WAD: Addressing Inequalities

Yesterday, the global community marked World AIDS Day 2022. Launched in 1988, World AIDS Day is held annually on December 1 to raise awareness of the AIDS pandemic and mourn those who have died from the disease. This year’s theme “Equalise” is a call to action for everyone to pursue the methods required to redress disparities and aid in the eradication of AIDS. Inequalities persist for the most basic services like testing and treatment. The world must ensure that everyone, everywhere has equal access to HIV prevention, testing, treatment and care.
Within 20 years, over 33 million individuals had contracted HIV, and since 1981, when the first instance of AIDS was documented, over 25 million people have passed away from the illness. Many who live with the disease still experience stigma and discrimination, since the public is unaware of the realities regarding how to protect oneself and others. World AIDS Day is significant because it serves as a reminder to the public and the government that HIV is still a serious problem that requires urgent funding, more awareness, the eradication of prejudice, and improved educational opportunities.
Therefore, the World Health Organisation (WHO) recommends a renewed focus on populations that have been left behind in the global response to HIV and AIDS. Globally, while 70% of new HIV infections are among people who are marginalised and often criminalised, only 52% of children living with the disease are on life-saving treatment. Efforts must be made to end new infections among children by ensuring all are on quality antiretrovirals (ARVs).
Commendably, after more than three decades of battling the menacing monster, Africa is finally slowing the rate of HIV/AIDS infections to a crawl. Over the last decade, progress in tackling the pandemic on the continent has been particularly notable following heightened emphasis on prevention, treatment, and care. According to the latest report by UNAIDS, new HIV infections declined by 14% between 2010 and 2015 in Eastern and Southern Africa, the world’s most affected regions, and by 8% in West and Central Africa.
However, despite Africa’s success in combating the menace, challenges remain. Sub-Saharan Africa still accounts for two-thirds of the global total of new HIV infections. In July 2016, UNICEF announced that AIDS is still the number one cause of death for those aged 10–19 in Africa. Despite progress in the prevention, the number of young people, especially girls who are contracting HIV because they are more vulnerable to exploitation by older men, needs to be reduced, says UNICEF.
In Nigeria, 1.7 million people live with HIV/AIDS. Women are the most affected group, accounting for 960,000 individuals, while children under the age of 14 accounted for 130,000. Women and young girls are heavily impacted by the HIV/AIDS pandemic because of deep-rooted gender inequality in the country, which spans every facet of society, including culture and law. In the most recent rankings, Nigeria was placed 139 out of 156 for the size of its ‘gender gap’, meaning that it has one of the most unequal balances of power between men and women in the world.
The National Agency for the Control of HIV/AIDS (NACA) says 1.6 million persons are receiving treatment for HIV in Nigeria. The Director-General of NACA, Gambo Aliyu, said this yesterday at a media briefing on the 2022 World AIDS Day (WAD). Aliyu said Nigeria had made some progress in the fight against HIV as new cases declined from 103,404 in 2019 to 92,323 in 2021, while pre-COVID-19 molecular laboratory assessment done in 27 sites is now conducted in over 100 sites accessible for prevention and treatment purposes.
Despite Aliyu’s claims and availability of free treatment services, Nigeria has the second-largest HIV epidemic in the world and one of the highest rates of new infection in sub-Saharan Africa. With the massive resources spent on prevention and awareness, Nigeria is still a long way off in meeting the global target of enrolling 90% of people diagnosed with HIV on antiretroviral treatment (ART). Poor treatment coverage and adherence means that the number of AIDS-related deaths in the country has remained high, with 150,000 deaths allegedly recorded in one year.
Furthermore, there is an unacceptable number of children living with HIV who are difficult to find and place on treatment. Work must be done to address the inequalities which pose barriers to ending HIV/AIDS in the country. We need to equalise access to essential HIV services, particularly for children, pregnant women, key populations and their partners and those in closed settings who are often forgotten. To accomplish this, we must consistently address and remove all structural barriers that negatively impact access to services.
States should complement the Federal Government’s efforts through effective collaboration and budgeting. Thankfully, states like Rivers are gradually achieving epidemic control regarding HIV/AIDS. Governor Nyesom Wike has demonstrated great passion and commitment in the quest to mitigate the spread of the virus in the state. He was the first governor in the country to abolish user fees for People Living with HIV/AIDS. The government’s Strategy of community testing and identification of positive cases in the neighbouring treatment facilities, which is described as Sexual Network Tracing (SNT) has yielded great dividends.
It is time for the Federal Government to face HIV/AIDS frontally and fund it adequately. Political leaders, civil society organisations, and development partners are on the same page on the fact that ending HIV/AIDS as a public health threat would require reasonable domestic funding. If the government fails in this important task and abandons those living with HIV/AIDS to source their drugs, Nigeria would be exposed to a pandemic, as all the gains recorded in the past would be eroded by new infections.
Apart from the need to allocate and release more funds for the prevention and treatment of HIV/AIDS, the government should tackle the sources of new infections. The government data shows that 32 per cent of new HIV infections were through sex workers, men who have sex with men and people who inject hard drugs into themselves. The authorities need to isolate these categories of Nigerians for proper enlightenment and counselling. The fact that HIV/AIDS is deadly cannot be over-emphasised. All hands must be on deck to reduce its spread.