Nigeria’s losing battle against AIDS
It is reminiscent of a disaster breaking out while people are napping. But this is not exactly the case with Nigeria where the campaign against HIV/AIDS has been quite sustained, gulping billions of naira in advocacy and the provision of ARV to sufferers to help them withstand the ravages of the scourge so as to […]
It is reminiscent of a disaster breaking out while people are napping. But this is not exactly the case with Nigeria where the campaign against HIV/AIDS has been quite sustained, gulping billions of naira in advocacy and the provision of ARV to sufferers to help them withstand the ravages of the scourge so as to enable them live normal lives. Rather, the hard fought battle seems to be yielding little results. Now, there is the fear of battle fatigue setting in with donor agencies involved in the fight against HIV/AIDS withdrawing from the country and funding from aid partners coming in trickles and the federal government committing less funds to the health sector and by extension starving the agencies involved in the fight against the scourge of needed funds.
Mr. Francis Ajbo of the monitoring and evaluation unit of the National Action Council on Aids (NACA) told Weekly Trust: “Of course we have challenges which have been major constraints in us achieving some of our strategies. Our major challenge is funding. Take for instance what is voted or budgeted for the health sector is very meager, so you can imagine what would be for NACA.”
The programme manager for the Association of Positive Youths Living with HIV/AIDS in Nigeria (APYIN), Mr. Peter Obi says: “There is always the challenge of funds and resources as they are not there to reach out to the people at the rural areas. Poverty on the other hand is also a major challenge. Poverty and HIV/AIDS need to be tackled together; if poverty is not tackled the menace of AIDS cannot be stopped.”
Update your status
Another cause of worry is the refusal of people to go to the hospital to be tested so as to know their status. This has meant that those carrying the HIV virus continue to spread it further unknowingly with every new partner they meet. “The reason for the perceived rise in HIV/AIDS cases is the failure of people to know their status and even when they know they prefer to remain silent about it for the fear of stigmatization, thereby pretending that all is well and in the process spreading the virus,” says Mr. Tony Uche, a pharmacist.“Until the economy improves, there is little that could be done to reduce the spread of the disease. If you look around, many of the young girls are forced to sleep around because of the high rate of poverty and the need to survive and in the process they get infected and pass the virus by having multiple sex partners so as to make ends meet.”
At the Federal Medical Centre, Lokoja some of those who came for HIV/AIDS screening had to be compelled for other reasons. One of them, who simply identified himself as David, looked very sick. “I have been suffering from acute tuberculosis for several years,” he said. “The doctors have just compelled me to go for the HIV test. That is why I am here. Otherwise, I would never have bothered to be tested for HIV/AIDS because of its psychological effect. But now, I have no choice. Even if I am tested positive, life must go on as long as I am placed on antiretroviral drugs.”
A lady in her late twenties who spoke on condition of anonymity says: “I am about to get married. Our pastor insisted that my fiancé and I, after a three-year courtship, should go and do the HIV test before he would solemnize our marriage which is already fixed for next month. If either of us is tested positive, I doubt if the pastor would go ahead to solemnize our marriage. That is my fear. Left to me, I could still go ahead with the marriage even if my man is tested positive and I am negative. At least there are ways we could still manage to live positively as a couple.”
Meanwhile the increasing figures recorded from the pandemic do not give much reason to cheer even if the stigma that is usually attached to those carrying the virus has reduced. The Head of Clinical Services and Team Leader of Antiretroviral Therapy (ART), Federal Medical Centre, Lokoja, Dr Ojo Julius Abiodun says he is baffled with the rate at which the disease continues to spread despite measures put in place to control it. He says as of March 2010, the number of cumulative patients, that is the grand total of the HIV/AIDS patients enrolled for care was 2, 640 while those on drugs were 2,189. In summary, the doctor put the average monthly new cases of those put on antiretroviral treatment in the hospital as 21 to 36. All these exclude pregnant women living with the virus. According to him, between January and December 2009, out of 1, 957 pregnant women who came to the hospital for Antenatal Care (ANC), only 1,947 accepted to undergo the HIV test. He said over 130, representing 6.6 percent of them, were tested positive. “It is unfortunate that as at 2008, while the national prevalence rate of HIV/AIDS was 4.6 percent, it was 5.1 percent in Kogi State alone,” he says.
The statistics from the State Agency for the Control of AIDS, made available to Weekly Trust by the Special Assistant to the Kogi State governor Mrs Mercy Okpe, show that no fewer than 165, 000 people are currently living with the disease in Kogi State apart from the over 1, 000 people that died of the disease in various hospitals within the state in 2009 alone.
“The situation had posed huge challenges to the state,” she says, “as the current prevalence rate of HIV in Kogi State is clearly above the national average of 4.6 percent, and most of those currently infected are rural dwellers without knowledge.”
In Kaduna State, instead of decreasing, the prevalence rate is climbing and the 7% rate of infection in the state, according to a 2008 survey, is the highest in the north-west zone. Sokoto State which has 6.0% is hot on Kaduna’s heels while Kebbi is a distant third with 2.9%. Katsina, Kano and Zamfara states have prevalence rates of 2.6%, 2.2% and 2.1% respectively. Jigawa State brings up the rear with1.6% prevalence rate.
