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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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Lagos Trains Health Workers On Handling SGBV Cases

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To address the increasing number of rape and defilement cases in Lagos communities, the State Ministry of Health has trained healthcare workers on the prevention and management of sexual assault cases.
The Director, Public Affairs in the ministry, Tunbosun Ogunbanwo, in a statement on Monday said the training equipped health workers with the knowledge and skills to provide professional, compassionate, and timely care to survivors.
Dr Folasade Oludara, Director, Family Health and Nutrition, State Ministry of Health, said the growing number of rape and defilement cases in Lagos communities necessitated the upskilling of healthcare workers who are often the first responders to survivors.
Oludara, represented by Dr Oluwatosin Onasanya, Deputy Director, Child Health, said the government recognised the critical role of health professionals in both clinical management and legal documentation of sexual assault cases.
She explained that the training was designed to ensure healthcare workers are adequately equipped to identify, document, and manage sexual assault cases effectively.
According to her, the training will strengthen Lagos’ coordinated health system response to gender-based violence.
She disclosed that the state government had already provided equipment and specimen collection tools to health facilities, noting that the training complemented this investment by building the competence of personnel handling such sensitive cases.
Oludara explained that doctors and nurses at the primary, secondary, and tertiary levels who serve as first contact points for survivors were carefully selected from all 57 LGAs and LCDAs, particularly from areas with higher incident rates.
The SGBV Programme Manager, Lagos State Ministry of Health, Dr Juradat Aofiyebi, emphasised that the capacity-building initiative was a strategic step toward improving survivor-centred healthcare delivery and prosecution outcomes.
Aofiyebi added that the training underscored the government’s commitment to reducing the prevalence of sexual assault through a robust, multi-sectoral approach.
“The training provides healthcare workers with the knowledge to properly identify survivors, document findings accurately, and provide comprehensive care, all of which contribute to justice delivery and prevention of repeat offences.
She said the ministry would sustain such training to ensure that every survivor who presented at a Lagos health facility received quality, non-judgmental care.
Mrs Adebanke Ogunde, Deputy Director, Directorate of Public Prosecutions (DPP), Lagos State Ministry of Justice, highlighted the importance of medical documentation in sexual assault trials.
She explained that most convictions hinge on the quality of medical reports and forensic evidence provided by healthcare professionals, noting that medical reports served as vital corroborative evidence in court, particularly in cases involving children.
“Your medical reports are crucial; they can determine whether justice is served or denied,” she said.
Ogunde reminded health workers of their legal duty to report suspected sexual assault cases to the police or the Lagos State Domestic and Sexual Violence Agency (DSVA).
Similarly, Dr Oluwajimi Sodipo, Consultant Family Physician, Lagos State University Teaching Hospital (LASUTH), underscored the importance of timely medical attention, psychosocial support, and non-stigmatising care for survivors.
Sodipo explained that immediate presentation within 72 hours of assault improved chances of preventing infections and collecting viable forensic evidence.
He commended Lagos State for sustaining its inter-agency collaboration and continuous professional training on SGBV.

Sodipo, however, called for the strengthening of DNA and forensic capacities, improved insurance coverage, and better remuneration for healthcare workers.

“We must sustain motivation and continuous retraining if we want to retain skilled professionals and enhance justice outcomes,” he added.

Also, Mrs Margret Anyebe, Claims Officer, Lagos State Health Management Agency (LASHMA), said domestic and sexual violence response had been integrated into the ILERA EKO Health Insurance Scheme.

Anyebe explained that survivors of sexual and domestic violence are covered for medical treatment, investigations, and follow-up care under the state’s Equity Fund for vulnerable groups.

“Hospitals are to provide first-line care, document, and refer survivors appropriately, while LASHMA ensures prompt reimbursement and oversight,” she said.

