Focus on HIV/AIDS treatment programme

For thousands of people living with HIV/AIDS in Nigeria, the long wait for affordable treatment appears set to end. From 1 September the government will launch an anti-retroviral treatment programme under which 15,000 people will each receive the required cocktail of drugs for less than US $1 daily. The drugs produced by the India-based pharmaceutical company, Cipla Ltd, are generic versions of more expensive anti-retroviral drugs produced by Western drug companies. President Olusegun Obasanjo’s government, through negotiations with the company, is buying the drugs for US $350 a year per person. “The government is providing up to eighty percent subsidy, leaving the patients to pay the rest, which amounts to no more than eight dollars a month,” a senior official of Nigeria’s Ministry of Health, who was part of the negotiating team, told IRIN. The new treatment programme by Africa’s most populous country of 120 million people is novel on the continent. Nigeria is an early beneficiary of the decision, early this year, by leading Western pharmaceuticals to drop their law suit against the South African government which insisted it had a right to produce or buy cheaper generic versions of their anti-HIV/AIDS drugs. “The government’s ... anti-retroviral treatment will be, at least initially, larger than anywhere else on the continent,” Stephen Lewis, the UN Secretary-General’s Special AIDS Envoy to Africa, told reporters in New York after a visit to Nigeria in July to discuss the programme. He said though only 10,000 adults and 5,000 children would benefit initially from the programme, the figures would rise “by the thousands over the next two years”. According to details of the treatment regime revealed by Nigeria’s Ministry of Health, 60 percent of the beneficiaries will receive two pills three times daily, while the remaining 40 percent will receive two pills twice daily. Over time the effectiveness of the treatment will be evaluated at two laboratories, one in the capital, Abuja, and another in the biggest city, Lagos. The US Ford Foundation has pledged to pay for the laboratory evaluations. Nigerian officials said the initiative for the HIV/AIDS treatment effort was propelled by President Obasanjo. Since hosting an international summit on HIV/AIDS and other related infectious diseases in April, where far-reaching decisions were taken to tackle the global scourge, Obasanjo has felt the need to demonstrate action in practical terms. Such a step became imperative as the scope of the AIDS problem in Nigeria became increasingly apparent. With at least 2.6 million Nigerians living with HIV/AIDS, the country is among the three worst affected in Africa. While a prevalence rate of 5.4 percent of the population is relatively low when compared with the most severely affected African countries, local health officials and their international partners realised that the spread of the disease had approached the threshold of exponential growth. According to the United Nations Children’s Fund (UNICEF), which is actively involved in the campaign to halt the spread of the AIDS virus in the country, infected people in Nigeria represent 10 percent of the total infected population in Africa and 8 percent of the global figure. “UNICEF finds that the disease has permeated every community and locality in the country and, as often is the case, the most affected are between 20 and 40 years,” the organisation said in a recent publication. Compared to several eastern and southern African countries, it took longer for HIV/AIDS to become a manifestly serious problem in Nigeria. Many health workers think the opportunity to keep the spread at the minimum was lost during the years of military rule from the mid-1980s to the late 1990s, when successive leaders paid scant attention to the dangers posed by the disease. “Under the rule of General Ibrahim Babangida and his military successor, General Sani Abacha, the government gave the impression that it had better things to worry about than an invisible virus,” Kelechi Okonkwo, an AIDS activist, told IRIN. Consequently, neither were enlightenment campaigns nor care for HIV/AIDS patients considered national health priorities as the country’s prevalence rate rose progressively from under 1 percent to 5.4 percent within a decade. Instead, misconceptions about the disease gained currency. Those infected or affected did not get any help but also faced severe social discrimination for disclosing their status. Since his election into office in 1999, ending more than 15 years of military rule, Obasanjo has demonstrated the political will to face the reality of HIV/AIDS in Nigeria and combat the disease. The summit he hosted in April provided the platform for UN Secretary-General Kofi Annan to announce his widely-welcomed proposal for the establishment of a $7-10 billion “war chest” to fight the disease and allied infections. A follow-up international summit has been slated for the Nigerian capital, Abuja, in November. In response to such activism, Nigeria has begun to attract international help to tackle the problem. The latest is a $90.3-million loan approved by the World Bank in July to back the country’s emergency action plan against HIV/AIDS. Over the next three years, the fund will be spend on HIV prevention, treatment for the infected and care for the affected, particularly orphans.