Significantly, within Kaduna State, Kafanchan tops the chart with 17.7% rate. Respectively, Kwoi, Zaria and Kaduna town have 7.3%, 3.4% and 2.3% HIV/AIDS prevalence rates in the survey. Apparently, from these statistics, the fight against AIDS seems like a lost battle but NACA is not relenting and in Kaduna state, the agency has co-opted faith-based organisations in the campaign. Specifically, the Cherubim and Seraphim church, from October 2009 to 2010, has focused on HIV/AIDS prevention, targeting the youth in Kaduna and Benue states.
The Kaduna State government, through the state’s AIDS control agency is working out steps to reduce the spread of the pandemic says Mr Patrick Katuka, the executive secretary of the agency. The agency, according to him, provides food items for people living with AIDS. The victims, the executive secretary pointed out, distribute the foodstuff through their support groups in the 23 local governments. In addition, the government plans to engage them in income generating activities to make them self reliant. Also, the government plans to introduce HIV/AIDS clubs in primary, secondary and tertiary institutions and the agency, according to him, will use the family life HIV/AIDS education curriculum in order to actualise this plan. The agency also plans to involve the community, encourage pre-marital testing and counselling as well as mobilise resources so as to sustain the programme’s funding, especially when external funding ceases. In addition, the state plans to sponsor an anti-stigma bill and develop a workplace policy for people living with AIDS. Significantly, out of these six agendas, only the feeding programme has taken off. The rest are in the pipeline.
More promises, less action
It is the same situation in most states of the federation where response by governments to the spread of the pandemic is lackluster. Our investigations have revealed that activities in Rivers State HIV/AIDS control is not empowered by the state government to function as an agency. Governor Rotimi Amaechi is yet to formally inaugurate the state committee for the control of HIV/AIDS although it has been transformed into an agency by the act of the legislation of the State House of Assembly and formally signed into law. The agency has no substantive director and it is dependent on meager funding from the state ministry of health and some foreign donors. The agency does not embark on any function except the annual celebration of the World AIDS Day, which is organized by the state ministry of health. Unconfirmed reports said that the prevalence rate of the disease in the state alone is higher than the national average. It is said that the burden of the disease was more on rural women, especially pregnant women and children. There is no official record available on the prevalence rate in the state.
There is little hope that HIV/AIDS campaign will be reinvigorated in the state because apart from the unwillingness of the governor to swear-in and empower the agency, work has been suspended on the 150 health centers across the state until the 200 medical doctors and nurses planned to be engaged by the state government to man the centers have been employed. Efforts to get the comments of Dr Chimezie Okey, chairman of the Rivers State Action Committee on HIV/AIDS (RIVSACA) failed as he refused to pick his call. The state commissioner for health, Dr Sampson Parker also did not pick his call. Owaifo Oviawe, Managing Director of Uwa Right to Live Foundation, a faith-based NGO in Port Harcourt said if the government of Rivers State does not take swift action soon, the prevalence of HIV/AIDS may escalate beyond control. He offered a guess estimate that it is likely that four out every ten persons would be vulnerable. He says: “From my experience in our church, where 580 persons attended a public lecture and 280 voluntarily accepted to be tested, eight people were instantly found to be positive. These people changed their telephone numbers and relocated because of the fear of stigmatization which is still a problem here.”
Leaving orphans in its trail
In Kogi State, there are 3,500 orphans living with the virus, says Mrs Okpe. She says she discovered them during her recent visit to all the orphanages in the state. According to her, the orphans, who are mostly children, got infected through mother-to-child transmission.
“During my visit to all the orphanage homes in the 21 local government areas of Kogi State, I came about this number of orphans whose parents have died of HIV/AIDS,” she says. “We have about nine of such homes in the state, and at present I can say it without any fear of contradiction that in this state, we have over 3, 500 orphans who have been, after test, confirmed HIV positive. It is very unfortunate. We treat them as vulnerable children.” She also confirmed that ten out of these orphans had died of the disease since the beginning of this year, while others were receiving antiretroviral treatment at various centres in the state.
These orphans’ mothers were tested positive. The problem is caused mostly during child birth as a result of mother-to-child transmission of HIV. This is common because most pregnant women do not obey medical advice and instructions. In all government hospitals in the state, it is mandatory for all pregnant women to undergo HIV test so that doctors would find ways of protecting the babies from getting infected. For instance, pregnant women tested HIV positive are often told not to breastfeed their babies, while at times, they are made to deliver through caesarean operations in order to protect the babies because research has shown that most mothers transmit HIV to their babies during delivery. But the most disturbing thing is that most pregnant women do not go to government hospitals for delivery. They still prefer going to local nurses for delivery. Most of these women, especially those living in the rural areas are ignorant of the existence of the pandemic. In Kano, the coordinator in charge of orphans and vulnerable children of the Community Support and Development Initiative (CSADI), Adam Usman says there are quite a number of children orphaned by HIV/AIDS in the state even though he could not be able to make an estimate of how many they are.
A grandmother who takes care of six children orphaned by HIV/AIDS in Gama, a suburb in Kano metropolis, who prefers to be anonymous says: “It is really not easy at the initial stage when people around know about what killed parents of the children. It was really not easy when my son in-law died and my daughter also died in less than two years after him. We were stigmatized to the extent that neighbors don’t allow their children to mingle with my grand children.” But she says that now the stigmatization rate has recently reduced as her grand children now mingle freely with children around and people also invite her to attend ceremonies, unlike before. When will the agony experienced by people like her ever end?