PARTNERING FOR PROGRESS: TRANSFORMING NIGERIA’S HEALTHCARE LANDSCAPE

   Leopold Zekeng writes that the upcoming visit by some donor partners presents an opportunity for Nigeria to further strengthen collaborations on the health system

 For the past two decades, the collaborative efforts of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM), the US President’s Emergency Plan for AIDS Relief (PEPFAR), and the US President’s Malaria Initiative (PMI) have been instrumental in supporting Nigeria’s battle against malaria, HIV, and tuberculosis. Cumulatively, these programs have invested approximately $11 billion in Nigeria’s response to the three diseases. 

The PMI alone has committed an additional $800 million since its inception in 2011. Together, these global funding partners have bestowed upon Nigeria one of the most substantial country investment portfolios, resulting in impressive achievements in disease control, improved population health outcomes, and enhancements in our national and sub-national health systems.

On the frontlines of HIV/AIDS, Nigeria reported in 2021 that approximately 1.8 million individuals were receiving life-saving antiretroviral treatment while, 6.2 million people underwent HIV testing, 34,000 mothers living with HIV received vital medication to safeguard their lives and prevent HIV transmission to their babies, and about 1.7 million people accessed HIV prevention services. 

These achievements have placed Nigeria among the nations closest to attaining the UNAIDS 95-95-95 epidemic control targets: 95% of people living with HIV knowing their status, 95% receiving life-saving treatment, and 95% achieving viral suppression, reducing the risk of HIV transmission significantly.

In the fight against malaria, Nigeria has distributed 16.3 million mosquito nets, provided preventive treatment to 2.4 million pregnant women, and tested 26.1 million suspected cases for malaria. 

For tuberculosis, Nigeria have treated 5.3 million people and currently provides treatment for approximately 1,600 individuals battling extensively drug-resistant TB.

The impact of these three donor partners extends beyond disease control. They’ve played a pivotal role in improving Nigeria’s healthcare infrastructure, including the establishment of world-class public laboratories, upgrades to central drug warehouses, and the implementation of efficient distribution and supply chain systems. 

These investments were not only crucial in responding to Ebola and COVID-19 but also in supporting agencies like the Nigeria Centre for Disease Control (NCDC), to strengthen service delivery and capacity for perhaps, future pandemics.

The success of these initiatives in Nigeria is as a result of a harmonious partnership with the government and its leadership. Through its political will, the government of Nigeria has created a favorable policy environment, ensured effective coordination, and significantly improved public health outcomes. 

Despite fiscal challenges, the Nigerian government has also participated in funding replenishment rounds for the Global Fund, pledging a total of $95 million to date.

However, the upcoming visit by the leaders of these donor partners, including Mr. Peter Sands, Executive Director of GFATM; Dr. John Nkengasong, Ambassador-At-Large, U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy; and Dr. David Dalton, the United States Global Malaria Coordinator, presents a unique opportunity for Nigeria’s new administration under President Bola Ahmed Tinubu to further strengthen collaborations and a chance to explore ways to build upon these successes.

Specifically, the visit provides an opportunity to expand the scope of Global Fund, PEPFAR, and PMI investments to encompass broader health system development which includes addressing non-communicable diseases such as diabetes, hypertension, and cancer, which remain significant contributors to morbidity and mortality. 

It’s also an opportunity to tackle childhood infections, immunization, pediatric health, and maternal health issues. More so, discussions around integrating Tuberculosis, malaria, and HIV services into Nigeria’s National Health Insurance Authority and implementing compulsory social health insurance are in focus. The ultimate goal is for the government at all levels to gradually take over service delivery responsibilities currently managed by third-party partners, aligning with sustainability goals outlined in discussions like the New Business Model and Alignment 2.0.

This visit and dialogue reiterate the importance of fulfilling replenishment commitments and counterpart funding requirements. 

This will also provide the forum to encourage increased domestic budget allocations for health by leveraging existing donor support, we can further strengthen our healthcare systems and enhance pandemic preparedness, ultimately leading to improved health outcomes for all Nigerians.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. 

UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.

*Dr Zekeng is UNAIDS’ Country Director, Nigeria