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How Southeast is responding to rising cases of HIV/AIDS

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The Director General of the National Agency for Control of AIDS (NACA), Dr. Gambo Aliyu recently raised a worrying point, when he disclosed that the Southeast has Human Immunodeficiency Virus (HIV) prevalence that was above national average.Aliyu stated that, while the national figure stood at 1.4 percent, Southeast prevalence rate was 1.9 percent. He explained that out of about 10,000 persons living with the virus, less than 2,000 availed themselves of retroviral drugs, which are available and affordable.Aliyu’s disclosure was based on findings from the July to December 2018 survey conducted by the Nigeria HIV/AIDS indicator and Impact Survey (NAIIS).
 
The report showed that Northwest has 0.6 percent; Northeast 1.1 percent; Southwest 1.2 percent; Southeast 1.9 percent; North Central 2.1 percent and South-South 3.1 percent. The implication is that South-South tops the chart, followed by North Central and Southeast.While Nigeria’s national HIV prevalence is 1.4 percent among adults aged 15 to 49, women in this age bracket are more than twice likely to be living with HIV than the men (1.9 percent versus 0.9 percent.) The difference in HIV prevalence between women and men is greatest among younger adults, with young women aged 20 to 24 years more than three times as likely to be living with HIV as young men in the same age group. Among children aged 0 to 14 years, HIV prevalence, according to the new data, is 0.2 percent.

Sources said the prevalence in the Southeast remained among adults aged between 15 and 64, and that mostly affected are the female in the age bracket. It was gathered that seven states of Akwa Ibom, Benue, Rivers, Taraba, Anambra, Enugu and Abia are most affected, and have high prevalence rate of 2.0 percent and above, accounting for 50 percent of the overall estimated number of Persons Living With HIV/AIDS in Nigeria.

A further breakdown of the figure showed that Akwa Ibom has 5.6 percent prevalence rate (200,000 burden), Benue 4.9 percent (188, 482 burden), Rivers 3.8 percent (196,225 burden), Taraba 2.7 percent (52,856 burden), Anambra 2.4 percent (87,312 burden), Enugu 2.1 percent (66,768 burden) and Abia 2.1 percent (51,261 burden).However, some insist that some of these figures are being bandied to attract unnecessary attention, given that reports on earlier timelines on the fight against the disease had not been made public.

Enugu Poised To Tackle HIV Headlong With External Collaboration
PERHAPS, it was in a bid to stem the tide that the United States government, in collaboration with Enugu State government, recently launched the anti-retroviral therapy (ART) surge response, aimed at treating 10,000 HIV/AIDS cases between November 2019 and September 2020.
Launching the scheme, the US Consul General, Claire Pierangelo, said it would, through its implementation partner, Caritas Foundation of Nigeria, reduce and ultimately eliminate the HIV/AIDS scourge among people of the state.She said: “The essence of ART Surge Response is to see how we can identify 95 percent of persons living with HIV in Enugu State, place them on treatment and also ensure they are virally suppressed after being on treatment for six months.”
 
She pointed out that the first thing they would do was to carry out test on patients in hospitals and other health facilities across the state. Aside government hospitals, however, they would also be working with faith-based hospitals and private hospitals.A health practitioner, John Ugwu, said the country’s economic situation has caused problems in many homes, as morals have been relegated to the background.He said: “The number of higher institutions and the rate at which hospitality facilities are springing up in the state has not helped matters. The state is endangered because 75 percent of those patronising these places are youths. Look at the clubs, drinking joints and tell me who patronise them.

“I think government and leaders of this state need to do something to discourage the lifestyle of our youths. That is why the scourge is spreading, and unless we tackle this now, the state’s future is bleak.“Who are those engaging in drug abuse? When you remember that these youths are creating health hazards, through consuming hard drugs and their immoral lifestyle, you will know we are doomed.
“I think the best way to get out of it is to continue to drum it loud that the society is ravaged by HIV/AIDS, and that the disease has no cure yet. Otherwise, we will lose the battle. We need to engage these youths in productive ventures, so that they can use their time effectively.”

 
Reacting to the development, Enugu State Chairman of the Nigeria Medical Association (NMA), Dr. Ike Okwesili, said the recent report on HIV/AIDS required a closer look and raised some concerns. He believed stakeholders had not given the issue adequate attention. He said: “Does the changing pattern of national prevalence (dropping from 3.4 to 1.4) and increase or decrease in some states or zones imply adherence to the National HIV/AIDS strategic plan 2017 to 2021 on the UNAID vision 90:90:90, or a failure of the previous survey plans or both? How far have we achieved the 2017 to 2021 plan before the announcement of the modified plan that extends to 2032?”Okwesili argued that the politics of HIV would either help or mar the efforts, depending on the approach, and that certain status rules and policies should be addressed and complied with.

