Director General of the National Agency for Control of AIDS, Dr Temitope Ilori, speaks in this interview with Sade Oguntola about Nigeria’s steps to revitalise the HIV response and to end HIV as a public health threat by 2030
How do you intend to bring HIV awareness back to the consciousness of every Nigerian?
Actually, this is part of our recent familiarisation tour to Oyo State. We want to create awareness that HIV/AIDS is still with us. The national HIV prevalence is around 1.3 percent, compared to 4.2 percent in 2018. So there’s been a significant improvement. However, HIV/AIDS still affects our most productive population, which is the youth between the ages of 15 and 45. This is why we have to increase awareness about HIV/AIDS to ensure that people stay safe and to reduce the number of people contracting the virus. We will go about this with a multisectorial approach. NACA was established to coordinate the multisectoral response to HIV, including the non-health response. We are talking to our religious leaders, traditional leaders and youth associations on HIV so that they can educate the people they lead.
Of course, our health workers have been trained and retrained. We will go on air, including using social media and traditional media to reach out to the youth and the general population at large. Also, we will not neglect the key populations. These include commercial sex workers, men having sex with men, people who are using injectable drugs, and, of course, pregnant women. Studies have shown that Nigeria unfortunately has the highest burden of children born with HIV, and we want to reduce this prevalence.
What are your plans to ensure increased local funding for treatment and drugs, particularly with the low earning power of many Nigerians?
We appreciate the efforts of President Bola Tinubu and, of course, all our partners and funders that have been helping us in this national HIV response. As a government, in the 2024 appropriation bill, we have some money to procure drugs in addition to that supplied to us by our different funders. Still, we continue to appeal to the federal government to continue to provide more money so that we can purchase these drugs. Our goal ultimately is to sustain the national HIV response. So we want the government to continue to appropriate enough funds to ensure that we can do this.
Today, all HIV drugs being used in the country are imported. We do not have any local production of HIV drugs and test kits, but we’re already talking to WHO-certified manufacturers so that we can start local production of these commodities. Do you know what this means? These commodities are going to become cheaper, which will bring employment and improve Nigeria’s Gross Domestic Product (GDP).
Figures on HIV for Nigeria are missing from the UNAIDS website. Many people visit the website for data regarding HIV in many countries. How do you intend to resolve this?
UNAIDS, one of the agencies under the United States of America, has been Nigeria’s good supporter. I do not know why the figures are not there. We are doing a scheme titled “getting the data right.” Just about last year, we were quoting 2.1 million Nigerians living with HIV/AIDS. We’ve gone ahead to verify some of this information through retesting at the hospitals, community-based testing, and the use of finger prints. We are also verifying those who are coming to pick up medications. Very recently, the figures have dropped, not because people stopped having HIV, but because we realise that maybe some were double counted and there were other technical issues like that. So, as of today, we’re quoting between 1.6 million and 1.7 million Nigerians living with HIV/AIDS. But that process is still ongoing, and very soon it will be perfected to give us a very precise figure of how many people nationally are living with HIV/AIDS.
Talking about your strategic plan, tagged ‘alignment 2.0,’ what is it all about?
‘Alignment 2.0’ is a new business model that includes the issue of ownership of the national response, raising domestic resource mobilisation for HIV treatment, and also having the local content of HIV treatment and response. We know there may be donor fatigue, and support from our international partners may dwindle. Therefore, we are looking at taking ownership of the national response at all tiers of government, including at the ward committee level. This is trying to take ownership of the testing, the drugs, the treatment, the support system, the counselling, and all that.
A part of this new business model includes local domestic resource mobilisation through partnerships with the private sector. A trust fund was actually launched by former President Muhammadu Buhari, which was then led by the private sector, including banks and industrious philanthropists. The trust fund has not been active, but we intend to leverage it and take this forward.
What are some of the key areas you want to work on to achieve the 2030 target for HIV?
The global target is a political declaration that says 95:95:95, and that means 95% of the general population should know their HIV status because they’ve tested and know if they’re negative or positive. Then 95 percent of those that are positive should be on treatment, and 95% of those on treatment should actually have viral suppression. What that means is that the virus in their blood is so low that it is undetectable when they are tested, and because of that, they will not be able to transmit it to their spouses, co-workers, or even to their unborn children.
Similarly, the global target is to ensure that by the year 2030, HIV is no longer a public health threat. That infers that we would have achieved epidemic control of HIV/AIDS. In Nigeria, we’re working towards that, and part of the strategies to ensure that, is the multi-sectoral response. We are working with sister ministries, departments, and agencies of governments on different issues like stigmatisation and discrimination and passing out information in a bid to meet these targets. And like we said, the issue of transmission from mother to child is also very key; it is a priority area for us.
So we’re working on ensuring that every pregnant woman is tested for HIV, and I use this medium to enjoin our mothers and our women to please ensure that they book in a hospital or setting that has trained or skilled birth attendants that can deliver, and then get tested and be on treatment. Like I emphasised, if you are compliant with your medications, then your viral load will be so undetected that you will not pass the virus to your baby. We have quite a number of children born with HIV; they are doing well because they are on treatment. We have some in their twenties and so on, and they’re doing very well both academically and physically.
HIV is a twin sister of diseases like TB. How are we bringing on board the other opportunistic disease in a bid to end HIV as a public health threat by 2030?
We have the HIV, malaria, and TB committees both at the national level, and this has been stepping down to the state level. The coordinating minister for health, Professor Ali Pate, and also the honourable minister for state for health, Dr Tunji Alausa, are quite passionate about this. So, we are working in collaboration with our international and local partners to make sure that there’s an integration of many of these issues. A state-wide approach to this was launched by the federal ministry of health, and it is all in a bid to integrate the treatment of many of these common ailments so that everything is under the same roof and we’re not duplicating efforts but using existing structures to get the best results.
At the state level, challenges such as the nonfunctional State Agency for Control of AIDS (SACA), inadequate quantity of test kits, and lack of funds for operations for many SACA programmes have been identified. How are you resolving these?
Well, it’s part of why I paid an advocacy visit to the states, starting with Oyo State. SACAs are actually launched by acts of parliament, and we enjoined and implored state governors to actually make resources available for this agency. But at the national level, we also locate funds for the SACAs to ensure they carry out their mandate of coordinating the HIV response at the state level.
What are the advancements in HIV research and treatment globally that you are looking forward to implementing going forward?
Research is ongoing on the treatment of HIV; new drugs are coming up, and, of course, recently injectables for HIV treatment were made available. It is taken monthly, and it solves the complaints of pill burden or taking drugs every day. We don’t have that in Nigeria, but it will be available very soon. We are discussing with partners; we are working towards that, and of course, there are so many other ongoing studies on treatment, but most of them are still at the clinical stage. But I assure you that Nigerians will not be left out of the gains on research on new treatments for HIV, even as the agency is working towards Nigeria achieving epidemic control of HIV/AIDS and ensuring that the virus is no longer a public health threat to every Nigerian. Our goal is to ensure that everyone stays and lives healthy.
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