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Why U.S. does not give direct funding to agencies in Nigeria

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A doctor attending to mother and child at a clinic CREDIT: USAID


*U.S.G. has invested N305.586bn in country’s health programmes since 2015
Officials of the United States (US) Consulate in Nigeria have provided more explanation why their government does not give direct funding to agencies and governments in Nigeria. They said it is more efficient to channel the resources through Non Governmental Organisations (NGOs) for effective utilisation and accountability. They also said Nigeria was not part of the countries that received cut in Human Immuno-deficiency Virus (HIV) funding that was suggested by President Donald Trump.

The officials, who were facilitators of a 2019 Health Journalism Seminar, held at the Multi- Purpose Room (MPR) of the US Consulate General, Public Affairs Section, Lagos, with theme “Working Together to Create Nigerian Solutions to Nigerian Challenges,” said Nigeria has done well in HIV programming and the impact has been celebrated.

The facilitators led by the Public Affairs Officer, US Consulate, Mr. Russell Brooks, include: Communications Specialist, US Centres for Disease Control (CDC) Nigeria, Usman Halilu; United States Agency for International Development (USAID) Supervisory Development Outreach & Communications Specialist, Mr. Zack Taylor; and Country Director, Nigeria Walter Reed Army Institute of Research, Ms. Laura R. Chittenden.“Yes, there has been cut in HIV funding from the US to some other countries but not in Nigeria. The programme here has been stable and successful,” Brooks said.

Taylor said: “USAID does not give any money directly to the Federal or State governments in Nigeria. USAID funding to Nigeria is allocated by Congress and earmarked into global health elements- malaria; family planning and reproductive health; maternal and child health; nutrition; HIV/Acquired Immune Deficiency Syndrome (AIDS), tuberculosis (TB).

“Global health programme guidance is negotiated with Congress which defines the exact use of funds. There are a variety of mechanisms by which we provide financial and technical assistance-USAID also partners with Public International Organisations and multilateral institutions like the World Health Organisation (WHO), United Nations Children Fund (UNICEF), Global Fund, GAVI Vaccine Alliance; local NGOs; and some private sector organisations.”

Taylor said the US government has invested N305.586bn ($846.5m) in health programmes in Nigeria since 2015 and about 800,000 of the 1.2 million people with HIV receiving free treatment are funded by the American people. He said funding for health activities comes from three places: bilateral operating budget; US President’s Malaria Initiative (PMI); US President’s Emergency Preparedness Fund for AIDS Relief (PEPFAR).He said USAID, in 2018, spent $160.5 million on health in Nigeria, which represents approximately 35 per cent of the overall USAID budget of $462 million.

Taylor said this includes $70 million from the PMI and does not include $209 million for HIV/AIDS from PEPFAR.He said including PEPFAR, more than 75 per cent of USAID funding in Nigeria goes to health.

According to him, the USAID in 2018 tested over two million people for HIV and of the 69,000 identified as positive, nearly 55,000 began treatment. “USAID also provides more than 285,000 HIV positive Nigerians with life-saving therapy, and continues to supply Nigeria with HIV test kits and medicines as part of the US government HIV/AIDS response. USAID also provides care and support for more than half a million children orphaned or otherwise affected by HIV,” he said.

Taylor said the goal of the cooperation with the Federal Government of Nigeria is to support Nigeria’s National Strategic Health Development Plan. He said USAID’s role in Nigeria’s health care system is to: provide financial and technical assistance to support the Ministries of Health (MOH) to accomplish their health objectives; coordinate with other donor partners to harmonize support; leverage strategic partnerships to increase resource base for health; emphasize data-driven approaches and evaluation; and explore innovative technologies, programming and creative solutions to address long-standing health challenges.

Taylor identified the challenges facing healthcare in Nigeria to include: stagnation in health indicators over the past decade; infant mortality has increased as one in eight children die before 5th birthday; total fertility rate of more than five children per mother; less than one in three have received all basic immunisations as highest number of children in the world who remain unvaccinated against measles; inadequate numbers of trained health workers in rural and remote locations; government’s inability to (financially) commit as less than four per cent of government budget dedicated to health against Abuja Declaration which promised 15 per cent; delays in the release of Basic Health Care Provision Fund as provided by the National Health Act (2014); and shortfalls in contraceptive procurement, widening the gaps that donors must fill.

