National Coordinator’s speech to the Press
Date: Monday, 30th November, 2020
Immaculate Platinum Hotel, Abuja
I am delighted to address the world today at this Press Briefing, as part of NEPWHAN’s 2020 World AIDS Day event.
1st December every year is a special day set aside globally to celebrate humanity for its capacity to mobilize goodwill and political commitment to halt the carnage of death, caused by HIV/AIDS to those who fought with their lives to ensure that we, living with HIV have access to life-saving anti-retro-viral drugs.
This special day is an opportunity to harness the power of social change to put people first and close the access gap. Ending the AIDS epidemic by 2030 is possible, but only by closing the gap between people who have access to HIV prevention, treatment, care and support services and people who are being left behind. Closing the gap means empowering and enabling all people, everywhere, to access the services they need, and most importantly putting the patient community at the center of our interventions.
With the prevalence of people living with HIV at 1.3%, the incidence of HIV has dropped slowly in recent years. We have seen above 1 million people accessing affordable and effective HIV treatment, and AIDS-related deaths have been reduced by more than half since 2004 when it was at the peak.
However, we have still not gotten to the bottom of this public health challenge in Nigeria because, Nigeria has not achieved the 2020 target goals of UNAIDS, which aims to diagnose 90% of all HIV positive people, provide life-saving anti-retroval therapy (ART) for 90% of those diagnosed, and achieve viral suppression for 90% of those treated by 2020. Available data shows that from 2010 to 2019, Nigeria only reduced by about 10% of HIV new infections, where about 293 adults become newly infected every day. If we are to achieve epidemic control by the year 2030, we must take responsibility by coming up with targeted HIV testing program, such as self-testing, awareness creation at community level (through sensitization and community dialogue meetings) in order to mobilize people to get tested, which is Nigeria’s theme for this year: “United to End AIDS in the Midst of COVID-19, Get Tested.
We recognize that there is much to do, as reaching those who, to date, have been left out of progress, is difficult. We also recognize that we need to be bold in our new policy, and demonstrate the resolve to take on the increased risks involved in reaching those who are left behind, while acknowledging and planning for the costs of this efforts.
In the context of vulnerability to HIV and AIDS, this will challenge us to ensure that those individuals and groups who are discriminated against, who are marginalized by virtue of their social and economic status, their sexuality or their gender, are not left behind. And this brings us to the global theme of this year’s World AIDS Day – Global Solidarity and Shared Responsibility, which for me, is Leaving No One Behind.
We urgently need to build a strong and resilient health system, which is integrated, people-centered, gender sensitive and rights based. Lack of investment in health has exposed a lot of countries, and so, we need to urgently build our epidemic preparedness capacity to enable us beat the next health security challenge via pandemics and epidemics. This will help us to sustain the gains we have made in the HIV response in the past years. As you already know, Nigeria is not on track to meet the fast-track 90-90-90 targets, even without COVID-19, and so, we need a renewed sense of urgency to redouble our efforts to address the dual and colliding impact of COVID-19 and HIV pandemics. We also need to have innovative and sustainable health and HIV financing strategies to eliminate the catastrophic cost on our vulnerable households. Out of pocket cost borne by Nigerians is about 71%, and this is unacceptable. We, therefore, welcome the Basic Health Care Fund instituted by the Government of Nigeria (GoN) which will strengthen the health insurance scheme to absorb basic health cost via pooling of risks. We also need to link the impact of humanitarian crises and HIV responses, especially in the North East of Nigeria.
We need to go granular and focus on the right populations and geographic areas with the greatest unmet needs for HIV prevention and treatment. We need to eliminate societal and structural barriers that drive the HIV epidemic. We must remove all punitive laws and policies, undertake law reforms which decriminalize key populations, reduces stigma and discrimination, and protects the human rights of PLHIV and key population, as well as eliminate inequalities associated with gender, gender-based violence and socio-economic inequalities. We have always talked about elimination of user fees to enable PLHIV and KPs, including women and girls have access to essential HIV services, which include sexual and reproductive health services they need.
To put the communities and networks at the centre of the response if we want to end the AIDS epidemic as a public health threat by 2030 is not in contention. This, however, requires that we have a tailored differentiated service delivery models to meet the different needs of PLHIV. Having community-based organizations plan, design, implement, monitor and evaluate programs allows for full ownership. Having communities and networks deliver services also allows for implementation of rights-based and gender- sensitive programs from the perspective of learned experiences. Peer supporters, mentor mothers are peer-led initiatives that put human face to the HIV response. Patient literacy, adherence support and tracking of lost-to-follow-up are critical ingredients for attaining sustained viral suppression. Having key populations support service delivery at One Stop Shops (OSS) ensure quality services are delivered, mental health issues are identified and addressed appropriately. Their meaningful involvement allows for critical services, such as condom programs, PrEP and HIV self-test services to be streamlined broadly into the OSS. In short, having communities lead services allows for identification of key barriers to the delivery of quality services, and to hold duty bearers accountable.
We need to be bold, to be brave, and to be out there in our efforts to tackle the formidable obstacles that stand in the way of providing HIV services to those who need them most. These are all qualities abundantly demonstrated by some of our formidable partners, especially FHI360, UNAIDS and NACA. The leaders of these great organizations have consistently stood with the people living with HIV and key affected populations in Nigeria.
With the advent of Corona Virus in Nigeria, the National COVID-19 Multi-sectoral Pandemic Response Plan was developed by the Presidential Task Force on COVID-19 with 10 pillars. Under the pillar on Epidemiology and Surveillance, led by the Nigerian Centre for Disease Control (NCDC), is the component of “community surveillance” and the use of health care workers and community volunteers to sensitize community members, and intensify contact tracing. In response, the UN System developed the one UN COVID-19 Response that is also structured around the 10 pillars of the Government plan. It further established the one UN Basket Fund for COVID-19 in Nigeria, of which NEPWHAN was identified as a potential community led organization of people living with HIV to lead and own the Community-led Monitoring (CLM) of COVID-19 and HIV response in Nigeria. This is financed through UNAIDS, and NEPWHAN is currently working in 15 States of the country.
As Nigeria works towards achieving national and global targets, as well as the sustainable development goals, community led monitoring becomes critical in all spheres to ensure the gathering of evidence, rapid response to red flags, improved quality and impact of services, and accountability at the programmatic and policy levels. This level of monitoring ensures community leadership and empowerment for sustainable response to HIV and COVID-19, and can be used as a catalyst in the management of other health programs.
It is within this context that NEPWHAN has commenced the implementation of the community-led monitoring initiative in Nigeria, by collecting quantitative and qualitative data amongst people living with HIV, key populations (MSM, FSW), women, girls, and people most at risk for HIV and COVID-19 infections. The responses will inform NEPWHAN’s advocacy campaigns to influence changes in policies and practices.
While we look forward to continued collaboration, working and partnering with everyone working for the interest of people living with HIV (PLHIV) and ending HIV by 2030, I want to appeal to all our donors, most especially PEPFAR and the Global Fund, to continue supporting the Nigerian Government to fight HIV and COVID-19. Let me state this emphatically, though COVID-19 is here with us, it should not reduce funding to fight HIV. I am also calling on the Government at all levels in Nigeria to increase their commitments in the fight against HIV and timely release of capitals to NACA and the Federal Ministry of Health to achieve their obligations.
Distinguished ladies and gentlemen, thank you for listening.