HIV/AIDS
HIV/AIDS is an epidemic in Africa
Source: UNAIDS (www.unaids.org)
Nigeria is Africa’s most populous country with a population of 140 million (NPC, 2006). She has over 373 ethnic groups (Ajaegbu et al, 2000) spread around the country. The major indigenous languages are Yoruba, Igbo and Hausa/Fulani. However, English is the official language in the country. In addition to the human resource, Nigeria is endowed with a lot of other natural resources, the major ones being crude oil, bitumen and agricultural products.
The country is a Federation, operating a 3-tier governance system at the National, State and Local Government level. It has 36 states including the Federal Capital Territory and 774 local government areas. For ease of administration and accelerated development, the states have been divided broadly into six geopolitical zones namely North East (NE), North Central (NC), North West (NW), South East (SE), South South (SS) and South West (SW). Interestingly, the HIV and AIDS coordination also takes along the governance structure.
The country lies on Africa’s west coast and occupies 923,768 square kilometers of land bordering Niger, Chad, Cameroon and Benin. The country is currently under a democratic government for a third consecutive term of 4 years each after about 30years of military rule. The emerging economic and political reforms arising from the democratic rule since 1999 have made significant impact in the health, financial, transport, environment and agricultural sectors etc.
This is re-affirmed in the 2007/2008 Human Development Report (HDR) which placed Nigeria on number 158 out of 177 countries with a Human Development Index score of 0.47. The score looks at a triple combination of life expectancy index (0.359), education index (0.648) and the GDP index (0.404).
The first case of AIDS in Nigeria was reported in 1986. Since then, HIV prevalence has steadily increased from 1.8% (1991) to 5.8% (2001) and a slight decline to 4.4% (2005). See Figure 1. Although the prevalence rates appear low, Nigeria ranks third in terms of the actual number of people infected with HIV after India and South Africa. Wide variations in HIV prevalence have been observed across states and rural-urban localities suggesting that there are sub-epidemics within an epidemic.
The response to AIDS during the military administration was characterised by denial. However, the advent of democratic rule in 1999 brought about a significant change in the attitude of government to the epidemic as well as the response to it. In 2000 a Presidential Committee on AIDS (PCA) and NACA were established and tasked to develop the HIV/AIDS Emergency Action Plan (HEAP), a multi-sectoral blueprint, in 2001. The HEAP served as an interim Action Plan to respond to the epidemic through a multi-sectoral approach covering the period 2001 to 2003. The HEAP focused on three major areas: creation of an enabling environment through the removal of socio-cultural, informational and systematic barriers to community- based responses; prevention; care and support. The revised HIV/AIDS Policy which was adopted and launched in 2003 entrenched the multi-sectoral approach and highlighted the need for the formation of a statutory agency to replace NACA which functioned as a committee. The National Action Committee on AIDS (NACA) has been legally transformed into an Agency for the Control of AIDS through an Act of Parliament in 2007.
A review of the national HIV/AIDS response in 2004 pointed to the need for a new and more comprehensive plan that included treatment. Therefore, the National Strategic Framework (2005-09) was developed through a widely consultative and participatory process. The document was officially launched on 11 October 2005 by Secretary to the Government of the Federation. As at now, all states have derived State Strategic Plans (SSPs) from the NSF that take into account their unique peculiarities.
Nigeria developed her roadmap for scaling up towards Universal Access to HIV prevention, treatment, care and support in February 2006. The consultative process identified obstacles and proffered solutions to each of the seven key thematic areas for scale up. National targets for Universal Access were developed and endorsed by all stakeholder constituencies in 2007. Currently, all State Strategic Plans have incorporated the Universal Access roadmap and targets.
Coordination and management are the core for an effective national response to the epidemic. The national response in Nigeria, in line with the country's federal constitution is coordinated through a three-tier system of administration led by the NACA, SACA and LACA. Despite some impressive responses in some states, not all states have effective SACAs and LACAs. Capacity and membership of most of the coordinating entities at state and local government areas still needs strengthening to ensure an effective response.
+ Download full 2008 UNAIDS Nigeria Country Progress Report
