Lieutenant Nsikak Ekpe is a 40-year-old Nigerian Navy engineer living with HIV/AIDS.
For eight years, he has struggled to remain healthy while providing counselling for people living with the ailment under the
auspices of Nigerian AIDS Alliance.
The rapid spread of the disease and the climbing death toll is very worrisome
for him and his colleagues. They equally berate the inability of the revelant authorities to emerge with plans and intervention
strategies to contain the spread of the epidemic. Information is not available, the society does not have a dependable support
system for people living with HIV and the much publicised talk of boosting access to anti retroviral drugs is not forthcoming. Already 60% of hospital admissions are for AIDS related ailments.
What are the chances for presenting a true situation analysis of the HIV epidemic
of Nigeria?
Data from the central health authority show that Nigerias HIV infected population
is 3,973,349 with 126,176 new AIDS cases reported by June 2003.
Already 106,343 Nigerians have died from the disease and in the capital city,
Abuja 10% of the citys population is infected.
A study conducted by the Ministry of health estimates that more than one in every
20 Nigerian adult has the HIV virus while the infection rate has increased by nearly 6% in Nigerians between the ages of 15
to 49 years.
These summaries present a gloomy picture and doubts have been expressed in a
lot of quarters about the accuracy of these figures. Without disregarding the opinions that these statistics could be an exaggeration
of the true situation, experts however suggest that the rate of infection is higher especially considering the significant
rise in new cases and the discovery of newer strains of the virus in recent times.
A UNICEF profile on HIV/AIDS suggests that Nigeria accounts for 10% of African and 8% of global HIV/AIDS cases. A follow
up to these statistics projects that by 2010 if the present situation continues unchecked; Nigeria would have 2.5 million
AIDS orphans.
With a population of infected adult Nigerians estimated to be about 3.5million and an additional 700.000 to 800,000
children also infected, I believe strongly that we have only seen the tip of the iceberg.(Obasanjo, 2002)
These statistics however do not insinuate that a permanent solution cannot be found for collating statistics that would
serve as a framework for developing a lasting intervention strategy. On the contrary
they are an indication to stakeholders that Nigerias HIV/AIDS crisis has reached epidemic level and that now more than ever
there is the need to seek effective measures for containing the disease.
National efforts at ousting the disease
In many parts of the country, majority of the afflicted especially the
young adults are not aware of their positive status, there is a low use of prophylactics abject poverty in the rural areas
and some cultural practices are reasons attributed to the continuous spread of the disease.
The present administration upon assuming office in 1999 made the management of HIV/AIDS a national priority. Committees
were created to observe and manage the trend of the disease, requests for grants were made to different global donors and
US$94million has been allocated to fight against HIV/AIDS for the next three years.
HIV/AIDS/STD control programme structures exist in all states and Local Government
areas in collaboration with Non Governmental Organisations and private sector participation but these are restricted to the
health sector.
There are also efforts to boost the access to anti-retroviral drugs, the government
announced an 80% subsidy for the monthly cost of anti-retroviral treatment for patients from US$350 to one thousand naira
about US$8.
This effort is commendable inspite of Africas lingering crises with pharmaceutical
companies over patents, generics and prices of medicines.
The government collaborating with other agencies in the fight against AIDS have also established counselling and testing
centres as well as 24 hours phone helplines to provide advisory and counselling services to facilitate early diagnosis and
management of the disease.
Challenges threatening the control programme and strategies
The efforts of the government so far are laudable but concerns have been expressed
about the inability of the government to provide actual statistics at the moment of how many Nigerians are living with the
virus. This considerably limits the effects of intervention strategies.
Also, a lot of Nigerians are still in denial about the existence of the disease
in spite of the massive campaigns on various media. Myths have emerged on the origin and possible cures for the disease; the
principle of abstinence is considered obsolete and in some areas, the theme of mutual fidelity exists in utopia.
When Fela Anikulapo Kuti, the musical maestro, who was popular for his open criticism
of the government succumbed to this ailment in 1997. The revelation came from his brother, Dr Olikoye Ransome Kuti who as
the Health Minister made the first announcement about the disease to Nigerians in 1986. For some Nigerians the pronouncement
was government propaganda to further blacklist his character, for others it was an attempt to instil fear about the mysterious
illness.
The Nigerian society is yet to devise
a means of support for people living with HIV/AIDS. Individuals that have publicly admitted to contracting the disease are
stigmatised and discriminated against. Employers and health officials at times subject individuals to compulsory tests without
their consent thus violating their fundamental human rights.
