HIV/AIDS Treatment No Longer Free iIn Nigeria Due To High User Fees On Chemistry And Haematology Tests

Nigeria with national HIV/AIDS prevalence rate of 3.4% (NARHS 2013) has continued to occupy the 4th position as one of the most affected countries in the world with estimated 210,000 AIDS related deaths annually. 

The national response to HIV/AIDS has been largely from the contributions of the United State Government through the Presidents Emergency Program for AIDS Relieve (PEPFAR), The Global Fund to Fight HIV/AIDS Tuberculosis and Malaria (GFTAM), UK Department for International Development (DFID), World Bank (WB), Joint United Nations Program on AIDS (UNAIDS) among many other international donors.

In fighting AIDS from 1986 when it was first diagnosed in Nigeria to 2015, Nigeria through these numerous international support placed 750,000 Persons Living with HIV/AIDS (PLHIV) on treatment with the PEPFAR program accounting to over 600,000 of them. It is however important to note that the government of Nigeria has not made meaningful contribution to the response since national emergency was declared on HIV/AIDS by former president Olusegun Obasanjo in 2003 when he also pledged governments’ commitment and support for combating the epidemic in the country.

There are evidences that people are still getting infected and more people are now living with the virus in Nigeria, government at all levels have not been committed to promises made with government’s present contributions put at just 7% of the total sum spent on HIV and AIDS intervention in Nigeria (GARPR 2014), and an unwillingness by donors and development partners to wholly fund or continue to make the most contributions that supports HIV and AIDS interventions in Nigeria is challenging the target of ending AIDS in Nigeria by 2030.

The PEPFAR program in Nigeria recently withdrew from supporting Chemistry and Haematology (essential laboratory) tests for PLHIV in their supported treatment facilities. This has in recent times had far reaching consequences on the nation’s socio-economic growth and development and could be a direct cause for increased disease burden on individuals and families, as hospitals in response to the withdrawal of support introduced huge user fees that are over bearing on the very poor PLHIV community to pay.

The Civil Society on HIV/AIDS in Nigeria (CiSHAN) which is the umbrella body coordinating civil society response in Nigeria recently concluded a fact finding mission to selected treatment facilities across all the geopolitical zones of the country and discovered that these facilities especially where the US Government withdrew its support are charging PLHIV as high as N12,000 to carry out the essential tests. In

UCH Ibadan and BOWEN University Teaching Hospital Ogbomosho, PLHIV pay N12,000 for these test. In FMC Gombe they charge N1,500 for the tests. In Shandam Hospital and many other government hospitals in Plateau state they charge N2,300. In University of Abuja Teaching Hospital Gwagwalada, the charge N5,600. Most worrisome is in the South East where PLHIV are being asked to pay for syringe and CD4 count test in addition to paying for the routine tests especially at District Hospital Oguute Enugu-Ezike.

CiSHAN in collaboration with other CSOs involved in the National response have held a number of consultative meetings with National Agency for the Control of AIDS, Federal Ministry of Health, UNAIDS and other agencies with a view to finding a lasting solution to this issue. Unfortunately this year’s allocation to all the government institutions fighting AIDS in Nigeria did not make provision for this huge gap in the national response.

Although the vaccine is still free, these necessary tests that qualifies a PLHIV to receive the vaccine according to the National guideline on treatment is no longer free, therefore treatment is not free in Nigeria anymore.

There is therefore an urgent need to revise the current budget for health to reflect this identified gap in order to avert increased AIDS related death in Nigeria from 2016 as many of the PLHIV have already started defaulting from treatment.

Written by

Walter Ndukwe Ugwuocha MNSE, MNChE, MBA Executive Secretary
Civil Society for HIV/AIDS in Nigeria (CiSHAN)