Nigeria

“West Africa HIV/AIDS epidemiology and response synthesis”

On the opening day of International Conference on AIDS and STIs in Africa (ICASA), taking place in Senegal under the theme “Africa’s Response: Face the facts,” the World Bank launched a new report exploring the character of the HIV epidemics and responses in countries in West Africa.

The “West Africa HIV/AIDS epidemiology and response synthesis” is a review and analysis of surveillance and research data in 15 West African countries: Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali, Niger, Nigeria, Senegal, Togo, Cape Verde, The Gambia, Guinea Bissau, Liberia, and Sierra Leone.

Aiming to gain an improved understanding of HIV transmission dynamics in this sub-region, the paper focuses on the degree to which epidemics in each country are concentrated or generalized, and the implications that this has for effective prevention strategies. The report argues that more prevention focus is needed on the specific groups in which HIV transmission is concentrated, including female sex workers and men who have sex with men.

The new publication highlights a need for better understanding of the complex nature of transactional sex in West Africa. Many women involved in commercial sex do not self-identify as sex workers and have other occupations as well. The boundaries between commercial and non-commercial sex are blurred and it is difficult to have an idea of the proportion of men having commercial sex due to substantial under-reporting.

The importance of men who have sex with men (MSM) in the HIV epidemic in West Africa is being increasingly recognized. High proportions of MSM are also married and/or have sex with other women with very low rates of condom use, acting as a bridge for HIV between MSM and women.

“Know your epidemic. Know your response”

The paper was written as part of the work programme by the World Bank’s Global AIDS Monitoring and Evaluation Team (GAMET) to support countries to “know your epidemic, know your response” so that interventions are carefully chosen and prioritized based on a careful characterization of each country’s epidemic.

Understanding the behaviors that are giving rise to most new infections is a crucial first step to being able to develop a results-focused, evidence-based response that will be effective in preventing new infections. In turn this will improve resource allocation, all the more appropriate when global economic outlook may impact AIDS response.

The work was carried out in partnership between the World Bank and UNAIDS and with the collaboration of the National AIDS Councils and AIDS programmes of the countries.

Relegious and government leaders at the opening
ceremony of the Forum.
Photo credits: UNAIDS/S. Aghaeze

Over 150 leaders from all denominations of Christian and Islamic faith communities came together in Abuja, Nigeria to take stock of faith-based organizations’ achievements and good practices within the AIDS response in the country and to examine challenges faced for the future. Hosted by the National Faith-Based Advisory Committee on AIDS – NFACA, the Forum was opened by the highest Muslim and Christian leaders in the country, the Sultan of Sokoto, Alhaji Muhammadu Saad Abubarkar III, represented by Dr Lateef Adegbite, Secretary-General of the Nigeria Supreme Council for Islamic Affairs and Most Reverend Dr John Onaiyekan, President of the Christian Association of Nigeria. 

“I want the Christian and Muslim communities in this Forum to come up with a stronger position on HIV prevention, to do more for people infected and affected, and to be more involved in the campaign against stigma and discrimination,” Dr Adegbite said in his opening address.

Most Reverend Onaiyekan pleaded for more recognition and a commensurate allocation of resources to the faith-based AIDS programmes. “There is growing acknowledgement and appreciation– including among the United Nations agencies – of the tremendous role being played by religious institutions and organizations, especially in the poorer countries of the world. However, put bluntly, the money is not going to those who are doing most of the work. It is hoped that this anomaly will be redressed in good time,” he stated.

The bi-annual Forum is the third to have taken place in Nigeria to strengthen the faith-based response to AIDS in the country. The forums provided unique avenues for the Christian and Islamic faiths to interact and to strategize on their role in the national AIDS response.

At the 2007 Forum, the participants made recommendations on the way forward and on policy and strategic issues relating to HIV prevention, testing, care and support, and gender in the Forum’s communiqué. They agreed that faith-based organizations should identify their areas of competence and do more of what they do best, including HIV prevention, promoting and providing services and caring for people living with HIV. The religious leaders and scholars called for the Nigerian government to accelerate access to free medical treatment and care for all people living with HIV who need it.

Most Reverend J. Onaiyekan and Dr Lateef Adegbite
declaring the Forum opened.
Photo credit: UNAIDS/S. Aghaeze

On the issue of HIV testing and counseling, the faith leaders committed to mobilizing their communities to access services on a voluntary and confidential basis as they had been exhorted to by Professor Babatunde Osotimehin, Director-General of the National Agency for the Control of AIDS, in his update on the status of the national response: “HIV generates harmony among faith communities. We expect this Forum to make a strong statement on how to mobilize communities to access voluntary and confidential HIV counseling and testing. Compulsory testing should not be in your vocabulary,” he said.

The Forum was organized by the National Agency for the Control of AIDS and supported by UNFPA and UNAIDS.

UNAIDS Country Coordinator Warren Naamara gave a goodwill message to participants of the Forum, underlining the importance of religious leader’s engagement in the AIDS response. “Your influence on opinions, policies, practices and attitudes reaches from the grassroots and remote communities to the very top level of government and decision-makers. Your compassion and support has always embraced the disenchanted and the vulnerable, the sick, the children and the weak in need of assistance,” he said. “Your speaking out against stigma and discrimination, against rejection and marginalization of people living with HIV, will make a world of difference to the everyday life of people infected, within and beyond their religious communities,” he added.

