South Africa Learns From Nigeria’s HIV Care Model

A delegation from South Africa’s Department of Health has visited Nigeria to study the country’s innovative approaches to HIV care and treatment. This learning exchange which was facilitated by the HIV Coverage Quality and Impact Network (CQUIN), provided an opportunity for South Africa to observe Nigeria’s successes in community-based pharmacy models and decentralised service delivery (DSD) systems.

The delegation was hosted by the National Aids and STI Control Programme and Dr. Irene Esu, a distinguished public health physician, epidemiologist, and DSD Coordinator, led the team to visit sites in FCT and Cross River State.

Speaking about the visit, Dr. Esu highlighted Nigeria’s commitment to ensuring equitable and sustainable access to HIV care. “Our decentralised drug distribution model has been transformative in bringing antiretroviral therapy (ART) closer to the people who need it most. By integrating private pharmacies and other community-based platforms into the national HIV care system, we’ve been able to address barriers such as long distances to health facilities, stigma, and overcrowding,” she explained.

The South African delegation, led by senior officials from the Care and Treatment Directorate, arrived on February 19 and visited multiple health facilities, including community pharmacies and district hospitals, to observe Nigeria’s DSD model in action. They were particularly impressed by the comprehensiveness of the services offered and Nigeria’s ability to track and monitor patient care effectively. “Nigeria’s approach demonstrates how strong provider-client relationships can enhance clinical outcomes. This is a key lesson we plan to incorporate into our strategies,” said Dr. Musa Manganye, South Africa’s DSD Coordinator.

Dr. Esu emphasised the importance of partnerships and capacity building in sustaining these initiatives. “We’ve achieved these milestones through collaboration with stakeholders at all levels, from government agencies to community leaders. Training and empowering healthcare providers has been central to our success,” she noted. Under her leadership, Nigeria’s DSD model has expanded to all 36 states and the Federal Capital Territory, offering tailored HIV care that meets the diverse needs of people living with HIV (PLWH).

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The learning visit also sparked discussions about how South Africa could adopt similar approaches to address its ART gap of over 1.8 million people. “Nigeria’s model shows how engaging private pharmacies and strengthening community-based care can improve access and retention in treatment programs. We are optimistic about implementing these lessons to optimize our healthcare delivery,” added Dr. Manganye.

Reflecting on the experience, Dr. Esu expressed pride in sharing Nigeria’s journey and challenges. “Hosting the South African team was a rewarding experience. It reaffirms the value of knowledge exchange in addressing global health challenges. We hope our efforts inspire other countries to adapt and innovate based on their unique contexts.”

Countries such as Tanzania, Zambia, and Kenya have also undertaken similar learning visits to Nigeria, drawn by the success of Nigeria’s implementation of the Differentiated Service Delivery (DSD) model. These exchanges contribute significantly to advancing global efforts to end the HIV epidemic and enhance health outcomes for vulnerable populations worldwide.