HIV/AIDS EPIDEMIC: GETTING TO ZERO
World AIDS Day was first conceived in August 1987 by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS (now known as UNAIDS) at the World Health Organization in Geneva, Switzerland. The first observance of World AIDS Day was 1 December, 1988. The theme for the 2011World AIDS Day commemoration is “Getting to Zero”. Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths. The “Getting to Zero” campaign runs until 2015 and builds on last year’s successful World AIDS Day “Light for Rights” initiative.
HIV/AIDS is a global crisis. Nigeria with a population of 152.6 million people and estimated HIV prevalence of 4.1 % in the general population has the second largest population of people living with HIV/AIDS after South Africa. It is estimated that 3.10 million people are living with HIV/AIDS in Nigeria as at the end of 2010.
Among the early achievements recorded in the fight against HIV/AIDS include the promotion of safer sex behavior, blood safety measures, reduction of HIV transmission through piercing objects like injections and razor blades and establishment of HIV/AIDS Counseling and Testing (HCT) centers. The 2010 United Nations General Assembly (UNGASS) report shows that Nigeria has experienced progress with some indicators which include:
• Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy, which increased from 16.7% (2008) to 34.4% (2010)
• Percentage of HIV-positive pregnant women who receive antiretroviral medicines to reduce the risk of mother-to-child transmission from 5.3% (2008) to 21.59% (2010)
• Percentage of estimated HIV-positive incident Tuberculosis (TB) cases that received treatment for TB and HIV from 55.95% (2008) to 69.1% (2010)
• Percentage of women and men aged 15–49 who received an HIV test in the last 12 months and who know the results from 8.6% (2008) to 11.7% (2010)
Despite the recorded achievements, the national HIV/AIDS epidemiological survey still presents a very worrisome picture. Some of the national HIV/AIDS epidemiological indices as at the end of 2010 are: Annual HIV positive births: 56,681; Cumulative AIDS deaths: 2.1 million (Male – 970,000; Female – 1.61 million); Annual AIDS Death: 215,130 (Male – 96,740; Female – 118,390); Number requiring Antiretroviral therapy: 1,512,720 (Adult – 1,300,000; Children – 212,720); New HIV infection: 281,180 (Adult – 126,260; Children – 154,920); Total AIDS Orphans: 2,229,883. The national HIV zero-prevalence rate has moved from a low of 1.8 in 1991 to a peak of 5.8 in 2001 before stabilizing to 4.1 in 2010. In Imo State, the prevalence has reduced from 4.6 in 2008 to 3.0 (urban 3.2, rural 2.7) in 2010.
The most-at-risk populations (MARPs) for HIV infection include female sex workers (FSWs), intravenous drug users (IDUs), men who have sex with men (MSM), long-distance drivers, and members of the uniformed services. The result of the mode of HIV transmission analysis in Nigeria carried out by the National Agency for the Control of AIDS (NACA) in 2008 showed that about 62% of new infections occur among persons perceived as practicing “low risk sex’ in the general population including married sexual partners. The rest of the new infections (38 percent) are attributable to IDUs, FSWs, MSM and their partners who constitute about 3.5 percent of the adult population.
The key drivers of the HIV epidemic in Nigeria include: low personal risk perception, multiple sexual partnerships, transactional sex, inefficient services for sexually transmitted infections (STIs), and inadequate access to and poor quality of healthcare services. Entrenched gender inequities, chronic poverty, and stubborn persistence of HIV/AIDS-related stigma and discrimination also significantly contribute to the continuing spread of the infection.
The National Strategic Framework(NSF)2005-09 identified a number of strategies to prevent new HIV infections and promote behavior change and these include HIV Counseling and Testing (HCT); Prevention of Mother-to-Child Transmission (PMTCT) of HIV; Prevention of Biomedical Transmission of HIV; Early Detection, Treatment, and Control of Sexually Transmitted Infections (STIs); Condom Promotion); Communication Interventions targeting the general population on the one hand and most-at-risk populations (MARPs) on the other hand;
This National Strategic Plan (NSP) 2009-2015 is in line with two important international commitments that Nigeria has signed on especially the Millennium Development Goals and the Universal Access (UA) to HIV/AIDS prevention and care and treatment services. The major priority of the NSP 2010-15 is to reposition HIV prevention as the centerpiece of the national HIV/AIDS response. Thus greater focus will be placed on scaling-up HIV prevention services that enable individuals to maintain their HIV negative status as well as improve access to quality treatment and care services for People Living with HIV/AIDS (PLHIV).
Despite recent improvements in federal government financial contributions, HIV/AIDS response remains largely donor dependant. Domestic sources account for only 5 % of resources needed; with vast pools of private sector resources still largely untapped. Many states actually made zero allocation for HIV/AIDS activities in 2009. The major aim is to leverage increased political and resource commitment to the national response by all stakeholders while ensuring transparency and accountability for all resources allocated for the national response.
The NSF strategic plan has been domesticated in Imo State by the production of the Imo State HIV/AIDS Strategic Plan 2010-2015. Civil Society Organizations (CSOs) have made outstanding contributions to Nigeria’s HIV/AIDS prevention efforts in areas such as collaboration and networking in sourcing for funding and implementing programs, partnership with government agencies and the private sector and program implementation and research where CSOs have shown leadership. Quite a number of HIV program interventions in Nigeria are being managed by international NGOs working with local counterparts. Despite the achievements of CSOs in Nigeria, there are a number of challenges militating against their successes. Some of these challenges are limited institutional capacity, poor documentation, monitoring and evaluation, donor driven agenda and poor resource mobilization:
There is an ongoing scale up of ART, PMTCT and HCT services in public, private and faith based institutions across the country. As at end of 2010, there has been scale-up of ART(446), PMTCT(675) and HCT(1046) sites respectively in Nigeria, from an initial 20 sites in 2002.In Imo State, there are nine comprehensive sites where all the services(ART, PMTCT and HCT) can be accessed. They are Federal Medical Centre, Owerri, General Hospitals in Owerri, Awo-omama, Okigwe and Aboh Mbaise. Imo State University Teaching Hospital, Orlu. St. Damian’s Okporo and Joint Hospital Mbano.
As the world commemorates the 2011 World Aids Day, the activities in Imo State will include a road show and rally on the 1st of December at FSP Wetheral road organized by the Imo State Agency for the Control of AIDS (IMOSACA) and it’s collaborating partners and a stakeholders forum on the 2nd of December at the Owerri Municipal Council Hall being organized by the Civil Society on HIV/AIDS in Nigeria (CiSHAN) Imo State chapter and its partners. You are invited to be part of these activities and join your voice in spreading the HIV/AIDS message in other to stop the spread of the HIV virus.
A VIEWPOINT ON THE COMMEMORATION OF THE 2011 WORLD AIDS DAY WRITTEN BY TONY AYOKA O. AND BROADCAST BY RADIO NIGERIA HEARTLAND F.M 100.5 ON 1ST OF DEC.2011.