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NACA, others intensify push for improved cases
From Fred Ezeh, Abuja
As Nigeria joins the rest of the world to celebrate the 2024 World AIDS Day on Sunday, December 1st, 2024, with the theme “Take the Rights Path: Sustain HIV Response, Stop HIV among Children to End AIDS in Nigeria by 2030”, the National Agency for the Control of AIDS (NACA) has raised concerns about the possibility of Nigeria meeting the 2030 global target of ending HIV/AIDS.
The Agency said its recent records indicated that more children are contracting the disease, an indication of serious gaps in the Prevention of Mother-to-Child Transmission (PMTCT) services in the hospitals.
NACA Director General Dr. Temitope Ilori had told journalists last week that Nigeria has an HIV prevalence of 1.4 per cent among the general population (15-64 years), with an estimated two million people living with HIV, of which 1.6 million are on antiretroviral treatment.
She added that Nigeria has continued to face a significant challenge in preventing mother-to-child transmission of HIV, making reference to the UNAIDS 2023 report which shows that approximately 160,000 children aged 0-14 are living with HIV, with 22,000 new infections and 15,000 AIDS-related deaths occurring each year.
She registered deep concern that despite the progress made in the fight against HIV, the PMTCT and paediatric HIV coverage remains low at 33 per cent, which is well below the 95 per cent target.
She said the target was to ensure that more cases are detected and brought into the treatment pool, so they can lose the ability to transmit the virus to others, thus achieving the 2030 global HIV target.
“2018 HIV/AIDS survey gave us clearer data and guidance for the response against the disease. Though we have not been able to conduct another survey on HIV/AIDS because of funding, we are doing something close to that in the states, to have a good and updated knowledge of HIV in Nigeria.
“However, the 2024 World AIDS Day will be another opportunity to raise awareness and consciousness among local and global leaders on the 2030 global target for HIV, and the need for improved funding and support,” she said.
National Coordinator of the National Hepatitis, HIV/AIDS, and STIs Control Programme (NASCP), Dr. Adebobola Bashorun, in his submissions at the launch of a newly developed toolkit for improved quality Early Infant Diagnosis (EID) services across healthcare facilities managing paediatric HIV, a few months ago in Abuja, said that Nigeria has made early gains in the fight against HIV/AIDS considering the 2030 global target.
He, however, said that the situation of paediatric HIV is worrisome, and should be a source of concern for all Nigerians, especially as the country prepares for the global target of ending epidemic control of HIV/AIDS by 2030.
He confirmed that Nigeria is not doing too well regarding HIV coverage among paediatrics, but in terms of national coverage among adults, the country is doing well. “It’s a known fact that the majority of people with HIV are adults. So, the paediatric cases among the population need to get more attention, starting with case finding.”
He said: “A system called the Paediatric and PMTCT Retention Care Programme, which focuses on case finding, treatment, and strengthening the PMTCT component of the treatment, was recently established, and positive results are expected.
“But based on data, prevalence among children is 0.1 per cent. For adults, it’s about 1.3 per cent. This is a huge number when compared to our population, which is over 200 million. So, the target is 0.0 per cent for children, which is achievable through collective effort, particularly in case finding and linkage to treatment.
“Having an HIV-free generation is very much possible. The target is to identify every child with the disease and place them on treatment. But the bigger target is to prevent further transmission to unborn children through the effective PMTCT programme. To this end, the EID programme is an effective way of achieving that.”
Similarly, a few months ago, an HIV advocacy group, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), launched a newly developed toolkit for improved quality EID services, which contained Standard Operating Procedures (SOPs) for several stages of paediatric HIV responses, and was recommended for all healthcare facilities involved in handling paediatric HIV cases.
The Foundation advocated for a family-centred approach to tackling the myths and other related issues of HIV/AIDS among children. It stressed that such an approach has proven to be efficient and effective in responding to paediatric HIV cases, thus giving them a sense of love and belonging as opposed to stigmatization and discrimination.
EGPAF Country Director, Dr. Avese Torbunde, explained that the toolkit was developed based on experiences and activities of the Foundation in Rivers and Taraba States through the EID Point of Care project supported by Johnson and Johnson and other partners.
She maintained that the involvement of family members with unconditional love and care from them would help to neutralise the myths and misconceptions associated with HIV treatment in Nigeria.
She added: “This approach and other measures were adopted in response to paediatric HIV cases in Taraba and Rivers States, where the Foundation carried out several advocacy and response projects.”
Meanwhile, there has been an observation of a growing silent fight and quarrel in many Nigerian homes and families, with marriages also being threatened as a result of the increasing number of children, surprisingly, testing positive for HIV and Tuberculosis (TB).
The development has caused deep suspicion among couples about who could have infected the child(ren) with such “deadly” diseases or how they might have contracted the disease, even when some of the parents are unaware of their HIV status.
Stakeholders involved in HIV response in Nigeria are concerned that such developments could affect the chances of Nigeria meeting the global target of epidemic control of HIV/AIDS by 2030.
To this end, they advocated for rapid change to case finding, particularly the EID, PMTCT services, and, most importantly, managing family crises that could arise thereafter.
An investigation by Sunday Sun revealed that many of the HIV-positive children might have contracted the virus through their parent(s) or a third party, who might have kept their status secret from the children, while subjecting the children to daily consumption of drugs that would, expectedly, suppress or maintain the already suppressed viral load.
