Conclusion

After many years of inaction and poor coordination by the global community, it has now become imperative that the problems and challenges posed by BTB and zTB in Africa must be addressed.

Who can calculate the number of lives saved and the amount of crippling (tuberculosis ranks second as a crippling disease) avoided if we had followed the advice of Abraham Jacobi, great man and great physician, and had been as active in our efforts against bovine infection of children as we have been against the human? The facts have been before us for 30 years. They have been proved and re-proved. Is there any excuse for longer complaisance or inaction?

As we reflect on these words, and given the lack of progress to achieve the stated objectives, African governments, scientists, and key stakeholders must join hands with global agencies such as the WHO, the FAO, the OIE (to mention a few), and the IUATLD (that for many years housed a small but influential group of veterinarians and physicians dedicated to the issue of zoonotic TB) and map out strategies to reduce the prevalence and threat of BTB and the burden of zTB in Africa’s human population (Olea-Popelka et al. 2016). More importantly, inter-sectorial collabora­tion particularly between veterinarians and the medical personnel across Africa must be strengthened to combat this disease. This collaboration should be directed at encouraging training programs at universities and related tertiary institutions and major stakeholders to engender advocacy (public health awareness), sustainability (continuous screening and monitoring), and progress (positive implementation of guidelines and policies by government agencies) in the fight against BTB and zTB particularly in neglected communities in the rural areas.

The way forward therefore is to develop a “Marshall Plan” of action (as highlighted earlier) that will help by employing a One Health approach to reduce the burden of BTB in livestock, wildlife, and zTB in humans. This roadmap is now contained in a recent document, Roadmap for Zoonotic Tuberculosis, which outlines the strategy to deal with the issue (WHO 2017). The overarching approach should focus on coordinated public education campaigns and interventions utilizing existing knowledge applied at a local level in a simple and practical way. Finally, cattle and certain wildlife species are maintenance hosts of M. bovis in the region, and unless BTB is controlled in Africa in all the infected species, the WHO’s goal of ending all forms of TB will be impossible to accomplish.

Acknowledgment Partial funding support received by Simeon Cadmus from the John D. and Catherine T. MacArthur Foundation, USA, under the Higher Education Initiative in Africa (Grant No. 97944-0-800/406/99) for the establishment of the Center of Control and Prevention of Zoonoses (CCPZ) at the University of Ibadan is acknowledged.

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