100m Nigerians’ll suffer from asthma in 2025 – Uba

Disturbed by asthma-related deaths, especially after losing his wife to the ailment in 2016, Mr.
Chiwuike Uba founded Amaka Chiwuike-Uba Foundation (ACUF) in 2016, to sensitise Nigerians on asthma.
PAUL OKAH caught up with him in his Abuja office recently, and the professional accountant, economist and governance expert bared his mind on asthmarelated ailments, activities of the NGO, the role of government in combating asthma and other sundry matters in this interview.
Excerpts.
Why ACUF? The Amaka Chiwuike-Uba Foundation, otherwise known as ACUF, is a child of necessity; an idea founded on the altar of pains.
The idea is to ensure that we stem the tide of increasing deaths and pains associated with asthma, allergy and other respiratory diseases.
Having lost my wife to death on July 4, 2016, from asthma crisis, I decided to have a platform to create asthma awareness; as well as provide support services to those suffering from asthma and other respiratory diseases.
For us, we want to see a society with better breathing and better living, a society with happier, united and prosperous people.
The idea is also to have an organisation that uses empirical evidence to make some interventions in the areas it has chosen to work.
Therefore, in implementing the programmes and activities of the Foundation, we decided that it must be anchored on five strategic approaches: research, education and training, policy analysis and advocacy, networks and partnerships.
Awareness creation The Foundation’s programmes and activities are carried out on the Foundation’s three Centres of Excellence.
That is, the Centre for Asthma, Allergy and Respiratory Conditions (CAARC), the Centre for Innovation, Youth, Rural and Sustainable Development (CIYRSD) and the Centre for Leadership and Global Education (CeLGE).
The Foundation, within one year of its establishment, has recorded some giant strides.
First, the Foundation carried out the review of studies on assessment of facilities and resources available for asthma management in Nigeria.
This study showed the inadequacy of infrastructure, equipment and human resources needed for the management of asthma in Nigeria.
The outcome of this study led to increased stakeholder awareness on asthma and stimulated demand for implementation of various reforms to address the challenges found by the study.
As an organisation, under our Schools Asthma Education and Awareness programme, we visited schools to create asthma awareness and also train teachers and students on various prerequisite techniques needed in managing asthma.
We have also organised trainings for medical practitioners; like doctors, nurses and pharmacists on the use of asthma management tools, especially the application, measurement and interpretation of spirometry.
This training is in response to addressing the challenges of either wrong or poor diagnosis of asthma, which we identified as one of the major problems, especially encountered by patients in our healthcare institutions.
Annual conference, experts’ participation ACUF also organised the annual Amaka Chiwuike-Uba Asthma Conference on July 6, 2017, in collaboration with the Nigerian Medical Association, the Nigerian Thoracic Society and other health organisations: where the issue of diagnosis and management of asthma was adequately xrayed by experts.
The annual conference had in attendance notable health experts, policy makers, including: Dr Ikechukwu Obi; a Community/Public Health Medicine specialist, Mr Larry Oguego; the National The Coordinator, Human Rights Volunteer Corps of Nigeria (HRVCN), Dr Adaeze Ayuk; a Consultant Pulmonologist and Paediatrician, Cajetan Onyedum; a Professor of Medicine and Consultant Respiratory Physician, as well as those suffering from the disease.
The conference also had top government officials, especially the Minister of Health; Prof Isaac Folorunso Adewole, Minister of Education; Malam Adamu Adamu, Minister of Science and Technology; Dr Christopher Ogbonnaya Onu, former governor of Delta state; Dr Emmanuel Uduaghan and former Speaker of the House of Representatives; Rt.
Hon.
Ghali Umar Na’Abba in attendance; which makes the implementation of some of the key decisions of the conference easier.
Workshop series Under the Centre of Leadership and Global Education, the Foundation has achieved so much with the training of our youth under the monthly Youth Development and Leadership Workshop Series. Our understanding is that, whereas youths are branded the leaders of tomorrow, they arealso leaders of today and need to be properly equipped to handle the challenges of the now and future.
Our first training was on visioning and goal setting. We are happy that the monthly training is yielding the desired results, going by the feedback we receive from the participants.