Taylor said USAID health priorities in Nigeria for 2019 and beyond are to: end preventable maternal and child deaths; improve the nutritional status of pregnant women and children under five; reduce unmet need for family planning; reduce HIV prevalence among most-at-risk populations; and health systems strengthening.

Chittenden said the partnership between WRAIR’s Walter Reed Programme-Nigeria (WRP-N) and the tri-service Nigeria Ministry of Defence Health Implementation Programme (MODHIP) was launched in 2005 to provide HIV services at 11 Nigeria military health facilities.

She said the sitting Honorable Minister of Defence and the sitting U.S. Ambassador to Nigeria chair the partnership’s steering committee.Chittenden saidsince 2005, MODHIP has increased the number of health facilities served under the partnership to 40, and health services provided are comprehensive – including HIV testing, care, treatment, and laboratory services.She said the scope of the programme has also increased, to include research studies in HIV and emerging infectious disease, malaria diagnostics, and bio-preparedness.

Chittenden said all activities implemented under the partnership are done shoulder to shoulder by the U.S. and Nigerian militaries to improve the health of the military service member and impact health outcomes worldwide.She said the programme has started a multi-country Phase 2 clinical trial to investigate the safety and immunogenicity of two Ebola vaccine regimens in healthy and HIV-infected adults up to 70 years old.

She also said the WRAIR EID Branch and USAMRD-A/N, in collaboration with NMOD and the African Centre for Excellence for Genomics of Infectious Disease (ACEGID, Redeemer’s University) are planning Lassa fever epidemiological studies in preparation for candidate vaccine studies.Chittenden said population-based sero-epidemiological studies are needed for better clinical evaluation of Lassa vaccine candidates and the planned studies will align with the Coalition for Epidemic Preparedness Innovations (CEPI) consortium of Lassa epidemiological studies.She said the proposed sites are Abuja and Lagos, anticipated start date is FY 2020 and the partnership is competing for inclusion as a clinical site in an upcoming Lassa vaccine Phase 2 clinical trial.

Halilu said due to the activities of PEPFAR, now, AIDS-related deaths globally have fallen by 50 per cent since their peak in 2005 just as the number of new HIV infections has been reduced by 47 per cent since 1996.He said with support from PEPFAR, more than 2.2 million babies were born HIV-free to mothers living with HIV or AIDS in 2018 alone. “Thanks to PEPFAR, there is now a 25 to 40 per cent decrease in diagnoses of HIV in young women in ten African countries,” Halilu said.

He said theU.S. government, through PEPFAR, has not only saved and improved millions of lives, but also transformed the global HIV/AIDS response.Halilu said, in 2018 alone: PEPFAR provided life-saving HIV treatment to over 800,000 Nigerian men, women, and children living with HIV; approximately 7.4 million Nigerians received HIV counseling and testing services; more than 1.6 million pregnant Nigerian women were tested for HIV; and more than 1.2 million orphans and vulnerable children received care and support services. Halilu said the primary responsibility of the US Centers for Disease Control and Prevention (CDC) is to detect, respond and prevent current and emerging diseases.

The CDC is the leading national public health institute of the United States established on July 1, 1946.
He said the CDC, among other things, performs the following functions:
*On the cutting edge of health security – confronting global disease threats through advanced computing and lab analysis of huge amounts of data to quickly find solutions.

*Putting science into action – tracking disease and finding out what is making people sick and the most effective ways to prevent it.
*Helping medical care – bringing new knowledge to individual health care and community health to save more lives and reduce waste.
*Fighting diseases before they reach our borders – detecting and confronting new germs and diseases around the globe to increase our national security.
*Nurturing public health – building on our significant contribution to have strong, well-resourced public health leaders and capabilities at national, state and local levels to protect Americans from health threats.


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