Links:

Read the opening address by Most Rev. John Onaiyekan, President of the Christian
  Association of Nigeria
Read the goodwill message by Dr. Warren Naamara, UNAIDS Country Coordinator
Read the Forum Communiqué

From right: Representative of UN Secretary General, Executive Director UNAIDS, Dr Peter Piot; President of Niger Republic, Mamodou Tandja and President Council of Senate Senegal, Mbaye-Jacques Diop on arrival for the opening session of the meeting of Heads of State and Government at the Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria in Abuja
Photo: Sunday Aghaeze

African leaders and Heads of State recently met in Abuja, Nigeria at a Special Summit on HIV/AIDS, Tuberculosis and Malaria to address the challenges posed by the three diseases that kill an estimated four million Africans every year.

Organized by the African Union in collaboration with UN Agencies and other development partners, and at the invitation of Nigerian President Olusegun Obasanjo, the Special Summit adopted the Abuja Call for accelerated action towards Universal Access to AIDS, tuberculosis and malaria (ATM) services in Africa, and a resolution to achieve this by 2010. The delegates also adopted an African Common Position to be presented to the High Level Meeting on AIDS in June 2006.

In the Abuja Call, participants urged for intensified leadership at all levels; further commitments regarding human rights; increased mobilization of resources including negotiations for debt cancellation; and collective advocacy with multilateral and bilateral donors.

African leaders renewed their commitment to allocate 15% of their national budgets to health, and to incorporate health financing plans into national development plans.

“For the first time the political commitment exists to work towards Universal Access to HIV prevention, treatment and care, but getting this will require that once more we change gear and further accelerate the response to AIDS. We have no other options that will save entire societies”, said UNAIDS Executive Director Dr Peter Piot.

Nigerian President Olusegun Obasanjo commended African countries for the progress they had so far made in responding to AIDS, tuberculosis and malaria. The Nigerian leader called for the development of structures and systems guaranteeing better and more transparent utilization of funds, as well as for the development of strategies translating national level goals into community targets.

Press Conference after the closing of the Special Summit (left to right) Alpha Oumar Konaré, Chairperson of African Union Commission and former President of Mali; President Sassou-Nguesso of Republic of Congo, Chairman of the African Union; President Olusegun Obasanja of Nigeria, Host of the Special Summit and Alhaji Mamadou Tandja, President of Niger Republic
Photo: Sunday Aghaeze

Also speaking on the occasion, African Union Commission Chairperson, Prof. Alpha Konare, outlined measures Africa should adopt to successfully deliver AIDS, tuberculosis and malaria services. These include local production of essential medicines, greater mobilization of resources, more efficient utilization of resources, and ensuring access to the most vulnerable groups.

Sub-Saharan Africa has just over 10% of the world’s population, but is home to more than 60% of all people living with HIV - 25.8 million. In 2005, an estimated 3.2 million people in the region became newly infected, while 2.4 million adults and children died of AIDS. Among young people aged 15-24 years, an estimated 4.6% of women and 1.7% of men were living with HIV in 2005.

Related links
Read Statement of the UNAIDS Executive Director Dr Peter Piot at the Special Assembly of Heads of State and Government, Abuja, 4 May 2006  

Photo gallery
3 April 2006
4 April 2006

Geneva, 21 September 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) mourns the tragic loss of life during a recent bomb attack on UN House in the Nigerian capital city of Abuja. According to information released by the UN Resident Coordinator in Nigeria, 23 people, including 11 UN personnel, died in this targeted attack by a suicide bomber on 26 August, and 124 people were injured.

“The UNAIDS family is shocked and saddened by this unspeakable act of violence,” said Michel Sidibé, Executive Director of UNAIDS. “On behalf of UNAIDS, I extend our sincere condolences to the families and friends of all who were killed and injured.”

UNAIDS was one of five United Nations organizations to lose staff members in the Abuja attack. Thirty-nine year-old Elisha Enaburkhan, who had worked as a driver for UNAIDS since 2007, was killed when the explosion hit the UNAIDS office in Abuja. A second UNAIDS staff member was injured in the attack and is currently receiving treatment in South Africa.

Speaking of his colleague and friend, the UNAIDS Country Coordinator in Nigeria, Kwame Ampomah, said: “Elisha was a highly committed staff member. Even though he lived about 45 kilometers from town, he was always the first person to get to the office and often the last to leave. Elisha was an attentive, courteous and very kind man. He was always smiling and laughing—we will miss Elisha’s smile.”

Geneva, 6 May 2011—President Goodluck Jonathan of Nigeria has confirmed his participation in this year’s UN General Assembly High Level Meeting on AIDS. The gathering of Heads of State and high-level representatives from government, the scientific community, civil society and the private sector will be a unique opportunity to review and renew global commitments for the AIDS response.

