By JONATHAN NDA-ISAIAH,
In this piece, JONATHAN NDA-ISAIAH x-rays the contributions of National Agency for the Control of AIDS (NACA) to the fight against AIDS in Nigeria.
The National Agency for the Control of AIDS (NACA) became a standalone governmental agency in 2007 through an Act of the parliament. Ever since then, it has undergone different evolutionary changes in terms of restructuring which have contributed significantly in helping it to actualize its mandate.
To be sure ,the core mandate of the agency, of course, is for the control and management of the Acquired Immune Deficiency Syndrome and Human Immuno Deficiency Virus(HIV) in Nigeria.
Instructively, The first two AIDS cases in Nigeria was diagnosed in 1985 and reported in 1986 in Lagos one of which was a young female sex worker aged 13 years from one of the West African countries.
The first HIV Sentinel Survey in 1991 showed a prevalence of 1.8%. Subsequent sentinel surveys produced prevalence of 3.8% (1993), 4.5% (1996), 5.4% (1999), 5.8% (2001), 5.0% (2003), 4.4% (2005), 4.6% (2008), 4.1 %( 2010) and 1.3 %( 2019).
As of June 2020, the number of people living in HIV include , women,811,288 , Men -362,188, young people-108,963 and children – 54,624.
For its 14 years of existence, there is no doubt that the agency has achieved some positives in the management and control of the virus whose spread has continued to decline in the country as far as morbidity and fatality are concerned as credible data have shown while awareness about it continues to increase. All thanks to NACA.
Also , from 2007 till date the number of persons receiving treatments have increased by 987%. Similarly, growth in the number of people tested counselled and received results since 2007 increased by 710%. It is gratifying to note that from 2010 till date there has been a 35% Drop in the number of people AIDS related death .
It is instructive to note that In the last fourteen years, NACA has established multisectoral and multiagency coordinating platforms through effective partnerships for the efficient delivery of HIV interventions in Nigeria through the National Prevention Technical Working Group, Gender Technical and Human Rights Working Group and National Task teams on HIV Testing Services, Antiretroviral therapy, Community Care & Support and Prevention of Mother to Child Transmission of HIV.
It’s without equivocation that courtesy of the deliberate intervention of the agency, there’s increased awareness of HIV prevention strategies amongst key population groups as a result of tailored and strategic HIV programming. This is in addition to HIV/AIDS mainstreaming interventions across critical Ministries Department and Agencies (MDAs) through the establishment and training of MDAs’ Critical Mass Teams (CMTS) to facilitate a stable on-going proactive multi-sectoral HIV response at each of these MDAs.
NACA has also championed the economic empowerment of HIV vulnerable and indigent persons including women, girls, young people and people living with disabilities at different locations across the country. Besides, over the years, the agency has been providing treatment and care for over a million people living with HIV in line with global best practices which has led to reduction in morbidity and mortality associated with the virus.
Also, all thanks to NACA, tremendous improvement has been made in the prevention and detection of opportunistic infections such as tuberculosis in PLHIVs through adoption of global health best practices in laboratory investigation such as LF-LAM and Tuberculosis Preventive Therapy
Through the instrumentality of NACA, there is no a linkage of TB/HIV care through the installation of 135 GeneXpert machines across the 36 states of the country including the Federal Capital Territory.
Another significant achievement of NACA in for the past decade is the evidence generation for the integration of HIV/AIDS into the routine healthcare services through piloting of key projects such as PMTCT+RMNCAH+N integration, PMTCT into MNCH week, HIV Testing Services in private facilities through Performance Based Financing.
NACA has also engaged and trained more than 500 gender desk officers, thematic programme staff members of the parliament at federal and state levels, paralegals, judicial and human rights administrators on skills for gender responsiveness and integration of gender and human rights concerns into the HIV/AIDS response at all levels through the years.
Today, there is a pathway for the sustainability of the National HIV response through a pilot in Abia and Taraba States now supporting 49,629 PLHIVs.
The pilot is coordinated by state government teams with investments by the federal government to the tune of 12 billion naira in the last six years. The FG is covering the provision of commodities, manpower, infrastructure, and information management systems.
Since 2020, the government has gone ahead to provide drugs for additional 50,000 PLHIVs. This brings the total number of PLHIVs being supported solely by government of Nigeria funds to about 90,000 individuals,
NACA has also proved to be handy as a support system to the COVID-19 response through provision of commodities, RDTS, ambulances, reagents, and cartridges.
As a gender sensitive agency, NACA has continued to roll out a responsive National HIV programme through the mainstreaming of gender and human rights into national response.