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Nch Technical Session Reviews 35 Memos …Sets Stage For Council Deliberations

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The technical session of the ongoing National Council on Health (NCH) meeting on Monday reviewed 35 out of the 82 policy memos submitted ahead of full Council deliberations scheduled for later in the week.
Dr Kamil Shoretire, Director of Health Planning, Research and Statistics, disclosed this on Tuesday during the Technical Session of the 66th Regular meeting of the NCH ongoing in Calabar, Cross River.
He said that 10 of the memos considered were recommended for Council’s approval, eight were noted, and 18 stepped down for further work.
According him, two additional memos were deferred and will be re-presented after revisions are made.
At the reconvening of the session, Ms Kachallom Daju, Permanent Secretary, Ministry of Health and Social Welfare, said that there were five memos from the Coordinating Minister of Health, adding that they were all related to the Department of Food and Drugs.
Daju said that the memos were stepped down on Monday and scheduled for re-presentation.
She also provided clarification on the previously contentious healthcare waste-management memo, explaining that the N3.5 million requests tied to the proposal had already been repurposed by the Global Fund.
“I have followed up, and I am informed that the funds have been reprogrammed. Just so we put it to rest, we will not be discussing that memo anymore,” she said.
She also said that the final memo considered on Monday was the proposal for the inclusion of telemedicine services under the National Health Insurance Authority (NHIA).
“The next memo scheduled for presentation is the proposal for the establishment of Medipool as a Group Purchasing Organisation (GPO) for medicines and health commodities in Nigeria.
Meanwhile, Dr Oritseweyimi Ogbe, Secretary of the Ministerial Oversight Committee (MOC), formally notified the Council of the establishment of Medipool, a new public-private GPO created to strengthen the procurement of medicines and health commodities nationwide.
Presenting an information memorandum at the technical session, Ogbe explained that Medipool was the first nationally approved GPO designed to leverage economies of scale, negotiate better prices, and ensure quality-assured medicines.
He said this was beginning with primary healthcare facilities funded through the Basic Health Care Provision Fund (BHCPF).
According to him, Medipool was established after a proposal to the Ministry of Health, followed by appraisals and endorsements by the Project Implementation and Verification Committee (PIVAC) and the Ministry of Finance Incorporated (MOFI).
“It subsequently received Federal Executive Council approval, with MOFI now owning 10 per cent of the company’s shares. The Infrastructure Concession Regulatory Commission has also approved its operations.
“Under the model, Medipool will work with Drug Management Agencies (DMAs) in all states to aggregate national demand and negotiate directly with reputable manufacturers to obtain competitive prices and guaranteed-quality supplies.
“The platform will function as a one-stop shop for DMAs, who will then distribute medicines to health facilities through existing state structures.”
Ogbe added that while Medipool will initially focus on BHCPF-supported primary healthcare centres, it was expected to expand to other levels of care nationwide.
“The organisation will provide regular reports to the ministry of health and participate in national logistics working groups to ensure transparency, oversight, and technical guidance,” he said.
The News Agency of Nigeria (NAN) reports that Day One of the 66th NCH technical session opened with a call reaffirming the Ministry’s commitment to advancing Universal Health Coverage under the theme “My Health, My Right”.
“The delegates also adopted the amended report of the 65th NCH, setting the stage for informed deliberations.
The implementation status of the 19 resolutions from the previous Council was also reviewed, highlighting progress and gaps.

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Health

Police Hospital Reports More Malaria Incidence

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The authorities of Police Clinic in Port Harcourt have reported high cases of Malaria in its facility.
The revelation was made by Mrs Udoh Mba Robert, a Chief Superintendent of Police and senior medical personnel in the Clinic.
She told The Tide that,”the Hospital admits sixty (60) to seventy (70) patients in a month”.
On how the facility runs, she stated that the hospital is under the National Health Insurance Scheme as most patients are treated almost free.
She maintained that staff of the hospital have been trained professionally to manage health issues that come under the purview of the National Health Insurance Scheme.
Mrs. Robert explained that malaria treatment also falls under NHIA, as patients are expected to pay only 10 per cent for their treatment while the government takes care of the outstanding bills.
NHIA, she further stated covers treatment and care for uniform personnel like the police force, military men, civil servants and all others working for the government.
Urging the public to seek professional medical attention, Mrs. Robert said the facility is open to workers in the federal services, especially police staff.

 

Favour Umunnakwe, Victory Awaji, Excel Nnodim

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