Dwindling funds, dearth of personnel impede fight against HIV/AIDS
A total of 3.2 million persons are currently living with the HIV (Human Immuno Deficiency Virus) in Nigeria, making the national HIV prevalence rate to stand at 3.2%. The current prevalence rate represents a drop from the 3.5% prevalence statistics recorded in the country over the last decade, thanks to the financial and technical assistance from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through the Ministry of Health (MOH) to mitigate the epidemic and implement an effective national HIV treatment programme.
However, unless urgent steps are taken by the Federal Government to take full ownership of funding and supply of commodities and drugs for management of the epidemic, the gains made, especially in the reversal of spread of the virus through Prevention of Mother to Child transmission may collapse, leading to resurgence and new deaths by the virus.
According to the UNAIDS, Nigeria is estimated to have the second highest burden of HIV in the world, second only to South Africa. The UNAIDS through research attributed the high infection transmission rate of the virus in Nigeria to Mother To Child Transmission (MTC), necessitating the extensive funding of the Prevention of Mother To Child Transmission (PMTC) across the country through PEPFAR funding. This support contributed significantly to saving the lives of men, women and children through HIV treatment services and a robust combination prevention strategy, and the reduction of national prevalence rate from 3.5% to 3.2%.
Former U.S. President, George Bush had before his exit signed into law, an act to extended the U.S. government’s commitment in Nigeria and elsewhere to an additional 5 years in funding the fight against HIV, down from the 2009 fiscal year when it first commenced, to 2013 fiscal year which it set to discontinue funding for the epidemic. However, the US government had variously urged the Nigerian government then under Olusegun Obasanjo to evolve ways of taking over sponsorship of the program in full to prevent a relapse of the gains so far made.
Funding through PEPFAR which is now technically wound down grew from $304.8 million in 2007 fiscal year to $447.6 million in 2008 fiscal year, making Nigeria the third largest recipient of PEPFAR funding among the 15 focal countries.
According to the PEPFAR FY 2008 budget for focal countries, the $447.6 million received by Nigeria was allocated as follows: the Department of Health and Human Services, through the Centers for Disease Control and Prevention, managed $221.3 million; USAID, $216.4 million; the Department of Defense, $8.1 million; and the State Department.
Due to the decision of the US government to cut back on funding of the HIV programme in Nigeria, there are now visible gaps in the treatment plan of the epidemic, especially with regards to dearth of trained medical personnel who are now thrown out of job because of unavailability of funds to pay their salaries or due to embargo on employment among other bottlenecks. The cut in the funding budget of PMTC among other strategic interventions by key development partners and other foreign financial assistance to Nigeria has left beneficiaries of these gestures at the mercy of limited resources provided by dwindling development partners.
In Benue state where a sentinel survey revealed a HIV prevalence of II.0%, I0.6% and I2.7% in 2005, 2008 and 20I0 respectively, the state witnessed a reduction in the prevalence rate, apparently benefiting from the availability of financial and technical partnership of development partners. The highly capital intensive treatment and commodities supply chain apparently relapsed when in 20I0 another sentinel survey conducted showed a rise in prevalence level.
These steep increases however prompted the Federal government through intervention from the National Agency for the Control of AIDS (NACA) to work closely with the Benue State AIDS Control Agency (BENSACA) under the leadership of Mrs. Achi Wendi to prioritize HIV prevention schemes as well as PMTC as core interventions to reverse the surge.
Speaking in Makurdi during a facility tour of HIV treatment sites in Benue, organised by NACA, Chief Medical Director of Federal Medical Center, Makurdi, Dr. Peteru Msuega Inunduh, said that although the Federal Government was doing a lot to make sure it covered the funding gap created by reduced donor funds, there was nonetheless a need to step up financial support for HIV management across the country.
He expressed worry that the oil gloom was also contributing to challenges being faced in others sectors of the economy, saying that the number one challenge faced in the HIV management programme is shortage of funds to execute key projects. He however urged government to look into ways of taking over the full funding process of the HIV programme.
“The biggest challenge we have is that of funding. But this is not limited to HIV treatment alone, but other sectors of the economy. And this is really a global scenario. We have also the problem of shortage of personnel who are trained to manage HIV cases. And again, we cannot afford to pay or hire new personnel. We have applied to government for the go-ahead to hire new hands to help in the management of the cases we have. However we are still doing our best in terms of logistics”, he said.
Also speaking in Makurdi, the Institute of Human Virology (IHVN) State Programme Manager, Mr. Sila Gurmdi said that a lot depends on government in terms of bridging the funding gap created by withdrawal of funds by some donor partners. According to him, the onus lies on the Federal Government to take over ownership of HIV treatment program in terms of providing adequate funding for all levels of treatment and tests, in order to conserve the gains so far made in management and prevention of new transmission of virus.
However, Mr. Maurice Archibong, a media specialist in the NACA said that the Federal Government was aware of the need for increased funding of the HIV treatment programme, adding that already government was doing a lot in the management of HIV across the country and would continue to strive for improved results as time goes on. He urged states to remain focused on the management of the virus, saying also that commitment to the fight against HIV was a vital tool needed to stamp out the virus from Nigeria.
Wendi who is the Executive Secretary of BENSACA, said that Benue state had continued to work tirelessly to prevent new cases of infection in the state, adding that the state has employed coordinated state strategic plan with a goal to reduce prevalence and new infection. She stressed that the state assembly had enacted a law criminalizing discrimination against persons living with HIV in the state. She stressed that part of the success story of state AIDs Control Agency was the passage of the law to end discrimination against people living with the virus, and that the law also helped to tackle silence and non-disclosure among people who had the virus.