NACA dismisses report on HIV/AIDS accounting for 59.3% of female deaths

‘Strengthening health systems decreases virus prevalence’

The National Agency for the Control of AIDS (NACA) has dismissed report in one of the national dailies, not The Guardian Newspapers, which quoted a National Bureau of Statistics Report titled “Statistical Report on Women and Men in Nigeria” that said “Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) accounted for 59.3 percent of female deaths recorded in Nigeria for four years between 2010-2013.”

The report also stated: “HIV/AIDS affected females the most by accounting for 63.5 percent of the fatalities, and 40.7 percent male deaths documented were attributed to HIV/AIDS.”

Director General of NACA, Prof. John Idoko, however, said the number of AIDS deaths in Nigeria between 2012 and 2014, according to the National Health Sector Validated Data 2012, 2013 and 2014, indicates that in 2012, the country lost 4,2017 males and 5,386 females; in 2013 the figures were 5,313 males and 7,791 females; and in 2014 the country lost 7,148 males and 8,961 females.

NACA, in a statement, yesterday, said: “It is pertinent to note that the editorial opinion only gave unfounded percentages of AIDS deaths without stating the total number of deaths upon which the percentages were based.

At page 8 of the report in question, under “HIV DEATHS” the report says, ‘More than 45 per cent of deaths recorded in 2013 were caused by HIV/AIDS. HIV/AIDS on the average accounted for 59.3 per cent female deaths and 40.3 per cent male deaths.’

However, the total number of deaths and the number of deaths due to AIDS, which resulted in the percentages, were not given. Even the ‘Summary Distribution of Deaths by Causes, Year and Sex (2010-2013)’ – Table 2.2a at page 7 of the report did not capture HIV/AIDS among the diseases.

“If the factual AIDS deaths given above were taken into cognizance, malaria which accounted for 108,453 deaths in 2012 and 46,612 deaths in 2013, according to the Summary Distribution of Deaths by Causes, Year and Sex, by far accounted for more deaths than AIDS in Nigeria, within the period.

“Given the facts mentioned above, we are compelled to conclude that your reputable newspaper has been misled with an inaccurate and incoherent report by the National Bureau of Statistics, in respect of AIDS deaths, to believe and conclude in your editorial opinion, that “the prevailing strategy” to win the war against the HIV/AIDS pandemic has not worked.

“On the contrary, HIV/AIDS has been in decline in Nigeria in the past five years, due to improved funding by the Federal Government and the sustained efforts of international partners. This has made it possible for the number of people living with HIV who are on Anti Retroviral Therapy to sharply increase from 359,181 in 2010 to 747,382 in 2014.”

Idoko, however, said there are more remarkable improvements attributable to Nigeria’s HIV response:*The number of HIV counselling and testing sites across the country from 1,046 in 2010 to 8,114 in 2014.
*The number of people tested for HIV has significantly increased from 1,380,418 in 2010 to 7,101,636 in 2014.
*On Prevention of Mother to Child Transmission (PMTCT), the number of sites has increased from 675 in 2010 to 6283 in 2014.
*Similarly, the number of HIV positive pregnant women who received anti-retroviral prophylaxis to pregnant mother to child transmission has increased by over 87 per cent from 33,891 in 2010 to 63,350 in 2014.

The NACA DG said HIV prevalence has declined from 5.8 per cent in 2001 to 4.1 percent in 2010, and new HIV infections have declined by about 50% from 338,423 in 2005 to 176,701 in 2015.

Idoko said, from these figures, it is clear that Nigeria has made significant progress in AIDS Response.

He further explained: “Effective antiretroviral treatment provides a dual effect of saving the lives of people living with HIV and sharply interrupting the transmission of HIV within the community. With improved domestic budgeting for HIV/AIDS and sustained external funding, there are plans to expand the coverage of antiretroviral treatment to 1.2 million adults and children by 2017 through the establishment of 2000 additional treatment sites. This and other prevention and control activities are important steps towards achieving an end to AIDS epidemic by the year 2030.”

Meanwhile, another tudy published in JAIDS Journal of Acquired Immune Deficiency Syndromes found that Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) prevalence decreased in Health System Strengthening (HSS) states between 2007 and 2012.

The researchers from the Population Council, HIV/AIDS Division, Abuja, the Society for Family Health (SFH), HIV/AIDS Division, Abuja, and the United Nations Population Fund (UNFPA), Accra, Ghana, concluded: “Respondents in HSS states were more likely to have lower HIV prevalence and reduced sexual risk behaviours. There appears to be progress in mitigating the burden of HIV by reduction of HIV-related risk behaviours through HSS. Thus, HSS intervention needs to be sustained and replicated to achieve a wider impact and coverage.”

The researchers led by Dr. George I. Eluwa, include: Dr. Sylvia Adebajo, Omokhudu Idogho, Oluwole Fajemisin, Jennifer Anyanti, and Babatunde Ahonsi.

The report is titled “Impact of Health System Strengthening on HIV/AIDS.”

The researchers wrote: “We evaluated the impact of health system strengthening (HSS) on HIV prevalence and sexual risk behaviours in Nigeria.

Impact of HSS was evaluated in a cross sectional analysis using two rounds of HIV bio- behavioural surveys. Logistic regression was used to assess the impact of the HSS programme on HIV and risky behaviour.

“Study was conducted between 2007 and 2012 in sixteen states in Nigeria. Subjects: Using a multistage selection criteria for households, a total of 4,856 and 11,712 respondents were surveyed in 2007 and 2012 respectively.

“Health system strengthening for state agencies for the control of AIDS was conducted in seven states.

“Overall change in HIV prevalence between 2007 and 2012 was 6·3 per cent vs. 5·3 per cent (p=0·113) and 3·0 per cent vs. 5·1 per cent (p<0·001) in the HSS and non-HSS states respectively. When controlled for age, gender, HSS intervention, location (rural vs. urban) and year (2007vs.2012), respondents in the HSS states were less likely to have acquired HIV (AOR:0.78;95%CI:0.63- 0.96), more likely to have comprehensive HIV knowledge (AOR:1·28; 95% CI:1·06-1·54) and to use a condom consistently in the last three months boy/girlfriends (AOR:1·35; 95%CI:1·03-1·79).” Until now, Nigeria has the second highest number of people living with HIV in sub-Saharan Africa after South Africa. Since the HIV prevalence peaked at 5.8 per cent in 2001, HIV prevalence has continued to decline with national estimates of 3.6 per cent and 3.0 per cent in 2008 and 2012 respectively.18 The multi- sectorial approach to combating HIV in Nigeria was endorsed by the National Council of Health in 1997 and commenced in 2000 by the Presidential Council of AIDS which metamorphosed into the National Agency for the Control of AIDS (NACA). Several studies have shown that the contribution of donor funding for HIV prevention, care and treatment has steadily decreased from 85 per cent in 2007 to 75 per cent in 2010, 19,20 however donor programs which are mostly based on vertical approaches, have a significant influence on HIV programmes implemented in Nigeria. In 2009, the United Kingdom Department for International Development, initiated a systems strengthening project, “Enhancing Nigeria’s Response to HIV/AIDS (ENR)” to reduce the prevalence of HIV in focus states across Nigeria. The study evaluated the impact of this health system strengthening initiative on HIV prevalence and sexual risky behaviour among the general population in Nigeria. It has provided empirical evidence to inform policy makers, donors and programme managers in designing HIV prevention interventions in Nigeria.