Sustaining Strategies on Elimination of HIV and AIDS beyond



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By Shittu Ahmed Obassa

A report by UNAIDS in 2010 listed Nigeria as one of the 33 countries in the world, and the 22nd nation in Africa, where the HIV incidence had declined by more than 25 per cent between 2001 and 2009.

Further to this, the UN General Assembly’s Special Session Country Progress Report says that HIV situation in Nigeria had improved due to greater attention by government even though with varying degrees of commitment in terms of political will and funding.

Experts say that in a100 males and females 26 males and 24 females now have comprehensive knowledge about mode of transmission, myths and prevention methods, adding that the rate of HIV prevalence on the national average is about 3.6.

Ananlsts say that the Human Immunodeficiency Virus (HIV) has remained the greatest health concern since it was first detected in the United States of America(USA) among men sleep with men(MSM) in the 80’s and has killed several millions in the last three decades owing to the apparent failure to find a universally acceptable cure for the dreaded disease.

A renowned Nigerian  physician, Prof. Shehu Umar, once observed that  HIVand AIDS  have had serious impact on the development efforts of Nigeria and further threatens  the nation’s effort at achieving the Millennium Development Goals(MDGs) by 2015.

Health analysts say the research into the pandemic has only succeeded in developing new modes of prevention and making treatment less toxic and expensive for the already infected.

Nigeria’s response to  the spread of HIV  include the repositioning itself  towards  achieving Universal Access to HIV services via  the establishment of  the National Action Committee Against  AIDS(now National Agency for the Control of AIDS) in 2001.

NACA was first headed the stewardship of  Professor Babatunde Oshotimehin as its pioneer Director-General who in his stride repositioned NACA to coordinate HIV prevention and treatment, care  as well as support for the victims.

The agency has also been coordinating all HIVand AIDS programmes in collaboration with  the foreign donors towards the  prevention of the adolescent and young people who are at the greatest risk of contracting the first type of Human Immunodeficiency Virus(HIV) and the  Prevention  of Mother to Child Transmission(PMTCT) among other responsibilities.

Recently,  HIV prevention among the adolescent and the  young people were issues of discourse at the 2012 UNICEF’s  review and planning meeting held in Kaduna, with participants drawn from nine states and the Federal Capital Territory. The other states were Kaduna, Katsina, Kebbi,  Kogi, Kwara, Niger, Sokoto and Zamfara.


The meeting sought to take stock of the new information on situation of children and women in the states and the federal capital territory as well as review any resulting implications for the country programme of the United Nations Children’s Fund (UNICEF). This is for the purpose of identifying the next year’s priorities.

Under the guide of the UNICEF Specialist in charge of Children and AIDS, Dr Idris Baba, participants looked at the various strategies including demand creation through the mass media that are driving the programme components such as PMTCT,and HIV prevention with the adolescents  and young people. In each of the programme components factors such as enabling environment, demand and supply and quality of servcie being rendered  were key.

And, under the enabling environment the highlighted issues included social norms, budgeting constraints (i.e no cash backing syndrome), absence of coordination of the relevant  activities to make the desired impact. In respect of quality of service being  rendered, there have also been  encumbrances such as social and cultural barriers( especially language barrier  in interpersonal communication), dearth of capable hands , lack of counselling skills among designated  service providers.

A major strategy  is the use of the members of  the  National Youth Service Corps (NYSC) and the various NYSC secretariats have indicated  significant efforts at building the capacity of the trainers of  Peer Educators and those mentored in and out school system.

While deliberate efforts were made at documenting the figures in respect of the Peer Educators Trainers(PETs) both in male and female categories from the NYSC camps and those Peer Educators(PEs) mentored in the schools, statistics of those in the disadvantaged group were not made available during the brainstorming session.

The figures submitted  by  the Coordinator of  PETs and PEs in Kebbi, Mr Rasheed  Zakari were as follows: 7, 949 males and 3425 females mentored as PEs in 15 schools. Out of this figure, 10 schools were urban based while five were in the rural areas. These PEs had their mentoring from 152 male and 96 female PETs .

In  Kaduna State, Gobe Elias’s report showed that 143 male and 82 female corps members mentored 1, 927males and 2, 293 females in unspecified number of schools. According to him, one of the PETs, Febisola Daramola, posted to Kubau Local Government Area, built one block of two classrooms and wrote a book on a Sexually Transmitted Infection (STI) called Heptitis B.

From Kogi, the coordinator,Mrs Aminat Abikoye, said that 1,855 male and 1, 816 female PEs  got mentoring from 124 male and 94 female PETs. She also  noted that one of  the PETs in her state   renovated  a science laboratory during her service year.

In all, 1,923 PETs mentored 74, 124 PEs  in nine states  including the FCT.Of these figures 39,258 males and 34, 866 females were in the latter category.

With the concerted effort of all stakeholders, the fight against HIVand AIDS in Nigeria is on the upswing towards  the sixth Millennium Development Goal (MDG) emphatic on halting the pandemic from getting beyond 2015.

