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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

Gender Violence Increases HIV/AIDS,RSG Warns

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The Rivers State Government has warned that gender-based violence increases incidence of HIV/AIDs, unwanted pregnancies among other health ailments.
The state Commissioner for Health ,Dr. Adaeze Oreh made the disclosure during the kick-off of the 16-days statewide campaign against gender-based violence.
“She also listed other health problems associated with gender based-violence that include sexually transmitted diseases (STDS), rectal incontinence and addictive behaviours.
“The commissioner used the occasion to enlist the support of individuals, organisations, government around the world to eliminate gender -based violence.“
“Dr. Oreh in a broadcast last weekend to commence the campaign against gender-based violence stressed the need to check the menace which she believed affects families and the society.
“According to her, all forms of anti-social behaviours like rape, sexual and child slavery, forced prostitution, forced abortion and pregnancy perpetrated against the girl child and women should be eliminated.
Said she, the concern of the Rivers State Government is the health implications of gender-based violence which includes increased HIV and sexually transmitted diseases.
She reiterated that the citizens have key role to play to prevent gender- based violence and its consequences by reporting cases promptly to health facilities in the state.

By: Kevin Nengia

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Health

Getting Trimmed Naturally

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There are a lot of misconceptions about weight gain. The first is that weight gain comes from extra calories we do consume that we do not expend. Experts say we eat too much and exercise little. So if one gets fatter, then, surely he or she must be eating too much.
The other misconception is that once we cut our food, then, we will naturally become trimmed. All these are hinged on the diet theory, which only works for some time.
Over the past 40 years, studies have shown that you can not get clinically significant effect from cutting down on your calories. Even though experts are saying that sloth is responsible for weight gains- they overlook one basic truth that dieting only works for a short period.
The new study that seems to break those myths about body fat is now revealing some stunning facts. The kind of food we eat makes us fat. Two scientists at University of Pennsylvania, Mitchell Lazar and Cardiologist Allan Sniderman at McGill University, all in the United States have shown that food that we eat often makes us pack in flesh. These include bread, plain baked potatoes, and plain pasta, rice, sweet corn. They confirmed that fatty foods are not the enemy but easily digested carbohydrates, while steak, burgers, cheese or sour cream help us lose weight and keep our heart healthy.
This sounds ironical, but it has been discovered that those who do diet and avoid those foods end up getting hungry. What happens is that when you conserve energy or burn less energy, you are bound to add more flesh. Many public health authorities want us to practise energy balance, which is a new way to say that you should not take more calories than one expends.
No matter how one counts what he or she eats, it is impossible to determine calories and know when we are over board. No matter how good you are at counting calories, you can’t do it. So its couple of sips of soft drinks and few bites of humburger that can make you add weight. That means it at the point when we eat extra than the body want that the body store excess as fat.
The myth of exercising to reduce weight is really making waves. Exercise is helpful but it is not the main ingredient for fat burning. The funny truth is that the two things we tell people to do in order to lose weight-eat less and exercise more- are the exact two things that make one more hungry. Thus, there is need for balance. If one must exercise, then it should be done moderately so as to allow the body to recover the strenght.
The reality is that insulin is the primary hormone that makes one to add weight, especially one eats food that spikes insulin like bread, biscuits, sweets, soft drinks. It is refined carbohydrates that raise insulin levels in the body. Explained in simple terms, your fat tissue is more like your wallet, and your meals are like going to the ATM. You know how you use the ATM: You put the cash in your wallet and gradually spend it, and when you get too low on cash, you go back to the ATM. It is the insulin that locks the money in your wallet, so you keep going to the ATM, and your fat cells are getting fatter and fatter. More often, you become hungry and you eat again because the insulin can not get at the fatty acids leading to weight gain.
Low carb diet is key if you are to get trimmed. In Africa where stables are more of carbohydrate it is best to choose those with fibre. It is difficult to follow the Atkins diet like eating skinless chicken and green salad, melted mozzarella cheese and all those western diet.
An example of a workable diet is to include eggs more often and cut down on processed foods, especially processed carbohydrate. Complex carbohydrate, and vegetables have more fibre and make you get filled quickly. Instead of Irish potato, go for sweet potatoes, oats that have more fibre. I advise people to eat garri than processed plantain and wheat meals. By the way, processed wheat can worsen the body ails.

By: Kelvin Nengia

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Health

Who Formulates New Drug Treatment For Children

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The World Health Organisation(WHO) has disclosed plans for new child care  formulations.
The new programme if approved will drive innovations for better paediatric medicines.
The world health apex body since 2015 has reported decline in infant and child mortality but observed that there is a lack of research into new life-saving tools targeted at children.
This  it said is partly due to the complexity of conducting studies including the youngest age groups.
“Children cannot swallow tablets or capsules, often cannot bear the taste of liquid medicines and metabolise drugs differently as they develop and grow.”
New drugs formulations is aimed at making  medicines palatable, scored, crushable, dispersible (i.e. disintegrates quickly in water), chewable, sprinkled on food orr mixed with breast milk.
Stressing the need to  improve the lives of infants and children , WHO stated that most drugs are not quality assured, especiallyin low income countries.
Once this is acheived it noted that it will help drive Sustainable Development Goals (SDG), particularly SDG 3, for good health and wellbeing, and the related target to achieve Universal Health Coverage (UHC) by 2030.
Already, GAP-f network partners are working together to remove barriers to developing and delivering appropriate, quality, affordable and accessible medicines for children.

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