Nigeria’s high HIV/AIDS prevalence

But in a swift reaction, the director general of the National Agency for the Control of AIDS (NACA), Professor John Idoko said that the statistics were misleading particularly as they relate to the number of new infections in the country.
According to him the figures are usually derived from modeling and if one gets the base assumptions wrong, then the whole figures will be wrong.
Idoko noted that in March of 2014, the main stakeholders in Nigeria HIV response led by NACA and UNAIDS met to validate the country’s national figures for the “Global AIDS Response Country Progress Report (Nigeria GARPR, 2014), adding that the figures were eventually published as representing the approved figures for Nigeria by UNAIDS in Geneva.
He pointed that the figures reported are as follows: Number of people living with HIV/AIDS at the end of 2013 was 3.5 million while the new HIV infections have been on the decrease since 2010; from 288,870 in 2009 to 283,589 in 2010; 274,367 in 2011, 239,706 in 2012 and 220,394 in 2013.
Explaining further the drop in new infections among young people aged 15-24 years who are new sex debutants and hence represent new infections in the population show similar trends: from 74,783 in 2009 to 72,814 in 2010, 70,992 in 2011; 59,739 in 2012 and 54,662 in 2013.
Nigeria according to the latest UNAIDS report is one of the heavily burdened countries that in the last decade has witnessed significant declining number of new infections.
Speaking on HIV/AIDS counseling and testing centres , the NACA boss noted that number of HCT sites in (2012 – 2,391 sites vs 7,075 sites in 2013); 2,792,611 tested in 2012 compared with 4,077,663 in 2013.
He mentioned that on ART there was 516 health facilities offering ART in 2012 compared to 820 in 2013; 490,021 were receiving ARV drugs in 2012 compared to 639,397 in 2014. This represents increase of 148,919 new individuals put on these lifesaving drugs in one year. At the end of 2013, 46% of eligible individuals were on ARVs compared to 30% in 2012.
However on the intervention of Prevention of Mother to Child Transmission (PMTCT), the professor pointed out that the PMTCT sites increased from 1,410 in 2012 to 5,622 in 2013.
Correspondingly, the number of HIV positive pregnant women who accessed ARV prophylaxis increased from 40,465 to 57,871.
This increase raised the percentage of women from 11% in 2009 to 30% in 2013. Though there is still some long way to go to achieve elimination targets of 90% but this is significant progress from a couple of years ago.
He said that though significant progress has been made in the national HIV response, Nigeria is not on track to achieve the universal access targets, unless a major scale up of prevention and treatment scale up is implemented in the next two to three years.  
He added that Nigeria contributes 29% of the global PMTCT burden (target 90%), has attained 46% coverage of persons requiring antiretroviral drugs (target 80%) and has the largest population of HIV orphans.
He lamented that the inability of Nigeria to attain its Universal Access targets as set  out in the National HIV/AIDS Strategic Plan 2010-2015, is attributable to many factors: Chief amongst these factors are inadequate funding, weak health system, and inadequate capacity.
The National HIV and AIDS Spending Assessment conducted in 2010 showed clearly that only about 25.3% of the spending on the HIV response was from the national government. This indicates that the national response is mainly donor dependent and unsustainable.  
The unsustainable nature of this spending profile was echoed repeatedly during the 2010 National HIV conference. The need to increase the domestic funding of the HIV response was also emphasized and re-enforced at Abuja +12 Heads of States Summit on HIV, Tuberculosis and Malaria in July 2013.
The current total funds from donors and the governments of Nigeria supporting the national response is about 600 million dollars annually.
Out of this the US Government contributes about 500 million dollars annually. If the current funding rate is maintained, the country shall continue to witness 270,000 new infections and 250,000 AIDS related deaths every year.
However, if the funding rate is increased to 1,400 million dollars annually, as recommended by the PCRP, the country will see much fewer new infections and deaths from HIV (210,000 new infections will be averted and 92,000 lives will be saved annually).
The President launched the PCRP in July last year with the aim of dramatically reducing the HIV epidemic in Nigeria and achieving an AIDS free generation in Nigeria. The plan aims in the next 2-3 years to test 80 million Nigerians to enable them know their HIV status, double the number of Nigerians on treatment to 1.2 million, interrupt transmission of HIV in 244,000 HIV positive pregnant women and strengthen combination prevention interventions among young people and Most At Risk Populations.
The cost of this plan over the 2-3 year period to be borne by the Federal Government, state Governments and the Private Sector is 1.6 Billion dollars (N262 Billion) with 80% of this cost going to procure antiretroviral drugs and HIV Rapid Test Kits.
However, the Federal Government in this fiscal year has provided only 40 million dollars (8 Billion Naira) through Sure – P and only a few states indicating their willingness to fund the plan. The private sector is yet to engage even though spirited efforts are being made by NACA and the Federal Ministry of Health to advocate to them to support the funding of the national HIV response.
The government must urgently come to the support of the national HIV response by providing funding at both the federal and state government levels.

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