This is a question that I have asked myself severally for many days since Saturday 10th January 2015 when I convened an interactive meeting with a section of media to brainstorm about 2015 and Nigeria’s Health Sector. Till today I could not find the answer, not even closer to the answer as I meander from one pole to another in my mind jostling many options. On that day two of the discussants were the ever energetic Edward A. Ogenyi National Coordinator and Samaila Garba Public Relation Officer of the Network of PLHIV in Nigeria (NEPWHAN) respectively. They informed the gathering that the group has a membership of 1,030 and their intervention was to reinforce their message with evidence that many of their members have stopped treatment due to demand for payment for consultation, consumables, lab tests, enrolment etc. They informed us that in many centers enrollment now cost N5000, consultation cost N2000 and drug pick up – N1000 per month and equally people living with HIV/AIDS are now asked to pay for laboratory test and consumables which hitherto all these were free as covered by the joint effort of international development partners and Nigerian Government.
Nigeria has over 600,000 people living with HIV/AIDS that are supposed to be on regular drugs, majority can’t afford these services. What is the implication? Many will or have already stopped treatment which will surely worsen their condition, weaken their immunity and increase morbidity and chance of death. Iam really sad with this development. How did we reach this stage? Iam wondering that we haven’t anticipated that international donors for HIV/AIDS may withdraw their support or reduce their funding. Are we saying as a Nigerian government we cannot cater for free drugs for People living with HIV/AIDS?
On 1st December 2014 to mark World AIDS Day Health Reporters did a special features about the plight of People Living with HIV/AIDS (https://healthreporters.info/2014/12/01/world-aids-day-3rd-november-nepwhan-protest-cry-too-loud-to-forget/). Some of the issues raised are worth buttressing here. On November 3rd, The Network of People Living HIV/AIDs in Nigeria (NEPWHAN) had protested and barricaded the premises of National Agency for HIV/AIDS Control insisting that members can’t afford to pay for drugs and more children are becoming positive. Over 300 People living with HIV stormed and shut down NACA office in protest of neglect and inadequate funding which led to deaths of many people from AIDS. In their placards were comments like “we are tired of attending funerals of our members” “our children are becoming infected, why take the drugs after our delivery” “save our souls give us drugs” “nothing for us without us” and some pregnant women asked “who takes care of my positive child when I die?”
The story narrated that from October 1st People living with HIV began paying N12, 000 a year for laboratory tests at one HIV clinic. This November, some members said another center where some 23,000 people seek treatment , begin charging patients N5,000 for registration, N2,000 for consultation, N8,900 for laboratory evaluation, N2,900 for lab follow-up, and N1,000 to pick up drugs. Ezinne Nwosu, a positive pregnant mother at the scene of the protest was full of tears , she said, “we pay too much to access these drugs” Nwosu who travelled from Abia State to Abuja to join the protest with hopes of accessing Drugs , before going back to her state is pessimistic of what may be the status of her unborn child, having missed her drugs for three months, because they were not available in her community, a little village she called, “Omoba” in Isi-Ala Ngwa, Abia State. 10 months old Samuel has tested positive already, his mother, who called her name Jane, said she stopped taking ARV prophylaxis after his birth, she did not breastfed but “somehow he is positive, I don’t know why” She was worried of the pediatric care the child could get.
In a widely circulated email recently the NEPWAN Coordinator Edward Ogenyi observed that “It is unfortunate that people living with HIV/AIDS are passing through the ugly experience of paying for HIV/AIDS related services (laboratory tests, consultation, enrollment, drug pick-up etc). You will recall that these ugly experiences was part of the reason for the conflict between NEPWHAN and NACA in 2014. During the conflict, the Secretary to the Government of the Federation – Senator Pius Anyim and UNAIDS Country Coordinator – Dr Bilali intervened in the matter with the hope that NACA will work closely with NEPWHAN to address some of the immediate challenges. But regrettably, negotiations and decisions on HIV/AIDS treatment are done without the involvement or participation of people living with HIV/AIDS.” He also lamented that “most of the HIV support groups are being sent to extinction because of lack of funding for their primary mandates, cannot afford to pay for treatment of opportunistic infection and are abandoned to face the consequences—-to worsen the situation, clients are now made to pay for HIV/AIDS related services and those who are unable to pay have no option than to face death.”
It is time for well-meaning Nigerians including the leadership of NACA and Federal Ministry of Health and development partners rise up and find a solution to this debacle. We must approach this problem to find a short term remedy and also on the longer term how will drugs be available.
- Can we explore the 50% funds that will be available in line with National Health Act to the National Health Insurance Scheme (NHIS) to include HIV/AIDS drugs and insures all people living with HIV in need?
- Can we establish an HIV/AIDS Fund via a public/private sector partnership?
Please more ideas and suggestions from any one as we confront this calamity.
1st published in Daily Trust Newspaper on 20th Jan 2015 by Dr Aminu Magashi Publisher Health Reporters (firstname.lastname@example.org)