From Umar Danladi Ado, Sokoto
The international humanitarian medical organisation Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has called for the inclusion of Noma in routine disease surveillance systems to improve early detection, reduce mortality and ensure timely referrals to specialised care.
Ajamah Samuel Afemike, Nursing Activity Manager at the Noma Hospital in Sokoto, made the call while highlighting the need for stronger prevention, diagnosis and treatment of the disease.
He explained that Noma is a non-contagious disease that rapidly destroys facial tissues and bones, potentially causing severe facial damage and life-threatening complications within days.
According to him, between 70 and 90 per cent of people affected by Noma die if the disease is left untreated, while survivors often experience difficulties with eating, speaking and breathing, alongside challenges in performing daily activities.
Afemike disclosed that between 2014 and 2025, MSF teams performed 1,645 reconstructive surgeries on 1,078 patients.
He added that in 2025 alone, 1,034 patients received medical treatment and support, including surgery, nutritional care, physiotherapy and psychosocial services.
During the first surgical intervention of 2026, held between April 17 and May 1, MSF teams performed 55 reconstructive surgeries.
He said the final surgical intervention for 2026 was ongoing at the Noma Hospital in Sokoto, where 40 patients were expected to undergo reconstructive surgery.
Afemike identified MSF’s advocacy priorities as integrating Noma prevention and treatment into primary healthcare services, strengthening training and awareness among frontline healthcare workers, and incorporating the disease into routine surveillance systems.
Other priorities include establishing effective referral pathways to specialised care, ensuring the availability of essential medicines and nutritional support, providing comprehensive care services, and increasing community awareness to encourage prevention and early treatment.
He noted that many Noma survivors also face stigma, social exclusion, psychological distress, barriers to education and employment, and financial hardship.
Afemike stressed that Noma was preventable and treatable and should no longer claim the lives of children, emphasising that early detection and treatment were critical to preventing deaths and disabilities.
He explained that when identified at an early stage, the disease could be effectively managed with antibiotics, wound care, nutritional support and treatment of underlying conditions.
Despite the World Health Organization’s recognition of Noma as a Neglected Tropical Disease (NTD) in 2023, Afemike said the disease remained largely absent from routine healthcare and child health programmes in Nigeria.
He therefore called for stronger efforts to integrate Noma prevention, detection, treatment, referral and surveillance into primary healthcare systems and child health programmes.
Poverty, Malnutrition Increase Vulnerability
Speaking on those most at risk, Afemike said Noma primarily affects children under seven years of age and is closely associated with extreme poverty, malnutrition, inadequate oral hygiene, low immunisation coverage, recurrent infections and limited access to healthcare.
He added that children living in remote and underserved communities were particularly vulnerable.
Explaining why the disease persisted, he described Noma as both a medical condition and an indicator of wider weaknesses in primary healthcare systems.
He said awareness of the disease remained limited among communities and healthcare workers, forcing many patients to visit several health facilities before receiving the correct diagnosis.
According to him, such delays could deprive patients of the opportunity for life-saving early treatment.
He emphasised that increased public awareness, healthcare worker training and effective disease surveillance were essential to preventing avoidable deaths and disabilities.
MSF Supports Noma Treatment in Sokoto
On MSF’s response in Sokoto, Afemike said the organisation had supported the Ministry of Health’s Noma Hospital in the state since 2014.
He described the facility as one of the few specialised centres for Noma treatment worldwide.
According to him, MSF supports early case detection, medical treatment, nutritional care, physiotherapy, psychosocial support and reconstructive surgery.
“Noma is preventable and treatable. No child should suffer or die from a disease that can be detected early and effectively managed,” he said.
He added that recognising Noma as a neglected tropical disease was an important step, but stressed that recognition alone was insufficient without practical investment in prevention, early diagnosis and access to treatment.
“Noma is a marker of inequality. Addressing it requires stronger primary healthcare, better nutrition, improved vaccination coverage and greater access to health services,” Afemike said.
