HIV/AIDS is a dreaded killer disease, how does one contract the virus apart from the known sexual intercourse or sharp objects?
The disease called HIV/AIDS by its name is actually a combination of two things. The first is HIV, as a virus. It is a viral infection. The second is AIDS which is a disease syndrome that comes from HIV infection. And HIV infection is a virus that can be acquired like you have said through sexual intercourse. But in Nigeria, 80 per cent of the infection is through sex. Another 15 percent of the infection is through transmission from pregnant positive mothers to their newborn babies which is called vertical transmission. Other sources of infection include the contamination or infection through unscreened blood products, blood transfusion and all other forms of organ transplant. It usually happens when you share contaminated sharp objects like razor blade or needle. You could also have transmission if you have procedures performed with unsterilized equipment. In Nigeria, there are loose ways by which HIV virus infection has been transmitted. There are other factors too that promote transmission. One of the new methods that is coming is up is that there are many more men that have sex with their male colleagues and that has increased the transmission of HIV/AIDS in Nigeria. We also have intravenous drug users (IDU) who share needles and many cities in Nigeria that are having a good number of ID use.
At what stage does the symptom begin to show?
HIV infection in itself is not symptomatic. It is symptomless. People begin to have the symptoms when they have a set of AIDS or what we call AIDS-related complexes because one can live with the virus for years, sometimes up to 15 years, without symptoms, just as we call it HIV infection if one is tested positive. However, it becomes symptomatic when the body immunity is compromised due to HIV infection and that is what we describe as AIDS and that is also, why we call it HIV/AIDS. And at that point, it can manifest in all form of diseases that could be described as opportunistic depending on the type of diseases that the person comes up with. And that can occur within two years of infection or sometimes, it may not come until 15 years after the infection with HIV virus and that actually depends on a whole lot of factors, the type of the virus, the virulent of that type, the viral load, the body system of the person, the immune status before the infection, the nutritional status of the fellow and so many other things.
Has there been any major breakthrough in the cure of the virus?
There have been a lot of breakthroughs in the HIV response environment and yes, we don’t have a permanent cure yet. But the discovery of the anti-retroviral drugs has been wonderful breakthrough since 2005 and now people can live long. The breakthroughs have converted HIV/AIDS to a chronic disease and no longer a killer disease. It can be likened to diabetes, and hypertension. People now take the medication and they live a normal life. We have also got a science that will completely eliminate transmission from mother to child HIV/AIDS infection. Several countries have taken vertical transmission near to zero level where every child doesn’t test positive, but negative. And if we get that intervention right, with the 70, 000 newborn babies that we have resulting from HIV infection in Nigeria yearly then, it can be completely averted and this is a significant breakthrough. Of course, the world is working at getting a mechanism that can cure the disease, but we have not got there yet. But there is a lot that can be done that will make people live a normal life.
How committed is the Federal Government through its agency, National Agency for the Control of AIDS (NACA) in the fight against the HIV/AIDS?
NACA is doing tremendous work. Many of us are working directly to support NACA through multi-lateral/bilateral agencies and like I said, NACA has been doing a whole lot to support. Take for instance, Nigeria as one of the 36 other African countries, our population is about 167 million and there is a whole lot that needs to be done; mobilizing resources, getting to people in every nook and cranny of Nigeria is a whole lot of work, but there is still so much to be done. If you look at Nigeria where we are now in terms of progress and where we have to be in terms of target, we are still miles apart. Most of the targets of treatment, testing or prevention of mother to child mission that we have set at 80 percent and yet, we have not passed more than between 20 percent and 30 percent of many of them and we have less than two years to get to the target and there is so much to be done. NACA is trying its best but I think what is needed is actually for the governments to put resources and their money. A situation where the donor agencies are responsible for funding more than 75 percent and what is happening in Nigeria is not good enough for the government. And what the donors are doing and what the government put together is less than 30 percent of what is required to meet universal access. So, the government needs to do more and Nigeria has assigned what I can call a partnership framework with the US government called the Federal Government of Nigeria/US partnership framework for HIV/AIDS control. And in that framework, the government has committed to funding 50 percent of the HIV/AIDS control strategies and activities in Nigeria, but the government is doing less than 25 percent now. And the government needs to honour its words by putting much more resources than we presently have for that environment because of course, HIV/AIDS is central to our human capital and of course, human capital is central to our economy and survival.
What contribution has the World Bank made towards the fight against the virus?
The World Bank has been supporting the control of HIV/AIDS since 2002. The first project was the US $140 million for between 2002 and 2009, with an extension of up to 2011. Presently, the World Bank is supporting the HIV/AIDS response in Nigeria with US $225 million project called the HPDP2 (HIV/AIDS Programme Development Project), which I am presently providing some consultancy support to the bank to implement. The project is now effective in 36 states and at the federal level and each state is benefiting to the tune of about US $5 million to support their control efforts at principally preventing new infection, making sure pregnant women don’t transmit the virus to their newborn babies, supporting the treatment initiatives, ensuring that awareness is created and behavioural change is communicated, ensuring that the systems are put in place and to ensure effective control. The state governments are supposed to be a form of support. It shouldn’t be the entire responsibility of the federal government alone. The onus should be on the state governments to actually put money down and to make sure that people are treated and new infections are prevented. And the counterpart fund that the World Bank demands for state governments to pay into to the credit should also be honoured. And beyond the counterpart funding, the state governments should resolve HIV/AIDS infections adequately at their respective states because it is the healthy population that can live in the houses or the roads or the schools the state governments are building.
Has there been a decline or increase in the virus in the country in recent times?
No, like I told you, the Federal Government of Nigeria through NACA and most importantly, the international friends that are helping the country have done tremendous work. I will just give you an instance of what has happened since 2003 or there about. The HIV prevalence in Nigeria was about 5.8 percent of the population and that has been on consistent decline. As at 2010, the prevalence is 4.1 percent and that has declined from 4.8 percent to 5.2 percent and to 5 percent to 4.6 to 4.4 and now 4.1 percent. In overall, there has been 25 percent decline in the burden of the virus in Nigeria, but several African countries have achieved even more than 50 percent decline. For instance, Ghana two years ago, the virus was very high in their own vertical transmission, mother to child. They have reduced that by 75 percent in less than two years and there have been a whole lot of coordinated efforts, while we still have 70, 000 newborn babies in Nigeria till 2012, I think we can take that to less than 50 percent in the next two years if all hands are on deck. But on the average, Nigeria is now described as a stable epidemic. We have reversed the trend and what we need to do is to sustain the tempo and we can do a lot better than we have done.
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