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)
Civil Society for HIV/AIDS in Nigeria (CiSHAN)