Nigeria, with an estimated population of 160 million, ranks second to South Africa in the factsheet on countries with people living with HIV and AIDS worldwide, representing nine percent of the global burden of the disease.
By Jacinta Nwachukwu and Franca Ofili
According to a recent report of the National Population Commission (NPC), Nigeria has put in place a sentinel surveillance system among pregnant women in the 15 to 49 age bracket, attending antenatal care, to track HIV prevalence since 1991.
The Demographic and Health Survey 2013 report says that new HIV infections in the country are fuelled by low perceptions of personal risk, multiple and concurrent sexual partnerships, intense transactional and intra-generational sex.
Also, ineffective and inefficient treatment services for sexually transmitted infections (STIs), inadequate access to health care services as well as poor quality of health care services are some of the factors responsible for the increase in new infections.
As part of efforts to increase public awareness of HIV issues, the United Nations (UN) designated Dec. 1 as the World AIDS Day to raise public awareness across the world about the issues surrounding HIV and AIDS.
The theme for World AIDS Day 2014 is “Focus, Partner, Achieve: An AIDS-free Generation’’.
The day presents an opportunity for people worldwide to unite in the fight against HIV, show their support for persons living with HIV and memorialise those who have died.
As part of efforts to actualise the objectives of the campaign against HIV and AIDS, stakeholders examine strategic plans aimed at reducing new HIV infections via Prevention of Mother-to-Child Transmission of HIV (PMTCT) strategies.
Dr Abiola Davies, a UNICEF HIV Specialist, said that Nigeria accounted for one third of new HIV cases among children in the world.
Her words: “Nigeria is among countries with slow mother-to-child transmission decline. This is responsible for the country accounting for one third of the new HIV infections among children worldwide.’’
Davies said that infant infection rate in Nigeria had not changed much since 2009, insisting that the country must improve on its ownership and coordination of HIV and AIDS programmes, particularly at the state level.
She, however, called for the decentralisation of Prevention of Mother-to-Child Transmission (PMTCT) services, empowering the Primary Health Centres (PHCs) to carry out such services.
Besides, Davies solicited the increased involvement of the organised private sector and private health facilities in the fight against HIV and AIDS.
She attributed some of the challenges facing PMTCT programmes to pregnant women’s lack of access to PHCs and the paucity of health workers.
Prof. John Idoko, the Director-General National Agency for the Control of AIDS (NACA), however, identified inadequate funding, poor coordination and lack of supervision as the major challenges facing efforts to eliminate mother-to-child HIV transmission (eMTCT).
He said that the eMTCT programme was aimed at eliminating the transmission of HIV from mother to child during the pregnancy, childbirth and breastfeeding stages.
Idoko recalled that in 2001, the focus of the eMTCT programme was on the prevention of mother-to-child HIV transmission, adding that the programme was then implemented in a few tertiary health institutions across the country.
“Poor monitoring and evaluation of eMTCT services, poor government supervision, lack of integration of HIV care in reproductive health services and poor infant feeding counselling services also hamper the exercise,’’ he said.
He also said that there was no early infant diagnosis in children hospitals and eMTCT centres because of inadequate funding and weak health systems.
Idoko stressed that estimated number of infants exposed to HIV via mother-to-child transmission annually stood at 85,450, while the estimated number of HIV-positive infants without intervention each year was between 67,620 and 121, 716.
“While HIV prevalence rate in antenatal clinics stands at 4.6 per cent per annum; not less than 1,857,616 pregnant women are tested for HIV every year,” he said.
On the strategies put in place to reduce new HIV infections, Idoko said that eMTCT outlets had been increased to 5,622 across the country in 2014, with services available in tertiary, secondary and primary health care facilities.
He, however, noted that the Federal Government had launched a Presidential Comprehensive Response Plan to tackle some of the challenges facing the eMTCT programme.
“The government had also allocated funds from the Millennium Development Goals (MDGs) Office to improve eMTCT services.
“Again, a National Strategic Framework and a Health Sector Strategic Plan had also been developed with a target plan to address these challenges from 2010 to 2015,” Idoko said.
Also speaking, Mr Sola Ogundipe, the National Coordinator of Journalists Alliance for Prevention of Mother-To-Child Transmission of HIV in Nigeria (JAPiN), an NGO, said that the group would strengthen efforts to articulate a sustainable PMTCT policy for Nigeria via advocacy.
He underscored the need to sustain existing HIV programmes and urged the media to disseminate more human angle stories on how to prevent new infections in children.
He said that the group would explore new frontiers of effective communication as a crucial component of the national response to the growing challenges facing mother-to-child HIV transmission.
Ogundipe pledged the readiness of JAPiN to partner with organisations interested in promoting effective and sustainable PMTCT policy and legislation in Nigeria.
A member of the group, Mrs Bimbo Amosun, an Editor with Federal Radio Corporation of Nigeria (FRCN), identified the stigmatisation of persons living with HIV and AIDS as a hindrance to the HIV/AIDS campaign.
“Although the issue of stigma is reducing, we need to do more to help expectant mothers who are infected to access the HIV treatment so as to enable them to have babies who are free from the virus,’’ she said.
Speaking on the campaign against HIV and AIDS, Mr Geoffrey Njoku, UNICEF Communication Specialist, said that the organisation had concluded plans to disseminate messages on HIV through video streaming for long distance travellers.
He said that UNICEF would collaborate with journalists in efforts to carry out the PMTCT campaign.
Njoku said that a movie titled “Born Free’’ had been produced as a public awareness tool on PMTCT to ensure effective communication, particularly at the grassroots.
“This film would be disseminated through various platforms to reach a large audience with especial focus on the 12+1 states.
“We will make use of mass transportation companies that move large numbers of passengers across the country every day, including women and girls of child-bearing age.
“Some of the vehicles are equipped with audio visual facilities for airing movies,” he added.
Njoku said that the video would also be shown at community viewing centres and cinema halls where people watched football matches, adding that the film would also be viewed at places such as restaurants, drinking joints and recreation parks.
Analysts, however, agree that the adoption of pragmatic disease-prevention strategies will aid efforts to achieve zero new HIV infections in the country.
They, nonetheless, concede that HIV and AIDS programmes in Nigeria have received a boost through the efforts of the government and development partners, leading to the upgrade of HIV prevention, care, and treatment schemes.
They also note that the monitoring and evaluation system has been strengthened; while there has been a perceptible increase in HIV research.
All in all, the analysts insist that the success of the fight against HIV and AIDS will depend on the structured implementation of well-articulated HIV prevention and management programmes across the country.