Closing the Care Gap: A Look at Nigeria's Tobacco Control Efforts in Light of the Cancer Challenge

One of the global causes of death is cancer. It is estimated that approximately 10 million people die of cancer annually. Notably, one out of every six deaths worldwide is attributable to cancer, making it the leading cause of mortality on a global scale. In Nigeria, the annual death toll from cancer is around 72,000. The prevalence of cancer is higher among women than men. More specifically, cancer kills approximately 40,647 women and 30,924 men annually (IARC, 2022)

Cancer is attributed to a wide range of factors, including but not limited to unhealthy dietary choices, consumption of canned foods, genetic predisposition, and inadequate hygiene. Consequently, a broad spectrum of cancers exists, including breast cancer, lung cancer, cardiovascular cancer, cervical cancer, bladder cancer, and brain cancer, among others. High prevalence of tobacco smoking is a major cause of cancer attributed disease.  According to research conducted by a UK-based cancer research centre, approximately 33% of cancer cases are directly attributable to tobacco smoking or usage, either through direct smoking or exposure to second-hand smoke. Lung cancer, primarily linked to smoking, is the most common cause of cancer-induced death. Moreso, smoking among pregnant women results in an increased risk of miscarriage, low birth weight, and sudden infant syndrome. 

Cancer has been identified as a serious threat, and significant global efforts have been geared towards its prevention and treatment. As we mark this year's Cancer Day, themed "Close the Care Gap," it is imperative to examine the link between tobacco use and the global prevalence of cancer, with a particular focus on Nigeria.

Over time, extensive studies have shown how tobacco consumption leads to various types of cancer, notably lung cancer. Smoking cigarettes damages the cell's DNA, which controls the function of the body, leading to weakness in some organs in the body and, ultimately, the development of a cancer tumour. To reduce the rate of smoking and, by extension, the deaths related to tobacco use, the government, in collaboration with other international development partners, has made significant efforts to regulate tobacco use in Nigeria. 

The effort dates back to the 1950s. Even though there is a presence of industrial interference, Nigeria has made significant progress in tobacco control efforts. This includes passing the National Tobacco Control Bill in 2015 and implementing policies restricting tobacco advertising, promoting, and sponsoring; creating smoke-free areas; increasing tobacco product taxes; and managing industry interference. These initiatives align with the WHO MPOWER Framework, although the country has not fully met the threshold recommended. 

Individuals grappling with tobacco-induced cancer often find themselves in vulnerable situations, predominantly characterised by economic hardship. Many of these people belong to the socio-economically disadvantaged strata of society, lacking the financial means to adequately care for themselves. Furthermore, a significant portion of this population may not have received adequate education to learn about living a healthy lifestyle while dealing with cancer. These issues are further aggravated by the inadequate healthcare infrastructure in some regions, making early cancer detection difficult. As a result, the disease may progress to a critical stage before being diagnosed. Additionally, individuals in this situation often confront psychological issues, including neglect by family members, social discrimination, ethnic origins, age, gender, and overall lifestyle.

Strategies to Close the Care Gap

Given the challenges experienced by people affected by tobacco-induced ailments, it is imperative to enhance the enforcement of the MPOWER framework. Specifically, the ‘O’ in the framework depicts the importance of offering help and care. Achieving this requires the concerted efforts of governments, civil society, and development partners. Public awareness initiatives and widespread campaigns to educate the public on the dangers of tobacco use and promote available support for those seeking help to quit are essential.  In addition, offering help involves promoting access to smoking cessation services, including counselling and nicotine replacement therapies, to support individuals in their journey to quit. 

Furthermore, studies have shown that health workers often blame patients for their predicaments; this often leads to delayed diagnosis of disease. Therefore, fostering empathetic communication is essential. Education initiatives can improve healthcare workers’ understanding of addiction challenges, thereby promoting cultural sensitivity to prevent making assumptions. Encouraging smoking cessation services, incorporating behavioural health support, and adopting patient-centred care all contribute to a holistic approach. Continuous professional development ensures healthcare workers stay informed while creating a supportive environment that builds trust. By adopting these strategies, healthcare workers can provide care while promoting a compassionate and effective approach to tobacco control.

The role of family and friends in supporting individuals with tobacco-related illnesses cannot be overemphasised. Providing emotional support and empathy helps create a positive environment for the individual. Encouraging them to seek professional help and participate in cessation programmes can help them quit tobacco use. Family and friends can communicate openly and non-judgmentally, building trust and support. Active participation in smoking cessation activities, such as attending counselling sessions or joining support groups, demonstrates a shared commitment to overcoming the challenges of tobacco addiction. Offering encouragement, celebrating milestones, and reinforcing healthier lifestyle choices contribute to a comprehensive support system for individuals who want to quit tobacco and avoid tobacco-related diseases.

