Foreign Funding: PLWHAs, others at the crossroads

THE PUNCH Newspaper- Niyi Odebode

Ibrahim Umoru is apprehensive about what awaits him and other people living with HIV/AIDS if foreign donors withdraw their funding of the response to the pandemic.

Currently, not less than 80 per cent of HIV/AIDS programmes in the country are donor-driven.

The fear of Umoru, the coordinator of the Lagos State branch of the Network of People Living with HIV/AIDS, was worsened on Monday when he went to the General Hospital, Marina, Lagos, to collect his anti-retroviral drugs. Although he succeeded in getting the drugs, he could not do his CD 4 count.

According to him, the centre did not have reagents to carry out the CD 4 count, which is necessary to determine his level of immunity and response to treatments.

He disclosed that the hospital was a site of the Global HIV/AIDS Initiative Nigeria. Umoru said, “It is so painful that Ghain has 15 sites in Lagos and all these sites lack HIV test kits, CD4 reagents and drugs such as cotrimoxazole for prophylaxis.”

Umoru added that the staff of the centre were also not motivated to work. “It is time for states and national government to take ownership of the national response,” he said.

Even now, when the donors have not withdrawn their funding, HIV/AIDS programmmes in Nigeria have hiccups. Umoru and others fear that they may face hard times when foreign funds stop.

With signs that international agencies financing HIV/AIDS programmes in Nigeria may reduce or withdraw their funding because of the global economic recession, the need for the country to fashion out ways of sustaining the national response to HIV/AIDS has come to the fore.

Currently, the fate of people living with HIV/AIDS is in the hands of the donor agencies. For instance, an international funding organisation, Global Fund, has, since 2003, disbursed $400m to Nigeria to fight AIDS, tuberculosis and malaria.

A media officer of the fund, Marcela Rojo, told our correspondent that $800m had been approved for Nigeria to fight the three diseases since 2003. According to her, half of that amount (about $400m) has been disbursed to date.

In a document titled, “Portfolio of grants: Nigeria and the Global Fund to fight AIDS, tuberculosis and malaria,” made available to our correspondent by the media officer, from 2003 to date, the country requested for $669,596,261 to fight AIDS; the agency approved $229,946,468, while $142,149,242 was disbursed.

She explained that the fund was performance-driven. The approved money is not released at once. It is disbursed based on the capacity of each country to meet specific targets set by the GF.

Besides the GF, the United States Government‘s Presidential Emergency Plan for AIDS Relief has committed $1.5bn since 2004 to HIV/AIDS programmes in Nigeria. The amount included $442m spent by the agency in 2009 on the disease in the country.

PEPFAR, which was inaugurated in 2003, is one of the largest donors to the battle against HIV/AIDS. It funds programmes such as prevention, care and treatment as well as support of orphans and vulnerable children.

Not less than 2.99 million people are currently infected with HIV/AIDS in the country. In 2004, only 10,000 people were on ART and it was mostly sponsored by the Federal Government.

With the intervention of foreign donors such as PEPFAR and the Global Fund, the people on ART increased from 10,000 in 2004 to 350,000 in 2010.

Stakeholders, including researchers and health workers are, however, worried that lives of millions of Nigerians affected by HIV/AIDS may be at risk if the donors withdraw their support.

Our correspondent gathered that although the donors had not withdrawn their support, they were limiting the number of people being tested for HIV. This may lead to a reduction in the number of people on ART.

The chairman of fifth National Conference on HIV/AIDS, Dr. Oni Idigbe, in an interview with our correspondent on Tuesday, said that it was time the country took over the funding of the programmes.

Idigbe said, “Eighty per cent of our national response is supported by our donor partners and in the light of the current global economic recession, there are signals that some of the donor partners may either withdraw their support or reduce it.

“We are concerned about what will happen to activities of the donor partners if they withdraw their support. If these people go, how do we fill the gap that will be created?”

Idigbe, a former Medical Director of the National Institute of Medical Research, said that as part of efforts to address the problem, all stakeholders would meet in Abuja between May 2 and 5 to discuss issues relating to HIV/AIDS.

He said that the country should reduce its reliance on foreign donors to ensure that HIV/AIDS programmes were sustainable. Idigbe disclosed that the US government had already instructed that its programmes should be handed over to indigenous non-liability corporations.

According to him, although PEPFAR will not end its programmes abruptly, it will reduce the number of people being tested. He explained that if the number of people being tested is reduced, enrolment for ART may not increase drastically.

“It is not an abrupt withdrawal. PEPFA has said that a patient on ART should continue getting treatment. If the US government is giving patients treatments, such patients are given drugs throughout their lifetime. We have been assured of this,” he said.

Idigbe added that there was the need to decentralise access to ART. According to him, treatments of HIV/AIDS are currently concentrated in urban and semi-urban areas. “There is the need to ensure that people can access treatment in primary health centres in rural areas,” he said.

Also, in an interview with our correspondent, the Vice-Chairman of the conference, Dr. Ernest Ekong, said, “Country ownership is the core area of concern in the world of HIV/AIDS right now, as there are no funds the way they were a few years ago.”

He said that there was a need for donor partners, researchers, clinicians, policy makers and researchers in the country to address contemporary issues on HIV/AIDS and the national response to it.


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