Nigeria marks world AIDS day 2017: Losing the traction!
Sir: We are here to mark the World AIDS Day on December 1, following the tradition since it was first held in 1988. As the norm, this gives us an opportunity to evaluate what is on ground in terms of the reality of the epidemic vis a vis our response as a nation and as individuals. This is one period the global population unites in the fight against HIV, show their support for people living with HIV and to commemorate people who have died.
For some of us, World AIDS Day means more than these facts stated above. Rather, there is an additional task of taking stock of what has been on ground; how has been my country’s and global response; what are the gaps and what should have been done better or not even done.
Realities from scientific breakthrough have moved us from the era where testing positive to HIV was seen as a death sentence. It has become a manageable disease with people living healthier longer and productive life. One is now dumbfounded with the naked truth that Nigeria as a country is gradually loosing the gains made in the response to HIV as PLHIV now become more apprehensive of what tomorrow holds. Our treatment sites now are becoming glorified prescription and dispensing centers where critical and core clinical care is now eroding. The quality of care to PLHIV in most treatment centers is now at its lowest ebb and worst of it is that clients are now made to pay for services hitherto free.
Globally, there are about 34 Million people living with HIV and Nigeria alone accounts for about 10% of this global population. As at July 2017, of the 3.4 Million HIV-Positive Nigerians, 1000,050 are on ARV out of which about 763,050 are on PEPFAR, 179,000 on Global Fund and 58,000 on Government of Nigeria support. This tells us of the total people on ART in Nigeria PEPFAR treats 76%; Global Fund 17% while the government of Nigeria treats 5.8%. There still exists a gap of about 2.4 million people to be put on treatment.
When ex-president Olusegun Obasanjo declared free comprehensive HIV care for 250,000 Nigerians in 2006, the largest rollout in Africa, we all jumped to high heavens in appreciation. This policy came with free Laboratory monitoring with Viral Loads test at many centers, ART drugs made available at no cost, there was nothing like consultation fees and there was a large chunk of drugs for management of opportunistic infections coupled with robust clinical care from very competent and willing healthcare workers.
Nigeria was progressively increasing treatment centers as well as increasing ART coverage.Nigeria in August 2010 signed a memorandum of understanding with the U.S. government called the PEPFAR Partnership Framework promising to support the U.S. government in her response to HIV in Nigeria with 50% of the cost by 2015. As at 2014, Nigeria has only met about 15% of this which led to the PEPFAR team to reduce their funding support to the national response and the worst hit of the programme is the Laboratory Monitoring back-up for HIV response.
As I write, many PLHIV in Nigeria now pay for their laboratory monitoring in some facilities. This is causing many to miss appointment and proper follow-up. In the long run, we would have a deluge of people failing treatment and requiring second line treatment. Second line treatment is about 10 times more expensive than the first line which our poor system is messing up now.
It is strongly recommended that treatment of HIV should be free, comprehensive, qualitative and accessible all over the country. This way we would begin the regaining already lost grounds and consolidating grounds still held. In working towards this, our government should take her rightful place in the national response by owning it and leading the whole process.
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