Recently, President Mohammadu Buhari presented the results of Nigeria National HIV/AIDS Indicator and Impact Survey, NAIIS, in Abuja. Results of the new survey, conducted by the National Agency for the Control of AIDS, NACA, with support from the Global Fund and the US government, indicate that Nigeria has an HIV prevalence of 1.4 percent among adults aged 15–49 years, while showing that 1.9 million persons in the country were living with HIV.
The survey generally provides a clearer understanding of Nigeria’s HIV epidemic and charts progress towards overcoming the country’s remaining gaps and challenges.
In this interview with Sola Ogundipe, the Director General of the National Institute of Medical Research, NIMR, Prof Babatunde Salako, responds to the development. Excerpts:
I‘m congratulating NACA for the successful completion of the Nationwide survey on HIV and beyond the fact that it was a successful project, the results were also very encouraging.
It shows that all efforts of the government partners, NACA and Nigeria has come to fruition.
We now have national prevalence of 1.4 percent which is 50 percent less than what it used to be and that cuts across for most regions of the country.
Perception of Nigerians about the system
So we are making progress, but Nigerians don’t believe in their own process. I’m sure before this survey if you had asked the average Nigerians what the National HIV prevalence was, they would have replied that the figure would have gone up.
You would have heard things like: “what are we doing?” The way we talk about our country sometimes leaves much to be desired and we need to begin to change the narrative.
Individual experiences sometimes determine how people respond and what they say, but despite that, on most fronts, Nigerians don’t talk well about Nigeria.
We need to start to believe in our effort, our capability, our knowledge and our system because we are the ones running the system.
If we believe in it and we demonstrate more confidence in the system then it will be possible for us a group to improve the system.
Expectations from the NAIIS
My fear is that we have got to where we are today because we have a lot of helpers and if they decide to carry their bag and baggage and leave Nigeria, we are unlikely to be able to maintain that system.
So there has to be in-country spending on health. Yes there is some spending, but it is really not enough and not close to what the WHO and UN have recommended in terms of the percentage of the total population and what the health budget should be.
We need to begin to look inward to start bringing on board the process of sustainability more like a take-over from the funders and taking full responsibility to run all these programmes.
The major fear that I have is that if the donors leave today, we will not be able to sustain this successes.
What FG needs to do
The Federal government has to begin to put in the front burner the process of ensuring that they take over the funding of HIV completely from donors.
Let the donors put their energy elsewhere because this is one disease that is ravaging our country and one of the top 10 diseases that is killing Nigerians.
So if we want to produce Nigerians with good health and well-being, good workforce for government that can translate into economic prosperity, HIV is one disease that the country must tackle and it has to be in a holistic way. We cannot afford to leave it for development partners alone
Key areas to focus on
The important focal areas have to be in the area of service, that is, detection, prevention, treatment, research in that order. So I’d expect that they put money on case finding, and on prevention which I believe has helped a lot in terms of awareness campaigns about how the disease is contracted, what preventive measures are available that people can be make use of, and what to do when people are engaged in risky behaviour among others. I believe those are the things that we have done very well and that has helped.
On HIV treatment
Although we have also been able to put a lot more people on treatment much more than before, so if we get a large majority of people to have very low undetectable viral load, then infectivity is unlikely to be high.
We have the issue of resistance but that is not in isolation. Resistance happens to many infectious diseases either because of fake drugs or because of patient behaviour in terms of low compliance or things like that. We can always battle that because a large majority of patients are responding.
Young persons with HIV
It will be a dangerous signal if we allow young people who still have mileage in terms of their age to get tired of taking their drugs.
What that would mean is that it is very likely that mortality and morbidity will increase and the rate of infection will become higher and then we go back to square one.
I think these days, we must begin to look at the role of social scientists and anthropologists who have the art of being able to make changes in the community, being able to talk to the community and also having the capability of convincing them on the positive ways and thinking that communities should be able to prevent people from stopping their ARV agents.
We need more of these people in the community motivating patients with HIV generally and talking to them about the danger that exists ahead if they stop taking the drugs.
Increasingly the role of social scientists is becoming more important in breaking that barrier and improving community knowledge of the particular policy or disease to improve access to treatment information and then exchange of ideas.