Nigeria's HIV Burden

Published: August 11, 2014

Even as global attention focused more on the tragic  shooting down of Malaysian Airline MH17 allegedly by Ukrainian rebels, the World AIDS Conference which held in Melbourne, Australia between 21-25 July  was another reflective milestone on a malaise that is threatening human posterity.

When one considers that the same crime against humanity which the shooting down of the Kuala Lumpur-bound plane represents at the same time, and quite unfortunately, consumed the lives of about seven passengers billed to attend the 20th World AIDS Conference, among them a leading researcher into the Human Immunodeficiency Virus, (HIV), Jeop and WHO Media Officer Glenn Thomas, it becomes even more beckoning on the annual conference to put the global impact of the HIV/AIDS menace in proper perspective.

It was on this reflective mode that the conference ended with calls for Uniting HIV, Global Health and Human Rights on the global spectrum.

This is where Nigeria’s struggle against the global epidemic comes into light. That Nigeria-and other sub-Saharan African countries like South Africa and Botswana- lead countries most ravaged by the menace is no longer news.

Nigeria has seen a national prevalence rate of up to 5.1 percent of the population infected with HIV in the early 2000s with the rate dropping to a manageable 4.1 percent as at 2012. Of this figure, 26.7 of the population know their HIV status with 5.8 and 5.6 prevalence rates for males and females respectively.

However, the more newsworthy are the efforts of the National Agency for the Control of AIDS, (NACA), the rallying platform in the fight against HIV/AIDS in Nigeria in combating the menace. At the heart of NACA’s interventions is “preventing new HIV infections and providing treatment and care services to those already living with the virus,” according to Professor John Idoko, the erudite authority in reproductive health who is Director General at the Agency. This twin-approach, preventing new HIV infections and increasing access to treatment has defined NACA’s actions in recent times with appreciable results.

As the United Nations Agency for AIDS, UNAIDS, recently revealed in a report released by Executive Director Machel Sidibe, although a lot more effort is required in preventing new infections, “about 79 percent of those living with the virus are accessing Anti Retroviral Treatments (ARVs)” and who can deny that this is a significant progress? NACA has been innovative in approaching the struggle against new HIV infection. NACA under Professor Idoko has identified possible routes of transmission and made it a priority to prevent the spread of HIV virus through these routes.

This approach has encouraged voluntary testing and counseling for individuals to know their status and live positively with or without the virus. The collaborations between NACA, international agencies like the USAID, UNAID, the World Bank (through the Global Fund), Nongovernmental Organizations and Community Based Organizations have combined to yield good impacts in the required  directions.

The innovations have seen NACA expand prevention frontiers to unpopular routes like infection among Men who have sex with men (MSM) and Transmission from Mother to Child. While new prevention technologies like PreExposure Prophylaxis(PrEP) was designed in collaboration with US Department of Defense to stem transmission via MSM, the expansion of anti retroviral services seeks to stem the Prevention of Mother to Child Transmission (PMTC) while also catering for the treatment and care needs of those living with the virus.

Interestingly, PMTC has been a recent preoccupation of NACA with the aim of expanding its uptake, especially among rural women through primary healthcare. Behavioral Change Communications approaches targeted at extremely vulnerable groups like sexually active youths and commercial sex workers has also helped to reduce the scourge of the menace. It is understandable that global attention has continued to beam on Nigeria’s progress  fighting HIV transmission to a finish. Currently, Nigeria still ranks behind South Africa in African countries who contribute most to the global burden of the pandemic. Though there is the need to compare the rate of progress in among the countries with the highest burden, there is also the need to take into cognizance the many peculiarities of Nigeria which often adversely impede progress.

On one hand is the diversity of Nigeria in respect of cultural and religious beliefs which make it a lot difficult to carry out public awareness about prevention of transmission and treatment services. On the other is Nigeria’s behemoth population (put at 180 million by UNFPA) which makes the struggle a more herculean task. All these factors combine to make Nigeria’s fight against the HIV burden a lot more challenging compared to similar efforts in smaller countries with relatively homogeneous backgrounds.

However, there can be no excuse at complacency in eradicating new infections of HIV in Nigeria. The federal government’s consolidated intervention through the President’s Comprehensive Response Plan (PCRP) is another window of opportunity in consolidating prevention and care efforts.

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