By Doris Obina and Henry Uche
As the world grapples with the COVID-19 pandemic, other diseases seem to have been overlooked. Among them is the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), which is gradually becoming a forgotten ailment, probably because it does not kill people living with it as fast as the coronavirus.
Director-general of the National Agency for the Control of AIDS (NACA), Mr. Gambo Gumel Aliyu, in this interview, highlights NACA’s efforts to put the scourge at bay.
Attention seems to have been diverted since the COVID-19 pandemic struck; what has NACA been up to?
NACA has been up and doing in the fight against HIV/AIDS by implementing our mandate. We have done extremely well during the pandemic and have recorded huge results we had never recorded before. We are passionate and optimistic to achieve our mission to the letter.
What about the $2.4bn investments to identify and treat an additional 540,000 people living with HIV/AIDS to reach the Joint United Nations Programme on HIV/AIDS (UNAIDS) target for epidemic control in the next three years?
So far, so good; we are on course. As you know, HIV/AIDS is largely funded by donor agencies, especially international bodies like the United States government and the Global Fund. Nigeria is contributing less than 10 per cent at the moment, and this contribution is what we are increasing on an incremental basis every year.
We have this agreement with them that, every year, we shall take an additional 50,000 people living with HIV/AIDS from the total number they are treating to add to our number, right now, we have 100,000 patients and they’re treating 1,400,000 people living with HIV/AIDS. So, every year, we take 500 persons from that number and add to ours and pay with our (Nigeria’s) money.
How would this $2.4bn investment budget be met?
The $2.4bn is an estimation we needed to reach where we have targeted to be. In order to achieve the 95-95-95 initiative of the United Nations, where 95 per cent of people living with HIV know their HIV status; 95 per cent of people who know their status are on treatment; while 95 per cent of people are on treatment with suppressed viral loads, and we are on track. United States government alone is investing this year over $400,000,000, you know global fund is investing over a $100,000,000 this year and the government of Nigeria is contributing its part.
How much has Nigerian government invested so far?
Over the last one year, the Nigerian government invested about a $100,000,000, and a 50,000,000 persons are needed to be tested annually, but now the figure has been reduced because, when we did the estimation, we never knew we would identify such a huge number over the last 20 months. So, with that projection, we may need to reduce the number and test below 50,000,000 persons to reach the range of 1,800,000 to 1,900,000; because, right now, we have 1,500,000. Remember the annual incremental number is 50,000 to 60,000 every year. In the last two years, we identified 350,000, which is more than five times the number we identified every year.
How feasible is NACA’s target to end HIV/AIDS by 2030?
It is very feasible. We are not mincing words. In 18 months, as I said earlier, we have identified an additional 350,000 on treatment. In another 18 months, if we identify another 350,000 persons, we are done, we have reached the control level. Once you reach the level, that is the first step. You have to reach the control level first, that is the condition. We have to control HIV first before we can end it. So, the control level is supposed to happen in 2025, but here in Nigeria we are very hopeful that this control level target will happen in 2022.
What about HIV/AIDS infrastructure used for COVID-19 pandemic control.
Yes, the HIV/AIDS infrastructure was used initially for COVID-19. For instance, the labs, they were used to hit the ground running in Nigeria when we identified the virus early last year, just to help control the pandemic. Fighting viruses is encompassing.
Why has HIV/AIDS awareness dropped?
It is because the COVID-19 pandemic is the talk of the town now, probably because of how quickly it terminates life, but HIV/AIDS has been on in the last 40 years and we talk about it every day. If you want to know the level of awareness of HIV/AIDS, meet citizens in the street and ask them when last they checked their HIV status, they would tell you they saw some people on TV talking about it.
It’s very simple. The mandate of NACA is to control HIV and provide sustainability structure to sustain the control efforts.
As said earlier, our timeline is 2030.
How common are false negatives and false positives?
It’s not very common; it’s possible because these tests are supposed to be highly sensitive and highly specific. Depending on what goes in there, the most important thing is the prediction, for instance, what is the probability that when one tests HIV positive, the person really has HIV?
How accurate are in-home- HIV tests?
Yes I can assure you, they’re accurate. One can use it because they have high sensitivity and specificity. Whenever one uses it, and the results turn out positive, that is alone is non confirmatory, one has to come to the facility for a repeat of the test to ascertain most accurately that one has HIV. So it’s very important we adhere to it.
Many people living with HIV in the rural area do not have access to HIV facilities… how…(cuts in)
Yes, it’s true, but they can access us through the number 6222 from anywhere in the country. They can get us, it’s toll free and the communication is in any indigenous language in Nigeria. By this, we carry everyone living with HIV along. And our response is swift.
We must reiterate to Nigerians that NACA is on top gear to end HIV, and we have given it the fight it deserves. The challenge before is sustainability of this fight, and to do this, we must conscientiously convince people to check and know their HIV statuses, and if anyone is positive, he /she should do something urgently by accessing the life saving treatment, because that would help to keep the virus in check.
Also, we shall make sure that the virus doesn’t kill the person. You can see people don’t discuss HIV /AIDS again because it doesn’t show on the face, but it’s there right inside the body of people, but they chose to keep mute and (maybe) unconsciously transfer it to those who don’t have it. It’s our mandate to ensure that HIV does not move to those who don’t have it. So we are working on denying HIV the opportunity to leave from people that have it to those who do not have it. We want it to remain only for those who have it. That’s our responsibility. And if one is negative, one should remain negative for the rest of one’s life. That’s the contribution we have.