Anxiety over HIV patients as U.S. reduces support

There is apprehension in the nation’s health sector over the sustainability of the official support for people living with the Human Imuno-deficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS).

The concern is worsened by fear that Nigeria’s HIV burden might increase, leading to more deaths from the ailment.
Investigations by The Guardian exposed recent funding gaps in the HIV/AIDS programme in the country, which has resulted in user fees being charged the affected people at the treatment centres.

A concerned stakeholder observed that many People Living with HIV (PLHIV) who cannot afford to pay these fees are now unable to continue with the treatment, just as some may have started defaulting from treatment while many newly confirmed positive cases are yet to be enrolled into treatment.

The cause of the situation is that the United States government that has largely supported the HIV/AIDS scheme in the areas of chemistry tests and antiretroviral drugs (ARV) for the affected people through the Presidents Emergency Programme for AIDS Relieve (PEPFAR) has now officially withdrawn a substantial amount of the support. The PEPFAR programme in Nigeria recently withdrew from supporting Chemistry and Haematology (essential laboratory) tests for PLHIV in their supported treatment facilities.

The Guardian learnt that the US Ambassador has written to the federal and state governments regarding the PEPFAR support withdrawal for these tests and the need for the governments to take responsibility.

Reacting to the development, Director-General of the National Agency for the Control of AIDS (NACA), Prof. John Idoko, confirmed that PEPFAR has stopped paying for chemistry and hematology tests. He said the agency was working with government on how to address the situation.

“I have met with the two past Ministers of Health to see how this support can be brought back. It is being discussed with the current Minister of Health. I also have met with a number of state governors to discuss how to handle the situation by increasing the state budget for HIV response and possibly establishing state health insurance schemes that can take care of prevention, treatment and care costs at state level.

“NACA will continue to address this issue as it negatively impacts the 90-90-90 strategy because it has been observed to badly affect retention which is pre-requisite for virological suppression,” Idoko explained.

The Guardian learnt that although the drug is still free, the necessary tests that qualify a PLHIV to receive the drug, according to the national guideline on treatment, are no longer free, a situation that makes stakeholders to described the treatment as not free in Nigeria anymore.

Stakeholders fear that this could be a direct cause for increased disease burden on individuals and families, as hospitals, in response to the withdrawal of support, introduced huge user fees that are said to be over bearing on the poor PLHIV community to pay.

Data available to The Guardian indicate, for instance, that at the University Teaching Hospital (UCH), Ibadan and BOWEN University Teaching Hospital, Ogbomosho, PLHIV pay N12, 000 for these tests. At the Federal Medical Centre (FMC), Gombe they charge N1, 500 for the tests. Shandam Hospital and many other government hospitals in Plateau state charge N2, 300. University of Abuja Teaching Hospital Gwagwalada charge about N5,600.

Reacting to the development, Executive Secretary, Civil Society for HIV/AIDS in Nigeria (CiSHAN), Walter Ndukwe Ugwuocha, noted that PLHIV are also being asked to pay for syringe and CD4 count test in South East. This, he said, is in addition to paying for the routine tests, especially at District Hospital, Oguute, Enugu-Ezike.

Ugwuocha also confirmed that “HIV/AIDS treatment is no longer free in Nigeria due to high user fees on chemistry and haematology tests.

“In fighting AIDS from 1986 when it was first diagnosed in Nigeria to 2015, Nigeria, through these numerous international support, placed 750,000 persons living with HIV/AIDS on treatment with the PEPFAR programme accounting for over 600,000 of them. It is however, important to note that the government of Nigeria has not made meaningful contribution to the response since the national emergency was declared on HIV/AIDS by former president Olusegun Obasanjo in 2003 when he also pledged governments’ commitment and support for combating the epidemic in the country.

“There are evidences that people are still getting infected and more people are now living with the virus in Nigeria, government at all levels have not been committed to promises made with government’s present contributions put at just 7 percent of the total sum spent on HIV and AIDS intervention in Nigeria.”
CiSHAN confirmed that facilities, especially where the US Government withdrew its support now charge PLHIV as high as N12, 000 to carry out the essential tests.

National Coordinator of the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN), Victor Olaore Omoshehin, confirmed the development and called on governments at all levels to take the matter seriously to averts crisis in the sector.