Government plans ambitious expansion of anti-retroviral therapy

Nigeria is appealing for US$248 million to help it provide subsidised antiretroviral (ARV) drugs for 200,000 people living with HIV/AIDS by the end of 2005, Health Minister Eyitayo Lambo said. Lambo told journalists on Wednesday that most of the money for this ambitious programme would probably come from the United States. “We are treating 14,000 people. By the end of next year we want to be able to treat 200,000,” the health minister said. Pierre Mpele, the head of UNAIDS in Nigeria, told IRIN on Friday that in addition to the United States, the Global Fund to fight AIDS and Tuberculosis and the World Bank were also expected to fund the expansion of ARV treatment in a big way. However, the government has budgeted only $9 million for ARV therapy this year and its existing programme has been widely criticised as poorly organised and underfunded. Some Nigerian AIDS activists said Lambo's drive to increase the number of people receiving these life-enhancing drugs 13-fold in one year was unrealistic and unachievable. “Regarding the situation we face, this plan is not realistic, it cannot just work,” said Mohammed Farouk, executive director of AIDS Alliance in Nigeria, an influential non-governmental organisation. Farouk told IRIN that the government’s existing plan to provide cheap drugs for 10,000 adults and 5,000 children living with AIDS throughout Nigeria was already inadequate and under threat from delayed funding and poor organisation. He noted that few ARV drugs were available outside the commercial capital Lagos and that stocks were always scarce. Nevertheless, Lambo said the Federal Executive Council, a government budget planning committee, had approved the $248 million plan to extend ARV treatment to 200,000 people next year and an ad-hoc committee would be set up to collect the necessary funds from donors. US President George Bush has launched a $15 billion aid programme aimed at helping 14 countries to fight HIV/AIDS over a five-year period. This Presidential Emergency Plan for AIDS Relief (PEPFAR) has allocated US$58 million to Nigeria this year, half of which will be channeled through faith-based organisations. PEPFAR has not yet announced how much it will provide in 2005. The Global Fund has been even more generous, granting US$70 million to Nigeria this year. But likewise, it has not yet indicated how much it plans to give the country next year. Lambo said the $248 million would not just be spent on ARV drugs, which can improve the quality of life of people living with AIDS and improve their survival rate, but which cannot cure the disease. The money would also be spent on training health workers, providing preventive counselling and expanding AIDS testing facilities, he said. Mpele said UNAIDS and the World Health Organisation (WHO) would back Nigeria's efforts to raise the necessary funds from donors. “The government, with our support, is scaling up the HIV/AIDS treatment plan to reach one million people living with AIDS by 2009, within the context of the 'three by five' initiative,” Mpele told IRIN. This global initiative by WHO and UNAIDS aims to provide antiretroviral therapy to three million people with HIV/AIDS in developing countries by the end of 2005. “Real efforts are being made and the improvement of the Nigerian situation will have positive repercussions throughout the region,” Mpele added. Nigeria is Africa's most populous country with an estimated 126 million people. Of these, more than six million are officially estimated to be infected with the HIV virus that causes AIDS and around one million would benefit from ARV treatment. Beneficiaries of the government's current ARV programme are charged just over US$7 per month for treatment, whereas they would have to pay between $25 and $72 to buy the same medicines at commercial prices The latest annual sentinel survey in Nigeria, released in May, showed that the HIV prevalence rate had declined to 5.0 percent from 5.8 percent in 2003. However, the survey, based on the voluntary testing of pregnant women attending ante-natal clinics throughout the country, forecast that the HIV prevalence rate would increase over the coming five years.