Aliyu Gambo: Nigeria Will End AIDS Epidemic By 2030

Nigeria earlier this year, launched a report which showed the prevalence of HIV/AIDS in the country has reduced from 3.5 million persons in 2005 to 1.9 million people by 2018. In an exclusive interview  Martins Ifijeh, the Director General, National Agency for the Control of AIDS (NACA), Dr. Aliyu Gambo said by 2030, Nigeria will be AIDS free.  He also warned employees from asking for HIV tests from their staff, among other sundry issues

What is the situation of HIV/AIDS fight in Nigeria?

We will say the situation is good at the moment. We didn’t know since the last 15 years that we were doing well in fighting the scourge until last year when we did the National HIV/AIDS Indicator and Impact Survey (NAIIS). This revealed that the programmes we have in place are working such that it has reduced the prevalence from 4.4 per cent in 2005 to 1.4 per cent in 2018. This has reduced the estimated number of people we thought had HIV in Nigeria from 3.5 million in 2005 to 1.9 million in 2018.

What does the new NAIIS result mean for Nigeria?

This means Nigeria has done very well and can control HIV epidemics. Right now, we are on the last mile push. When President Muhammadu Buhari released this result earlier in 2019, he urged the stakeholders and NACA to push for the last mile. This means we should work hard to control HIV epidemics in Nigeria, and that is exactly what we are doing at the moment. We are pushing hard to see that we fight stigma and discrimination, make HIV testing attractive, and to ensure people know the benefits of knowing their status, as well as for them to take action.

How has the NAIIS result shaped NACA’s future response to the epidemic?

Our response has been shaped by the NAIIS data. Now we know that we are dealing with an epidemic not as large as we earlier envisaged. We now know the estimated number of people living with HIV/AIDS. So, in terms of planning, we now have enough capacity to plan for 1.9 million Nigerians as against 3.5 million in the past. The epidemic is shrinking, and what we need to do is to make sure it continues to shrink until it is no more.

Making this work well includes using data that has been generated to make informed decisions, and that is exactly what we are doing. We are spreading our wings to achieve this. We have launched in Rivers, Akwa Ibom, and soon we will launch in states like Lagos.

Are there plans to include AIDS care in the National Health Insurance Package?

There are plans to include AIDS care in the National Health Insurance Scheme package.

Can Nigeria Meet 2030 global target to end AIDS?

Yes, Nigeria can meet the global target to end AIDS by 2030 as long as we keep this momentum we presently have. If we keep this energy for the next 10 years, we will attain zero or negligible transmission or zero or negligible death from HIV, and at that point, we will beat our chest and say, yes, we did it.

Stigma is still a major challenge in Nigeria, how are you addressing this?

Stigma is our number one enemy. It has prevented people from testing and from doing something about their status if they test positive to HIV. This is why we are decentralizing NACA offices from the central one we previously have, to six offices; one in each geopolitical zone. The purpose of this is to be vigorous in our campaign against stigma and discrimination, creating awareness on the benefits of testing and treatment. It will help achieve our target of ending AIDS by 2030.

What is your take on employers still asking employees to undergo HIV testing?

This is what we are presently embarking on. We are enlightening employees that HIV has changed from a chronic disease that kills, to that which can be managed effectively just like we manage hypertension and diabetes. Once you take your drugs, the virus is suppressed and then you cannot infect another person, or have the virus destroy your body system. HIV no longer gives body and face the kind of look it previously gives. So, if it doesn’t do that, then why discriminate, and why prevent somebody from being a productive staff, as some may be very intelligent or be the best staff you have, so why put them away?

Will NACA deploy self-test kit to enable Nigerians know their HIV status themselves?

NACA is planning to deploy self-test kits. We will start this with certain communities and then expand. We want to make sure that the test-kits are available, accessible and affordable for people who want to know their status in the comfort of their home, because the essence of knowing your status is to help yourself. Once you realise you don’t  have HIV, you do the needful to remain so for the rest of your life, and if you realise you have it,you get our attention, and then we help to control the virus in you in such a manner that it doesn’t show in your face. With our support, you cannot transmit it, which means technically, we deactivate HIV in you.