In conclusion, tackling cancer issues and bridging the care gap requires a collaborative and holistic approach. Given that tobacco smoking is a major cause of cancer, effective implementation of the MPOWER framework, particularly in terms of providing assistance, necessitates coordinated efforts from government, civil societies, and development partners. These collective strategies would go a long way towards providing a supportive environment, encouraging healthy lifestyle choices, and preventing tobacco-related diseases in our society. 

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Addressing Nigeria's Cooking Energy Crisis and Possible Measures for Change

Globally, around 2.4 billion people primarily use unclean cooking energy (such as wood, coal, charcoal, biomass, and agricultural residues), resulting, in an estimated 3.2 million deaths annually (World Health Organization (WHO) 2022). The “Kitchen killer”, also known as indoor pollution, has a direct effect on human health, which is devastating, particularly in Africa, where only 21 per cent of the total population primarily relies on clean cooking facilities, compared to the global average of 71 per cent. Consequently, the prevalence   of diseases such as lung cancer, chronic obstructive pulmonary diseases, and other related ailments is significantly higher in the region.

According to a report by the Nigerian Alliance for Clean Cookstoves (NACC,2022), smoke-related deaths trail only Malaria and HIV/AIDS as the leading cause of mortality in Nigeria, accounting for an estimated 95,300 deaths annually, the highest rate in Africa.

Based on a World Bank report published in 2021, while considerable progress has been recorded in the past decade toward achieving affordable and clean energy, as specified in SDG 7, there has been uneven progress across regions of the world. Electricity is the cleanest form of energy from water, wind and solar.   The report emphasizes  that over one billion people now have access to electricity on a global scale; however, the  International Energy Agency (IEA) reports that it remains inaccessible to about 770 million people, and 77 per cent of these people reside  in Sub-Saharan  Africa, with Nigeria, the Democratic Republic of Congo, and Ethiopia having the largest share of electricity access deficits.

Figure 1: Access to Clean Cooking Energy by World, SSA and Nigeria

Figure 1 displays the global, Sub-Saharan African, and Nigerian percentage of access to clean cooking energy from 2000 to 2021. Globally, the proportion of people with access to clean cooking energy has gradually increased, reaching 71 per cent in 2021. In sub-Saharan Africa, the access rate has also shown improvement, rising from 9 per cent in 2000 to 18 per cent in 2021. However, Nigeria has lagged behind the regional and global averages, with access to clean cooking energy starting at 0.60 per cent in 2000 and reaching 16.80 per cent in 2021.

Apart from the global unequal distribution of access to affordable and clean energy, a similar challenge persists at the country level. According to the Tracking SDG 7 data for 2020, Nigeria had an overall electricity access rate of 55 per cent, which is far below the global average rate of 91 per cent.  The divide between urban and rural populations is stark, with 84 per cent of residents in urban areas having access to electricity while only 25 per cent of rural dwellers had access.  As shown in Figure 2, access to clean cooking fuels is worsening. Only 15 per cent of the Nigerian population had access to clean cooking fuel, and the rate is even lower in rural areas, with just 4 per cent of the population having. In contrast, the urban population has a relatively higher rate of access, with over 30 per cent of the population using clean cooking fuels (WHO, 2023).

Figure 2: Access to Clean Cooking Energy in Nigeria by Settlements

Figure 2 presents the share of access to clean energy in Nigeria between 2000 and 2021, categorized by rural and urban settlements. Over this period, both rural and urban areas have shown an increasing trend in accessing clean energy. The share of access in rural areas has grown from 0.20 per cent in 2000 to 4.60 per cent in 2021, while urban areas have experienced an increase from 1.40 per cent to 32.80 per cent during the same period. This can be attributed to the lack of adequate infrastructure and investment in the rural areas compared to urban settlements in Nigeria, coupled with the fact that over 70 per cent of the rural dwellers are multi-dimensionally  poor, and 94 per cent of the poor and vulnerable households are faced with clean cooking fuel deficits in the country.

Efforts towards Tackling the Cooking Energy crisis in Nigeria

Over the years, concerted efforts by the government, individuals, private institutions, as well as International and local NGOs have been channelled towards achieving SDG 7 in Nigeria. Specifically, the Nigerian Government initiated the National Renewable Energy and Energy Efficiency Policy (NREEEP) in2015, which aims to provide a framework for the development of renewable energy and energy efficiency in Nigeria. This initiative sets a target of installing more than 23 gigawatts (GW) of renewable energy capacity, including substantial contributions from large hydropower projects by 2030. Also, the Building Energy Efficiency Code established in 2017 sets at least 20 energy-efficiency standards for new buildings in Nigeria.

