HIV treatment: Need for govts to take ownership as donor funding dwindles

The first two cases of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) in Nigeria were identified in 1985 and were reported at an international AIDS conference in 1986.

Unfortunately, 32 years down the line, the infection has continued to spread rapidly creating great impact on health welfare, employment and criminal justice sectors, thereby affecting all social and ethnic groups throughout the world.

Nigeria has not done enough over the years due to its highly dependent on donor funding for its HIV and AIDS response, with only 5% coming from the Federal government.

Currently, 95% of HIV interventions programme are managed by international donors and NGOs in collaboration with local civil society organisations (CSOs), which are critical in terms of providing HIV-related services in the states.

Globally, the progress has been immense; more people than ever before living with HIV are accessing antiretroviral therapy;

since 2010, new HIV infections among adults declined by an estimated 11%; new HIV infections among children declined by 47% since 2010; and AIDS-related deaths have fallen by 48% since the peak in 2005. However, the case is different in Nigeria.

Currently, Nigeria has the second largest global burden of HIV/AIDS and also contributes the largest proportion of new vertically acquired HIV infections among children.

According to the 2017 report of the UNAIDS, Nigeria is responsible for over 12.4% of the global burden of HIV infected children with an estimated number of 267,000 children living with HIV in the country.

With this alarming figure, it is indeed a wake-up call on government to take full ownership of HIV funding. Nigeria’s heavy dependence on external donors at 95 percent, while domestic financing is 5 percent;

and the dwindling global funding for HIV in developing countries; there is the need for the Nigerian government to bridge this funding gap.

The Assistant Director, Prevention of Mother-To-Child Transmission (PMTCT) and Head, National AIDS and STI Programme, (NASCP) Federal Ministry of

Health Dr Gbenga Ijaodola had revealed that 95% of Nigeria’s HIV response funding is supported by partners/donors.

Dr Ijaodola who made this known in Calabar at a media dialogue on PMTCT organised by the United Nations Children’s Fund (UNICEF) in collaboration with the Child Rights Information Bureau of the Federal Ministry of Information (CRIB) expressed worry that donors dwindling funding and gradual withdrawal may increase the burden of HIV/AIDS.

”At the moment 95 per cent of the national HIV response is supported by partners, this includes PMTCT and Paediatric treatment.

”U.S. Government contributes 75.5 percent of treatment interventions, Global Fund 17.4 per cent, AIDS Healthcare Foundation (AHF) 1.2 per cent and Nigerian Government 5.4 per cent.

”At the moment 95 per cent of the national HIV response is supported by partners, this includes PMTCT and Paediatric treatment.

”For Nigeria to be able to address the challenges of the global burden of PMTCT, pregnant women must have access to PMTCT’’, he said.

According to him, 267,000 children are infected with HIV virus in Nigeria, 54,167 children less than 14 years are under anti-retroviral drugs, 10,464 children have their viral loads tested, while 4,699 Nigerian children have viral load suppressed.”

Also speaking UNICEF HIV/AIDS Specialist, Dr. Abiola Davis who expressed worry over the gradual decline in global findings by donor agencies , called on the Nigeria Government to map up plans on how to meet up with global standard of HIV prevention.

”There is need for collaborative efforts from agencies and stakeholders to address the situation by redesigning HIV funding plan to meet up with global standard”.

Report released at the 9th International AIDS Society (IAS) Conference on HIV Science in Paris showed a continuous decline in funding and its potential impact on HIV patients and death rates.

The Resource Tracking for HIV Prevention, Research and Development Working Groups RTWG 13th Annual Report noted that funding for HIV prevention and research decreased by another three per cent in 2016.

According to the report, funding for HIV prevention R&D fell by three per cent ($35 million) in 2016 from the previous year, falling to $1.17 billion.

“It had maintained a steady downward trend between 2012 and 2016, falling from US$1.31 billion to US$1.17 billion with an annual funding loss of US$40.5 million, US$10.3 million, US$10.4 million and US$2.8 million for the four years.

The report which had tracked global funding for HIV science since 2000 also revealed that the United States’ public sector and the Bill & Melinda Gates Foundation donate about 88 cents of every dollar spent on HIV prevention R&D in 2016.

It added that the European public sector funding fell by $10 million from 2015 and at $59 million, accounted for just six per cent of all public sector investment, according to the 2016 research document. The number of philanthropic donors fell sharply from a total of 27 in 2015 to just 12 in 2016.

The Minister of Health, prof. Isaac Adewole in his address during the 2017 World AIDS Day, observed that over 1 million Nigerians are now on life-saving antiretroviral therapy (ART).

The Minister pointed out that providing service to Nigerians living with HIV/AIDS is a fundamental human right and must be met by all.

He further noted that access to services need scaling up in order to achieve the 90-90-90 target (which specify that by 2030, 90% of all people living with HIV will know their HIV status, 90% of all people living with HIV who know their status will be on ART, and 90% of all people receiving ART will have viral repression).

However, the sad reality is that the Nigerian government is only managing to provide ART funding for about 60,000 people living with HIV/AIDS in Abia and Taraba state. The significant funding shortfall is left to donors.

The Minister did promise that the Federal Government of Nigeria is working with relevant partners to improve access to HIV treatment and especially prevention of mother-to-child transmission (PMTCT) in Nigeria.

Of all the challenges with HIV care, mother-to-child transmission is probably the most tragic there are more children infected by their mothers in Nigeria than any other country in the world.

In spite of several years of intervention, access to paediatric ART services continues to hover around the 28% of need for six years running and PMTCT services are available only to 30% of the pregnant population annually. We can and must do better.

Poor funding and lack of ownership of HIV treatment and care by the country is responsible for the high prevalence in the country.

Nigerians that died due to the scourge would not have died if the government had taken up ownership of the fight by ensuring availability and accesses to HIV prevention, testing, treatment and support programme.

The only way to address this burden is for the Federal Government to take ownership of the fight against HIV scourge rather than relying solely on donor agencies.

The problem of Nigeria can never be solved by foreigners except for Nigerians and by Nigerians with adequate and realistic budget.

Budget in all AIDS, Tuberculosis, Malaria control, prevention and treatment for all the Ministries, MDAs could make big difference if is been released 100 per cent in the life of persons living with HIV in and lives of Nigerians who are not infected.

This could be achieved by dedicating adequate funding through budgetary allocation by all tiers of government for its prevention, treatment and care and implementing 100 per cent of such funds in fighting the scourge.