[afro-nets] HIV/AIDS, civil society and the three ones in Nigeria

[Uzodinma]

HIV/AIDS, civil society and the three ones in Nigeria
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Nigeria recorded her first official AIDS case in 1986. Twenty years later, the national prevalence of 4.4 percent is an improvement, an indication that the number of cases of HIV/AIDS had since skyrocketed. 

Generally, the major areas of concern in the management and coordination of the control of the HIV/AIDS scourge in Nigeria include Private Sector involvement, Service Delivery, Policies and Guidelines, Program Management and Leadership, Models of Care, Human Resources, Community Involvement, Laboratory Services, Public-Private Partnership, Drug Supply and Management, Cost of Providing HIV Services, ARV Drugs, Staff Salaries, Staff Training, Monitoring Tests, Laboratory Equipment, Screening and Confirmation Tests, etc.

Before the advent of the new democracy in 1999, HIV/AIDS control suffered neglect and was fragmented. Since 1999, government has placed high HIV/AIDS priority on prevention, treatment, care and support, as the disease has yet got no cure. As a result, HIV/AIDS activities have received a high level of political commitment and donor support.

In recognition of the need to scale up a multi-sectoral response from government and civil society, the Nigerian government established the President?s Committee on AIDS and the National Action Committee on AIDS (NACA) within the Presidency, and the National AIDS and Sexually Transmitted Disease (STD) Control Program (NASCP) within the Federal Ministry of Health.

Then, NACA?s primary responsibilities were centered on the execution and implementation of activities under the government?s HIV/AIDS Emergency Action Plan (HEAP), introduced in 1996 as a bridge to a long-term strategic plan. NASCP was responsible for managing the health sector?s response to the epidemic, within the Department of Public Health of the Federal Ministry of Health (FMoH). Its primary responsibilities were centered around formulating and disseminating national health sector HIV/AIDS policies and guidelines as informed by a series of nationwide stakeholders (including civil society) meetings; providing training and technical support to state and local government AIDS control programs, health care facilities, and development partners; and facilitating the procurement of antiretroviral (ARV) drugs for the government?s existing ?plan of action for broad access to anti-retroviral drugs.? 

The potential impact of a bourgeoning HIV/AIDS epidemic was eloquently frightening to both the government and civil society. It became necessary to scale up the HIV/AIDS response in Nigeria and improve ART program management and financing through the engagement of the civil society and major stakeholders to develop a National Strategic Framework to prioritize programming areas, define resource requirements, ensure financial sustainability, and set program performance measurement. NACA became the national coordinating authority while an acceptable, affordable and effective monitoring and evaluation system was put in place. An umbrella body, the Civil Society on HIV/AIDS in Nigeria (CiSHAN) was also established by civil society organizations involved tin the ?struggle?. There is also the NEPWAN ? the Network of Persons Living with HIV & AIDS in Nigeria. Nigeria was/is on the match to ?fighting AIDS to finish?.

Civil Society involvement has ensured more transparent and accountable utilization of all resources as the basic watchword. The civil society members have also committed themselves to inviting the Police, Economic and Financial Crimes commission (EFCC) and the Independent Corrupt Practices Commission (ICPC) to examine any such issues that compromises transparency and accountability, to ensure that the watchwords are upheld. The Foreign Affairs Ministry in collaboration with NACA and civil society continues to intensify and widen foreign bilateral relations in order to bring the attention and generosity of donors to HIV/AIDS control in Nigeria.

With a three tier federal system of government comprising federal, state and local governments, the ?Three Ones? effort seeks to enable NACA to have the political authority to coordinate the activities of key government line ministries, parastatals, private sector and civil society institutions which are manifestly important for effective national and sub national responses to the pandemic.

In 2006, the civil society joined NACA to pursue the enactment of a legislation to improve NACA?s capacity to deliver on its mandate. This resulted in the passage of the NACA bill by both chambers of Nigeria?s bicameral legislature, and ultimate assenting by President Olusegun Obasanjo. One fall-out of this was the re-naming of the National Action Committee on AIDS (NACA) to National Agency for the Control of AIDS (NACA). It is expected that this would strengthen NACA?s ability to continue to spearhead the realization of an effective 3-ones regime, by strengthening and repositioning the Agency to improve on its coordination function, beginning with the implementation of its new organizational structure, recruitment of key staff and provision of logistics, and more involvement of the civil society. Guidelines have been prepared to provide similar coordination mechanisms in Nigeria?s thirty-six states and Federal Capital Abuja; and in the 774 Local Government Areas (LGAs)
in the country, including all relevant stakeholders and civil society at each level, in order to ensure effectively coordinated and regular monitoring and reporting from the LGAs and States, to the federal level. 

Suffice it to record that Nigeria produced a ?National Policy on HIV/AIDS? in 2003, a ?Rapid Assessment of HIV/AIDS Care in the Public and Private Sectors? in 2004, and the ?Nigeria HIV/Aids National Strategic Framework 2005-2009?. This is truly commendable. Civil society and stakeholders are recognized and being involved, as much as can be, and more progress in the implementation of the 3-ones in Nigeria are expected in the months and years ahead.

It is imperative that NACA should factor the limitations in the financial and logistics capacities of the civil society members/groups, into its entire ?Three Ones? activities. The need for support to the civil society in this regard, can never be overemphasized. The civil society can and should do more, but needs more support and encouragement. Quietly but sure-footedly, Nigeria is ?fighting HIV/AIDS to finish?, and NACA is leading the way, with the support of the civil society.


References:
Adirieje, UA (2003). HIV/AIDS Care: Beyond ARVs and Advocacy; Afrihealth Information Projects/Afrihealth Optonet Association
National Policy on HIV/AIDS; National Action Committee on AIDS, Nigeria, 2003
Nigeria: Rapid Assessment of HIV/AIDS Care in the Public and Private Sectors?; Partners for Health Reformplus, Abt Associates Inc., 2004
Nigeria HIV/Aids National Strategic Framework 2005-2009; National Action Committee on AIDS, Nigeria

Better Health for All, 

Uzo?

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Dr. Uzodinma Adirieje
Resource Centre Manager/Project Coordinator, Study of Nigeria?s Massive Roll-out of ART
Health Reform Foundation of Nigeria [HERFON]
10 Sakono Street, Off Adetokunbo Ademola Crescent, Opposite AP Plaza, Wuse II, Abuja, Nigeria
Ph: 2349.4618496, DL: 2349.4818145, Mobile: 234803.4725905, Fax: 2349.5240433
Email: uadirieje@herfon.org, uaadirieje@yahoo.com 
Website: http://www.herfon.org, http://www.nhc2006.org