Asthma care: Upholding the right to breath
By Abiemwense Moru, News Agency of Nigeria (NAN)
At 34, Ada Gaius, a single mother of two and hairdresser living in Nasarawa, has battled asthma since she was diagnosed at the age of 10.
Gaius’s story is a stark reminder that asthma is more than just a medical condition; it is a daily struggle that many Nigerians face in silence.
Her childhood was marked by nights filled with terror, gasping for air while her mother frantically tried to find relief.
“Growing up, my family couldn’t afford the proper inhalers.
“Most times, I relied on herbs or boiled water, hoping it would ease my breathing; sometimes, my attacks were so severe, I truly believed I would not survive.”
As an adult, the battle has only grown more challenging.
With a monthly income of about N40, 000, Gaius finds it nearly impossible to afford her N35, 000 combination inhaler regularly.
She resorts to using salbutamol inhalers, short-term relief medications, sparingly, even though they do not manage the disease’s underlying inflammation.
“I often skip meals just to buy my inhalers; when I cannot afford them, I pray; last year, I had a severe attack and was rushed to the hospital; I was unconscious for hours.”
That terrifying experience was a turning point; since then, Rita has become an active volunteer with an asthma support group and speaks publicly to raise awareness.
“I speak up because so many people are like me, suffering silently; we just want to breathe,” she said.
Prof. Chiwuike Uba, founder of the Amaka Chiwuike-Uba Foundation (ACUF), said the personal stories underscored the gravity of Nigeria’s asthma crisis.
“The statistics are more than just numbers, they represent real people’s pain, sacrifice, and, tragically, preventable deaths.
“The estimated asthma prevalence in Nigeria ranges from 5.12 to 14.7 per cent, with projections warning of a further increase by 2025; this trend demands urgent, coordinated public health intervention.
“Across Africa, asthma rates vary widely, but in Nigeria, worsening air pollution and rapid urbanisation are accelerating the disease burden.
“Behind these numbers are children missing school, families forced to choose between food and medicine, and countless patients struggling to access even the most basic care.”
His foundation tirelessly advocates for awareness and support, emphasising that asthma is not just a medical challenge, it is a social and economic crisis.
He said one of the biggest barriers to effective asthma management in Nigeria is the prohibitive cost of medications.
According to him, basic short-acting beta-agonist (SABA) inhalers which offer immediate relief during asthma attacks, cost between N5, 000 and N8,500.
However, he said the inhalers only alleviate symptoms temporarily and do not address the chronic inflammation at the heart of the disease.
“Inhaled corticosteroids (ICS), the cornerstone of long-term asthma control, and combination inhalers containing ICS and long-acting beta-agonists (LABA) can cost anywhere from N34,500 to N70,000, amounts far beyond the reach of many Nigerians.
“These are not luxury items; they are life-saving medications; expecting someone to spend an entire month’s salary on a single inhaler is inhumane.”
He said the situation was worsened by the withdrawal of major pharmaceutical companies such as GSK from the Nigerian market, Nigeria’s heavy dependence on imported drugs, and the devaluation of the Naira, all factors driving prices even higher.
“With 75.5 per cent of rural dwellers and 41.3 per cent of urban residents living below the poverty line, many Nigerians face a heartbreaking choice: either purchase asthma medication or meet basic needs like food and shelter.
“Tragically, this trade-off often leads to fatal outcomes.”
On systematic gaps and solution, he said Nigeria boasted approximately 40,400 healthcare facilities, but the reality was sobering.
He said about 85 per cent of these facilities were primary health centres (PHCs), and more than 80 per cent of those were reportedly under-equipped, understaffed, or barely functional.
“This fragile healthcare infrastructure is ill-prepared to offer consistent, effective asthma care.
“Compounding the problem is the absence of a comprehensive national guideline for asthma management.
“Without standardised protocols, care varies widely across regions, often leaving patients without the necessary treatment and follow-up.”
Uba said environmental factors also played a deadly role in Nigeria’s asthma crisis.
“Cities like Lagos, Port Harcourt, and Kano are plagued by severe air pollution resulting from vehicle emissions, biomass fuel use, industrial waste, and persistent gas flaring.
“These pollutants do not just worsen symptoms for asthma sufferers; they can trigger the onset of the disease in people who previously showed no signs,” he said.
Uba, therefore, called on the Nigerian Government to prioritise the development and enforcement of national asthma guidelines, noting that such measures could dramatically improve patient outcomes.
Worthy of note, the Federal Government, through Health and Social Welfare Coordinating Minister Prof. Muhammad Pate, has acknowledged the severity of the problem.
Pate appealed to pharmaceutical companies to utilise import duty waivers to increase the availability of inhalers and reduce their cost, emphasising that “breathing should never be a privilege.”
The minister said that government’s Non-Communicable Disease (NCD) Control Programme had rolled out policies aimed at improving asthma treatment.
“The Nigeria Package of Essential Non-Communicable Disease Interventions (NIG-PEN), integrated into PHCs, focuses on early diagnosis and continuous care for asthma patients.
“These initiatives align with the broader Nigeria Health Sector Renewal Initiative and the national vision for Universal Health Coverage,” he said.
More so, an expert perspectives and public awareness, Dr Oluwafemi Ojo, a pulmonologist at Lagos State University Teaching Hospital (LASUTH), estimates that more than 20 million Nigerians live with asthma.
“Yet most cannot access the treatment they need; we need to move beyond short-acting inhalers like salbutamol.
“The global standard is now inhaled corticosteroids, which target the underlying inflammation and prevent attacks he explains.’’
Ojo advocates government support to stimulate local inhaler production, reducing dependence on costly imports and foreign exchange.
He also called for expanded health insurance coverage that included asthma medications, particularly for low-income earners.
Supporting these efforts, Dr Oluwatoyin Ojo, Director of Pharmacy at LASUTH, highlights the critical role pharmacists play in educating patients about proper inhaler use, adherence to treatment, and managing side effects.
“Education can significantly reduce preventable asthma morbidity and mortality,” she said.
On prevention, education and equity, Dr Modupe Ajibawo, a Family Physician at Federal Medical Centre Ebute Metta, stressed early prevention strategies as key to reducing asthma’s impact.
She underscored exclusive breastfeeding as a protective factor against childhood allergies and asthma.
Ajibawo also points out common asthma triggers such as dust, pollen, air pollution, and weather changes.
She advised patients to avoid exposure whenever possible and adhere strictly to prescribed treatments.
“Asthma, though chronic, can be effectively managed, allowing individuals to live full, productive lives,” Ajibawo said.
Globally, the World Health Organisation estimates that more than 250 million people live with asthma, with more than 450,000 deaths annually; Nigeria alone recorded 8,192 asthma-related deaths in 2020.
Stakeholders say World Asthma Day is not just about statistics or policy declarations; it is a clarion call to action.
For people like Gaius and millions of others across Nigeria, every breath is precious.
Asthma care advocates say with coordinated efforts from the government, private sector, healthcare professionals, and communities, Nigeria can turn the tide against asthma.
They say no one should be left breathless because of poverty or neglect.(NANFeatures)
***If used, please credit the writer and the News Agency of Nigeria.
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