These rules, according to him, include the tendency to isolate control treatment of AIDS from society’s healthcare needs, adding that Universal healthcare was preventive, curative and rehabilitative without discrimination.“It follows that failure of facilities at primary healthcare level will affect everything, including patients living with HIV,” he said. “Secondly, the woolly task sharing/shifting being advanced as a strategic intervention plan in the control of HIV/AIDS infection is an escape from the reality on ground. The human resources for National health Act 2014 are yet to be determined by the National Council on health.

“It is only when the adequacy or otherwise is determined that solution can be sought. This must not include compromise on standard of care and practice. These can be resolved by full operationalisation of the National health Act 2014. It equally requires political will to implement all government promises at all levels in the care and control of HIV/AIDS infections. It is a cause we all must commit to.”

Meanwhile, Enugu State governor, Ifeanyi Ugwuanyi, has announced the removal of all financial barriers hindering people living with HIV in the state from accessing medical treatment.“Henceforth, all card fees, consultation fees and charges for basic laboratory investigations stand removed for people living with HIV, to guarantee them financial access to HIV prevention and treatment services in Enugu State,” he declared at the ART launch. “My administration is desirous of expanding the HIV Anti-retroviral Therapy by enhancing case-finding, through provision of more Rapid HIV Test Kits to enable new cases benefit from treatment programme supported by the United States’ Centres for Disease Control and Prevention.”

Imo To Embrace Aggressive Advocacy And Sensitisation
THE Imo State government is looking for about 10,000 persons suspected of having HIV.Confirming this recently, the State Commissioner of health, Dr. Vincent Udokwu said in August, 4,225 people were tested with the 5,000 Quick Check HIV test kits donated by Imo State Chairman of the Council of Traditional Rulers, Eze Sam Ohiri, as well as pregnant women.Udokwu noted that currently, 18,205 persons living with the virus are receiving anti-retroviral treatment (ART) in the state, projecting that about 22,000 were expected to be on treatment soon.
 
He explained that out of 53,113 pregnant women tested between January and June 2019, 270 were positive, and that over 500 babies delivered by positive pregnant women within the period were HIV negative, due to the medical innovations put in place.He disclosed that the survey conducted by NAIIS showed that out of approximate 5.6 million population of the state, there were unidentified 10, 000 Persons Living With HIV (PLHIV).
 
He said: “The NAIIS 2018 report showed that we are just five feet away from gold in achieving the elusive epidemic control. According to the survey, Imo State HIV prevalence has dropped from 14 percent (ANC Survey 2014) to 1.8 percent. This means that out of every 100 Imo State residents aged 15 to 64, we have less than two persons infected with HIV…

“So, our collective responsibility as a state is to, among other things, identify these persons, provide comprehensive care to them; halt the transmission of new infections and be among the first to reach the epidemic control target of September 2020.”The Chairman of Imo State Council of Traditional Rulers, Eze Sam Agunwa Ohiri, said he was touched by the prevalence, and since his company is into manufacturing of the test kits, hence his donation of 5,000 pieces.
 
The Director General, Imo State Agency for the Control of HIV/AIDS (Imo SACA), Dr. Charles Durueke said “the NAIIS 2018 study showed that in Imo State, out of every 1, 000 persons, 18 people are carriers of HIV/AIDS. So, it is not a comfortable result.”Durueke said aside the commonly known contributory factors that encouraged prevalence of the virus, such as ignorance, poverty, religious beliefs, carefree attitude, denials and stigmatisation, some other factors are peculiar to the state. He listed these to include high number of tourist facilities, with Owerri having over 300 hotels and high students population.

He said: “Imo is relatively peaceful and so, we have high influx of tourists. Again, there is the high student population, which constitutes mostly adolescents. Another factor peculiar to Imo is the presence of high number of sex workers.”On the way out, Durueke said: “There is need for sustained and more aggressive advocacy and sensitisation, even at community level, where people should be made aware that the disease exists, and that there is now treatment that can sustain life, and that it is not a spiritual thing.

“Funding is equally essential. Government alone cannot undertake the funding. People in good positions can assist by going to treatment sites, finding out patients’ needs and lending support in that area. There is also need to assist available agency and government in carrying out prevention activities, which are key in fighting HIV/AIDS.”
 
Abia Encumbered By Economic Hardship And Beliefs
IN Abia State, economic hardship and beliefs system have encumbered the fight against the disease. Inferences from discussions and interviews with people from across the state, especially the unemployed, suggested that the control and eradication of the disease remains an uphill task.

However, some segments of the state believed that with the discovery, availability and affordability of the Anti-retroviral Treatment (ART) medicines, the epidemic has become treatable like malaria, tuberculosis and other sexually transmitted diseases.This impression may have energised those who rely on commercial sex as a source of living.
 
“Why should I avoid sex, if I will no longer die of the consequence,” a 30-year-old woman asked The Guardian, when she was seen hanging around a nightclub, obviously soliciting sex business.A trader said since he hadn’t heard of anti-HIV campaigns in a long while, he believed the scourge had disappeared, adding that even at the peak of the campaigns, he always used condoms.


