Around 1.8 million Nigerians are thought to be infected with the Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), as the country observes World AIDS Day (WAD) today.
The National Agency for the Control of AIDS (NACA) asserts that HIV/AIDS deaths and new infections are declining nationally, in contrast to what is happening in other parts of the world.
The agency claimed that HIV no longer kills as long as people are aware that they have it. The Federal Government had spent more than N18 billion on capital projects related to HIV in just three years.
Additionally, The Guardian’s investigation reveals that individuals living with HIV still pay some fees for ostensibly “free” treatment provided by the Federal Government nationwide, even though AIDS activists claim that delays in access to accessible, cost-effective long-acting, injectable HIV medicines globally would result in lives lost.
The WAD 2022 theme, “Equalize,” emphasises doing away with the disparities that have slowed the battle against the disease.
According to the Joint United Nations Programme on AIDS (UNAIDS), 650,000 people died from AIDS in 2021, 1.5 million people contracted the virus, and there were an estimated 38.4 million (33.9-43.8 million) people living with HIV at the end of the year, with 25.6 million of those people living in Africa.
In addition, the United Nations Children’s Fund (UNICEF) reported that 110,000 young people under the age of 19 died last year from AIDS-related causes, bringing the total number of young people living with HIV to 2.7 million when combined with the 310,000 newly infected.
In its most recent global snapshot on children, HIV, and AIDS, UNICEF cautioned that while there has been some progress in HIV prevention and treatment over the past three years, many regions have yet to reach pre-pandemic service coverage.
In a recent interview, Dr. Gambo Gumel Aliyu, director general of NACA, stated: “We have an estimate of about 1.8 million and we are working with our data to know the actual number that is now very active, that is, they are alive and receiving medication. These are the people we count because we are aware of them, they are alive, listed on our register, and they are aware that they are HIV positive.
“Those ones that are no longer alive but are in our register, we will take them out and at the end of the day, we will have an alternative number. So, we are working on our data to get that exact number but our estimation is less than two million people that are currently living with HIV in Nigeria.”
The leaders of the nation have been urged by the AIDS Healthcare Foundation (AHF) to ensure that there are no new infections, stigma, or discrimination, particularly against young girls.
“This is because our data is showing that of the 7,600 new infections that happen in young people in 2021, 6,800 of them are girls, while less than one million are boys,” said Dr. Echey Ijezie, Country Program Director for AHF Nigeria.
“So, if we invest more in girls, we secure their future, we secure their future partner and the life of the child she will give birth to.
“This is a call to Nigeria as a country; we have gone a long way in HIV response, we have good plans, now we need to implement with our monies, energy and commitment,” she said.
Equalize to end AIDS, the theme of the year’s commemoration, was to give everyone the opportunity to access their health rights, HIV prevention, and access to treatment, according to Dr. Takpa Koubaguine, Strategic Information Admin, UNAIDS.
Dr. Daniel Ndukwe, NACA’s deputy director of prevention and social behaviour change communication, said the organisation was currently reviewing the nation’s National Strategic Plan. According to Ndukwe, the new plan is superior to the previous one and provides more informed responses. He also noted that the plan takes into account how HIV affects women.
He emphasised that due to their biological make-up as well as socio-cultural factors, women were more susceptible to HIV.
NACA has stated that HIV continues to be a serious health challenge in Nigeria, with 41% of new cases occurring in young people between the ages of 15 and 24. This statement was made in collaboration with the MOSAIC project.
The Generation Negative (Gen-N) campaign, which aims to create a movement powered by the nation’s 43.2 million youths between the ages of 15 and 24, released a statement yesterday that included this information. The campaign’s goal is to encourage young people in the nation to use HIV prevention, treatment, and care services.
“It is within our power to stop the spread of HIV,” asserts Ndukwe, “but we cannot expect young people to do it alone when they are shamed for visiting health facilities, taking medications, or purchasing condoms.”
Ndukwe exhorted youth to act as Gen-N heroes by utilising the services for HIV prevention and treatment that are available and by encouraging other youth to support peers in remaining HIV-negative and leading fulfilling lives.
The NACA DG, an Assistant Professor of Epidemiology and Public Health at the University of Maryland School of Medicine, commented on the numbers of deaths and new infections, saying: “We are collecting this information and one thing we have seen over the last three years is that the numbers dying from HIV/AIDS are declining and the numbers of those getting infected with HIV are also declining.”
The epidemiologist commented on the proposed HIV budget from the 2023 appropriations bill: “For the last three years, our capital budget has been around N6 billion and that includes all the work we do on HIV prevention and treatment, creating awareness, coordinating stakeholders, monitoring and evaluating programmes, interventions for prevention and treatment across the country.”
According to Aliyu, NACA is working to promote access to anti-retroviral baby (ARB) services among the paediatric population and to increase services for the prevention of mother-to-child transmission.
