Since AIDS was first reported 40 years ago, a lot of efforts have been put toward eradicating the disease , by way of sensitization and other preventive measures. What has Kaduna state been doing to end the pandemic in 2030 as proposed by the United Nations?
Sometimes in 1992 or ’93, the then government of Kaduna state created a committee which was saddled with the responsibility of taking care of all issues as they related to HIV/AIDS. That committee was then under the chairmanship of the late Dr Tanimu. Shortly after he was given that responsibility, he coopted a number of persons and later the immediate past Executive Secretary of KADSACA, Dr Mark Anthony was posted to support him in the programme. Not after long after Dr Anthony was posted to the AIDS committee, the need for a Project Manager arose. The project manager was supposed to anchor the project under the World Bank. He served in that capacity until 2016, when he was made the Executive Secretary of KADSACA. He took over form Dr Haliru Soba.
Now, as to what the government has been doing, first of all let me say that all the personnel that are working here are all staff of Kaduna State Government. This is part of the government’s efforts to ensure that HIV/AIDS is properly tackled. Following the need by the World Bank for more staffing, the state employed and redeployed people to the agency. Presently, we have a staff strength of 23 people even though, based on its organogram, KADSACA requires 46 staff. So, we have a gap of about 23 staff.
Amongst other things, KADSACA does a lot of testing activities and sensitization programmes. In addition, the state has been doing a lot of things to eradicate HIV/AIDS like engaging in preventive and treatment activities. You will recall that when HIV/AIDS came to limelight, one of the things that everyone tended to worry about was the fact that it had no cure. So, the only activity that people tended to worry about was the preventive services and Kaduna state embarked on them holistically at that time, to ensure that people adopted practices that will prevent them from contracting the disease. So, there was a lot of enlightenment programme going on. These exercises are still ongoing.
We have also been carrying out testing services. When you test to know whether or not you have this disease, to us it is a way of prevention. If you know that you have the disease, the next thing is what to do. So, we advise people that once they have this disease, they should adopt safe behaviour models that will protect other people from contracting it. We have made efforts to ensure that not only are people protected from contracting the virus but they live right and live well. If someone has the virus, and he or she is on treatment, to us it is a plus because it will help him or her to know how to treat others. It will interest you to know that if one has the virus, and he is taking treatment, it prevents the disease from being passed to another person. In HIV/AIDS services, we call it You=You. What this means is that the number of viruses have dropped to a certain level that makes you and your partner safe.
How do HIV/AIDS patients get Antiretroviral drugs? It is free? What are the processes of accessing them?
In Kaduna state, since I came into KADSACA, one of the first things that struck me is that treatment is free. Anywhere you are and whatever you are doing and you want to get treatment, it is free of charge. Not only that, testing and monitoring are also free. Virtually all services as they pertain to HIV/AIDS in Kaduna state are free. That is why we keep telling people, if they have challenges, they should call us. We are only too willing to ensure that no one is charged for any service.
So, how can patients get access to this free testing, monitoring and treatment?
We have about 33 General Hospitals in Kaduna state; there is at least a General Hospital in each of the 23 local governments. We also have Primary Health Centres and clinics. All our General Hospitals provide services for testing, treatment and monitoring. Then, we also have some special centres which we call Comprehensive Treatment Centres which offer free treatment and all the services that I have enumerated. Presently, we have about 57 Comprehensive Treatment Centres. All the General Hospitals are part of these Comprehensive Treatment Centres; the Primary Health Centre at Magajin Gari in Kaduna North local government and Zakari Isa Memorial Hospital are Comprehensive Health Centres. There is also a Comprehensive Health Centre at Sabon Tasha, there is one at Makera, Unguwan Rimi and Badarawa all within Kaduna town. The others are outside the state capital, in strategic areas within the state.
We also have Comprehensive Treatment Centres in areas where we think the prevalence of HIV/AIDS is a little bit high, like Jaji, Mararaban Jos and Kagarko because it is close to Tafa, where tanker drivers usually park. So, besides the 33 General Hospitals, we have another 24 Comprehensive Treatment Centres, making a total of 57 Treatment Centres.
What has Kaduna State Government done to prevent stigmatisation of people who are HIV positive?
When HIV/AIDS started, one of the first things that confronted the entire populace was fear. People thought generally, but not inappropriately, that the disease has no cure; so, people started stigmatising those who have it. Again, people tended to worry about the fact that the disease is contracted through sex but that is a wrong assumption. Then, people didn’t know that there are other ways that the disease can be contracted. So, HIV/AIDS patients became subject of stigma. But over the years, a lot has happened and government came to the rescue and simply because someone has the disease, it is no reason why he shouldn’t live a reasonable life.
