Feature story

Nigeria to accelerate universal access efforts in HIV response

23 February 2010

(from left) UNAIDS Executive Director Michel Sidibé greets Acting President of Nigeria Goodluck Jonathan while Ambassador Eric Goosby, United States Global Coordinator on AIDS looks on. Presidential Villa, Abuja, Nigeria. 22 February 2010
Credit: UNAIDS

There are nearly three million people living with HIV in Nigeria. After South Africa, the country has the largest number of people living with HIV in the continent. Each day there are about 1000 new infections. National HIV prevalence is around 4.6%. But these figures mask the multiple epidemics in the various states of the country. Many of the people living with HIV are poor. Add to this stigma and discrimination.

Acting President Dr Goodluck Jonathan of Nigeria knows this first hand. In his past role as Governor of Bayelsa state, he pioneered cash transfer of 10,000 Naira (around US$ 70) per month for each person living with HIV to meet their nutrition needs. He also hoped that this would also lead to greater awareness about HIV and contribute to reducing the stigma faced by people living with HIV in the community.

“I feel that nobody should die of AIDS,” said the Acting President Jonathan in a meeting with the Mr Michel Sidibé, UNAIDS Executive Director and Ambassador Eric Goosby, United States Global Coordinator on AIDS at the Presidential Villa in Abuja, Nigeria today. “HIV is fast becoming a disease of poverty and we must take a developmental approach to address the issue.”

(from left) Nigeria’s Health Minister Professor Babatunde Osotimehin in discussion with UNAIDS Executive Director, Michel Sidibé. 22 February 2010, Nigeria.
Credit: UNAIDS

Commending the Acting President for his progressive policies on AIDS, Mr Michel Sidibé, UNAIDS Executive Director said, “ Nigeria must take the lead in setting the regional and African Union agenda in eliminating mother to child transmission of HIV by 2015. Without Nigeria’s leadership, this goal will not be met in the African continent.”

Echoing the similar sentiments Ambassador Eric Goosby called for new strategic thinking on how to get ahead. “Programmes to prevent mother to child transmission of HIV will need to be owned and sustained locally,” said Ambassador Goosby.

Mr Sidibé and Ambassador Goosby are on a joint visit to Nigeria during which they also met with Health Minister Professor Babatunde Osotimehin. The health minister commended UNAIDS for mobilizing the participation of non-governmental organizations, faith-based entities and the private sector to support the national AIDS response. “This has helped us gain momentum in rolling out access to services,” said Professor Babtunde. “We still have challenges. We are aware that resources are limited, but we must meet the expectations of the people we have mobilized.”

(from left) Kaduna State Deputy Governor, Patrick Yakowa; UNAIDS Executive Director, Michel Sidibé; and Kaduna State Governor, Arc. Muhammed Namadi Sambo. 22 February 2010, Nigeria.
Credit: UNAIDS

Before his meetings in Abuja, Mr Sidibe also visited the Kaduna state, where adult HIV prevalence is around 7%. While in Kaduna he called on the Governor of the state, Mr Namadi Mohammed Sambo. Kaduna is on the verge of eliminating polio, the Governor proudly announced at the meeting attended by senior state officials. “We must now show similar dedication in reaching the universal access goals in Kaduna,” said Governor Sambo. “However we need continued technical and financial support to scale up access to services.”

Nigeria has only 30% of the resources available to meet the needs of the national AIDS response. The global economic downturn has had a negative impact on the resources available at the national and state level. Only 15% of spending on AIDS in the country comes from the domestic sources. But this has not stopped them from pursuing a dynamic agenda. A new national strategic framework on HIV is being prepared, that will aim to catch up on its universal access targets. Making most of the money available is one of the top priorities for the National Agency for the control of AIDS (NACA). It has begun to take the lead in coordinating the divergent sources of support the country receives and channel them towards people most in need. “Management of all resources—external and internal is very crucial to make a difference,” said Acting President Goodluck Jonathan.

(from left) United States Ambassador to Nigeria Robin Renèe Sanders; Ambassador Eric Goosby, United States Global Coordinator on AIDS; and UNAIDS Executive Director Michel Sidibé.
Credit: UNAIDS

At the same time Nigeria has to start a policy dialogue to explore alternate approaches for promoting universal access that is sustainable. “One approach would be to democratise problem solving,” said Mr Sidibé. “This would give communities and people a chance to prioritise and hold themselves accountable.” The country is now applying the lessons learnt from the UNAIDS “three ones” principles to other health issues. It is forming a combined taskforce for AIDS, tuberculosis and malaria. The country now has a single national strategic framework for health that is costed and disaggregated for each of its states.

There is a growing demand for access to treatment and prevention services within Nigeria. This can be met by strengthening the current partnership between global, national and local partners. “The economic meltdown is not a reason for reducing investments that save babies and keep mothers alive,” said Mr Sidibe. “We cannot afford to let down the four million people living on treatment and the millions who are waiting for it.” Nigeria has a long way to go, but it is on the road already—providing access to HIV prevention, treatment, care and support.