Only about 10 per cent of Nigerians have had their HIV test done. How do you increase this?

We are going to be at the community level, work with gate keepers, traditional leaders, volunteers, health workers, people living with HIV or affected by HIV, young people and every segment of the community. We will make sure these communities are mobilized to preach about the fight against HIV/AIDS.

Does Nigeria still heavily depend on donor agencies for funding?

At the moment, yes. Nigeria heavily depends on donor agencies because as we speak, donors take up over 80 per cent of the bill. What the federal government is planning for 2020, is to make a change whereby Nigeria begins to absorb more funding, putting people on treatment and sustaining them on it.

There are still issues of non-availability of ARVs in some government institutions. What is NACA doing about this?

We are not sure of this information because every facility that has been tagged as Anti-Retroviral Drugs (ARV) facility has their drugs, and services are been provided. If there is any facility lacking of drugs or services are interrupted, we want us to be alerted either directly or indirectly, and we will figure out what is going on there

What challenges is the agency facing in addressing HIV/AIDS in Nigeria?

The challenges are stigma and discrimination, people not accepting to get tested, or not doing something about their status if they are positive. Another challenge is funding which should come as much as we need it.

Please comment on the 2020 health budget for HIV/AIDS

The allocation for HIV for 2020 budget has never been this good. It is now very encouraging.  The president graciously approved increment in the amount of money NACA receives. In 2020, NACA will now put additional 50,000 Nigerians living with HIV on the bill of the government. By next year, Nigeria will be treating 100,000 persons instead of the current 50, 000.

Currently, how many people are living with HIV, and how many are on treatment in Nigeria?

1.9 million people are currently living with HIV in Nigeria, our records have shown that about a million people are on treatment. That means 55 per cent of people living with HIV in Nigeria are currently on treatment.

There have been series of HIV cure claims. What is your take, and how should Nigerians respond to them?

The world has passed the stage where you wake up and use people as guinea pigs to show how their body reacts to something. The agreed thing globally now is that when you use human beings for experiment, you must respect three things; principle of autonomy, which means it has to be voluntary, know what they are used for, and its implication. They must know the benefits they are getting. They must know there has to be justice, meaning there is justification for what ever you are doing, and that you are not exploiting or harming them.

That is why products are tested in animals before they are tested in humans. So, if you have your claim, please come, we will help you, and make sure that you follow the normal procedure to verify your claim. If there is any cure claim in Nigeria, and it is now found to be globally accepted, it will be a pride to Nigeria, and an economic advantage for Nigeria.

Can you throw light on the Community Makes the Difference slogan?

The communities of people living with HIV/AIDS, the volunteers, people affected by HIV/AIDS, media, health workers, religious leaders, traditional leaders, people that have healing centres and implementing partners that are out there with their staff, the activist, and other community groups that have made significant contributions in terms of taking this message to the grassroot, have all helped to ensure at least more than half of those living with the virus are on medication. This is very encouraging. We really didn’t appreciate what these communities did until the last year survey which showed the prevalence has reduced from 3.5 million to 1.9 million persons. We will now further work with them to ensure every Nigerian know his or her HIV status and then take necessary action.

Persons living with HIV/AIDS in prison are often neglected. What are you doing about this?

We have started reaching out to the prison management, and we are working together with them to make sure people in the correction centres have access to HIV services, knowing their status, and if found to be HIV positive, have access to uninterrupted medical services.

What is the take home message as Nigeria celebrates 2019 World AIDS Day today?

Every Nigerian should know about his or her HIV status and do something about it. Test if you are HIV negative. If you are, remain so for the rest of your life. If you test positive, it means a new journey has begun. Come to us and we will deactivate HIV in you. We will make sure HIV doesn’t give you the bad look, and it doesn’t leave you to infect your loved ones.