Cardiovascular Journal of Africa: Vol 31 No 4 Supplement (July 2020)

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Cardiovascular Journal of Africa • Volume 31, No 4 August 2020 S25 AFRICA
changes.52 Furthermore, Nigeria is said to pose a threat to
ending world poverty by 2030 and has overtaken India in
having the poorest people in the world, which could affect
people’s health.54,55
Weaknesses
No relevant data are available on the estimated direct cost
(in current US$) of tobacco use in the Nigerian population.
Although there is a national Tobacco Control Act 2015, not
all aspects have been implemented in Nigeria.32 Various NGO
played an active role in advocacy, however, a policy for the
tobacco control plan took 10 years after approval of the
FCTC before being passed because of constraints in funding
and conflict of interest.
Most of the essential CVD medicines are not available
in the public health sector, although they appear on the
Essential Medicines List (EML).5,22 In his foreword of the
EML, the minister of health urged that essential medicines
should be available to everyone throughout the country at
all times as it expands its primary healthcare system.22 Other
services or interventions that are not widely used as a policy
at public sector health facilities are CVD risk stratification,
measurement of total cholesterol levels, and provisions for
secondary prevention of rheumatic fever and RHD. These
services, however, are available in many tertiary hospitals
in the country. Efforts spearheaded by the Nigerian Cardiac
Society task force on Rheumatic Heart Disease are in
progress to implement locally relevant clinical guidelines for
managing pharyngitis, ARF and RHD, however, no data are
available regarding AF-related guidelines.
Although the availability, affordability and accessibility
of healthcare along with sustainability were available,
deficiencies were present in all of these aspects.38
No data regarding judicial orders protecting patients’
rights and mandating improved CVD interventions, facilities,
health system procedures or resources are available. The
same applies to sustainable funding for CVD and taxes on
unhealthy foods or sugar-sweetened beverages.
Priorities
At a meeting held in Abuja, Nigeria in August 2017, it
was recommended that government and other relevant
organisations join hands to prevent and control NCD.53
Funds should be increased for healthcare, and access to
affordable and effective medicines ensured to meet the WHO
recommendations. NCD risk factors, including a sedentary
lifestyle, unhealthy diet, overweight, and tobacco and alcohol
use should be addressed via legislation, health education and
advocacy. Integration of prevention and control strategies for
NCD should also be encouraged and intensified.53
At a consensus summit in 2016, researchers suggested
Nigeria’s FMoH should provide guidelines for acceptable
dietary lipids along with commissioning research and a
nationwide survey on NCD.30
Not all the tobacco control policies in Nigeria instil the
principles of multi-sectoral actions or best-buy strategies in
their formulation. Therefore, an urgent need exists to address
these neglected areas that may hamper tobacco control
efforts.31,32
To achieve the global target of a 25% reduction in
premature death by 2025, the president of the Nigerian NCD
Alliance, Dr Sunny F Kuku, said this would be challenging
and recommended that prevention of NCD be targeted early.
Therefore, awareness and management of NCD would need
determined efforts to prevent these diseases and their risk
factors effectively.45
This publication was reviewed by the PASCAR Governing Council and
approved by the the Nigerian Cardiac Society.
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