“The High Level Meeting will be a milestone in the global AIDS response,” said UNAIDS Executive Director Michel Sidibé. “As the leader of a country that is heavily impacted by the epidemic, President Jonathan’s voice and engagement in this meeting will be critical to move the AIDS agenda forward,” he added. The High Level Meeting will be held in New York City from 8-10 June 2011.  

Nigeria has the second largest population of people living with HIV after South Africa. The estimated HIV prevalence among adults in Nigeria is 3.6%, with wide variations across the country.

In recent years, Nigeria has made progress in its efforts to expand access to HIV prevention, treatment, care and support. According to UNAIDS estimates, coverage of antiretroviral treatment in Nigeria reached 21% in 2009, up from 1% coverage in 2004.

World leaders call on South-South cooperation to reverse the AIDS epidemic and lead an integrated approach to accelerate progress towards the Millennium Development Goals

NEW YORK, 22 September 2010—World leaders gathered at the United Nations called for a new model of partnership to strengthen the AIDS response and achieve broader health and development outcomes. Without synergy between AIDS and other health and development initiatives, the leaders agreed sustainable progress towards global goals to end poverty and ensuring healthy societies will not be achieved.

A high-level meeting co-hosted by China, South Africa, Nigeria, Ethiopia and UNAIDS brought together world leaders including the Premier of China, the Prime Minister of Ethiopia and Ministers from South Africa, Nigeria, Burundi, Democratic Republic of Congo, Kenya, and Rwanda. They were joined by heads of international organizations and civil society.

"The era of health and development programmes operating in isolation is over,” said Mr Michel Sidibé, UNAIDS Executive Director, who chaired the meeting. “We have to work together to make this one movement—we cannot afford to have a fragmented approach to health and development. This Africa-China partnership can be the engine that accelerates progress towards the MDGs.”

Developing countries are joining hands to push for a combined approach to health and development and giving communities a strong voice in defining their health needs. The new South-South partnership will promote innovation, local solutions that make a difference, sharing of technology, and building local capacities.

The AIDS epidemic is stabilizing globally and new infections are steadily declining around most of the world. This has been possible as the international community has made significant progress in achieving goals towards universal access to HIV prevention, treatment, care and support.

"We cannot turn a deaf ear to the call of life, and we must not be slow in reaching out,” said H.E. Wen Jiabao, Premier of China. “We should redouble our effort to advance the global campaign against HIV/AIDS and ensure that the related MDGs be met on schedule. China has been actively involved in the international cooperation on HIV/AIDS prevention and treatment."

Endorsing the UNAIDS approach of “AIDS plus MDGs”, the leaders called for the AIDS movement to take the lead in bringing about integration and innovation.

“The ‘AIDS plus MDGs’ approach seeks to bring about change that will create a new dimension of performance. Not just in the response to AIDS, but also in efforts to achieve other MDGs, accelerating progress on those that are trailing behind,” said Dr Asha-Rose Migiro, UN Deputy Secretary-General. “Progress towards reversing the HIV epidemic is therefore central to the broad international development agenda.”

Investments in AIDS have contributed to strengthening health systems and primary health care as well as better access to social welfare programmes in many countries. In Ethiopia, a strong, results-driven alliance between the Ethiopian Government and its key development partners is producing win-win results by channelling more than US$ 300 million of AIDS resources to strengthen the county’s health systems.

“Ethiopia’s strategy to integrate AIDS and health issues has not only decreased the burden on health facilities, but it has also enabled the health system to reach the vulnerable and poor,” said H.E. Meles Zenawi, Prime Minister of Ethiopia. “Community ownership of development has helped us achieve progress that is sustainable over time.”

South Africa has integrated HIV and TB services under one roof, reducing both AIDS and Tuberculosis-related deaths. Under its ambitious programme to test 15 million people for HIV, it is offering comprehensive health checkups for women and girls. In 2009, nearly 90% of all pregnant women were able to access treatment to protect their babies from being born with HIV.

“We have to strengthen primary health care services that integrate HIV, maternal and child health, sexual and reproductive health into development,” said Dr. Aaron Motsoaledi, Health Minister of South Africa. “Communities must own the health agenda which is at the centre of their own development.”

However, HIV continues to hamper progress in reducing maternal and child mortality in many sub-Saharan countries. More than 40% of all maternal mortality in countries such as Botswana (77%), Swaziland (75%), Lesotho (59%) and Zimbabwe (53%), Namibia (50%), South Africa (43%) is attributable to HIV.  Where health services are integrated, the results have been spectacular. In Pampaida, Nigeria, a Millennium Development Village in Kaduna state, there have been very few maternal deaths or children born with HIV in recent years, thanks to an integrated approach to health care delivery.

“We are saving mothers and children by strengthening the health system,” said Professor Onyebuchi Chukwu, Health Minister of Nigeria. “We are investing in health using resources from debt relief because access to good quality health care is a necessity and a basic human right, not a luxury.”

In 2000, world leaders adopted the Millennium Declaration. This milestone in international cooperation inspired development efforts that have improved the lives of hundreds of millions of people globally. Five years remain to move forward to meet the eight Millennium Development Goals by 2015.