Need to prioritise autism care

World  Autism Awareness Day (WAAD), marked on April 2, provides an opportunity to reflect on the dignity, rights, and worth of persons living with autism. This year’s theme, “Autism and Humanity – Every Life has Value,” is both a celebration and a challenge. In Nigeria, it rings with painful urgency. For thousands of families, the value of autistic lives is affirmed in principle but undermined in practice by prohibitive costs, weak systems, and enduring stigma.

According to the World Health Organisation (WHO), autism spectrum disorder (ASD) is a group of conditions characterised by challenges in social interaction, communication, and restricted or repetitive patterns of behaviour. It is a lifelong neurodevelopmental condition that varies widely in severity and presentation. Crucially, the WHO emphasises that early diagnosis and appropriate interventions can significantly improve outcomes and quality of life. Yet in Nigeria, early diagnosis is largely missed.

Autism care is not fully integrated into primary healthcare systems. The result is that many children are identified late—if at all. Consequently, parents often move from one facility to another in search of answers. This delay in diagnosis deprives children of the critical early interventions that can make a profound difference in their development.

Even when families secure a diagnosis, the financial burden of care is staggering. Autism management typically requires a combination of speech, occupational, and behavioural therapies. In Nigeria, monthly specialised care, including speech and behavioural therapy costs between N50,000 and N300,000.  Quarterly, it costs from N350,000 to N600,000. For a condition that requires sustained, often lifelong intervention, these costs quickly become unsustainable—especially in a country where many households live on limited incomes. The national minimum wage is N70,000, which some states struggle to pay.

Beyond therapy fees, access itself is a barrier. Specialised centres are concentrated in urban areas, forcing families in rural communities to travel long distances to access services. Transportation costs compound the financial strain. For many, the result is simple but devastating: therapy is discontinued, progress stalls, and the child’s potential is diminished.

The scale of the challenge is stark. Studies suggest that autism prevalence in Nigeria ranges between 0.8% and 1.2%, translating to roughly 600,000 individuals. Globally, the WHO estimated in 2021 that about one in 127 people—around 62 million individuals—were autistic. More recent figures from the United States’ Centre for Disease Control and Prevention, however, indicate that approximately one in 36 children is diagnosed with autism. These numbers underscore that autism is not a marginal issue; it is a public health concern that demands coordinated policy action.

Unfortunately, Nigeria’s policy response remains inadequate. While the country enacted the Discrimination Against Persons with Disabilities (Prohibition) Act to safeguard the rights of persons with disabilities, enforcement has been weak. Public facilities remain largely inaccessible, inclusive education is inconsistently implemented, and employment opportunities are limited. For autistic individuals, this translates into exclusion at multiple stages of life.

The consequences are profound. Many autistic children drop out of school due to lack of support, becoming isolated and dependent. As adults, they face significant barriers in the workplace, not because of lack of ability, but due to societal misunderstanding and limited accommodations. Stigma persists, fuelled by harmful myths—including the dangerous and unfounded belief that autism is linked to witchcraft. Such misconceptions not only delay care but also erode the self-worth of affected individuals and their families.

Government intervention is therefore not optional; it is imperative. First, autism services must be integrated into primary healthcare. Training frontline health workers to recognise early signs of autism would enable timely referrals and interventions. Second, autism care should be included in the National Health Insurance framework to reduce out-of-pocket expenses. Subsidising therapies would ease the financial burden on families and ensure continuity of care.

Third, the government must invest in expanding service delivery. Establishing more therapy centres across the country—particularly in underserved areas—would reduce travel costs and improve access. Partnerships with private providers and non-governmental organisations can accelerate this process. Nutrition also deserves attention. Evidence shows that proper nutrition supports the overall health and development of autistic children. Public health programmes should incorporate nutritional guidance tailored to their needs, ensuring a more holistic approach to care.

Equally important is public education. Nationwide awareness campaigns are needed to dispel myths and promote understanding of autism as a medical condition, not a spiritual affliction. Schools must be equipped and mandated to adopt inclusive practices, while employers should be incentivised to create opportunities for people with neurodevelopmental challenges.

At its core, the call for government intervention is a call for justice. If every life truly has value, as this year’s WAAD theme proclaims, then public policy must reflect that conviction. Leaving families to shoulder the burden alone is neither humane nor sustainable. Nigeria should ensure that every autistic child has the opportunity to thrive.