Ending AIDS in 2030: How achievable for Nigeria?

BEFORE 2003, there was progression in the incidence of HIV/AIDS in Nigeria. Records show that from 1991 – 1999 the HIV prevalence increased from 1.8 percent to 5.4 percent. It dropped to 4.1 percent in 2011 and further dropped to 3.8 percent in 2013. Nigeria is currently treating 800,000 people living with the virus with Anti Retroviral (ARV) drugs. Currently the number of people living with HIV that are on Anti Retroviral Therapy increased from 359,181 in 2010 to 747,382 in 2014. Regardless of all efforts, Nigeria still accounts for 55 percent of the new HIV infections in West Central Africa Region (WCAR), and with 3.4 million people living with the virus, the nation is rated as the country with the second highest burden of HIV in the world after South Africa. More worrisome is the increasing number of infected women and children, and the fact that most of the children infected with the virus contacted it from their mothers. A 2014 survey showed a decline in HIV cases among pregnant women who attend antenatal clinics to 3.0 percent compared to 4.1 percent in 2010, but 10 percent of HIV infections are still as a result of mother-to-child transmission.

Of these, 154,920 new infections are in children out of an estimated 281,180 new infections and data shows that about 229,480 pregnant women are HIV positive annually. The high morbidity and mortality associated with pediatric HIV infection has virtually eroded most of the previous gains towards elimination of mother-to-child transmission in Nigeria. Worse still, the high prevalence of HIV among pregnant women, high total fertility rate, culture of prolonged breast feeding, and non-use of modern health facilities for antenatal and delivery purposes have contributed to the high rate of mother-to-child HIV transmission in the country. Nigeria has found herself in this precarious state as a result of socio-cultural issues such as preference for Traditional Birth Attendants (TBAs) instead of orthodox health facilities. Gaps in coordination of partners and underutilization of maternal and newborn services contribute to the challenges. The way forward for Nigeria is to be guided by the new UNAIDS target of 90:90:90, which is to ensure that 90 per- cent of the global population are tested for HIV, 90 per cent of those who test positive have access to treatment and for 90 per cent to be virally suppressed.

The current drive to eradicate HIV/AIDS by 2030 as part of the Sustainable Development Goals is instructive. Government agencies at all levels in Nigeria must review the visibility of eliminating HIV/AIDS with a view to integrating it into the broader Maternal and Newborn and Child Health agenda. The argument for closer relationships between managers of HIV and AIDS control agencies and other stakeholders at the national and state levels cannot be overstated. Tackling the root causes of vulnerability to HIV/AIDS remains the sure way to achieving the goals, even while creating strategic local funding initiatives and sound monitoring mechanism for transparency. Nigeria can only achieve elimination of mother-to-child HIV transmission through proper legislation, realistic policies and adequate resource appropriation.