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HIV/AIDS is reported to affect around 5 per cent of Nigeria's 120 million population.
HIV/AIDS is reported to affect around 5 per cent of Nigeria's 120 million population. Battles against prevention of the scourge are being fought on different fronts, from religious to education to health. Professor Babatunde Osotimehin, Chairman of National Action Committee on AIDS (NACA) spoke with THISDAY Development on the issue at two different fora. ABIMBOLA AKOSILE highlights his excerpts.
Current situation in Nigeria:
The first case of HIV/AIDS was discovered in Nigeria in 1986. Today, about 5 percent of the nation's population live with the virus. The figure may be higher than that, because not everyone has been tested, but the awareness is being created. In 2000, awareness was the issue, today what is lacking is transmission of knowledge acquired. There is life after testing positive.
Stigma discrimination is going down. There is a shift in emphasis now, from awareness to transmission of knowledge. There are 4 million Nigerians currently living with the virus, who need timely treatment and also treatment for life to cope with.
Efforts at prevention and awareness creation:
We have a report drafted by a constituted 14-man committee two years ago. We can talk to young adults through our Faith-Based Organisations (FBOs), those we are sure can take up the challenge of spreading the word to them. We shall set up an advisory committee to give strength to the FBOs (already set up). Faith based organisations can induce intervention on this knowledge to effect positive change. They can also provide support and care for People Living With HIV and AIDS (PLWHA).
Apart from setting up different structures, we need to look at issues of prevention among young adults. We also need to create a right environment for those infected. Faith-based leaders are looked to in communities and they should give back to those communities the kind of instruction and advice for those living with the virus so that they can be accepted fully in the communities. We have a great task ahead of us, which can make a difference in our response to HIV/AIDS.
Progress on resistance:
Now we had the 2nd Inter-Faith Forum recently, where we were able to get a measure of progress on responses to the virus since this fight commenced. The forum also created greater awareness. There was a mapping exercise of gaps and areas to fill in faith-based response. We have achieved a network of FBOs and set up an advisory council to provide advice to NACA, based on deliberations of the 14-man committee's report, which formed the substratum of the Inter-Faith forum. We have made great progress. Behavioural change is starting to take place. Treatment programme is starting to take root nation-wide. We are looking at an affected percentage of less than 5% in 5 years' time.
Our greatest challenge has been coordination of activities in the fight against the virus. There are so many people working with HIV/AIDS.
Currently, we are working with 14,000 People Living With HIV/AIDS (PLWHA), and there is a Presidential directive that the number of people to be treated should be increased to 250,000 by 2006. We are not finding things easy, but President Obasanjo means well for Nigerians and he wants things to happen. We have to ride on the crest of political will. I am told the President wants to concentrate on HIV/AIDS and Tuberculosis (TB) in the next two years and he has given orders to that effect.
We have a template and we believe it is do-able. We need to counsel and test about 22 million people to be able to treat 250,000 people. We have to think of entry points to reach 22 million people, through primary health care units, even private clinics and hospitals. To admit, we have to get new algorithms to ensure speedy and effective testing and treatment. We have to find spaces in General Hospitals all over the States.
18 months ago, no one believed we could do it. The pilot we started with has now stabilised. However, we need to look at the cost implications. Once you start people on treatment, it is for life. Tomorrow, we might need secondary line of drugs. We have to do everything possible to make sure those who want to get it. The whole issue will be re-examined accordingly. In 1993, USA pulled out of Nigeria and took the immunisation process with them. We are just trying to recover from that process.
Cooperation and Coordination:
Alongside NACA and Ministry of Health, the Ministry of Education, non-governmental organisations (NGOs) and the public sector are also taking up the challenge, with 42 line Ministries now involved from the previous 6. The Organised Private Sector (OPS) is also in the struggle. We have the Nigerian Business Coalition Against AIDS (NIBUCAA), who have also done a lot to create awareness.
Vehicles of Response:
Response to HIV/AIDS in any country can only succeed if we have three sectors on board. We have the Faith-Based Organisations, the Education Constituency, and the youths.
The best way to prevent new infection is through education. If you are educated then you are empowered to make all the best choices in life. My dream is to have all the sectors working together to wipe out HIV/AIDS in Nigeria. Education addresses all sectors. Educators must come forward with specific objectives and goals to empower the Nigerian child.
