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‘Why HIV cases, AIDS-related deaths are still high in Nigeria’

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Ujah

Prof. Innocent Ujah is a consultant obstetrician and gynaecologist at Jos University Teaching Hospital (JUTH) and the immediate past Director-General of the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos. Ujah is also the National Chairman of the Nigerian Medical Association (NMA) committee on Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). He, in this interview with The Guardian ahead of the World AIDS Day (WAD), among other things, revealed how the association plans to reduce the scourge of the virus and meet national and global targets of eliminating the disease by 2030. ISA ABDULSALAMI AHOVI writes.

Why is HIV rampant especially in Africa and Nigeria?
HIV/AIDS is a public health issue and although the prevalence rate is decreasing, the number of cases and AIDS-related deaths are still unacceptably high. It is not so much that the rates are high; it is so that every death from any condition is unacceptable. Dying from any condition should not be reduced to mere statistics. The prevalence of HIV/AIDS in Nigeria was 1.8 per cent in 1991, peaked in 2001 at 5.8 per cent and is currently on the downward trend of about 2.8 per cent. This, translating to real figures shows that about three million people are still living with HIV/AIDS Nigeria. To specifically answer your question, HIV/AIDS is rampant in Africa, including Nigeria largely due to poverty of knowledge and financial poverty, oiled by superstitions and conflicting perception on the aetiology of AIDS. First, was the denial that HIV/AIDS existed and then to the fact that the “white man” decided to inflict Africa with the virus. Those who were infected claimed they were “poisoned” and therefore, sought the services of prayer houses and traditional healers, including the “Babalawo” instead of availing themselves of available orthodox medical care.

How is lack of funds and technical capacity inhibiting efforts to find solutions?
More than anything else, what is needed most is the political will and commitment of Government. Once there is commitment, the Government will give priority to the national response through the elimination of HIV/AIDS by 2030 with the aim of ensuring zero new infections, zero AIDS-related deaths and zero discrimination. The NMA is committed to partner with stakeholders, like the National Agency for the Control of AIDS (NACA) to contribute to the effective national response and ensure that many Nigerians have access to Counselling and testing as well as anti-retroviral drugs. The irony is that whereas, the US government has committed over $4 billion to the HIV/AIDS programme in Nigeria, the same could not be said of the Federal fund contribution to HIV/AIDS programme as paltry sum of money is usually budgeted. This makes Nigeria unable to take ownership in the national response and perpetually depending on donor funds.

Why is WAD so important, are we marking our inability to cure the disease?
December 1 every year is set aside for all countries of the world to raise awareness about HIV/AIDS and to show support for people living with the disease. The day provides opportunity for people worldwide to unite in the fight against HIV/AIDS. The NMA, as an important stakeholder in the National response, decided to put up extensive plans to create awareness throughout the 36 states and Federal Capital Territory (FCT) Abuja towards the prevention, treatment, care and support of HIV/AIDS with the overall objective of reducing the scourge of the disease.

Why is it impossible to cure HIV?
A great deal of effort is on to develop effective vaccine that will immunize against HIV. This takes time and money and also knowledge and skill. The global community is committed to the elimination HIV/AIDS. However, while no effective vaccines have yet been produced, there are effective preventive strategies such as the use of condoms, particularly among the at risk groups of sex workers, gay population and intravenous drug users, screening blood for HIV before transmission and prevention of mother-to-child transmission of the disease. The fundamental basis is predicated on the fact that everybody should be subjected to HIV counselling and testing to know his or her status.

Can we trace its history?
I do not think that we should remind ourselves of the history of HIV, however, the first case of HIV was discovered in Nigeria in Nigerian Institute of Medical Research (NIMR), Lagos in 1985 and presented in a conference in 1986. Globally, the first case of HIV was discovered in 1981 in the USA. Despite this unique scientific discovery, the Government of Nigeria at the time denied that there was HIV/AIDS in Nigeria.

This probably is responsible for the raging epidemic before effective intervention strategy was put in place through the collaborative efforts of the US Government, through the Presidential Emergency Plan for AIDS Relief (PEPFAR) to slow down the epidemic, but without when incalculable damage had been done to our people. If the Government at time had accepted the scientific discovery and raised appropriate response, the number infected and affected may not be as high as was recorded. The lesson learnt from this tragedy, is the Nigerians should believe in the power of research and also believe in the knowledge and skills of Nigeria Scientists, because the use of research outcomes is central for, strategic policy plans, advocacy and implementation

Why was Dr. Jeremiah Abalaka’s claim to have its cure dumped and not even tested?
Science is not about media propaganda or beauty contest. There are processes and procedures, including ethical clearance. Obviously, Dr. Abalaka threw these processes to the wind. More importantly, Dr. Abalaka who is a well renowned surgeon failed to avail his methodology to expert scrutiny and the methodology could not be reproducible. Finally, what has become of his “discovery” today? We are interested to know.

Are practitioners of orthodox medicine exhibiting jealousy at times?
Scientific discovery is not about jealousy. It will be a great and welcome addition if a Nigerian like Dr. Abalaka can win a Nobel prize for his discovery and of course, a pride to the Medical Community if one our members is elevated to such status, but the reality is that credible research findings must still be subjected for further evaluation by the global community for universal acceptance.

Will you recommend African alternative medicine for AIDS’ cure?
Any alternative is acceptable provided such alternative conforms to the acceptable research protocol. We shall certainly not acceptable Yahoo-Yahoo research result in Nigeria since we are part of the global community and bound be processes and procedures of research protocol

What will you bring to bear to make your tenure memorable?
NMA has been at the forefront of awareness creation, through advocacy and sensitization and ever since 1990, the Association established a Standing Committee on AIDS as part of it contribution to the National response and working in partnership with other stakeholders to eliminate HIV/AIDS from Nigeria. This is the dream of the Nigerian Medical Association.


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