…Laments gaps in HIV baseline testing  

By Sola Ogundipe

The Network of People Living with HIV/AIDS in Nigeria, NEPWHAN, has called on the Federal government and other key stakeholders to urgently enable a comprehensive and inclusive approach to HIV response in Nigeria.

The NEPWHAN also called for urgent measures to address the gaps identified in the baseline testing protocol for persons diagnosed with HIV in the country.

Making the call on the occasion of 2024 World AIDS Day, the Lagos State Coordinator of NEPWHAN, Mr Patrick Akpan, emphasised the critical need for a united effort to end AIDS by 2030. Speaking in Lagos, Akpan highlighted the theme “Take the Right Path,” underscoring the shared responsibility in combating HIV/AIDS.

“Ending AIDS requires everyone’s involvement. If we don’t stop stigma, we won’t end AIDS. We must all work together to ensure that by 2030, AIDS is no longer an issue in Nigeria. If we don’t all join hands and see how we can end AIDS, then HIV will still remain, so, what it means is that everybody needs to work and see that by 2030, AIDS will no longer be an issue in the country.”

Noting that the era of stigmatisation is over, Akpan stated: “The era of stigmatization is over. We cannot end AIDS if people living with HIV are still hiding. If you continue to hide, there is no way AIDS will end because people hiding will be transmitting the virus. But if the stigmatisation stops, more people will come out, and if people are coming out and living their normal life, nobody is afraid of anything.

“People living with HIV can live their normal lives and come out to talk of it and it will be easier to end AIDS.  The stigmatisation of children that are born with HIV in particular should stop. So I am calling on Nigerians that they should stop stigmatisation and discrimination, I believe with that, we can end AIDS.

On the importance of baseline tests for individuals diagnosed with HIV, he explained that the tests, which assess the condition of vital organs such as the liver and kidneys, are crucial in determining the appropriate medication required for each patient. Noting that the current practice of “test and start” often bypasses these essential tests, leading to potential harm, Akpan regretted the high cost of the baseline tests, posing another challenge, even as he expressed concern for individuals with renal issues who require specific medications not provided by donors.

According to Akpan, the baseline test is not free and that is why it is difficult to do it in most of the state hospitals.

“Baseline tests should be conducted early to prevent further damage. Unfortunately, many state hospitals and HIV implementing partners delay these tests, conducting them only after six months of medication. This delay can result in significant harm to patients.

“I think the amount is around N12,000 per test. Okay, per test. There are two tests, one for the liver and another one for the kidneys. I think one is around N7,500 and the other around N5,000. These tests should be taken every six months. This expense makes it difficult for many to access timely testing.

“Not everyone can take the standard ARVs. Those with renal issues need a particular brand, which is not included in donor supplies.

This gap in provision needs urgent attention. That’s why I’m calling on the government of Nigeria, and even some of the state governors, they can now be the ones to buy this drug to support what the international bodies are doing,” he urged.

On his part, the Executive Director of Good Learning Educators Initiative,  Ibrahim Umoru, called for intensified efforts in HIV response and awareness.

 Umoru who acknowledged the ongoing challenges in achieving targets for the Prevention of Mother-To-Child Transmission, PMTCT, programmes, called for intensified efforts from stakeholders as he highlighted the pressing need for a renewed focus on HIV response and disability awareness in Nigeria.

Lamenting that Nigeria’s commitment to funding the national response has fallen short, he called for local production of drugs and diagnostics, emphasising that Nigeria has the resources and talent to achieve this.

“Despite significant efforts on the field, the achievements in PMTCT are not aligning with the set targets.

We need to revisit the basics and evaluate our methods to ensure they are effective.

“In 2010, Nigeria aimed to contribute 50 percent to the national response by 2015, but by 2014, only 15 percent had been achieved. This donor-dependency is unsustainable. The government must invest more and take ownership of the response. Global Fund and PEPFAR have done well, but Nigeria must manage its resources better for the benefit of its people,” he asserted.

Addressing the issue of stigmatasation, particularly for persons living with disabilities, he emphasised the multifaceted nature of stigma, which he said can be both self-imposed and perceived, noting that while Lagos State has robust laws against stigma, their implementation remains weak.

“People are often stigmatised and remain silent, which undermines the effectiveness of these laws.  We need to invest in awareness creation to ensure people can access tests and treatments. People need to work to build their capacity and play their roles effectively.”

Looking ahead to 2030, Umoru warned that without local resource mobilisation and government ownership, Nigeria will continue to face the same challenges.

“The response programmes require individuals to equip themselves to meet expectations,” he said.