Can Nigeria end HIV/AID by 2030?

World AIDS Day is commemorated on December 1 every year to show support for People Living with HIV/AIDs, and the fight against HIV/AIDS. With an estimated 1.7 million Nigerian women and 380,000 children living with the virus, Nigeria has the largest number of paediatric HIV cases in the world. AJUMA EDWINA OGIRI writes on the high prevalence rate of HIV and stakeholders efforts in overcoming further spread of the disease.

HIV prevalence in Nigeria
Available statistics show that 3.4 million people are estimated to be living with HIV in Nigeria, and this has been rated as the 2nd highest burden in Africa.

Out of this 3.4 million, about 1.1 million, 32 per cent, of the People Living with HIV (PLHIV) know that they are living with the virus, while 970,000 people are on treatment with about 780,000 PLHIV attaining viral suppression.

This is a far cry from the UNAIDS 90.90.90 goal, which outlined targets that must be achieved and interventions that must be front-loaded to close the chapter of AIDS epidemic globally by the year 2030.

The 90.90.90 goal states that by 2020, 90 per cent of all people living with HIV will know their HIV status, 90 per cent of all people diagnosed with HIV infection will receive sustained anti-retroviral therapy and 90 per cent of all people receiving anti-retroviral therapy will have viral suppression.
Even though Nigeria has aligned with the global community to treat all infected with HIV, about 68 per cent of people living with HIV are not aware of their status for them to be placed on treatment. This has created a huge gap in curbing the spread of the virus.
In 2016, an average of 160,000 AIDS-related deaths is reported to have occurred, with 37,000 new infections among children in Nigeria.

Presenting the Investment Case Model for National Agency for the Control of AIDS (NACA), at the State House, Abuja, recently, the Director General of NACA, Dr Sani Aliyu, said the HIV prevalence in Nigeria stands at 3.0 per cent of the population, an estimated 3,165,000, living with HIV virus, with the treatment programme at 987,132 persons, which is just about 31 per cent of those who are eligible to commence HIV treatment.

According to him, this is due to many factors, including paucity of funds, capacity to absorb, human resource issues, and health systems issues, among others.
Dr Aliyu also noted that: “The United States government contributes 73 per cent; Global Fund provides 18 per cent; while only seven per cent of enrollees treatment is being supported by government of Nigeria.”

Commemorating World AIDS Day 2017 in Nigeria
Celebrating this year’s World AIDS Day, stakeholders in Nigeria are hoping that zero stigmatization and discrimination against people living with HIV/AIDS can be achieved.

As part of activities to mark the day, the US Embassy and the Institute of Human Virology Nigeria (IHVN), gathered 200 young children from senior secondary schools in Abuja to interact on the theme, ‘Changing Behaviour for Epidemic Control.’
Speaking at the event, the United States Ambassador to Nigeria, Stuart Symington, said the quest to stop 250 new Nigerians from acquiring HIV and AIDs yearly, is realisable.

According to Symington, HIV which has no cure or vaccine, can only be defeated through prevention, which can only be possible through collaborative efforts between the media and young people.
Speaking on the theme, the Associate Director of Community Medicine at IHVN, Asabe Gomwalk, who represented the Chief Executive Officer of IHVN, Dr. Patrick Dakum, noted that behavioural change is more effective when targeted at young people.

“Today we are celebrating the World AIDS Day, and you can see the target is on the youths and the adolescents. IHVN is an organisation that specialises in HIV, cancer, tuberculosis and other infectious diseases.
“Today we are opportune to meet with the youths in Nigeria, to talk to them on how to prevent themselves from becoming infected with HIV.

“The emphasis is on taking action to control the epidemic. In Nigeria, as at today, there are people that are still being diagnosed with new HIV infection.
“So, what do we do to control and overcome this epidemic? It is to target our youths, because we found out that the infection is more among them.”

Speaking further, she said: “If we create awareness among the youths, educate them and help them to be resilient, then we will be able to overcome this epidemic.

“Our focus now is on using a strategy that is called DREAMS. D is for being determined; R for being resilient; E is for them to look at what the epidemic is all about; the A is to have an AIDS free nation; M is to get somebody to mentor them; and as much as possible to be Safe. “So, it is all about the youths. If we are able to send the message to them, then we will achieve what we have set out to do.”

Increase in adolescent, mother-to-child transmission
Turning the tide against HIV/AIDS will require more concentrated focus on adolescents and the young people. The present generation of young people are the largest in the Nigeria.

Coincidentally, this group have the highest rate of HIV infection recorded. Young people are one of the most vulnerable groups to the disease.

National data suggests that 4.2 per cent of young people, between ages 15-24, are living with HIV. In 2016, more than 46,000 young women were infected with HIV compared to 33,900 young men.

The data also indicated that early sexual debut is common in Nigeria, and begins at less than 15 years for 15 per cent of the youths. This is one factor that increases HIV vulnerability among young people, alongside very low HIV testing rates, as only 17 per cent of young people know their HIV status.
It further indicated that an estimated 270,000 children, 0 to 14 years, in Nigeria are living with HIV, with only 21 per cent having access to antiretroviral treatment.

On June 29, 2017, there was a report of 260 children, who tested positive for HIV in Niger state. These children were between the ages of 0-14.

Despite the efforts by the government, new indication by NACA emerged that a sizeable number of Nigerian children and pregnant women are still living with HIV in 2017, with 1.7 million women and 380,000 children living with the virus. This has ranked Nigeria as the top country with the largest number of paediatric HIV cases in the world.

The NACA boss, who expressed worry over federal government’s seven per cent contribution to the funding for HIV/AIDS actions in the country, said: “One of the things I’m really keen to sort out as the Director General is the issue of mother-to-child transmission.”

He added that every pregnant woman should have an HIV test and the HIV-positive among them should be given anti-retroviral, which he said is “so effective.”

Government’s commitment
NACA has said it would generate about N26 billion to fund HIV programmes and enrol another 500,000 people for treatment.
“The money would be generated through deduction of 0.5 to one per cent of the monthly federation allocation to states. Every Nigerian has a right to good health.
“We have a responsibility to ensure that this basic right is available to all Nigerians. The government is committed to enhancing ownership and sustainability of the HIV/AIDS response,” Aliyu said.

Similarly, the Nigerian Senate has vowed to ensure the commencement of the implementation of the 2014 National Health Act from the 2018 fiscal year, in other to fund all health services including HIV/AIDS.
The Act, which was signed into law by former President Goodluck Jonathan, stipulates that one per cent of the Consolidated Revenue Fund be set aside for healthcare provision.

Speaking at an event marking the 2017 World AIDS Day at the Presidential Villa, the Chairman of the Senate Committee on Primary Health Care and Infectious Diseases, Senator Mao Ohuabunwa, said the Senate has resolved to go ahead with the implementation of the Act.
“We have resolved as a parliament that in 2018, we are going to implement the National Health Act, 2014, which states that one per cent of consolidated revenue fund should go to basic health care so that we can fund all our health services, including HIV/AIDS.

“Immediate implementation of the National Act 2014, especially the clause on basic health care provision funds, to free up funds for healthcare services is necessary if the country would take ownership of the HIV/AIDS funding,” he said.
President Muhammadu Buhari, who reaffirmed his administration’s commitment to fighting the scourge, said he had directed that an additional 50,000 persons be placed on anti-retroviral drugs annually, starting from 2018.

The extent to which these programmes and directives are yet to be seen and would go a long wat in determining whether the country ends HIV/AIDS by 2030.

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