Rising asthma cases Unfortunately, it is evident that the government has not seen asthma as an emergency and something that requires urgent attention.
Currently, more than 15 million Nigerians are suffering from asthma and this is projected to increase to 100 million by year 2025.
It is important to have national guidelines on asthma management in Nigeria, but this very important policy document is lacking in Nigeria.
I know that the Nigerian Thoracic Society developed national guidelines, but that has not been adopted and gazetted by the government.
A policy is a road map to solving the challenge. Government should also increase the allocation to the health sector, most importantly giving critical attention to the infrastructure and equipment required for the management of asthma in Nigeria.
It is also important to ensure that we have a cleaner environment.
It is worrisome that currently, there is no well-articulated and followed-through government policy in Nigeria to reduce the level of pollution in the country, even when Nigeria was rated as the most polluted country in the world as at 2015.
Painfully, in Nigeria, the estimated proportion of registered respiratory physicians to national population is one per 2.3 million individuals.
This actually lends credence to the fact that part of the causes of increased mortality and morbidity is poor diagnosis; traceable to poor governance and environmental management.
In addition to other poor infrastructure issues, 13 states, with an estimated combined population of 57.7 million people, offer no specialist respiratory services.
In view of the above, effort should also be geared towards encouraging more doctors to specialise in pulmonary medicine.
It may interest you to note that Nigerians are already spending so much on asthma management.
This is corroborated by the findings of a cross-sectional study conducted in three tertiary hospitals in Nigeria by Dr. Cajetan Onyedum in 2014.
The annual out-of-pocket cost of asthma incurred by patients in Nigeria was US$368.4 per patient.
Medication cost accounted for the majority (87%) of this cost.
This cost does not include other direct, indirect and intangible costs and is not related to costs incurred by patients with exacerbation and differing severity of the disease.
This shows that in Nigeria, the annual average out-of-pocket costs incurred my asthma patients is $5.5 billion (N2 trillion).
Government should also encourage the private sector and individuals to see asthma as a national epidemic that requires the contribution and support of everyone.
There is need for national dialogue on asthma management in Nigeria.
Sponsorship, media partners Currently, ACUF does not have official sponsors.
Most of the programmes and activities are funded by the Founders’ savings.
Having said that, it is important that I acknowledge the support of the GlaxoSmithKline (GSK) for donating 70 pieces of Pek Flow Meter during the first Amaka Chiwuike-Uba Annual Asthma Conference.
I am equally grateful to Charles Winnsboro Group, which has continuously allowed ACUF to make use of its meeting room for the Youth Development and Leadership Workshop Series in Enugu. We have also enjoyed technical support from the Nigerian Medical Association, Nigerian Thoracic Society, Human Rights Volunteer Corps and Knowledge and Policy Management Initiative.
ACUF is also a member of NCD Alliance Nigeria and Nigeria Network of NGOs.
ACUF has also enjoyed the support of many media houses in Nigeria (too numerous to mention); for wider outreach.
Blueprint has been wonderful as well. At ACUF, we are more interested in delivering on our mandate. However, we are confident that as people begin to appreciate the impact we are making, they will be encouraged to support us.
For example, we have not been able to establish some asthma crisis management centres across the country, because we currently do not have the resources to assemble the required equipment.
Recession, economic implications President Buhari recently said that Nigeria is out of recession.
Surely, we are out of recession; but in the nominal sense. After all, recession is a function of numbers.
“An economic recession is typically defined as a decline in gross domestic product (GDP) for two or more consecutive quarters.” This means also that, if the GDP grows for two or more consecutive quarters, you are automatically out of recession.
Therefore, the question should be: is Nigeria’s purported growth, anchored on GDP, a real growth? Is it inclusive? What is the impact on the well-being of the citizens? Anyway, the reality on ground is that, whereas Nigeria is out of (nominal) recession, poverty is increasing in Nigeria.
Unemployment rate is widening, depression and suicide are beginning to be part of our daily news item.
It will interest you to note that, in 2014, when Nigerians were spending about $368.4 per patient, the cost of Ventolin inhaler was about N980/per one and other asthma medications were a lot cheaper.
Today, average cost of an inhaler is about N1100/per one.