So, government promulgated the anti-stigma law and Kaduna state was one of the first states to promulgate that law in 2011. It was amended by His Excellency, the present governor of Kaduna state, Malam Nasir El-Rufai. The law provides that no one should look down on somebody simply because he or she has HIV/AIDS. The law also said that all AIDS patients should be accorded all assistance that they require to live healthy and normal lives. Since the creation of the edict, no has been caught breaking the law but it doesn’t mean that people are not violating it. But if they are caught, government will surely deal with them.
The law was promulgated by Kaduna State Government; it was not a federal law that was domesticated by the state. In fact, Kaduna State Anti-Stigma Law came up before the federal government promulgated its own. Last week, we went for a stakeholders’ meeting in Abuja and that was the first issue that we discussed. The anchor of the programme talked a lot about how people who have HIV/AIDS should not be stigmatized simply because of their status.
Covid-19 Pandemic came to Nigeria last year and stretched health facilities and personnel. To what extent did the pandemic affect the activities of KADSACA and how did you cope with the shortage?
Shortly after the Covid-19 pandemic surfaced, one of the challenges that we all faced, particularly in the HIV/AIDS programming, was the fact that the Covid was seen as a disease that tended to bring down anybody that had some form of health challenge. If you have hypertension for example, and you contract Covid-19, you are likely to be tagged as one of the casualties of the pandemic. Therefore, we tried to ensure at that time, that all our patients were protected. And what we did was that all people who are HIV-positive should as much as possible stay away from people who have Covid-19.
We also decided to interface with the EOC of Covid-19; that the best way was to recruit the people who are working with us on HIV/AIDS sensitization and awareness campaign, into the Covid-19 campaign Team. You know when Covid-19 came, there was the challenge of sensitization and so we decided that all members of Young Persons Living With HIV/AIDS, people who have become health-wise, should join in the campaign against Covid 19. These people went out despite the lockdown, to access vital medicines for members of the HIV/AIDS community. We also gave letters to some of our Development Partners, to enable them give treatment to HIV/AIDS patients during the lockdown, without harassment by security agents. So, we ensured that all our services were provided to our patients.
We also decided that not only were HIV/AIDS patients protected but they also benefited from Covid-19 palliatives. We told the palliatives distribution committee to ensure that all our members were adequately taken care of. We realized that if our members were prevented from going out to get food and access medication, then there was every likelihood of HIV/AIDS bouncing back. And therefore, the spread of the disease will further worsen. Right now, the prevalence in Kaduna state is 1.1.
What was the HIV/AIDS prevalence rate before this administration came in 2015 and what is it now, as against the national average?
The prevalence rate, prior to the advent of this government, was about 2.2% but the prevalence rate in Kaduna state was as high as 11.6% in the early 90s down to 1999. So, we had a big challenge then but when the civilian government came, and following the intervention of Senator Khairat Gwadabbe, the international community as well as the federal government, directed all state governments to work round the clock to reduce the numbers. First, it dropped to around 5.4%, then it dropped further to 2.2% by 2015 to 2016.
And His Excellency, the Executive Governor of Kaduna state was magnanimous enough to approve and release N200 million to this agency immediately he came into office, to address the scourge. Simultaneously, the President’s Emergency Plan for AIDS Relief (PEPFAR), a US-based international programme, in collaboration with Kaduna State Government, decided to do a survey to assess the impact of the government’s intervention. The programme was referred to as Kaduna State AIDS Indicator Survey (KADAIS) and it discovered that the prevalence rate has dropped to 1.1%. Following this result, the federal government decided to do National AIDS Indicator Survey (NAIS) and it was confirmed that the prevalence rate in Kaduna state is 1.1% and the national average is 1.4%.
-The prevalence rate of HIV/AIDS in Kaduna state was 11.6% in the early 90s to 1999 but dropped to 2.2% in 2015;
-When the Malam Nasir El-Rufai administration assumed office, N200 million was released to KASACA;
-There are 57 Comprehensive Treatment Centres, including the 33 General Hospitals, where testing, treatment and monitoring services are free;
- Kaduna State Government in collaboration with the United States President’s Emergency Plan for AIDS Relief (PEPFAR), conducted a survey to assess the impact of government’s intervention;
-The survey showed that the prevalence rate has dropped to 1.1%;
- Kaduna state was one of the first states to promulgate that the Anti-Stigma Law in 2011, which has been amended by Governor El-Rufai.