Within the week, Nigeria joined the rest of the world to mark World AIDS Day with the theme “Universal access and Human Rights”. On that day (December 1st) health experts and stakeholders across the globe gathered in several fora to raise awareness about the pandemic even as it international solidarity is demonstrated.
While World AIDS day is one of the most visible opportunities for public and private partners to spread awareness about the status of the pandemic and encourage progress in HIV/AIDS prevention, treatment and care in high prevalence countries and around the world have continued to remain a major concern. This is as the 2008 figures released by the World Health Organisation (WHO) reveal that 33.4 million people are living with HIV and an estimated 2.7 million are newly infected with the virus.
Driving this matter home, when the HIV virus was first discovered in Nigeria in 1986, billions of Naira was pumped in through various fronts which were targeted at fighting the scourge. Latest reports suggest that the huge sums spent on the prevention and management of the pandemic may not be over yet in the country as Director General, National Agency for the Control of AIDS (NACA) John Idoko revealed that the country needs about N6 billion to effectively combat the Acquired Immune Deficiency Syndrome (AIDS). Idoko made this disclosure at Abuja while briefing the press on activities lined up to mark the 2010 World AIDS Day.
Been that as it may, Olusoji Adeyangu, a medical expert at Adeoyo Maternity Hospital, Ibadan, who spoke with BusinessDay recently, disclosed that recent statistics of HIV/AIDS, may continue to be scary for the African continent despite all sorts of campaigns and investment, unless something drastic is done.
According to Adeyangu, "There are serious emerging challenges for the continent in terms of treatment. This is the soul of the epidemic- it intersects with the weaknesses of the human condition: sex, drive to procreate, power imbalance between the genders, poverty etc. Don’t forget that gender issues and poverty as the unique drivers of the spread of the virus in sub-Saharan Africa.”
As the United Nations recent report of 4.6 percent as HIV prevalence rate in Nigeria, some school of thought are of the view that the reduction in prevalence rate may not really justify the huge funding that the HIV/AIDS project has gulped so far in the country.
At the moment, it is very difficult to make reference to any credible statistics for Nigeria given the fact that the treatment situation is such that about half a million people among those who are HIV positive in the country need to be on treatment.
From this figure, almost half access their treatment from sources other than that of government, yet, every year, it is believed that HIV/AIDS gulps so much from the federal budget and attracts heavy grants from donor agencies.
According to the Global Fund which is the largest donor agency in Nigeria on HIV/AIDS, Nigeria has attracted approximately $200m over five years to fight HIV/AIDS. This figure, the body said, is outside the yearly budgetary allocations to the agency from government and grants from other donor agencies. The principal recipient of most funding for HIV/AIDS remains the National Agency for the Control of AIDS (NACA).
In 2006, the Global Fund cancelled a grant to Nigeria for reasons that border on non-performance. If the grant for that year was approved, it could have got thousands of People Living with HIV/AIDS (PLWHA) who need treatment on the anti retroviral therapy. Inadequate capacity for efficient programme management of large-scale financial interventions for public health was one important reason the body cited for the cancellation.
Apart from claims that the agency presented questionable data, it also said that NACA favoured a manual accounting system, which was inefficient. To the Global Fund, "funds should not just be spent simply for its own sake, just as a process, or disappear into deep private pockets, but to achieve concrete outcomes in prevention, treatment and lives saved by the interventions funded".
For the United States President’s Emergency Plan for AIDS Relief (PEPFAR), another major funder of HIV/AIDS activities in Nigeria, the size of the population and the nation pose logistical and political challenges particularly due to the policy of the Nigerian Government to achieve health care equity across geopolitical zones.
However, the necessity to coordinate programmes simultaneously at the federal, state and local levels introduces complexity into planning, the body noted.
“The large private sector is largely unregulated and, more importantly, has no formal connection to the public health system where most HIV interventions are delivered. Training and human resource development is severely limited in all sectors and will hamper programme implementation at all levels. Care and support is limited due to the fact that existing staff are overstretched and most have insufficient training in key technical areas to provide complete HIV services,” it stated on its website.
Going further, between 2005 and 2006 alone, a total of N14.7 billion was budgeted to fight HIV/AIDS from the federal allocation.
While efforts are been intensified by NACA, development partners and other relevant stakeholders in the country towards curtailing the economic damage caused by the high level of morbidity resulting from AIDS, it is imminent to state that genuine efforts should be made at channeling the funds earmarked for treatment and management of AIDS should be judicious spent.
For a HIV/AIDS activist, “if the treatment of the virus is the main challenge a country like Nigeria is facing in tackling HIV, then major effort and funding should be directed at making treatment available for all living with HIV and other related infections. And if we are grappling with mobilisation and advocacy or behavioural change, it will be beneficial and better to channel our effort financially and otherwise in that direction.
“Our collective sincere effort and activities that are aimed at reducing the spread of the pandemic must be visible and evident for us to be encouraged and hopeful of a reversal in the spread of the virus. Our effort and the resultant impact must justify the funds that are being received, which would then justify demand for more funds from donors and the government.”
In addition, the plans by the Federal Government to halt and reverse the spread of HIV by 2015 may not be achieved if it doesn’t sincerely provide universal access to HIV prevention, treatment, care and support programmes in the country.
By Alexander Chiejina
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