In addition, many Nigerians live below poverty level and with anti retroviral
treatments priced a little under a third of the minimum wage, life saving medicines are placed out of the reach of those for
whom they are intended. More so poverty has been identified as a major contributing factor for the spread of the disease in
Nigeria.
Accusing fingers have also been pointed at the government that the medicines
procured for AIDS victims are sabotaged. The governments announcement of an 80% subsidy was welcomed with a lot of excitement
from the victims, advocacy groups and other stakeholders. However months after the pronouncement, the beneficiaries are yet
to receive this subsidy and currently some Nigerians pay between US$270-360 to obtain these drugs monthly.
The illicit trade in counterfeit and sub standard drugs further aggravates the
situation. It is estimated that over 25% of the drugs on sale across pharmacies in Nigeria are sub-standard or fake. This
has huge implications on the access to quality medicines to manage HIV/AIDS and other opportunist infections.
These fears are also incensed by the inability of the government to build an efficient health care delivery system;
the problem of corruption is rife amidst concerns that the true beneficiaries of this life saving intervention strategies
will not get them.
Though the mass medias role in promoting campaigns to control and oust the disease from Nigeria is commendable, it
is worrisome that its role of watchdog for safeguarding the interest of the masses could be jeopardised in place of circulation
and profit.
In March 2000, the pronouncement of Dr Jeremiah Abalaka, a medical practitioner
working in Abuja that he had successfully created a vaccine for AIDS sparked off media frenzy. It was not the first time an
announcement of this sort would be made, but why the media chose to celebrate this particular incident is still baffling.
Media organisations granted interviews,
exclusives, screaming headlines continued to tantalise millions who were hopeful for a lasting solution to the problem. Till
this moment conclusive evidence to prove or disprove the claims have not been provided, but instead the legal tussles ensuing
the pronouncement were continuously circulated to boost sales and patronage.
In no time the event succumbed to
the life cycle of news, from novelty to obsolesce and the AIDS victims were left to count their losses.
The future of Nigeria and the AIDS epidemic
Nigeria as the most populous country in Africa, plays key roles in the political,
economic and social affairs of the continent. With its big brother position in African affairs; a public health catastrophe
that could undermine this position is emerging:
In 2003, medical scientists engaged in HIV/AIDS research in the country identified
four new strains of HIV-1 that are peculiar to Nigeria. (Olaleye, 2003)
Furthermore, with the population increasing at a rate 2.83% annually and the
debilitating impact of the virus on the productive population of 15-49 years; the economy is left very fragile and susceptible
to political, economic and social problems.
The situation calls for drastic measures; the realities of the ailment should
be promoted and publicised. There is a need to revisit some of the moral and social virtues that would help contain the spread.
Most importantly, African nations must unite because the battle is collective... it is not the sole responsibility of governments,
advocacy groups or the private sector but a collective effort to save Africa from HIV/AIDS.
AIDS: An overview
The Acquired Immune Deficiency Syndrome (AIDS) is a fatal transmissible disorder of the immune system that is caused
by the human immuno deficiency virus (HIV) which slowly attacks and destroys the bodys defence system against diseases.
The methods of transmission are numerous but sexual contact is most pervasive
means of the spread.
Since the epidemic began in 1981, 60 million people have been infected with the
virus and it is now the leading cause of death in Sub- Saharan Africa.
Africa accounts for 70% of the 36 million people afflicted with HIV/AIDS
worldwide and more than 18 million
Africans have died from the epidemic.
Bibliography
1 AIDS Global Overview
Http://www.unaids.org
Http://www.who.org
27 June2003
2 Africas Largest Generic AIDS Drug Program Delayed in Nigeria
Http://www.hivnet.ch
27 June 2003
3 Nigerias AIDS population Underestimated,
Says President Obasanjo
Http://.studlife.com
27 June 2003
4 Okereke C.O Nigerian HIV Epidemic, January 13, 2002
Http://www.nigeriamasterweb.com 27 June 2003
5 Situational Analysis Report on STD/HIV/AIDS in
Nigeria (March 2000)
Http://www.nigeria-aids.org
25 June 2003
6 Journalists Against AIDS Nigeria
Http://www.nigeria-aids.org
25 June 2003
7 Falobi O. Abalaka: Where the Media Went Wrong, April 1 2000
Http://www.nigeria-aids.org
25 June 2003
