Sunday, 11 October 2015

SDGs Stir New HIV Control Target In Nigeria

After goals in New York, the real test will be how Nigeria sustains anti-HIV efforts back home.

Control of AIDS has a new target: a generation free of the virus by 2030. World leaders convened at the 70th United Nations General Assembly; they pumped hands and made speeches, and ended up signing up to new commitments that push for a fairer, better world by 2030.

But Nigeria’s own side event in New York had experts mulling over what to do about HIV/AIDS. One goal is to eliminate vertical transmission of HIV from pregnant mothers to their new born children by 2020. A second goal is to end the AIDS epidemic by 2030.

Both goals are not satisfactorily captured in the Sustainable Development Goals - a set of 17 goals that replace the worn-out Millennium Development Goals in the quest for a better world - which world leaders signed up to in late September.
National Agency for Control of AIDS is concerned about some unfinished business of health-related MDGs within the SDGs framework.

Pampaida, a community in Kaduna State has become a role model for eliminating mother-to-child transmission of HIV. This year, so far, no child has been positive to the virus despite having HIV-positive mothers.

Executive director of the UNAIDS (the UN joint progamme on AIDS), Michel Sidibe has recommended the Kaduna model, done between NACA and UNAIDS, be expanded to all 13 states (and Abuja) with highest HIV burden in Nigeria, where 70 percent of all HIV positive pregnant women and new HIV infections exist.

Success of Kaduna model is among NACA’s “significant progress in the fight against HIV/AIDS in the last decade,” according to the director-general of the agency, Prof. John Idoko.

“We have achieved the MDG goal six of halting and reversing the HIV epidemic and we are committed to sustaining the momentum in the era of the SDGs to achieve an AIDS-free generation by 2030,” he said.
The plan is for Nigeria to adopt new World Health Organisation guidelines of “test and treat.”

Figures from the agency indicate the number of people positive to the virus has topped 750,000 but less than half are on treatment.
A presidential plan put up former president Goodluck Jonathan’s administration calls for testing - to ensure up to 80 million people know their status, while gradually enrolling them into treatment programmes.

“Nigeria has the second highest burden of HIV in the world after South Africa, representing 9.0 percent of the global burden of infection,” said Babatunde Osotimehin, executive director of the United Nations Population Fund.

The fund’s interest in the virus is because the associated disease is “still a woman’s disease in Nigeria.”
“Sixty-six per cent of new HIV infections were concentrated in 12 of the 36 states and the Federal Capital Territory,” Osotimehin said.

The SDGs are inadequately silent on HIV/AIDS issues, analysts have said but does not preclude attempts to funnel targets about the virus and disease into the goals.
Nigeria’s own goal is “greater prominence” for HIV/AIDS as part of target for the SDGs.

Finance is an issue: funding from the US President’s Programme for AIDS (PEPFAR) is declining, and proponents are looking for commitment in Nigeria at the highest level for resources.

They also want AIDS programme to be owned and sustained.
And “need to hold governors accountable at state level and move from a federal-led to a state-led effort to fight HIV/AIDS” is listed among ways forward.

Pampaida is one success in line to be scaled up, alongside integrating testing for pregnant women during dedicated twice-yearly weeks for maternal, new born and child health.
Last year, more than three million pregnant women were tested for HIV and 63,000 of them enrolled in anti-retroviral therapy, according to NACA figures.

But what the country needs most, analysts have said, is improve systems of delivering health, education and cheaper production of anti-retroviral drugs through technology exchange.
The plan is to push for pharmaceutical companies to produce generics that could reduce the cost of antiretroviral drugs.

Nigeria’s national report on the end of MDG era highlights “early implementation, local ownership, and consolidation of incentive-based mechanisms” like conditional grants after MDG era, according to Ochapa Ogenyi from the office of the senior special assistant to the president on MDGs.
It also notes “continuation of the strong political will in order to attain the SDGs by 2030.”

The report, which charts Nigeria’s progress, provides MDG achievements as milestones against which to benchmark progress as Nigeria adopts the SDGs.

President Muhammadu Buhari summed up the target in New York. “Let us work together to make HIV and AIDs history by 2030,” he said.

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