National Agency for the Control of AIDS (NACA) is Nigeria’s number one agency that is saddled with the constitutional rights and role of controlling HIV infection in Nigeria. NACA was established in February 2000 to coordinate the various activities of HIV/AIDS in the country. HIV is the short form for human immunodeficiency virus. It is the causative agent of acquired immunodeficiency syndrome (AIDS). Acquired immunodeficiency syndrome (AIDS) is a global epidemic whose pandemic level is either staggering or on the increase especially as a result of newer infections and the onward progression of acute HIV infection to AIDS (clinically characterized by CD4+ T cell count < 200 cells/µl and presence of specific HIV-infection co-morbidities). There are two major types of strains of HIV that affects people around the world viz: HIV-1 and HIV-2.
HIV-1 is responsible for causing AIDS (acquired immunodeficiency syndrome) in humans; and unlike its less-pathogenic counterpart, HIV-2 (which is notable and common in some West African states and some countries outside Africa), HIV-1 is the most virulent and globally distributed HIV strain.
HIV-2 is the less-widespread relative of HIV-1; and its pathological conditions are usually restricted to the sub-Saharan continent and some other parts of the world where it may have spread to. Unlike HI-V-1 which is a worldwide epidemic, HIV-2 is not spread worldwide. It is mainly found in the West African sub region.
According to the United States Agency for International Development (USAIDS), Nigeria had 220 000 new HIV infections and 160 000 AIDS-related deaths in 2016. About 3 200 000 people lived with HIV in 2016, and only about 30% (19% – 42%) were accessing antiretroviral therapy. But the number of people currently living with HIV in Nigeria has gradually increased to about 3 million. This figure makes Nigeria to be the second largest HIV epidemic in the world. Nigeria also ranks among the in terms of those who have new HIV infection in sub-Saharan Africa. It was also estimated that about 37 000 children were newly infected with HIV due to mother-to-child transmission.
The key populations most affected by HIV in Nigeria are:
- Sex workers
- Gay men
- Men who have sex with men (MSM)
- Drug users
But since 2010, new HIV infections have decreased by 21% and AIDS-related deaths have also decreased by 6% in Nigeria. The HIV epidemic in Nigeria affects all population groups and geographic areas of the country. And Nigeria also ranks among the largest epidemic of HIV infection in the world.
Currently in Nigeria, the issue of mother-to-child transmission of HIV is gaining more priority and progress is being made in this aspect because the elimination of mother-to-child transmission of HIV is a top health priority even at the doors of the government and private sector. The major challenge in the issue of HIV infection in Nigeria is the problem of stigmatization and discrimination. People tend to ostracize and run away from people who live with HIV. And this is why serious and sustained public awareness is critical to containing the emergence and spread of newer HIV infection.
Some of the ways of preventing HIV infection include: avoiding the sharing of sharp objects with people, having safer and protected sex, remaining faithful to your partners in marriage or relationship, avoiding the use of drugs especially injected drug use and avoiding female genital circumcision. Though the use of condom does not guarantee and prevent one from contracting HIV, its use is recommended especially among people who engage in illicit sex. Sex of all types especially with infected persons and without a proper protection can give you HIV. The figure below summarizes the prevalence of HIV across Nigerian states.
Since HIV/AIDS made inroad into Nigeria in the 1980s, it has wrecked unimaginable havoc on this country, countless human resources have been lost to the epidemic and billions of naira have gone down the drain at present.
Nigeria has the third largest infected population (2 to 3.2 million) of people living with HIV/AIDS (PLWHA) in the world after South Africa and India.1Till today, scientists across the world are working tirelessly to find a cure to this scourge, but so far the dream has yet to be realized. While institutions like World Health Organization and our agency, NACA (National Agency for the Control of AIDS), are working hard to eradicate the disease by reducing infection rate to zero, there is still need to take proper care of those already infected with the Virus. This is where antiretroviral therapy comes in; a therapy that has proved very effective when adhered to strictly by the patient.
Simply explained, standard antiretroviral therapy (ART) consists of the combination of at least three antiretroviral (ARV) drugs to maximally subdue the HIV virus and stop the progression of HIV disease. Huge reductions have been seen in rates of death and suffering when use is made of a potent ARV regimen, particularly in early stages of the disease. The Federal government of Nigeria introduced the national ART programme in 2002 and under the programme couple of thousands of adults and children were given access ARV drugs. The price of the drugs was heavily subsided by the government with help from several donor agencies. In 2004, the programme experienced some supply challenges. In 2006, another program was started with the goal of providing ARV drugs at no cost to about 250,000 HIV-positive patients. Although a total of 74 treatment sites were participating in this program by the end of 2006, only about 15% of PLWHA needing ARV drugs in Nigeria had access to this treatment (Monjok et al., 2010). NACA remains at the forefront of these efforts.
WHO reports has made it clear that expanded access to ART can reduce the HIV transmission at population level, significantly reduce orphan-hood help in preserving families.In 2010, WHO and UNAIDS launched the Treatment 2.0 strategy, which promotes radical simplification of ART, with accelerated treatment scale-up and full integration with prevention, in order to reach Universal Access. WHO launched in July 2013 new guidelines with recommendations on ART for adults and adolescents. All these will make sure that more PLWH have access to the ART and their lives could be better as the disease is kept at bay. With ART, a patient has a great chance at a long life deprived of complications of HIV. Our agency has been playing an indispensable role in making sure that the percentage of people with access to subsidized ART is greatly improved. At around 30 percent presently and with over 600,000 on ART in Nigeria, all hands are on deck to up this number. NACA will continue to be reference point in the fight against HIV/AIDS in the country and continent.