There is the Family Life and HIV/AIDS Education (FLHE) Curriculum, which has already been accepted by the National Council on Education. The curriculum will have to be domesticated at all States' levels. We must all share our experiences and move ahead together. Every Nigerian child deserves information and education to enable him or her make the best choices in life.
Involvement with Education Sector:
What we try to do with the education sector is that we recognise education as a very important sector and over the years we have tried to build the sector to take up more responsibilities. At the inception of NACA in 2001, education sector was chosen as key, and the current Minister, Mrs. Chinwe Obaji is very committed. There was a disconnect between the HIV Unit and the Ministerial level before but now there is a change.
The National Educational Research and Development Commission (NERDC) has led the effort on the curriculum, which we are using now. It was discussed and a final decision was taken at the 49th meeting. There is a generic curriculum now, which is available to every State, which covers from primary school to university level. But the current focus is on primary and secondary school levels.
We observed that not every state is taking it (curriculum) seriously. We felt the need to bring together all the education Commissioners all over Nigeria, to the same level, to buy into the idea. We are also planning to provide 10,000 copies of the curriculum to each state, and we hope to have the FLHE curriculum planned into the work scheme at primary and secondary school levels. The recent launch of the curriculum (July 26, 2005 in Abuja) was to kick-start that process.
After the curriculum, specific things need to be done. We have training of teachers, step-down activities. NERDC has talked about that. We will have State Governors putting money down to create awareness on the issue. Fortunately, each State has access to credit funding on HIV/AIDS related activities.
This is the most effective way of slowing down the epidemic. We believe education should be a main pivot and education is very important in mainstreaming HIV/AIDS.
The National Universities Commission (NUC) is working on the issue already, and it is hoped that every student that comes into the university would have information on HIV/AIDS. We have a comprehensive programme for Nigerian universities.
Informal Sector Participation:
We are working through Small and Medium-scale Enterprises Development Association of Nigeria (SMEDAN) to reach out to those in vocational groups. Also, we are working with the National Union of Road Transport Workers (NURTW), and we have given money to different small groups in the informal sector. However, there has to be a larger push in the informal sector.
Initially it was all about denial, but in the last two or three years, there has been progress. Stigmatisation is still there, but there is a fight against that also.
Synergy between Platforms:
We are hoping the faith-based platform will make major incursions into the educational sector and work with them. We consulted the faith-based leaders on the FLHE curriculum, and we must ensure that all the platforms talk to themselves. The first 2 versions of FLHE curriculum were rejected by religious leaders because of language issue, but it has now been reviewed and accepted.
AIDS Cure Claims:
Those who claim they have found cure to AIDS, we have told them, "If you have a cure, you must allow us authenticate it, other wise we may not really vouch for the cure.
Monitoring and Evaluation:
A unit is to be set up with the World Bank footing the bill. We are also into capacity building.
NACA's Current Status:
Even as a committee, we are doing well. Nigeria is a continent, more than one country. We cannot compare ourselves to Uganda or Botswana in terms of achievements. As long as we have a federal structure, the problem remains. Commitment is not as strong as expected at the State level. It is difficult to push more than a moral oversight.
There is a Bill to establish NACA as an Agency before the National Assembly. We expect the Bill to be signed into law before December.
Steps to Sustainability:
We must ensure speedy indigenous production of drugs for treatment, and also ensure that test kits are produced locally and that all requirement are provided. If cost of testing can be eliminated, this will bring down the cost of treatment. Testing is probably more expensive than the drugs. Focus should be on sustainability.
The fight against HIV/AIDS is global. No country can do it alone. President Obasanjo's legacy is that we shall be producing Anti Retro Viral drugs (ARVs), test kits and condoms before he leaves.
We are working with Chief Magnus Kpakol, Chairman, National Poverty Eradication Programme (NAPEP), but we need to do more. From the youth network, the 2nd meeting is about skills development. We are looking at opportunities of creating wealth for PLWHAS.
Nutrition is also a major issue. Some programmes actually provide supplements for people living with HIV/AIDS. We want to see how we can encourage States and Local Governments to provide supplements across Nigeria.
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