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HIV/AIDS: Effects, Implication Of Donors’ Exit

Most donor organizations have had issues with lack of accountability in the management of funds by Nigerian officials. This had become a cardinal problem that has short-changed the success of the Nigerian intervention.

Global Fund to Fight AIDS, Tuberculosis and Malaria, for instance, said it has disbursed more than $81.4 billion in Nigeria since 2003. Nigeria, they said, currently represents their largest portfolio with a total of $81.1 billion allocated to fighting HIV/AIDS, TB and Malaria in 2014 to 2016.

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There is no doubt
that the contributions of international donor agencies towards the elimination of HIV/AIDS in Nigeria is immeasurable.
In fact, from the point at which donor agencies came on Salvage Mission in Nigeria, they have virtually been vested with the responsibility of providing HIV/AIDS commodities in the country.
Global Fund to Fight AIDS, Tuberculosis and Malaria, for instance, said it has disbursed more than $81.4 billion in Nigeria since 2003.  Nigeria, they said, currently represents their largest portfolio with a total of $81.1 billion allocated to fighting HIV/AIDS, TB and Malaria in 2014 to 2016.
On its part, National Agency for the Control of AIDS (NACA) 2012: 59 stated that $300 million was committed in 2007 in expenditure on implementing HIV/AIDS programme in Nigeria.
Of this amount, the majority in the sum of $225,392,257.00 amounting to (85.3%), was from international funds, with bilateral contributions totalling $197,219,307.00, which amounts to (19.43%).
The rest were from International Not-for-Profit organizations and foundations amounting to $32,479 (0.01%).
The same trend was recorded in 2008 with international funds contributing 92.3% of the $364,581,432.00 of the total expenditure.
Meanwhile, $364,581,432.00 (80.8%), $845,477,907,00 (11.5%) and $63,00.00 (0.01%) were respectively contributed by the direct bilateral contributing multilateral agencies and International Non Profit Organizations and Foundations.
Investigations revealed that under the consolidated phase 1 of Rounds 5,8 and 9 Global Fund HIV/AIDS Grant (2009-2012), NACA received about $151.6m for HIV/AIDS activities in the country.
It further gathered that about $228m was later approved for Phase ll (2013-2015) for the scalling up of gender sensitive HIV/AIDS, Prevention, treatment care and support for adult and children including health and community strengthening in Nigeria.
In spite of these and other contributions, in October 2014, the Network of People Living with HIV/AIDs in Nigeria (NEPWHAN), mobilized its members in Abuja to protest at the NACA office over perceived responsiveness of the agency to the dwindling fortunes of the HIV treatment programme in Nigeria.
NEPWHAN’s National Coordinator, Victor Omoshein, had said:  “We are concerned with the miserable conditions of PLWHIV in Nigeria, as well as the high number of people dying daily of AIDS related complication in large part to lack of access to Anti-retroviral (ARV) medications as a result of withdrawal support by donor agencies.
Omoshein continued that “only 649,000 out of about 1.8million in need of treatment have access to drugs”.  This figure represented about 30 per cent of treatment needs.
The immediate past Director General of NACA, Professor John Idoko had responded then that there were challenges.  But he reiterated Government’s Commitment to scalling up from 600,000 to 1.4million. People on treatment, though he did not give a time frame for this ambition.
The real picture of HIV/AIDS response in Nigeria can be seen clearer when it dawns that from inception, funding for Nigeria’s HIV/AIDS intervention has been donor dependent and donor driven as 90 per cent of available funds came from donor agencies.
These agencies get involved in various forms of support ranging from training of personnel, provisions of technical knowhow, supply of life-saving drugs and kits, etc.
Comparatively, the contributions of Nigerian government was mainly  reduced to the provision of physical infrastructure, such as provision of health facilities and payment of salaries of medical and other allied personnel employed.  The core and major burden of intervention have been borne by the donor agencies.
However, most donor organizations have had issues with lack of accountability in the management of funds by Nigerian officials.  This had become a cardinal problem that has short-changed the success of the Nigerian intervention.
The result is that on several occasions, there had been drugs stock-out, which had resulted in truncation of treatment.
There had also been instances where expired drugs were dispensed, as well as fake and substandard testing kits been deployed to counseling and testing centres.
Meanwhile, myriads of PLWHIV lack access to life-saving drugs, while officials have had to destroy valuable supplies due to the expiration of the drugs.
The question that readily comes to mind is, why were these drugs not supplied to those who required them before they got bad.
In Rivers State for instance, FHI 360 is the major provider of HIV/AIDS commodities.  The implication is that if FHI 360 seizes to supply these drugs and given that the state government has not given any clear indication to commence the purchase and distribution of HIV/AIDS commodities, the fate of PLWHIV can at best be imagined.
The reason given by donor agencies for their gradual withdrawal include the global financial crisis and changes in their focus of priority, as well as funds available and the allegation of mismanagement of funds by Nigerian officials.
It is notworthy that although these donor agencies have made their intentions to pull out known long ago, nothing concrete seemed to have been done by the Nigerian government in terms of seeking solutions to replace loopholes likely to be warranted by such pull out.
The effect is that when the total pull out is finally implemented and there are not enough remedies, Nigeria’s HIV/AIDS status will be worse than what it is currently.
Beyond the alleged mismanagement of fund meant for HIV prevention, treatment, care and support is a serious lack in policies to ensure smooth running of efforts geared towards checking the HIV/AIDS trend in Nigeria.
The situation is further worsened by the fact that the National Assembly has slashed NACA’s proposed N18.9billion HI V/AIDS budget for the 2016 physical year to N1.5billion.
If donor agencies have invested billions in Dollars to check the trend of HIV/AIDS in Nigeria and the Nigeria government is only willing to invest N1.5billion, the implication smirks of doom.
This is because, if all the billions in dollars could only place Nigeria where it is today in HIV/AIDS, treatment, prevention, care and support, where would N1.5billion place the country. Especially given the present setting of chronic mismanagement of funds?