The Sustainable Energy for All (SE4ALL) Action Agenda aims to triple generation capacity by 2030, reaching a total of 30 GW. Additionally, it targets that 30 per cent of this capacity will be sourced from renewable resources.  The Nationally Determined Contributions under the framework of the Paris Agreement established in 2016 and subsequently updated in 2022, encompass a range of commitments related to agriculture, industrial waste, oil and gas, transportation, cooking, hydrofluorocarbon and more. Long-Term Low Emissions Development Strategy (LTS) introduced in 2022 plays a key role in the creation of climate-resilient and low-carbon solutions. It achieves this by analysing the socio-economic consequences of the shift and establishing the necessary framework. The current objective of the Ministry of Environment is to provide 10 million households with access to clean cookstoves by 2025. However, despite  these efforts, access remains a challenge with over 90 per cent of the poor population lacking access to clean cooking fuel, and an estimated 95,300 annual deaths in Nigeria attributed  to the use of unclean cooking fuel.

Another initiative the government designed to increase cooking fuel is revealed in the Nigeria Integrated Energy Plan Report released in 2022, through the Nigerian Energy Support Programme (NESP) co-founded by the European Union and the  German Federal Ministry for Economic Cooperation and Development. The initiative incorporated a 4-step approach model into the Sustainable Energy for All (SEforALL) project in an attempt to expand access to clean cooking fuel and foster its commitment to the Nationally Determined Contributions as a party to the Paris Agreement. These four steps include; determining the settlements with clean cooking equipment deficits, evaluating each household’s cooking energy use or consumption, assessing the prospect for clean cooking solutions expansion in the identified settlements, and defining the required infrastructure to achieve the primary goal of increasing access.

Measures to improve access to clean cooking equipment in Nigeria

Enhancing Policy Support: The promotion of clean cooking fuel in Nigeria can be facilitated by the development and implementation of a comprehensive national strategy. This strategy should have specific targets, well defined timelines, and clearly designated roles and responsibilities for relevant stakeholders. In addition, the government should provide financial incentives and regulatory support to promote the production, distribution, and adoption of clean cooking equipment, as well as strengthen the enforcement of existing regulations related to energy efficiency and emissions standards for cooking fuel. These would help the process of achieving the global goal of access to clean and affordable energy by 2030.

Investment in Infrastructure: Through Public-Private Partnerships, the government can also improve access to clean cooking energy by investing in infrastructure development through joint efforts or collaborations with the private sector and non-governmental organizations. This includes expanding the distribution network for liquefied petroleum gas (LPG), increasing the number of refilling stations, particularly in rural areas and building storage facilities for clean cooking fuels. Moreover, investing in renewable energy sources such as solar power can provide sustainable and clean energy for cooking. By collaborating with local governments and communities to identify suitable locations for clean energy centres and establish them as hubs for accessing and promoting clean cooking solutions, all of these objectives can be met.

Capacity Building and Training: Provide training programs and capacity-building initiatives for stove manufacturers, distributors, and end-users. This will enhance skills in the production, maintenance and proper use of   clean cooking technologies. Training can also focus on behaviour change campaigns to increase comprehensive public awareness about clean cooking practices, health, and environmental benefits.

Lastly, given the disparities between the rural and urban settlements, priority can be given to rural communities and vulnerable populations.  The government and humanitarian organizations can also implement targeted initiatives to address the specific needs of rural communities, such as providing financial support, technical assistance, and capacity-building programs, with a focus on reaching vulnerable populations, such as low-income households, women, and marginalized groups, by ensuring affordability, accessibility, and inclusivity in clean cooking interventions.

Implementing these strategies in a coordinated and comprehensive manner can accelerate the transition to clean cooking energy in Nigeria, improve health outcomes, reduce environmental pollution, and enhance energy access for the population.

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Fiscal policy options for growing out of debt: Evidence from Nigeria

Despite the essential role debt plays in enabling structural transformation and development, the rate at which Nigeria’s debt is rising has constrained the country’s ability to generate sufficient growth, cope with crises, and invest for development. In 2023, Nigeria’s debt reached $108.3 billion. This represents an increase of 123% since 2012, a rate roughly six times the country’s growth rate of GDP. Nigeria’s increased debt is as a result of an interplay of factors including the COVID-19 pandemic and the Russia-Ukraine war. Most of the new debt has been externally obtained leading to an increase in the risk of the burden of that debt becoming unsustainable. This is because global financial pressures have weakened local currencies and increased interest rates, thus increasing the cost of servicing that debt in real terms. Nigeria’s external debt as a share of total debt has increased from 14% to 40% between 2012 and 2022.