Critical to NACA’s actualization of its mandate for the past years is the Public Relations and Protocol Unit of the agency which is saddled with the responsibility of managing the image of the agency and providing media visibility aimed at creating awareness, dissemination of information and mobilisation for the uptake of HIV related services.
The division over this period has maintained a cordial relationship with the media which has translated to a strong partnership as well as improved reportage of HIV and AIDs related news in Nigeria which in no small measure has doused tension resulting from misinformation, misconception and misrepresentation of the HIV programme and policies through press releases and rejoinders, leading to improved HIV status disclosure, reduced stigma, discrimination and increased service uptake.
Because of the dynamisim of the unit, , NACA, over the years, has emerged as a brand that is responsive and accountable. The theme: “fighting AIDS to finish” resonates both nationally and internationally. NACA’s presence in the new media (Facebook, twitter, you tube and Instagram) reaches millions globally especially the young population.
In driving the core mandate of NACA on its AIDS National Response, the agency’s Directorate of Policy, Planning and Stakeholders Coordination has developed several HIV/AIDS strategic documents, National and sub-National HIV/AIDS policies and the engagements of Public, private and civil society in the National Response.
Some strategic documents that aided the response include: HEAP 2002, National HIV/AIDS Policy 2009 & 2020, NSF (I) 2005, NSF (II) 2009-2015, NSF (III) 2017-2021, RNSF 2018, NSF (IV) 2021-2025, NSP (I & II) 2009-2015 & 2017-2021. All these strategic documents can be downloaded at www.naca.gov.ng/publications.
Through this particular department of the agency in collaboration with other critical stakeholders, NACA has developed and facilitated two National HIV/AIDS Policies, two HIV Workplace Polices, Implementation of the anti-discrimination Act, passage of the Child Rights Act in states as well as the National HIV/AIDS Research Agenda.
Interestingly, these documents have facilitated the creation of an enabling policy and research environment, provided strategic direction and guidance to all stakeholders in the HIV/AIDS response. Most importantly, it created an atmosphere of protection for persons living with HIV (PLHIV) as well as young persons in Nigeria.
It needs be stated that in the last 14 years, four National Strategic Frameworks, two strategic plans, several medium term plans and operational plans have been developed both at the national and sub-national levels. The success of these HIV/AIDS National Strategic Plans catalyzed the development of the maiden National Strategic Health Development Plan (NSHDP I) by the former DG of NACA Prof. Babatunde Oshotimehin, who was then serving as the Honourable Minister of Health. Implicitly, these HIV strategic documents have provided the roadmap utilized by all key stakeholders in fighting the war against HIV/AIDS in Nigeria.
The implementation of the core mandate of the Agency through this directorate has facilitated the development of over 3000 support groups, setting up of 36+1 State Agencies for the Control of AIDS, organizing and creation of country coordinating entities (CCEs), capacity building of over 3000 CSOs in project management, proposal writing, and procurement amongst others. Also, not less than 100,000 PLHIVs have been economically strengthened to contribute to the economy of the country.
The modest success of NACA in the last 14 years per its core mandate cannot be totally divorced from the activities of the Legal Directorate of the agency which has helped essentially in facilitating reduced risk of litigation for NACA through effective contract management.
The unit also organized and facilitated a study visit to the Kenyan National Assembly for members of the ATM / Health Committee of the National Assembly to share experiences and understudy Kenya’s existing HIV/AIDS Law which aided in the passage of the HIV/AIDS Anti-Discrimination Act in 2014.
It coordinated the Stakeholders Forum on the HIV/AIDS Anti – discrimination Bill that re- energized the process of effecting the passage of the Bill to Law and also served as legal technical contributors to numerous standing committees and adhoc working groups on National HIV/AIDS Policies.
The directorate provided legal and technical support towards the establishment for the Gender and Human Rights National Technical Working Group in addition to supporting the Coalition of Lawyers on Human Rights, Legal Aid Council and Lawyers Alert who provide pro – bono legal services for indigent persons living with HIV/AIDS.
Within these past years, the unit also championed the inauguration of the Freedom of Information (FOI) Unit in the Agency such that any member of the public can invoke the FOI to ask the agency any question.
Truth is, all other directorates of the Agency have contributed and continue to contribute to the continued advancement of the agency as it continues to actualize its mandate which is targeted at eradicating AIDS/HIV by 2030. Such other units in no particular order of superiority are; research, monitoring and evaluation department, management information system/information technology, admin and support services department, finance and accounts department and admin and support services.
Of all government agencies in the country, NACA remains one of the most active, visible and functioning.