Eliminating Mother-to-Child Transmission of HIV in Nigeria

Despite Nigerian Government’s target to eliminate mother-to-child transmission of HIV by 2016, over 60,000 children are still being infected yearly in the country. Odimegwu Onwumere writes on need to tackle the scourge head on

60,000 Nigerian children are infected with HIV annually

A fair skin-tone pregnant woman expected to be in her mid 20s refuses to give her name or where she resides as this writer accosts her in June this year for an interview at a hospital in Port Harcourt, the capital of Rivers State.

All that she could say was that she’s tired of taking HIV drugs and would not bother about the status of the unborn child even as her doctors were counseling her to the contrary.

Her stance was without a doubt one of the reasons that formed the view of the then Dr. Goodluck Jonathan-led federal government to launch the national elimination of Mother-to-Child Transmission of HIV (eMTCT) Plan 2015-2016, in Abuja, on November 13, 2014.

In spite of this, there’s a bloodcurdling data of January 2016, suggesting, “Nigeria currently accounts for 55 per cent of the new HIV infections in West, Central Africa Region (WCAR), and with 3.4 million people living with the virus.

“Nigeria is regarded as the country with the second highest burden of HIV in the world after South Africa. Currently, an estimated 60,000 new HIV infections are recorded among children in the country yearly.”

Regardless of this, the National Agency for the Control of AIDS (NACA), described the launch of eMTCT, as being in affirmative with the Global Plan towards putting out HIV infections among children by 2015, as according to a statement by a Director General of NACA, Prof John Idoko.

Idoko said: “Achieving the eMTCT is inextricably linked with and directly contributes to the Millennium Development Goals (MDGs), especially MDG 3 (gender equality), MDG 4 (reduced child mortality), MDG 5 (improved maternal health) and MDG 6 (combat HIV/AIDS).

“This positions eMTCT as an important part of the maternal and child health and the overall development agenda… You are aware that the President’s Comprehensive Plan For HIV/AIDS (PCRP), was launched in 2013 and this marked a major commitment by the government to accelerate the implementation of key interventions against HIV, including eMTCT.”

Upon the ‘germane progress’ the government said it recorded in the purging of Mother-to-Child Transmission of HIV, Jonathan was yet befuddled about the transmission from mother to child. He hinged his fears on the fact that the scourge had gone out of the control of the health sector and had drastically endangered the economies and developmental hard works of many countries in the world that included those in sub-Saharan Africa.

“With over three million people living with HIV, Nigeria has one of the highest burdens of HIV in the world. It is a matter of concern that more than half of the people living with HIV in Nigeria are women, and young people, within the productive age group,” Jonathan said in 2014.

According to him, “The 2010 National Sentinel Survey for pregnant women attending antenatal care in Nigeria recorded a HIV prevalence of 4.1 per cent, while the population survey carried out in 2012 observed a HIV prevalence of 3.4 per cent. Only about 61 per cent of pregnant women attended antenatal care in 2013 and only 36 per cent delivered in health facilities.”

But for another pregnant woman, Margret James, 30, taking her drugs is a routine thing she has not failed to do. James speaks out that her consciousness was built after the initiation of the eMTCT Plan 2015-2016. However, James is expected to deliver a child free of HIV through the birth canal, not Caesarean Section (CS), her doctors say.

For Lucy Iwho, 35, her three children were born HIV-negative. She says that she detected her status earlier and has been conscious with her drugs, good diet and nutrition.

During the event of 2014, upon that Nigeria Government said that it was committed to the execution of the plan to eliminate Mother-to-Child Transmission of HIV by 2016, it was yet afraid to realise the plan by crying out loud that support from international partners had flattened in the last three years.

Government was at a point skeptical of some international partners plodding and pulling-out of funding aid for some facets of HIV services in the country. This formed the views of Jonathan, saying, “I, therefore, call on government at all levels, the private sector and civil society organisations to support the federal government in sustaining a robust response to HIV in Nigeria… Together we shall end the AIDS epidemic among children.”

The presidency nonetheless did not solely rely on international donors; there was the release of fund for the implementation of the President’s Comprehensive Response Plan for HIV and AIDS (PCRP). But on November 30, 2016, the government of Muhammadu Buhari through the Federal Ministry of Health developed another National Operational plan for the Elimination of Mother-to-Child Transmission of HIV (2017-2018), cried about lack of funds amongst others that characterised the programme.

The Assistant Director, HIV/AIDS Division, Ministry of Health, Dr. Deborah Odoh, disclosed this at the National Conference on HIV Prevention in Abuja. According to her, the programme was aimed at curtailing the spread of HIV by 2030. It was observed that in the bid to end the Prevention of Mother-to-Child Transmission (PMTCT) of HIV, it was marred by speculations that the initiative had to address the availability of Anti-Retro Viral (ARV) drugs for HIV positive pregnant women, said the source.

Checks revealed that “Nigeria had been one of the first to adopt each revision of guidelines recommended by World Health Organisation (WHO)… and wanted to use available resources to reach more pregnant women with the WHO recommended Option B alternative” since the PMTCT started in 2002.

According to Odoh, “We are intensifying efforts to source funds in order to bridge the gap created by the dwindling resources and support for PMTCT services in Nigeria. Advocacy to governors, lawmakers, the Ministry of Finance and the Ministry of Budget and Planning is being carried out by the Minister of Health to ensure that key activities are captured in the 2017 budget.’’

In his bid, Jonathan wanted Nigeria to be like Cuba where the World Health Organisation in July 2015, acknowledged as the first country in the world to eliminate Mother to Child Transmission of HIV, eMTCT, and syphilis. According to media reports, “WHO Director-General Dr Margaret Chan recognised that the elimination of transmission of a virus is one of the greatest public health achievements possible.”

But in 2011, the government of Jonathan said that it recorded germane progress in the purging of Mother to Child Transmission of HIV. Dr. Jonathan as President said that the number of HIV counselling and testing sites augmented from 1,357 in 2011 to 7, 075 in 2013 while 8, 202,124 people were tested for HIV and they knew their statuses.

Through the Subsidy Re-investment Programme (SURE-P) and other programmes, the Jonathan government initiated Health Systems Strengthening in order to realise the elimination of Mother-to-Child Transmission of HIV in the towns and villages of the country.

The government said it partnered with international bodies for the realisation of the scheme. Yet, those who know better say that Mother-to-Child Transmission is on the rise in 2017.