Nigeria working towards ending HIV/AIDS by 2030 – NACA DG – Punch Newspapers

The Challenges of Fighting HIV/AIDS and Meeting the Sustainable Development Goals

The Director-General, the National Agency for the Control of AIDS, Dr Gambo Aliyu, speaks to LARA ADEJORO about the challenges of fighting HIV/AIDS and efforts being made to meet the United Nations’ target of ending the disease by 2030

How interesting or challenging has your job been since you assumed office in 2019?

It has been interesting and challenging. It has been interesting in the sense that one is called upon to contribute to the national response to Human Immunodeficiency Virus, which is the work I have been doing for the last 25 years. I have solely been working on HIV nationally and internationally. So, when I was called upon in 2019 to contribute to the country’s response to HIV, I was thankful and humbled to be called upon to contribute my quota. However, in terms of the challenges, it is good to know that the national response coordination is a multi-sectoral activity, which means that HIV is a developmental illness and a disease that has health and non-health components. It has security issues attached to it; it has economic issues attached to it; it has health issues attached to it and it has social issues attached to it. All these sectors are represented. In coordination, you need to bring all the stakeholders on board.

How many are these stakeholders?

These stakeholders include nine ministries. Apart from the Federal Ministry of Health, we have the Ministry of Defence, Ministry of Education, Ministry of Youth and Sports, Ministry of Women Affairs and a lot of line ministries that one way or the other have something to do with HIV, either as a health issue or as a developmental issue. The challenge is bringing everyone together and making sure that you work as a team.

The other challenge is seeing how they work together and how they work to achieve the targets locally and globally. The global target is to see the end of Acquired Immunodeficiency Syndrome by the year 2030. Every country is expected to work towards that and Nigeria is not an exception. We have been working towards that. I find the job very interesting and in terms of challenges, they keep coming every day and we work hard to overcome them.

Late last year, you said there was a decline in new HIV infections from 103,404 in 2019 to 92,323 in 2021. What were the factors responsible for the decline?

As we approach 2030, this is one of the yardsticks to measure whether we are on course to ending AIDS or not. The new infections must be seen to be on the decline and eventually tending towards zero. Some of the responsible factors have been all these things that we have been doing in the past 20 years. We have been working together with the American government, the Global Fund, the United Nations, civil society organisations and the private sector in a concerted effort to see how to get those taps that are running to stop running.

What do you mean by taps that are running?

One of the biggest taps running and we must get it to stop running is the tap of new infections. If you do not stop the transmission, it will be difficult to discuss how you end AIDS, because you will continue to have issues to do with AIDS. But, as you make efforts and stop new transmission, you now have only the transmission that has happened in the past to deal with, and dealing with that involves identifying all these people that are infected all over the country and putting them on life-saving medication and making sure they remain on the life-saving medication to make the virus disappear from their blood.

Once the virus is not seen, the virus cannot be transmitted and once you achieve that, it means these individuals will remain with the virus in their bodies until we get a cure for it or they live and end their lives with the virus in them. So, the plan is to work towards ending AIDS by the year 2030 and making sure that new infections are not seen. Part of the responsible factors is because of the way we approach our programme. Before now, we concentrated on clinics and health facilities to identify patients, new infections and to treat old and new infections, but now, we have moved out of the facilities to include the community.

We have programmes at the community level and we have programmes at the facility level. We are now much closer to the people than before. We are much closer in terms of service delivery to the people and the people have the opportunity to access our services at their doorsteps. As a result of this, we have identified more people living with HIV/AIDS in the last four years than we have ever done in the history of HIV control in this country and we have placed people on treatment in the last four years more than we have ever done in the history of HIV response in this country. We are now in the driver’s seat globally in terms of marching towards ending AIDS by the year 2030. Nigeria has done remarkably well and Nigeria is respected globally.

Between then and now, what is the prevalence rate in Nigeria?

You may remember that a few years back, precisely in 2018 and 2019, we did a survey to find out the actual distribution of HIV in the country and a survey of its kind had not been done before in the country. We were in every local government in this country taking samples from people in their households to determine the distribution of HIV and the actual number of people living with HIV. Before that time, we projected that we had about 3.5 million people living with the virus, but after that estimate, we found out that we have a little less than two million people living with the virus in the country.

This encourages us because it shortens our way to getting to enrol everyone and getting everyone on board in terms of the number that we need to identify to prevent new infections and transmission. This is the number you always hear like 90-90-90, 95-95-95. All these targets are used to measure the ability of the country to go in and find out people living with the virus, place them on life-saving medication, make sure they do not transmit the virus to others and make sure the virus does not kill them by taking them to the hospital. We have done that remarkably well in the last four years.

Despite the progress, there is still a disturbing rate of mother-to-child transmission of the disease. What are you doing differently to ensure that this avoidable transmission is reduced?

There are two things about mother-to-child transmission. Number one is that we are looking at our data and we are looking at

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases
• Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs
• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences
• Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age, and key populations
• Indicator 3.7.1: Proportion of women of reproductive age (15-49 years) who have their need for family planning satisfied with modern methods
• Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care
• Indicator 10.3.1: Proportion of the population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law

SDGs, Targets, and Indicators