 

Sogbeba Dokubo

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Health

RSG Plans Fresh Training For TBAs

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Plans are in the works by the authorities in the Rivers State Ministry of Health to conduct training for Traditional Birth Attendants(TBAs) in the State.
State Commissioner for Health, Dr. Adaeze Oreh gave the hint while chatting with newsmen recently in Port Harcourt.
She said the training has become crucial to school the TBAs on methods and measures to complement in maternal health care.
In her words,”  We are aware of of their roles, but we need to be confident that they can still play that role, especially the skills set needed to complement what government is doing.’’
Dr. Oreh explained that maternal and child care has evolved, hence, the TBAs need to be schooled,” we want them to scale up their skills, especially on high risk pregnancies.”
She continued, “ We want to make sure that our system mops up those high risk pregnancies, because we know that many of them carry out clandestine activities they are not helping us.”
Assuring of improved manpower in the State health sector, Dr. Oreh said the Governor Siminalayi Fubara administration has embarked on fresh recruitment exercise for health workers to meet current challenges.
She assured that once the recruitment exercise is completed, the various health centres and hospitals will be staffed with qualified manpower to provide efficient health services in the State.

Kevin Nengia

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Viral Hepatitis Claims 3,500 Lives Daily -WHO

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The World Health Organisation (WHO) has raised an alarm on viral hepatitis infection that claims 3,500 lives each day.
According to the World Health Organisation (WHO) 2024 Global Hepatitis Report, the number of lives lost due to the viral hepatitis is increasing.
The disease is the second leading infectious cause of death globally — with 1.3 million deaths per year, the same as tuberculosis, a top infectious killer.
The report, released at the World Hepatitis Summit revealed that despite better tools for diagnosis and treatment, and decreasing product prices, testing and treatment coverage rates have stalled.
It, however, said, reaching the WHO elimination goal by 2030 is still  achievable, if swift actions are taken now.
New data from 187 countries show that the estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, 83percent were caused by hepatitis B, and 17percent by hepatitis C. Every day, there are 3,500 people dying globally due to hepatitis B and C infections.
“This report paints a troubling picture: despite progress globally in preventing hepatitis infections, deaths are rising because far too few people with hepatitis are being diagnosed and treated,” said WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus.
He added, “WHO is committed to supporting countries to use all the tools at their disposal – at access prices – to save lives and turn this trend around.”
Updated WHO estimates indicate that 254 million people lived with hepatitis B and 50 million with hepatitis C in 2022. Half the burden of chronic hepatitis B and C infections is among people 30–54 years old, with 12percent among children under 18 years of age. Men account for 58percent of all cases.
New incidence estimates indicate a slight decrease compared to 2019, but the overall incidence of viral hepatitis remains high.
In 2022, there were 2.2 million new infections, down from 2.5 million in 2019.
These include 1.2 million new hepatitis B infections and nearly one million new hepatitis C infections. More than 6,000 people are getting newly infected with viral hepatitis each day.
The revised estimates are derived from enhanced data from national prevalence surveys. They also indicate that prevention measures such as immunisation and safe injections, along with the expansion of hepatitis C treatment, have contributed to reducing the incidence.

