By CHARLES IWUOHA

The Amaka Chiwuike-Uba Foundation (ACUF), a Non-Governmental Organisation, has called on government at all levels and health stakeholders to cover widening gap in asthma treatment and management in Nigeria.The Founder of the Fondation, Professor Chiwuike Uba, made the call in a statement he issued on Tuesday in Enugu, on the 2025 World Asthma Day, themed, "Make Inhaled Treatments Accessible for All."

Uba, who is a development economist, said that in Nigeria, Asthma was becoming increasingly prevalent, with studies indicating general prevalence ranging from 5.12 per cent to 14.7 per cent, and some projections expecting to rise even further by 2025.

He said that Africa was seeing a significant increase in asthma cases, with estimates ranging from 1 per cent to 53 per cent across various populations and age groups, with urbanisation and rising levels of air pollution remained key drivers of this trend.

"Beyond the numbers are the heartbreaking stories of people silently struggling to breathe.

"These are children who miss school due to frequent asthma attacks, parents who must choose between feeding their families and buying medication, and elderly people in remote areas unable to access even basic healthcare.

"Their pain and resilience often go unnoticed, hidden beneath the surface of national statistics. These silent battles must be brought to light if we are to make lasting change," he said.

According to him, the cost of managing asthma in Nigeria has skyrocketed, placing essential medications out of reach for the vast majority of patients.

Uba noted that a basic Short-Acting Beta-Agonist (SABA) inhaler, commonly used to relieve acute asthma symptoms, now costs between N5,000 and N8,500; while Inhaled corticosteroids (ICS), which are critical for long-term asthma control, are often unaffordable for many.

"Combination inhalers that include both ICS and long-acting beta-agonists (LABA)?recommended for moderate to severe asthma?can range from N34,500 to N70,000 per unit.

"For context, Nigeria's national minimum wage is N70,000 per month. Expecting a person to allocate an entire month's salary?or more?on a single inhaler is not only unjust, it is inhumane.

"For clarity, these medications include examples such as salbutamol for SABA, budesonide or beclomethasone for ICS, and formoterol combined with ICS for combination therapies.

"These are not brands but standard pharmacological agents essential for effective asthma management," he said.

The founder noted that the reasons behind this crisis are complex but not insurmountable; adding that the depreciation of the Naira had made imported medicines significantly more expensive.

Uba also said that the exit of major pharmaceutical companies like GSK had further reduced market competition, creating scarcity and inflating prices.

He added that the Nigeria's heavy reliance on imported medications also exacerbates costs, with high operational expenses compounding the problem.

He said: "These issues are unfolding in a country where poverty is widespread. The World Bank has revealed that 75.5 per cent of rural dwellers in Nigeria live below the poverty line, alongside 41.3 per cent of the urban population.

"More than 133 million Nigerians live in multidimensional poverty. When individuals must choose between feeding their families and purchasing asthma medication, the result is delayed treatment, deteriorating health, and, in too many cases, death."

Uba said that the inadequate healthcare infrastructure and investment further deepens the crisis, adding: "Nigeria has approximately 40,400 hospitals and clinics, of which 34,385?or 85.1 per cent ?are classified as Primary Health Care (PHC) facilities."

He said that over 80 per cent of these PHCs are not functional, due to poor infrastructure, inadequate staffing, and lack of essential medical supplies.

"The quality of available care is another concern. Many PHCs lack the essential equipment, medicines, and trained personnel needed to manage chronic conditions like asthma.

"The essential medicines list (EML) in Nigeria is outdated, continuing to include oral salbutamol and corticosteroids, which are not recommended by the World Health Organization (WHO) due to their adverse side effects.

"Oral salbutamol, for example, is associated with tremors, cardiac arrhythmias, and a higher risk of asthma exacerbation and mortality.

"Yet, it remains more readily available than modern inhaled therapies, likely due to a combination of cost, ignorance, and outdated prescribing practices," he added.

Uba noted that Nigeria currently lacks a comprehensive national guideline on asthma management, adding that in the absence of standardised, evidence-based protocols, healthcare providers often rely on outdated or inconsistent treatment methods.

He said that the gap in policy and guidance contributes to poor disease control, increased health disparities, and unnecessary suffering. Establishing and disseminating national asthma management guidelines must be treated as an urgent health policy priority.

"Environmental pollution further exacerbates the asthma crisis. Nigeria faces some of the worst air quality levels in the world, particularly in urban centers like Lagos, Port Harcourt, and Kano.

"Vehicle emissions, industrial pollutants, and the widespread use of biomass fuels for cooking contribute to dangerously high levels of particulate matter in the air.

"Compounding this is the persistent practice of gas flaring in the Niger Delta, which releases massive amounts of harmful pollutants including sulfur dioxide, nitrogen oxides, and volatile organic compounds.

"These pollutants not only worsen asthma symptoms but also contribute to the development of respiratory diseases in previously healthy individuals.

"Addressing pollution?especially through stricter environmental regulations and the enforcement of anti-flaring laws?is essential to reducing the asthma burden in Nigeria," he added.

Update news