This article was first published by Brookings Institution. READ MORE

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The State of Digital Education in Africa

In a rapidly evolving global landscape, where digitalization and the corresponding skill sets are gaining significance in the transformative process of economies, the role of digitalization in shaping labor markets and economies, both at a regional and global level, cannot be underestimated. Africa is witnessing a digital revolution, with technology playing a vital role in shaping its future. As industries increasingly embrace digitalization, the demand for individuals proficient in digital skills is soaring. A crucial aspect of the digital ecosystem is the availability of skills and education necessary for effectively utilizing and developing digital technologies. With the advancement of technology and increased connectivity, digital education has become a powerful tool in transforming learning experiences, expanding access to higher education, and meeting the demands of the post-industrial economy across the continent.

The Digitalization Drive

Africa has experienced a surge in digitalization, with governments and private organizations investing heavily in enhancing digital infrastructure. This has resulted in increased access to the internet and mobile technology, bringing new opportunities for education and skill development. As digitalization sweeps across the continent, it holds the potential to democratize education and open doors to new learning possibilities for millions. 

Demand for Digital Skills: Identifying Key Players

From the World Economic Forum (WEF) data, I.C.T, Engineering, and Sciences were identified as core STEM fields, and their prevalence in the workforce of different African countries was examined. Egypt (6.85%), South Africa (5.7%), Congo (3.53%), and Nigeria (2.83%) stand out as the nations with the highest share of STEM fields in their workforce, indicating a greater need for digital skills in these regions. With regard to demand for digital skills Egypt (31%), South Africa (25%), Nigeria (12%), and Congo (11%) emerge as the top four African countries with the highest demand for digital skills. These findings present a promising outlook for job seekers and policymakers, highlighting potential opportunities for skill development and economic growth in these nations.

Source: Author’s computation from WEF and International Labour Organisation (ILO), (2022)

The Digital Skills Gap

In the face of a rapidly evolving digital frontier, African economies are currently at risk of falling further behind due to significant gaps in infrastructure, technology, and skills that pose both challenges and opportunities for the future of digital education in Africa. The lack of access to quality education and relevant training programs impedes the development of digital competencies among the workforce. Additionally, disparities exist between urban and rural areas, where limited access to technology hinders the spread of digital education in remote regions.

Factors Contributing to the Gap

Education Infrastructure: Inadequate educational infrastructure, including a lack of computers, tablets, and reliable internet connections, presents a major challenge for integrating digital education into classrooms.

Teacher Training: A dearth of teachers proficient in digital tools and methodologies obstructs the effective adoption of technology in the education sector.

Content Localization: The scarcity of localized digital content that caters to the diverse cultures and languages in Africa affects the engagement and relevance of digital learning materials.

Affordability: High costs associated with digital devices and internet connectivity make it difficult for many African families to participate in digital education.

Potential Solutions

To foster digital empowerment in Africa and bridge the skills gap, several initiatives can be undertaken:

Specialization in STEM: African universities can play a pivotal role by focusing on specialized STEM-related fields, and providing quality education to produce a skilled workforce.

Skill Development Programs: Skill development programs should be promoted, catering to both young individuals entering the job market and professionals seeking to upskill.

Investment in Education and Infrastructure: Governments and private sectors across Africa need to prioritize digital education in their agendas, allocating resources to improve educational infrastructure, including access to computers and reliable internet connectivity to facilitate digital learning, support teacher training programs, and subsidize digital devices for students.

Public-Private Partnerships: Collaboration between the public and private sectors can facilitate the creation of relevant digital content and foster innovation in education.

Teacher Training Programs: Investing in comprehensive and ongoing teacher training initiatives will empower educators to integrate technology effectively into their teaching methods.

Internet Connectivity: Expanding internet infrastructure and making it more affordable will ensure that even remote areas have access to digital learning resources.

Mobile Learning: Leveraging the widespread adoption of mobile technology can help overcome the digital divide, as smartphones can become a powerful tool for delivering educational content.

Conclusion

The digitalization of education in Africa offers immense potential for transforming lives and nurturing a digitally skilled workforce that drives economic growth. While the region faces challenges in meeting the growing demand, it is crucial to address the existing digital skills gap and invest in solutions that ensure equal access to quality education for all. By prioritizing STEM education, investing in infrastructure, and promoting skill development programs, Africa can harness the power of digital education to unlock a brighter future for its people, fostering innovation, and creativity. Embracing digitalization in education will not only benefit individuals but also propel the continent toward sustainable economic growth and development. The journey may be challenging, but the destination holds the promise of a more inclusive, digitally empowered Africa.

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Why we need to unlock data’s potential responsibly and inclusively

In today’s digital age, data has become an invaluable asset, driving innovation, economic growth, and societal development. Africa, with its vast population and diverse landscapes, holds immense potential for leveraging data to transform various sectors. However, to harness the power of data effectively, responsible data governance is essential. This blog post explores the concept of responsibly unlocking the value of data for all, the evolving data governance efforts in Africa, and the potential of sandboxes in fostering cross-border data sharing.

This blog was first published by Datasphere Initiative. Read More Here.

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