The NACA boss responded to a study that revealed HIV patients continue to pay ‘hidden’ costs for anti-retroviral (ARV) medications that are supposed to be free: ‘We are aware of it, the costs vary from state to state and hospital to hospital; they are called user fees. In order to help us waive user fees, we have been collaborating with the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN), stakeholders, and a few partners, including the Global Funds for AIDS, TB, and Malaria and state authorities. We are pushing for states to actually abolish user fees and the registration and consultation fees that people with HIV must pay.
“However, the tests we provide to monitor treatment progress are free. Some of the tests we provide to initiate people on treatment are also free, but some of the tests are not free and these are user-dependent or patient-specific; some patients may require additional tests, while some may not. So, those additional tests that are needed based on doctors’ assessments are fees that patients should be responsible for, but fees that cuts across everyone and which we believe are an unnecessary burden, the states can help. We are working with the states to see that those fees are waived and some of the states have encouragingly done that,” he said.
In response to the question of whether Nigeria will achieve the goal of eradicating HIV by 2030, Aliyu stated: “The truth is HIV no longer kills now as long as people know they have it. We can help them keep it in their body without allowing it to be seen on their faces or their body or allow it to leave their body to infect someone else. That is the progress that has been made; this is what we are working with to end AIDS.
The day you stop seeing people with HIV by their features, the day you ask and you are told that for the last year all over the country, there is no record of someone dying at any facility in the country with HIV, the day you hear or see people going out of their way to demand for HIV services because they no longer fear the stigma and discrimination that was previously associated with HIV/AIDS, then HIV/AIDS has ended or is about to end.”
The manifestation of HIV, which causes AIDS, can undoubtedly be eliminated before 2030, and this is what NACA is working hard to achieve, he added, adding that HIV may persist for as long as there is no cure for the virus.
While HIV continues to be a serious public health problem that has an impact on millions of people worldwide, the World Health Organization (WHO) has stated that the global HIV response is in danger. According to the report, resources have decreased, progress toward HIV goals has stalled in recent years, and as a result, millions of lives are at risk.
WHO cites a number of failures that contributed to the rise and persistence of HIV as a global health crisis, including division, disparity, and disregard for human rights.
Therefore, WHO is urging world leaders and citizens to courageously acknowledge and address the inequalities impeding progress in the fight against AIDS. They are also urging them to equalise access to vital HIV services, especially for children and vulnerable populations and their partners, such as men who have sex with men, transgender people, drug users, sex workers, and people in prison.
UNICEF Associate Chief of HIV/AIDS, Anurita Bains, said: “Though children have long lagged behind adults in the AIDS response, the stagnation seen in the last three years is unprecedented, putting too many young lives at risk of sickness and death.”
Ending AIDS in children and adolescents
This is on top of a treatment gap that already exists and is widening between adults and children, teenagers and pregnant women. “Every day that goes by without progress, over 300 children and adolescents lose their fight against AIDS,” the statement reads.
Despite making up only 7% of all HIV-positive individuals, children and adolescents last year accounted for 17% of AIDS-related deaths and 21% of new HIV infections.
Ending AIDS in children and adolescents will remain a distant goal unless the causes of inequities are addressed, UNICEF warns. Longer-term trends are still positive, the snapshot reveals.
In a similar vein, the percentage of pregnant women with HIV who received lifelong antiretroviral treatment (ART) rose from 46% to 81 % in a single decade.
While there are fewer kids living with HIV overall, there is a growing treatment gap between kids and adults.
Children’s ART coverage in UNICEF’s HIV-priority countries was 56% in 2020 but dropped to 54% in 2021.
The decline was caused by a number of factors, including the pandemic and other global crises that have exacerbated poverty and marginalisation.
Only 52% of children living with HIV worldwide had access to treatment, a number that has barely risen over the past few years.
Meanwhile, coverage among all adults with HIV was 76%, more than 20 percentage points higher than it was among kids.
Additionally, there was an 81 percent difference between HIV-positive pregnant women and children.
Furthermore, the proportion of children under the age of four who have HIV and are not receiving ART increased to 72% last year, matching the level from 2020.
Because pregnant women were not diagnosed and started on treatment, there were more than 75,000 brand-new infections in children in 2021.
Impossible for World to beat AIDS- UNAIDS
In response to the new report, Winnie Byanyima, executive director of UNAIDS, said that maintaining patriarchy would make it impossible for the world to defeat AIDS. She emphasised the necessity of addressing the intersecting injustices experienced by women.
She said: “What world leaders need to do is crystal clear. In one word: Equalise. Equalise access to rights, and services, as well as to the best science and medicine. Equalising will not only help the marginalised, but it will also help everyone. In areas of high HIV burden, women subjected to intimate partner violence face up to a 50 per cent higher chance of acquiring HIV.
“Across 33 countries from 2015-2021, only 41 per cent of married women aged 15-24 could make their own decisions on sexual health. The only effective route map to ending AIDS, achieving sustainable development goals and ensuring health, rights and shared prosperity, is a feminist route map. Women’s rights organisations and movements are already on the front doing this bold work. Leaders need to support them and learn from them.”