HIV, Transiting From Donor Dependence

The initial announcement by United States President, Donald Trump, to cut funding for international
HIV/AIDS initiatives sent shockwaves through the global health community. In Nigeria, a country facing a significant HIV/AIDS burden, the potential consequences were dire. However, the subsequent waiver granted by the administration has provided a lifeline for the millions of Nigerians who rely on the President’s Emergency Plan for AIDS Relief (PEPFAR) for their treatment and support.
PEPFAR has been an important partner in Nigeria’s fight against HIV/AIDS. Since its inception in 2003, PEPFAR has committed more than $7.8 billion to the country, catering to approximately 90 per cent of HIV treatment requirements. With this funding, Nigeria has been able to enhance its HIV prevention, treatment and support services and has witnessed a reduction in HIV/AIDS deaths.
The waiver granted by the Trump administration guarantees that PEPFAR’s life-saving medicines and medical services will continue to reach the needy. Antiretrovirals (ARVs) are the most common type of medicine used to treat HIV and reduce the virus’ spread. Through the provision of ARVs, PEPFAR helps prevent the spread of HIV and enhances the quality of life of those with the condition.
Although Nigeria was recently exempted from the requirement, the signs are evident: the country has to graduate from dependence on donor funds for its HIV/AIDS control programmes. Over the years, partners including the U.S. government have been central to the provision of treatment to people living with the virus. However, it is time for Nigeria to own its national response to HIV/AIDS.
Nigeria’s HIV/AIDS burden remains critical, accounting for 10 per cent of the global total. In 2023 alone, there were 75,000 new infections and 45,000 HIV-related deaths. The battle against Mother-to-Child Transmission remains challenging, with only 35 per cent of the target 75 per cent being met. Nearly 1.7 million Nigerian children have been orphaned due to HIV. Vulnerable populations, especially women and children, continue to disproportionately suffer.
To transition away from donor dependence, a multifaceted approach is necessary. Firstly, the country must increase its domestic financing for HIV/AIDS programmes. This can be accomplished through innovative funding mechanisms, such as leveraging public-private partnerships and exploring local revenue sources. Secondly, the government needs to strengthen its healthcare system to ensure equitable access to testing, treatment, and care. This involves expanding access to antiretroviral drugs, investing in community-based models, and addressing the stigma associated with HIV.
Thirdly, Nigeria must prioritise prevention efforts. This entails promoting condom use, providing comprehensive sexual education, and increasing awareness about the risks and modes of transmission. By focusing on prevention, the country can decrease the incidence of HIV infections and ultimately lessen the burden on its healthcare system.
Finally, Nigeria should develop a sustainable human resource strategy for its HIV/AIDS response. This involves training and equipping healthcare workers, engaging community volunteers, and empowering people living with HIV to advocate for their rights. A well-trained workforce is essential for delivering high-quality services and ensuring the long-term success of the response.
The transition beyond donor dependence is a complex but necessary journey for the country. By increasing domestic financing, strengthening healthcare systems, prioritising prevention, and investing in its human resources, the country can create a sustainable and effective response to HIV/AIDS. Also, the government should consider alternative funding mechanisms, such as increased domestic funding, public-private partnerships, and philanthropic initiatives. The time to act is now, for the well-being of present and future generations.
Nigeria’s National Agency for the Control of AIDS (NACA) has made momentous strides in combating HIV/AIDS, including expanding access to testing, treatment, and education. However, challenges persist, hindering the effectiveness of these efforts.
One major obstacle is limited access to healthcare facilities, particularly in rural areas. This impedes timely diagnosis and treatment, reducing the likelihood of optimal outcomes for those living with HIV. Additionally, stigma surrounding the disease remains a formidable barrier, preventing individuals from seeking testing and care. Inadequate awareness campaigns further contribute to low testing rates and delayed diagnosis.
Addressing these challenges requires concerted action by the government and stakeholders. Allocation of adequate funding is crucial to expand healthcare infrastructure and ensure the availability of essential services. Moreover, targeted interventions to reduce stigma and promote awareness are vital for increasing testing and early detection.
Collaboration between civil society organisations and grassroots movements is also essential for advocating for protection of HIV funding. Advocacy campaigns can mobilise public support and pressure lawmakers to prioritise the fight against HIV/AIDS. By addressing these challenges and ensuring sustainable funding, Nigeria can depend less on donor countries, drastically reduce HIV transmission, and provide the necessary care to those affected by the disease.