BY PATIENCE IVIE IHEJIRIKA, Abuja
As HIV remains a global public health issue, countries of the world are striving to end the pandemic by 2030. Nigeria is not left out in this struggle.
According to the United Nations Programme on HIV/AIDS (UNAIDS), Nigeria has shown steady progress on increasing access to treatment for people living with HIV, with the adoption of a test and treat policy in 2016.
This measure, the UNAIDS said has further accelerated referrals to treatment facilities for people who test positive for the virus. It noted that from 2010 to 2017, Nigeria almost tripled the number of people living with HIV having access to antiretroviral therapy, up from 360, 000 people in 2010 to more than 1 million people in 2018.
In a bid to sustaining this credit and enhancing ownership and sustainability of HIV response in the country, the National Agency for the Country of AIDS (NACA) has restrategised.
This new strategy has helped to double the number of people living with HIV on treatment as we now get the same drugs at about 50per cent cheaper rate, said Dr Aliyu Gambo, director general of NACA.
He said, “Sustainability is the key because we are now at a point where we are thinking that in the next three or four years, we should control this epidemic.
The focus now is that we have changed the way we procure our drugs to now buy directly from the manufacturers; this gives us the value for money and allows us to treat more people with less money.
” For example, the contractors give me the price that is almost twice what the companies give me. I am now having a target to add 50,000 people on our domestic resource, in terms of getting them on treatment, treat with our money.
If I am adding 50,000 more people every year and the budget I have has not changed much, I have to change strategy and part of my strategy change is to make sure that I use they money efficiently. I buy from the manufacturers and I get drugs that will treat 100,000 people with money that will only treat 50,000 for me if I am using vendors.
“The plan is, first we change the way we do business; where we buy drugs and kits, and we change them and get value for money,” said Gambo.
According to him, the Agency is also working on HIV trust funds. “This has been worked in the past two years, we are happy now, we will say we are approaching that stage where we will get the fund launch, which is private sector coordinated just like the CACOVID for COVID. It is private sector drive and we are hoping that sufficient amount of money will be raised and this trust fund from the time it is brought to life will continue to support us with kits, consumables to enable the government to address the issue of shortage of drugs, shortages of kits, shortages of consumables by the time our major partners and donors begin to withdraw.
“Also, bringing the state onboard and making sure that the state drive the response. Health is on concurrent list and is it not fair for the federal government to drive the response and own the response entirely. Majority of the facility which provides this services belong to the state and patients that access this service belong to the state, service providers that are providing services belong to the state. It therefore makes sense for the state to be under government control. Just the same way the state is in control when it comes to tuberculosis and malaria, the states also need to be in command and control when it comes to HIV.
“Our contribution from the centre will be to ensure that the states are not lacking when it comes to drugs. We will make sure that the states are not lacking when it comes to other things, but in terms of the state proving coordinating role, in terms of the state providing logistics, contributing in buying kits to identify the citizens we think these are the things the states should be able to do.”
Lending it’s support to the federal government’s decision to purchase HIV drugs directly from manufacturer, the Civil Society Legislative Advocacy Centre (CISLAC) / Transparency International Nigeria, said the contractors currently sell the anti-retroviral drugs at $13 per patient as against $7 given by the manufacturers.
Executive director of CISLAC, Auwal Musa, who stated this at a press briefing in Lagos, said that non-affordability triggered by high production and supply costs encourages the sale of fake and substandard drugs in the country, while consumers who are compelled to seek cheaper drug alternatives ceaselessly fall prey to fake and substandard drugs with damage to their health.
“As the Nigerian government struggles to sustain provision of free anti-retroviral drugs as part of HIV programmes at health facilities in the country for an estimated 3.1 million people living with HIV/AIDS, this effort is mostly sabotaged by inflated prices quoted by supplying contractors, whose activities render government’s effort inadequate to eliminate the high and sometimes inequitable economic burden of HIV/AIDS on households.”
“This exorbitant prices quoted by existing contractors renders government financially incapacitated to adequately provide for, and make anti-retroviral drugs accessible across health care facilities, which records resultant regular stock-out, health hazards and relapse of illnesses.”
According to him, “We observed the strong resistance by some contractors with support of some insiders to prevent NACA from buying HIV drugs directly from original manufacturers which allows government to put more people on treatment.”
“While we acknowledge NACA’s plan to establish HIV Trust Fund driven by private sector to support existing efforts of the government, we observe that without current support by US Government and the Global Fund, it would cost Nigeria N50 billion to treat one million people living with HIV annually.”
The organisation therefore called on NACA DG to engage stringent reforms in the Agency’s procurement process for impactful, efficient and cost-effective wider and sustainable service delivery in the country.
“We insists that fraudulent contractors who undermine the Public Procurement Act must be thoroughly scrutinised and discouraged from defrauding the government through inflated anti-retroviral drugs supply services”, he said.
“We also call on the government to develop a pricing policy to reduce reported high prices and wide disparity between prices of essential drugs in the country.