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REVERSING THE TIDE: NIGERIA'S HIV RESPONSE AT A CROSSROADS

Nigeria's HIV response has made significant strides in recent decades, driven largely by donor funding. The introduction of antiretroviral therapy (ART) has slowed the progression of HIV to AIDS, and the "Undetectable = Untransmittable" (U=U) campaign has raised awareness about the importance of viral suppression. Furthermore, many females living with HIV who adhered to their treatment regimens have given birth to HIV-negative babies, a remarkable achievement in the fight against HIV. However, despite these gains, the government's lack of commitment to domestic resource mobilization has raised concerns about the sustainability of these efforts. With the US government's recent review of its foreign aid, the HIV response in Nigeria is facing a critical juncture.


The recent US waiver for HIV treatment for millions of persons living with HIV is a welcome development. However, it is imperative to recognize that the HIV response extends far beyond treatment and access to ARV. Nigeria needs to look inward for a more sustainable approach, one that prioritizes domestic resource mobilization and addresses the complex social, economic, and cultural factors driving the epidemic.


CHALLENGES AHEAD

1. Funding Uncertainty: The pause in US interventions has created a sense of pandemonium in the HIV response, with many activities relying heavily on donor funding.

2. Poverty and Economic Challenges: Poverty is driving people to engage in risky behaviors, including transactional sex, while limited access to condoms exacerbates the problem.

3. Drug Use and Risky Behaviors: The high prevalence of drug use among youths, coupled with associated risky behaviors, is fueling the transmission and spread of HIV.

4. Lack of Awareness and Sensitization: Insufficient awareness and sensitization activities, particularly among children and adolescents, are leaving them vulnerable to HIV infection.

5. Patronage  and nepotism resulting in Inefficient Resource Use: patronage and nepotism are  hindering the effective use of resources meant for HIV interventions, undermining the response.


WAY FORWARD

1. Declare a State of Emergency: The President of Nigeria, Bola Ahmed Tinubu, should declare a state of emergency in the HIV response to mobilize urgent action.

2. Domestic Resource Mobilization: The government must prioritize domestic resource mobilization to ensure the sustainability of HIV efforts.

3. Stakeholder Collaboration: All stakeholders, including government, civil society, and the private sector, must come together to address the HIV response with a unified approach.

4. Increased Awareness and Sensitization: Awareness and sensitization activities should be scaled up, particularly among children and adolescents, to prevent new infections.

5. Addressing patronage and nepotism : These  must be tackled head-on to ensure that resources are used efficiently and effectively.


The time to act is now. Nigeria cannot afford to reverse the gains made in the fight against HIV. With collective action and a renewed commitment to domestic resource mobilization, Nigeria can get its HIV response back on track and achieve its goal of ending AIDS by 2030.


Dr. Bright Oniovokukor,

South-South Zonal Coordinator 

For: Chairman Governing Council, Civil Society for HIV/AIDS in Nigeria (CiSHAN)

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