The Civil Society for the Eradication of Tuberculosis in Nigeria (TB Network) has called on the Federal Government to urgently address persistent systemic challenges that undermine access to HIV, tuberculosis (TB), and malaria services across the country.

The group raised concerns over the acute shortage of health workers in many public facilities, noting that inadequate staffing has forced many community members to seek care from pharmacists, patent medicine vendors and traditional birth attendants, often at the expense of quality and continuity of care.

Speaking at the Q4 National Media Roundtable organised by the National ATM Networks, the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) and the Civil Society in Malaria Control, Immunisation and Nutrition (ACOMIN) in Abuja, Programme Manager of TB Network, Theresa Jatau, said gaps in human resources, commodities and infrastructure continue to weaken service delivery and public confidence.

Jatau noted that periodic shortages of HIV, TB and malaria commodities disrupt treatment and prevention efforts, while limited government-driven financing poses a long-term threat to sustainability. She expressed concern over the rising cost of malaria treatment, particularly in the South-South and South-East, warning that this trend is pushing many patients towards informal and unregulated sources of care.

She also highlighted persistent stigma and confidentiality concerns, explaining that many HIV and TB clients are reluctant to provide feedback or seek services openly due to fear of discrimination. According to her, these social barriers further compound already strained health systems.

Jatau identified poor infrastructure in primary healthcare centres (PHCs) as a major challenge, citing the lack of basic amenities such as electricity, water supply, hospital beds, chairs, drug storage shelves and systems for tracking drug issuance. She called for urgent investment in boreholes, stable power supply, improved facility environments and security to make PHCs more functional and patient-friendly.

She advocated increased budgetary allocation to primary healthcare, stressing the need for greater attention to infrastructure, medical equipment and accountability systems. As Nigeria approaches the end of the Global Fund COVID-19 Response Mechanism (C19RM) grant in December, Jatau said the government must strengthen commodity supply systems to ensure the uninterrupted availability of HIV, TB, and malaria commodities.

She also urged the expansion of project coverage to more local government areas and states, noting that additional communities should benefit from C19RM and Resilient and Sustainable Systems for Health (RSSH) investments.

According to Jatau, the National ATM Networks, NEPWHAN and ACOMIN, with support from the National Agency for the Control of AIDS (NACA) as principal recipient, have been implementing the C19RM/RSSH community component across 18 states and the Federal Capital Territory through 270 community-based organisations (CBOs).

She explained that under the grant, which commenced in 2022, the ATM Networks were mandated to implement key community activities, including gender-based violence prevention and post-violence care, community-led monitoring of HIV, TB and malaria services, and advocacy and accountability engagements at state and national levels.

The project covered states including Ogun, Delta, Ekiti, Lagos, Cross River, Rivers, Edo, Sokoto, Akwa Ibom, Anambra, Kaduna, Kano, Jigawa, Nasarawa, Plateau, Gombe, Ondo and Oyo, alongside their respective local government areas.

Jatau said continuous engagement with communities and health facilities by the 270 CBOs has generated valuable evidence on what is working, what is failing and what must change to sustain gains beyond the life of the grant. She added that domestic resources valued at about N40 million were mobilised across implementing states such as Lagos, Plateau, Ekiti, Rivers, the FCT, Anambra and Cross River, contributing to improvements in the quality of HIV, TB and malaria services.

She noted that coordinated advocacy by the ATM Networks has resulted in tangible upgrades across multiple PHCs, including donations of generators, hospital beds, solar bulbs and batteries, an ambulance, construction of facility toilets, and structural renovation and expansion of health centres. These interventions, she said, have led to increased patronage and renewed public confidence in PHCs.

According to Jatau, these outcomes demonstrate the impact of intentional, coordinated and sustained community ownership. She stressed that, as the C19RM grant ends in December 2025, Nigeria must transition from dependence on donor funding to a more resilient and domestically driven health system.

She urged the media to play a stronger role by drawing national attention to systemic gaps, highlighting accountability concerns, holding stakeholders to their commitments and amplifying community voices calling for stronger health systems.

Also speaking, a representative of the ATM Networks and NEPWHAN Programme Coordinator, Dr Daniel Ismail, said the Global Fund-supported COVID-19 Response Mechanism project has operated across 21 states since 2022 and will conclude in December 2025.

Ismail explained that the networks worked in selected local government areas and wards to support service delivery in PHCs, focusing on improving affordability, accessibility and quality of care through community resource mobilisation. He noted that while the government provides facilities and some infrastructure, it cannot meet all needs alone.

“These three ATM Networks came together under the COVID-19 grants to support the Federal Government in providing critical amenities and revitalising PHCs where gaps exist,” he said. “We have many success stories that show what has been achieved.”

However, he acknowledged persistent challenges, particularly in human resources. He stressed that civil society organisations do not have the mandate to recruit health workers, even as many facilities operate with just one or two staff members serving large populations.

“In such conditions, those few health workers cannot cope with the volume of clients,” he said, calling on the government to prioritise recruitment and equitable deployment of health personnel to sustain gains made in HIV, TB and malaria control.