Lagos: The first cases of AIDS in Nigeria were diagnosed in 1985 and reported in 1986. They were a 13-year-old sexually active girl and a female commercial sex worker who arrived in Lagos State, from a neighbouring West African country. The news of the first cases caused panic and disbelief in Nigeria, as AIDS was reported to be a killer disease without a cure. The number of people infected with HIV and AIDS in Nigeria has increased rapidly since the first cases. In 1992, 367 new AIDS cases were reported, and by 1994 that number had risen to 1,490. However, the first national response to the epidemic was the creation of the National Expert Advisory Committee on AIDS (NEACA) in 1987.
According to News Agency of Nigeria, AIDS, acquired immunodeficiency syndrome, is caused by the human immunodeficiency virus (HIV). Johns Hopkins University says the virus kills or impairs cells of the immune system and progressively destroys the body’s ability to fight infections and certain cancers. Through the 1980s and early
1990s, the outbreak of HIV and AIDS swept across the U.S. and the rest of the world, with concerns on how to tackle the disease. Over the years, the situation looked gloomy with sparse information on the new disease, high mortality incidents and the comorbidities that make the management of the condition more complicated.
Globally, work and researches into the disease became intensified with reports saying that HIV/AIDS is transmitted through sexual contact, blood, needles, or from mother to infant of an infected person. With no clue to the cure for HIV/AIDS in sight, hope came in 1987, as the Food and Drug Administration (FDA) approved Zidovudine (AZT), the first antiretroviral drug used to treat HIV. FDA also approved, and authorised the sale of male condoms as prevention for HIV.
According to the World Health Organisation (WHO’s) report, 88.4 million (71.3-112.8 million) people have been infected with the HIV virus and about 42.3 million (35.7 to 51.1 million) people are reported to have died since the b
eginning of the epidemic. The report added that globally, 39.9 million (36.1-44.6 million) people lived with HIV by the year 2023. WHO Regional Director for Africa, Dr Matshidiso Moeti, regrettably said, ‘HIV is a complex health challenge, inseparable from social determinants such as poverty, gender inequality and violence, and complicated by stigma and discrimination, especially among marginal populations.’
However, after years of ravaging and killing millions of people, Moeti acknowledged that a remarkable reduction in the number of new HIV infections and AIDS-related deaths was being recorded. But she added that the number of new HIV infections was higher outside of sub-Saharan Africa for the first time in 2023. The Joint United Nations Programme on HIV/AIDS (UNAIDS), inspiring global shared vision of zero new HIV infections, is leading the world in achieving the 95-95-95 UNAIDS HIV testing, treatment and viral suppression targets, aimed at closing gaps in treatment coverage and outcomes.
In Nigeria, Dr
Temitope Ilori, Director-General of the National Agency for the Control of AIDS (NACA), also gave a ray of hope to the citizens. According to her, the country has made notable progress in shaping ‘our response and strategies to address the HIV/AIDS epidemic in the country.’ At a news conference ahead of the 2024 World AIDS Day, she said about two million people were living with HIV in Nigeria, with approximately 1.6 million out of them currently receiving treatment. The 2024 World AIDS Theme is: ‘Take the Rights Path: My Health, My Right!’, a rallying cry for accessible, rights-based healthcare that empowers those affected by HIV/AIDS to live vibrant and fulfilling lives.
However, UNAIDS’s Country Director, Dr Leo Zekeng, painted a gloomy picture, saying the level of progress made to eradicate HIV in the country was not encouraging. Zekeng disclosed that the world made a commitment to reduce new HIV infection by 83 per cent; that is new infections to 370,000 by 2025, ‘but the data for 2022 suggests that we h
ave 1.3 million new infections.’ He said the progress attained by the 11 countries served as a testimony and had reinforced the hope that reducing HIV infections was achievable with determination. Zekeng then noted that achieving the set target by Nigeria was achievable with renewed commitment, political will, increased funding and strengthened efforts at prevention by states and Federal Government.
One of the challenges in AIDS control in Nigeria, according to Ilori, is the prevention of mother-to-child transmission of HIV (PMTCT), with coverage remaining below 33 per cent. Stigma and discrimination remain Ilori, who also referenced the stigma barrier, urged Nigerians to join hands with NACA to break the stigma, jinx and embrace equity, to drive collective action to stop HIV, especially among children. ‘We must empower every individual, especially women who are most vulnerable to contracting HIV, and other vulnerable populations, to access life-saving services and live with dignity”.
The Network of People
Living with HIV/AIDS in Nigeria (NEPWHAN) decried the high rate of stigmatisation faced by persons living with the virus. NEPWHAN’s Edo chapter chairman, Mr Christopher Osayande said stigmatisation remained a significant challenge for Persons Living With HIV/AIDS (PLWHA) in society. ‘Stigmatisation is still high and as a result, persons living with the virus are being denied meaningful employment. ‘For those in business, once people know they have the virus they stop patronising their businesses,’ he said.
According to him, people with HIV/AIDS are a vulnerable group, with the majority being poor, hence the need for the government to make provisions for skills acquisition for PLWHA to enable them to fend for themselves. ‘There are still new cases of HIV in the state and the number of people needing care is increasing due to lack of food and transportation. ‘As an association, we are trying to see that the viral load reduces, but because most PLWHA do not have means of livelihood, the viral load remains high,
‘ Osayande said.
On ways to end AIDS, Dr Patrick Dakum, Chief Executive Officer of the Institute of Human Virology Nigeria (IHVN), advocated sustainability, renewed political commitment, and collaborative action to address the challenges ahead. Funmi Adesanya, Nigeria Country Coordinator for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), called for the expansion of preventive efforts to end HIV/AIDS and to look beyond 2030. Adesanya, represented by Deputy Country Coordinator, Mr Emerson Evans, at an event, stressed the need to scale up evidence-based prevention strategies, such as Pre-Exposure Prophylaxis and harm reduction services to often-overlooked populations like children.
Improved funding is also critical strategy of ending HIV/AIDS A ray of hope in that direction is the recent proposal by the House of Representatives Committee on HIV/AIDS, Tuberculosis, and Malaria (ATM), of allocation of one per cent of the Federal Government’s Consolidated Revenue to address HIV/AIDS and other publi
c health diseases. Chairman of the committee, Rep. Amobi Ogah, at the end of the committee’s retreat with the National Agency for the Control of AIDS (NACA), said the decision was aimed at reducing dependency on foreign aid to sustain the fight against public health diseases.
According to him, the committee is committed to reviewing the Anti-Discrimination Act of 2014 to address stigmatisation. ‘Other key decisions reached at the retreat that will help toward the goal of ending AIDS include, promoting local production of HIV drugs, ensuring accountability of NGOs, and enhancing NACA’s oversight capabilities,’ he said.
What is the Government doing? Illori said NACA had implemented various strategies including combination prevention therapy, HIV self-testing, harm reduction initiatives, treatment as prevention, and the re-evaluation of Nigeria’s HIV epidemic through the NAIIS in 2018, among others. ‘Among other initiatives, is the advancement of PMTCT programme in Nigeria, which is key to eliminating new HIV
infections among children. ‘The federal government has adopted a comprehensive approach for the implementation of PMTCT and this includes: Primary prevention of HIV infection among women of childbearing age.
All in all, the need for improved multi-sectoral coordination, accountability, and adoption of global best practices in HIV response, is vital to ending HIV/AIDS and prevention of its resurgence.