollom mni, represented by Dr. Muhammad Ozi, National Coordinator, Non-Communicable Disease disclosed that while SCD remains the commonest human inherited disease, it can be effectively prevented and managed at community level through sustained public creation, capacity building of health workers, early diagnosis, genetic counselling and improve compressive care, treatment and support.
In his goodwill message, Dr. Kelias Msyambota, who represented the WHO Country Representative to Nigeria, said in 2022, a campaign was launched by the African Health Ministers to enhance advocacy and shore up political will as well as financial resources for sickle cell disease prevention and control across the African region. Additionally, the Package of Essentials NCDs Interventions (the PEN-Plus strategy) was adopted during the 72nd session of the regional committee, which address severe NCDs including sickle cell disease through an integrated approach. Nigeria, he said has been selected as one of the 20 priority countries to implement the PEN-Plus intervention.
Patricia Deworitshe
Director (Information & PR)
