HIV/AIDS: As 2030 Draws Near…

Years ago, the immediate past National Coordinator of the Network of People Living With HIV/AIDS In Nigeria (NEPWHAN), Victor Omoshehin, expressed fear over the ability of Nigeria to meet the United Nations’ “Vision 2030” of eliminating HIV in the country.
His fear stemmed first from the fact that Nigeria relies more on international donor agencies in terms of finance for HIV/AIDS-related programmes, and also the seeming inability of the Federal and State Governments to take up the responsibility of fully financing HIV/AIDS programmes. 
There was also the gradual withdrawal of their finances by such international donor agencies that were of the belief that, given the length of period they had spearheaded HIV/AIDS preventive programmes in the country, government at various levels should have been in position to own-up the processes.
Omoshehin summed up his fear thus: “If the Government of Change will not increase the domestic funding for HIV, then Nigeria cannot own up to the responsibility of achieving the Vision 90:90:90 by 2030 and we cannot end AIDS by 2030”.
During a visit to Nigeria from 7th to 10th of February, 2016, the then Executive Director of the United Nations Programme on AIDS (UNAIDS), Michel Sidibé, met with Nigeria’s Vice-President, Yemi Osinbajo, and urged the Federal Government to increase its support for the Maternal, Neonatal and Child Health Week, with the aim that all pregnant women are tested for HIV by the end of 2016, and all women who test HIV-positive have immediate access to antiretroviral therapy.
The Vice President told Sidibé, during the meeting, that Nigeria was making huge budget allocations for social investment programmes, in part, to increase access to health care and help end the AIDS epidemic. 
How much this amounts to, and to what extent such budget was truly executed on the purpose it is meant for was not clearly stated. This was in the face of widespread allegations of non-accountability of funds allocated to the fight against the HIV/AIDS epidemic.
One question that readily comes to mind at this juncture is if anything else has been done towards changing the narrative for the better, especially in the light of the emergence of the Covid-19 pandemic which many believe has distracted attention from HIV.  
In a recent interview with newsmen, the Director-general of the National Agency for the Control of AIDS (NACA), Mr. Gambo Gumel Aliyu, stated that the focus on Covid-19 has not affected the mandate of NACA in its quest to check the HIV/AIDS trend in Nigeria.  
According to him, “NACA has been up and doing in the fight against HIV/AIDS by implementing our mandate. We have done extremely well during the pandemic and have recorded huge results we had never recorded before. We are passionate and optimistic to achieve our mission to the letter”.    
While noting that HIV/AIDS in Nigeria is largely funded by international donor agencies, Aliyu explained that “Nigeria is contributing less than 10 per cent at the moment, and this contribution is what we are increasing on an incremental basis every year.    
“We have this agreement with them (donor agencies) that, every year, we shall take an additional 50,000 people living with HIV/AIDS from the total number they are treating to add to our number,” he said. 
On June 8, 2021, the United Nations’ General Assembly held a high-level meeting on AIDS in which United Nations member-states adopted a set of new and ambitious targets with a pledge to end all inequalities faced by communities and people affected by HIV towards ending AIDS.
Towards this end, they agreed to reduce the annual number of new HIV infections to under 370, 000 and AIDS-related deaths to 250, 000, eliminate new HIV infections among children, end paediatric AIDS and eliminate all forms of HIV-related discrimination by 2025. They also committed to providing life-saving HIV treatment to 34 million people by 2025.
It is believed that if the international community reaches the targets, 3.6 million new HIV-infections and 1.7 million AIDS-related deaths will be prevented by 2030. To achieve this, the political declaration calls on countries to provide 95% of all people at risk of acquiring HIV within all epidemiologically relevant groups, age groups and geographic settings with access to people-centered and effective HIV combination prevention options. 
It also calls on countries to ensure that 95% of people living with HIV know their HIV status, 95% of people who know their status to be on HIV treatment, and 95% of people on HIV treatment to be virally suppressed. 
This target, 95:95:95, is an improvement from the previous ambitious target of 90:90:90, but has the same goal of either eliminating HIV, or reducing its spread to the barest minimum.
The question is what does this mean for Nigeria, knowing that towards the previous target of 90:90:90 the country’s efforts at meeting the target took a nosedive at some point in terms of funding, especially after international donor agencies started reducing their funding, leading to gradual pulling out.
Already, several HIV/AIDS programmes aimed at checking its trend have either gone moribund, or ignored because donor agencies no longer sponsor them. This is in the face of rampant allegations of deep-rooted fraud by way of diversion of monies meant for HIV/AIDS interventionist activities amounting to billions of Naira.
Meanwhile, the NACA DG last October stated that Nigeria needed the sum of $2.4 billion to control the spread of HIV in the country for the next three years. He explained that the amount is an estimation needed “to reach where we have targeted to be”.
According to him, the amount will enable Nigeria “to achieve the 95-95-95 initiative of the United Nations, where 95 per cent of people living with HIV know their HIV status; 95 per cent of people who know their status are on treatment; while 95 per cent of people are on treatment with suppressed viral loads, and we are on track”. 
He noted that “United States Government alone is investing, this year, over $400,000,000, global fund is investing over a $100,000,000 this year and the government of Nigeria is contributing its part”. 
Explaining Nigeria’s contributions further, Aliyu said “over the last one year, the Nigerian government invested about a $100,000,000, and 50, 000,000 persons are needed to be tested annually, but now the figure has been reduced because, when we did the estimation, we never knew we would identify such a huge number over the last 20 months. 
“So, with that projection, we may need to reduce the number and test below 50,000,000 persons to reach the range of 1,800,000 to 1,900,000; because, right now, we have 1,500,000. 
“Remember the annual incremental number is 50,000 to 60,000 every year. In the last two years, we identified 350,000, which is more than five times the number we identified every year”, he said.
With this, the NACA boss says the Agency is on its way to attaining its target to end HIV/AIDS by 2030.
“It is very feasible”, he said, adding that “We are not mincing words. In 18 months we have identified an additional 350,000 on treatment. In another 18 months, if we identify another 350,000 persons, we are done: we have reached the control level. 
“Once you reach the level, that is the first step. You have to reach the control level first, that is the condition. We have to control HIV first before we can end it. So, the control level is supposed to happen in 2025, but here in Nigeria we are very hopeful that this control level target will happen in 2022”, he said.

By: Sogbeba Dokubo