The Civil Society for Malaria Control, Immunisation and Nutrition (ACOMIN) has raised concerns over persistent gaps in HIV/AIDS, Tuberculosis (TB), and malaria healthcare services in Gombe State, calling for urgent collective action to strengthen the continuum of care and improve health outcomes.
Speaking during a media meeting on the Global Fund Community-Led Monitoring (CLM) Project in Gombe, the State Coordinator of ACOMIN, Mrs Hassana Maisanda, said that despite significant progress recorded by Nigeria in combating the three diseases, many communities still face barriers that hinder access to prevention, testing, treatment, referral, and follow-up services.
According to her, evidence generated through the Community-Led Monitoring intervention revealed that weak referral mechanisms, treatment interruptions, shortages of trained healthcare workers, inadequate facility resources, and economic hardship continue to undermine efforts to eliminate HIV, TB, and malaria as public health threats.
“Nigeria has made significant progress in the fight against HIV/AIDS, tuberculosis, and malaria through sustained government efforts and support from development partners such as the Global Fund. However, many communities continue to experience barriers that limit access to quality healthcare services,” she said.
Maisanda noted that populations affected by one disease are often vulnerable to others, making an integrated approach to healthcare delivery even more critical, especially amid dwindling donor funding.
She explained that weak referral systems often delay treatment initiation, as patients diagnosed with TB and HIV are not always effectively linked to treatment centres.
“Some Primary Healthcare Centres that cannot manage severe malaria cases are also not adequately connected to secondary health facilities for referrals, leaving patients to suffer avoidable complications,” she said.
The ACOMIN coordinator further disclosed that treatment interruptions remain a major concern, with many patients missing clinic appointments because of rising transportation costs and other indirect expenses.
“Although treatment for HIV, TB, and malaria is free, indirect costs such as transport fares, feeding expenses, and lost wages discourage many patients from completing treatment. Some daily wage earners avoid clinic visits because attending appointments means losing their source of income for the day,” she stated.
She also highlighted the shortage of trained healthcare workers across many primary healthcare facilities, noting that health personnel are often overstretched.
“An average healthcare worker in a primary healthcare facility may be responsible for screening, counselling, testing, dispensing medicines, monitoring patients, and maintaining records. This affects service quality and increases waiting times for patients,” Maisanda added.
She lamented the inadequate resources available in many facilities, including shortages of malaria, HIV, and TB test kits and medications, as well as the absence of functional diagnostic equipment such as GeneXpert machines.
According to her, these gaps force patients to travel long distances for diagnosis and treatment, thereby delaying access to care.
Maisanda said that to address these challenges, ACOMIN, with support from the Global Fund, is implementing the integrated Community-Led Monitoring intervention aimed at improving accountability and strengthening healthcare service delivery in communities.
“The CLM approach empowers communities to identify barriers, generate evidence, engage decision-makers, and advocate for timely solutions that improve access to quality healthcare,” she said.
She added that the intervention had significantly boosted domestic resource mobilisation and community ownership, with communities contributing financial support, construction materials, renovations of health facilities, borehole projects, hospital beds, medical consumables, and volunteer services.
“The CLM has contributed to improved access to HIV, TB, and malaria services through strengthened referral pathways and increased responsiveness from health facilities and health authorities. It has also amplified community voices by creating platforms for citizens, traditional leaders, civil society organisations, and policymakers to work together in strengthening health systems,” she noted.
Despite these achievements, Maisanda stressed that challenges relating to the availability, accessibility, affordability, and quality of healthcare services persist.
She therefore called on governments at all levels, development partners, the private sector, philanthropists, healthcare providers, the media, and community stakeholders to intensify efforts towards closing the existing gaps.
“We call on all stakeholders to strengthen referral systems, ensure uninterrupted access to essential medicines and diagnostics, invest in healthcare workforce development, expand community-based screening services, and reduce financial barriers to healthcare. These actions are critical to improving health outcomes and ending HIV/AIDS, tuberculosis, and malaria as public health threats,” she said.
She concluded by emphasising that combating the three diseases requires strong and functional health systems that place communities at the centre of healthcare delivery.
“Through partnership, accountability, domestic resource mobilisation, and sustained community engagement, Nigeria can build a more responsive health system that leaves no one behind,” Maisanda said.
Also speaking, Programme Manager of the Gombe State Malaria Elimination Programme, Ubayo Ali, said seasonal malaria chemoprevention had reduced malaria prevalence to 14 per cent.
“It will further reduce malaria cases during the peak transmission period associated with the July rains,” he said.
On his part, the State Programme Officer, Samuel Chuwang, said government agencies need to organise refresher training programmes to update the knowledge and skills of health workers.
Chuwang, while bemoaning poor infrastructure in some communities, added that much more could be achieved in tackling the scourge of malaria if existing challenges were addressed.
“Even among community dwellers, we ensure they understand the value of the drugs through proper awareness and education,” he said.
He added, “There is a need for increased funding for malaria interventions by governments at all levels, support for project implementation in terms of human resource development, and stronger government ownership to ensure sustainability and improve the quality of health service delivery.”