As 2015 approaches,  other efforts are  now being geared towards consolidating the gains achieved through several strategies. One of these efforts is the recent formation of a non-governmental organization, named Journalists Alliance for Prevention of Mother to Child Transmission (JAP). Mr. Sola Ogundipe is the National Coordinator and his deputy is the Managing Director of Kaduna State Media Corporation(KSMC) Mrs Tamani Yusuf. In September, 2012, JAP held a workshop in Calabar on the need to strengthen their advocacy as a strategy that will ensure that babies are henceforth born free of HIV.

In the words of Ogundipe, “The workshop is aimed at strengthening the advocacy role of JAP with the ultimate intention of influencing and attaining an effective and sustainable Prevention from Mother To Child Transmission (PMTCT) policy and legislation for Nigeria.”

According to him, government should own and sustain the HIV prevention programme as donors are showing fatigue and withdrawing their resources.

“We as a country must look inwards for funding”, he said.

Other participants  who expressed their views after the workshop promised to create more awareness on mother to child transmission especially in the rural areas.

Mr David Diai,  the Publisher of Flashpoint newspapers in Delta, told the News Agency of Nigeria (NAN) that there had been lack of information on the transmission among the rural dwellers.

“The country has not created more awareness on PMTCT because the media has not lived up to its responsibility in that direction.

In order for the media to live up to  the expectation of demand creation, Kaduna State Agency for the Control of AIDS (KADSACA) in collaboration with the C field Office of UNICEF organized a two- day workshop for health reporters and editors in Kaduna.

At the end of the workshop held in August 2012, the participants identified the specific strategies to adopt so as to be able to fill the gaps in the fight against HIV and AIDS in the state as well as the Federal Capital Territory.


These include drama series, reporting maternal and new child health week as well doing necessary follows on the activities of health facilities, documentaries, phone-in programme in the electronic media with medical experts, discussion programmes involving religious leaders and traditional rulers,  publishing human interest stories as well as community dialogue.

Kaduna State is among the very first states to address the issue of stigma and discrimination in the fight against HIV and AIDS. The state government has taken the initiative to put in place a work-place policy as well as a law promulgated on June 6, 2011.

The policy document titled,Kaduna State HIV and AIDS Workplace Policy seeks to eliminate stigma and discrimination in both public and private sector workplaces in order to reduce the effect and transmission of HIV/AIDS  in the society; to increase access of workers to preventive, treatment, care and support services; to foster behavior change among workers and empower them to adopt appropriate behaviour that prevents further transmission of HIV in workplace and the community; to provide adequate support for workers infected or affected by HIV and AIDS and to build the capacity of workplace management and workers in handling HIV and AIDS  related issues. Rights, benefits and compensations of workers under the policy have clearly been spelt out.

The state governor, Mr Patrick Yakowa says, close to  400,000 persons are living with HIV, making Kaudna one of the states with highest burden of infection in the North West Zone of Nigeria.

According to him, the state effort at combating the pandemic is being challenged by  stigma and discrimination being directed persons living with HIV and AIDS among whom are many workers

Recognising that the worker is the most important factor in the production chain the government of Yakowa  collaborated its development partners, the civil society organisations, the private sector and the network of people living with HIV and AIDS to comme up with  at this policy that will guide the prevention of HIV and AIDS and the management of its impact in the workplace.

The 13-page document has been premised on international conventions and agreements including the International Labour Organisation Code of Practice on HIV/ AIDS and the World of Work and at the same time it is complementary to the 1999 Constitution of Nigeria, the National Health Policy, labour laws and other national and states policies and laws regarding the rights and dignity of workers and development  and corporate existence of Kaduna  State.

The policy says HIV infection in itself does not constitute lack of fitness and therefore should not be used to determine the suitability of a person for employment in Kaduna State.

Kaduna State Law No.4 of 2011 is titled A Law to Protect Persons Living with HIV/AIDS in Kaduna State 2011. The government has even gone ahead to gazette it so as to give it the needed legitimacy  to be quoted in a competent law court.

Under this law, Section 11(a) says Any employer or person who engages in any discriminatory practice under this Law is guilty of an offence and upon conviction shall be liable to a term of imprisonment of less than 3 months or one hundred thousand naira fine or both; and if a corporate body whether public or private , it shall be liable to a fine of five hundred thousand or imprisonment of its directors to a term three years or both.

Section 11(b) states Any Employer or person who has been found of discriminatory practice shall in addition to a term and /or fine also refund to the employer all arrears of wages unlawfully deducted.

The purpose of the law is to prohibit all forms of stigma and discrimination against people living with HIV/AIDS in Kaduna and for other matters connected there with. Both the policy and the law have come into force at a time that discrimination and stigmatization against workers with HIV have been discouraging the disclosure of ones HIV status.The stigma and discrimination are also said to discourage people from seeking care, treatment and support in the state.

Health analysts say that Kaduna State has been turned into a haven for the people living with HIV and AIDS, adding that it is imperative for both the policy and the law to be given the widest publicity in the mass media for the benefit of the entire society.

In furtherance of the initiative of  the present administration in Kaduna State  to reach out to as many citizens and residents as possible, KADSACA  has started publishing a magazine called KADSACA News Magazine. The first edition  of it saw the light of the day in September 2011.

Health analysts say this kind of multiple approach to the eradication of HIV and AIDS should be replicated across the country.

Obassa writes from Abuja  

 


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