What this shows is that it is costlier to manage asthma in Nigeria, currently.
A conservative annual estimate currently should hover around N3 trillion.
It is important to note that the above amount is out-of-pocket expenditure by those suffering from asthma.
Role of the media The role of the media in creating asthma awareness is incontrovertible.
In fact, the media is at the center of creating asthma awareness.
It is in recognition of the critical role of the media in this project that we have made the media our best friend.
In all honesty, the media have been extremely supportive of our programmes.
ACUF has enjoyed free airtime and space from the electronic and print media in Nigeria and outside the country.
For instance, when the first Annual Conference was organised last year, we had over 400 media mentions across the globe, including the Reuters, yahoo news, fox, etc.
We have had many activities this year covered by the media.
I’ve been on air twice at Army FM in Abuja.
I have also been to Solid FM Enugu, Dream FM, Enugu, NTA Asaba, etc, to enlighten people on asthma and provide support services to patients.
We’ve also organised many youth development and leadership trainings in the past.
In fact, our two-day Youth Conference and Concert ended last week, but we will still organise more events in the future.
Therefore, without the media, our work may not achieve the desired impact, so we are appreciative of the existing support and collaboration from the media.
Advice for patients The first way to manage asthma is the identification of asthma triggers; different things trigger asthma in different people.
Therefore, reducing exposure to environmental factors, such as indoor and outdoor asthma-triggers, is important for asthma management.
It is also very important for an asthma patient to use the prescribed medications by the doctor as prescribed.
Most times, asthma patients tend to abandon their routine drugs as soon as they get relief.
People also learn how to avoid and manage stress. Strong emotions, such as anger, stress, fear, excitement, laughter, yelling, crying, etc, have been identified as one of the triggers of asthma because, during such period, breathing changes.
For those working in an industry that exposes them to the identified substances that triggers asthma, it is important to consult either qualified occupational physician or respiratory physician to check their systems.
Asthma is not a death sentence. If you can manage it, you can live a normal life. Platform for more info on asthma ACUF has established different platforms that enable people to learn more about our activities.
The first platform we have is a boundless and virtual platform – that is our website: www.acuf.org.ng We also have an office in Enugu and liaison offices in Abuja, and Owerri.
It is important to also state that, outside these conventional information hubs, ACUF, through its programmes and activities, create periodic platforms; where people can learn more about us and asthma management.
Some of these platforms include: Physicians and Medical Practitioners Asthma Management Education (PMAME), which is a periodic meeting and capacity building workshop for physicians and other medical practitioners on asthma management tools.
The Asthma Management Education sessions provide up-to-date, evidence-based information on key asthma management principles and techniques, including the consumerpatient perspective; to enhance an improved care for people with asthma.
Enlightenment for schools We also have the Schools’ Education and Training Workshops on Asthma Management; this is aimed at educating and training students, teachers, school nurses and school staff members on asthma and how to manage asthma in schools.
This is geared towards increasing asthma awareness among the community as well as protecting a child with asthma.
The Asthma Awareness and Advocacy Programmes focus on improving asthma, allergic and other respiratory diseases awareness and understanding (including advancing basic and clinical research to prevent, treat and cure these conditions).
ACUF also works with the media (electronic, print and social media) to create awareness on these diseases.
These include: Live radio and TV phone-in programmes, production and distribution of newsletters and fact sheets, syndicated articles, and facilitation of conclaves with champions/asthma advocates, religious and traditional institutions. Advice for Nigerians As Nigerians, it is important that, while we recognise the role of government in providing goods and services to the citizens, it is also important to note that health management and its outcomes are the collective responsibilities of all involved.
As citizens, we must seek accountability, transparency and openness in governance; while also, as individuals and corporate institutions, we should make our contributions to the overall well-being of the nation.
It is in recognition of this shared responsibility that ACUF is doing what it is currently doing.
Companies should also invest in critical infrastructure.
To digress a bit, you only get to know that greater percentage of our elite and politicians are asthmatic, only when they face the law and are in danger of being incarcerated.
It is important, therefore, that collective effort should be made towards building the required infrastructure for asthma management in Nigeria.
Remember, together, we shall beat asthma.

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