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How Dates Boost Fertility -Research

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Now, researchers in a study, suggest that date palm is an arsenal to fight infertility in couples. They found that 1-month consumption of date palm has a positive impact on the sexual function of infertile couples.
The study to investigate the effect of date palms on the sexual function of infertile couples  was in the 2022 edition of the BMC Research Notes.
In a double-blind, placebo-controlled clinical trial conducted on infertile women and their husbands who were referred to infertility clinics in Iran in 2019, researchers found sexual function in females (arousal, orgasm, lubrication, pain during intercourse, satisfaction) in the intervention group was significantly increased compared to females in the control group that had no date palm.
Infertility and infertility management affects different dimensions of a couple’s life. Sexual dysfunctions can appear in both partners and might provoke problems in every stage of sexual response. Infertility negatively affects the sexuality of infertile couples.
Numerous studies show that infertile women have lower sexual function than fertile women. Sexual satisfaction is strongly affected by the consequences of infertility such as reduced self-esteem, feelings of depression and anxiety, and failed sexual relationships.
The intervention group was given a palm date capsule and the control group was given a placebo. The starch powder was applied to prepare the placebo capsules.
Also, all areas of male sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) significantly increased in the intervention group compared to the control group.
Infertility is not only a medical problem but also affects all personal dimensions and social life of most infertile individuals. Infertile couples are more prone to psychological problems (anxiety, depression, and stress), which may result in marital distress, social dysfunction (stigma, social exclusion, and feelings of failure), and reduced quality of life.
Infertility and infertility management affects different dimensions of a couple’s life. Sexual dysfunctions can appear in both partners and might provoke problems in every stage of sexual response. Infertility negatively affects the sexuality of infertile couples.
Numerous studies show that infertile women have lower sexual function than fertile women. Sexual satisfaction is strongly affected by the consequences of infertility such as reduced self-esteem, feelings of depression and anxiety, and failed sexual relationships.
Dates palm is known to have come from what is now Iraq. In Nigeria, dry and soft date fruits are sold out for consumption. However, in the northern part, they are added to the locally brewed alcoholic beverage to help reduce the intoxicating power.
Dates are a good source of energy and vitamins and important elements such as phosphorus, iron, potassium and a significant amount of calcium. It is also rich in phenolic compounds possessing free radical scavenging and antioxidant activity.
Since ancient times, the date palm has been used in Greece, China and Egypt to treat infertility and increase sexual desire and fertility in females. There are few studies on the effect of date palms on male and female sexual function in human beings.
Besides, studies have shown that the various parts of its plant are widely used in traditional medicine for the treatment of various disorders which include memory disturbances, fever, inflammation, paralysis, loss of consciousness and nervous disorder.
Culled from Tribune online.

 

The researchers suggested that the improvement in male and female sexual function can be due to active ingredients and increased levels of sex hormones following the consumption of date palms since studies indicated that increasing sex hormones are effective in sexual function.

They, however, recommended more studies with a longer duration on the use of date palms on sex hormone levels in infertile couples.

Previously, a study revealed that using date palms in postmenopausal women for 1 month had a positive and significant impact on sexual desire and arousal.  Another suggested that using date palms had a positive impact on orgasm, satisfaction and lubrication in women and also reduced pain during intercourse in women.

In the laboratory, administering date palms to male rats and measuring their sexual behaviours, researchers showed that sexual behaviour parameters (number of ejaculations, number of intercourse) increased compared to the control group.

 

 

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