Antiretroviral scheme draws poor response

A programme to provide subsidised treatment for people living with HIV/AIDS in Nigeria got underway in April after a months-long delay, but so far it has had a poor response from the over three million people infected nationwide, hospital sources said.

Under the scheme, which is novel in Africa, 10,000 infected adults and 5,000 children are to receive treatment thanks to a subsidy of over 80 percent. A cocktail of generic drugs obtained by the government at US $90 per person is being provided to patients at less than US $10. The drugs come from CIPLA Limited, an Indian pharmaceutical company.

The ultimate target is to provide treatment for 10,000 adult people living with HIV/AIDS in 100 hospitals across the country in the first year of the scheme, Shehu Suleiman, permanent secretary in Nigeria's federal ministy of health, said. Another aspect of the treatment programme is aimed at stopping mother-to-child transmissions of HIV. It takes off on 14 June, he added.

But figures collected by the ministry by the middle of May showed that only about 800 patients had registered for the treatment in 25 hospitals designated for that purpose across the country of over 120 million people.

"Some of the hospitals had only about 10 patients reporting, only a few had more than 20 people registered," a senior official of the National Institute for Medical Research, which coordinates the programme, told PlusNews.

Some HIV/AIDS activists blame the low response on the deep-seated stigma attached to the disease in Nigeria.

"The treatment scheme requires that patients go public with their HIV/AIDS status by coming to the designated hospitals to register," Dupe Onitiri, who is involved in the campaign to reduce HIV/AIDS transmission, told PlusNews. "Perhaps the response would have been much better if a confidential treatment programme was being run."

Others feel additional costs may be discouraging people from joining the programme. For instance, participants are required to pay for a series of tests to determine the most suitable doses of the cocktail of drugs for them. Each test costs about US $40, plus a US $10 administrative fee.

"Few people can indeed afford these expenses in a country where the minimum monthly wage is less than $30," Dr Ben Ezeobi, of the Lagos University Teaching Hospital told PlusNews. The hospital is one of the treatment centres.

With most of the drugs due to expire by March 2003, there is a danger the scheme may miss many of its targets. However, senior Nigerian health officials said they were aware of the problems and had plans for periodic reviews of the scheme in order to make adjustments and keep it on course to fulfil its objectives.