Mr. Kalu Ogba, a traditionalist, said HIV/AIDS issue only exists in people’s psyche. He said African herbs are ready remedies for the disease, but that sadly, many do not believe in them. “I do not believe nature can come up with an ailment without prescribing the cure. HIV/AIDS can’t be different,” he said.

An undergraduate once called this correspondent from a neighbouring state, requesting for the contact address of the professor at Michael Okpara University of Agriculture, Umudike Abia State, who reportedly invented a cure for AIDS.When asked how she contacted the disease, she said: “There are many ways to contact it. Some victims deliberately infect others with the virus, so that their number will increase or to harm those who mock them. I once ran short of money in school, and a man who had been pestering me for sex promised to solve my problem. I succumbed, not knowing he was a carrier.

“When I went for test, I met other young people at the HIV testing centre. While exchanging experiences, we decided to form a network to increase our number and become more sexually liberal towards people that would solicit sex from us. Since then, we have been increasing our number.”

Pioneer Abia State Coordinator of the Network of People With HIV/AIDS (NWPWHAN) Mr. Jude Munonye said: “You can’t talk of curbing HIV anywhere without a dedicated/committed person or persons living with it actively involved.”He disclosed that no NWPWHAN member or people living with the disease are working in the Local Government offices or state.

Suggesting ways of curbing HIV, the State Coordinator of the agency, Mr. Michael Ozeh said government should provide employment to jobless people, especially HIV victims. “This is because a victim that has no job to sustain self must find a way to survive, including prostitution. However, I don’t agree that the HIV prevalence ascribed to the Southeast as being above the national average is correct,” he said.

Ozeh advised that campaign against HIV/AIDS should be re-energised, with more centres created for testing and free distribution of ART, discourage stigmatisation of victims, as well as disabuse the impression that permanent cure has been found, among others.Rev. Ken Johnson, a Pentecostal Church priest, attributed the reportedly growing prevalence to people’s neglect of their obligations to God and the quest for money and materialism.
 
Declining Fund Inhibits Anambra From Effective Intervention
ANAMBRA State is said to top the list of HIV prevalence in the Southeast. Statistics made available to The Guardian revealed that of the 1.9 percent HIV prevalence in the region, Anambra has the highest with 2.4 percent, followed by Abia with 2.1 percent, Enugu 2.0 percent, Imo 1.8 percent and Ebonyi 0.8 percent.

Confirming the development, the Director, Public Health Services and Diseases Control in the State Ministry of Health, Dr. Uche Onyejimbe said: “Actually, it is Anambra State that has the highest in HIV prevalence in the Southeast. It is not that efforts are not being made to stem the tide. Part of the reasons for the increase is the social mobility, fluctuation in funding by international donor agencies, interruption in donor cycle for implementing partners, laxity or reduction in sensitisation programmes and irregular media jingles.“Anambra is a commercial state, with Onitsha and Nnewi having big markets, which attract traders and travellers. Because of daily mobility and influx into the state, it is possible that people come in with HIV. Again, when there is an interruption in the screening and treatment of HIV, it can rebound, as its viral load can increase.”

He suggested that the government invests more in its eradication, noting that there was declining fund to intervene in the state.A Social critic, Ezeude Onyemazu said the high prevalence of HIV indicates a failed moral standard in society. He said: “Some churches are playing down on sexual immorality because they are part of the problem. This is because their members are both sexually and morally corrupt, and they find it hard advising or cautioning members on their permissive sexual life to avoid being implicated. Some churches spend most of their time preaching their own welfare to the detriment of moral decadence in the society.”He also blamed some parents and guardians, who according to him, “have lost out in the control of their children and wards because of extreme poverty.

He said: “The current hardship is such that the children and wards are fighting for themselves to have something to eat; hence they fall prey to all manner of moral decadence, including sexual voyage.“The way out is for us to return to our culture and value system, which condemns sexual immorality. Our Christian religious leaders should see sex as ordained by God for procreation by married persons. School authorities should organise such extra-curricular activities as school debates, quiz competitions and sports to keep students busy.”

The social critic urged parents and school authorities to limit the use of the phone by students in secondary schools downwards, to check social exclusion and tendency to internalise sexual escapades they learn through social media. The Vicar, Church of The Holy Spirit, Awka, Venerable Dr. Rex Kanu said: “The high incidence is caused by poverty and immoral persons, including sugar daddies, who lure young girls with money and gifts.

The implication of engagement in immoral acts is punishment from God, which may be in the form of incurable disease like HIV/AIDS.“That means we have sidelined God in what we do. If God says we should not commit adultery and fornication, then we should abide by that. But fornication is being committed, and people now take to lesbianism and homosexuality. So, God’s anger is against us and that is why HIV is prevalent. God is using it to teach us a lesson, to follow His ways.”


In this article:
Gambo AliyuHIV/AIDSNACA
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