The National Agency for the Control of HIV/AIDS (NACA) in Nigeria is worried that the country has the second highest Human Immunodeficiency Virus (HIV) epidemic profile in the world.
It is estimated that around two-thirds of new HIV infections in West and Central Africa in 2017 occurred in Nigeria. Together with South Africa and Uganda, the country accounts for around half of all new HIV infections in sub-Saharan Africa every year.
Unprotected heterosexual sex accounts for 80 per cent of new HIV infections in Nigeria, with the majority of remaining HIV infections occurring in key affected populations such as sex workers.
Approximately 150,000 people died from AIDS-related illnesses in Nigeria in 2017. Since 2005, the reduction in the number of annual AIDS-related deaths has been minimal, indicative of the fact that only 33 per cent of those with a positive diagnosis in Nigeria are accessing antiretroviral treatment (ART).
Nigeria has also the highest number of children contracting HIV in the world, according to the United Nations.
In 2017, an estimated 1.8 million children were orphaned by AIDS, which experts said could have huge impact on their health, safety and wellbeing.
HIV also has an indirect impact on children in Nigeria, whereby often they become the caregivers for parents who are living with HIV.
Normally, this responsibility lies with girls rather than boys and can contribute to the imbalance in schooling between the two genders in Nigeria, with girls missing out on HIV education that could teach them how to protect themselves from infection.
This sad and frightening trend, we dare to say, is not helped by the scarcity of funds to address the challenges of providing drugs and care for infected Nigerians amidst fear of dwindling funding from donor agencies and government.
The United States of America and other major donors to HIV/AIDS programmes in Africa have reduced their funding for anti-retroviral drugs and research.
The priorities to funding innovation in global healthcare have hit an all-time low in the annual investment for HIV prevention, research and development as major donors have reduced their support.
A report released at the 9th International AIDS Society (IAS) Conference on HIV Science in Paris showed a continuous decline in funding and its potential impact on HIV patients and death rates. For years, the treatment for HIV/AIDS has been largely run with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
PEPFAR has invested more than $5 billion as at 2017 to provide antiretroviral treatment for 880,668 people, testing for 7.76 million, and care and support for 1.28 million orphans, vulnerable children and their caregivers.
Total funding from PEPFAR dropped from $409.1m in 2016 to $383.6m, in 2017.
This is a loss for close to a million said to be on treatment across nearly 4,000 facilities that provide services.
Recently, NACA said that Nigeria must take full sponsorship of its HIV/AIDS programme or risk losing one million of its citizens currently living with the disease before 2022.
The state governments early this year promised to contribute one per cent of their monthly federal allocations to the fight against the disease, but they are yet to do so.
Nigeria is a long way off meeting the global target of enrolling 90 per cent of people diagnosed with HIV on antiretroviral treatment (ART) according to NACA. Just 33 per cent of all people living with HIV were receiving treatment in 2017. Among children this is even lower, with just 26 per cent on ART. Of the people on HIV treatment, only 24 per cent had achieved viral suppression in 2016. This is unacceptable for a disease that is no longer a death sentence anywhere in the world.
Poor treatment coverage and adherence means that the number of AIDS-related deaths in the country has remained high with 150,000 deaths in 2017.
Although Nigeria adopted a ‘test and treat’ policy in 2015, which means that anyone with a positive diagnosis is eligible for treatment, this is far from a reality.
Most Nigerians who are down with the HIV/AIDS virus do not have access to anti-retroviral drugs. Similarly, many pregnant women who are infected with the virus cannot afford the anti-retroviral drugs and are also not on the list of patients that could be treated through the instrumentality of foreign donors or the federal government. Experts say that this accounts for Nigeria being classified as the country with the highest mother-to-child HIV transmission rate in the world.
It is sad, in our opinion, that Nigeria’s government has ‘outsourced’ the responsibility of providing health care for its citizens suffering from HIV/AIDS related sicknesses and diseases. Out of the one million Nigerians who are on HIV/AIDS treatment, Nigeria’s government is treating only 60,000. The remaining 840,000 were left for the United States government and other international donor agencies. That was why NACA’s warning of dire consequences if the US government and other donor agencies were to withdraw their services to these Nigerians should be taken seriously.
Federal and state governments should therefore scale up funding for HIV/AIDS and especially provide anti-retroviral drugs to patients, so that they can live a normal life. Easy access to anti-retroviral drugs would also encourage more Nigerians to test to know their status, knowing that treatment is available. As we call for more funding for HIV/AIDS treatment, we also advocate more enlightenment campaigns to halt the spread of the disease through unprotected sex and other means.