Ensuring Sustainable Funding for HIV

Head, Public Relations & Protocol

In 2020, the world witnessed a disease that would upend all aspects of human life. The highly contagious COVID-19 virus, which began its journey in Wuhan, China, spread across the world quickly, as governments in a bid to curb the spread, announced the closure of schools, banks, borders, worship centres and airports, altering daily life.

When Nigeria recorded its first case on February 27, 2020 in Lagos, there was widespread panic as experts wondered how a country with a fledgling health sector would survive since treatment for COVID-19 is generally free. But Nigeria weathered the storm.

One thing that would prove decisive was the massive financing that would go into the COVID-19 response. The wealthiest people and companies across Nigeria came together to create a Private Sector Coalition and put billions into a relief fund that would be used at the state and federal level.

With the COVID-19 pandemic now winding down and life returning to normal, there still remains other epidemics most notably – HIV/AIDS. The question now is, how can we ensure that the spirit behind such philanthropy and cooperation does not disappear? How do we institutionalise this culture of wealthy individuals and firms channeling money in record time into a common pool to defeat HIV/AIDS?

To this end, the National Agency for the Control of HIV/AIDS (NACA) alongside the Nigerian Business Coalition Against AIDS (NIBUCAA) initiated the HIV Trust Fund intended to draw N62 billion. The initiative, which was launched in January 2022, by His Excellency, President Muhammadu Buhari, is expected to help Nigeria end AIDS as a public health threat and place more people living with HIV on treatment annually.

President Buhari noted that Nigeria’s purposeful partnership with the private sector in the response to COVID-19 pandemic had provided a readily available financing solution to leverage to sustain the HIV response. “Going forward, I hope The HIV Trust Fund of Nigeria will galvanise more of the private sector and other partners to surpass the target of N62 billion in the next five years,” he added.

In his remarks, the Secretary to the Government of the Federation, Mr Boss Mustapha, revealed that over $6 billion had been spent on the HIV response in Nigeria with the organised private sector contributing less than 2% to the sum.

Since 2005, about $6.2 billion dollars has been spent on the HIV response in Nigeria and about 80% of the funds were contributed by external donors mainly the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“The private sector contributed 0.1% to 2% of total funds with the rest of funds provided by the Nigerian government,” Mustapha stated.

Indeed the donations from the private sector in recent years have not really been substantial enough to make the needed impact. But all hope is not lost. Chief Launcher and Chairman and CEO of Dangote Group, Alhaji Aliko Dangote, pledged that the private sector would be able to enter into a 50-50 partnership with the government in the area of funding.

He therefore appealed to individuals and corporate organisations in the country to donate generously toward the Fund, currently chaired by Dr Herbert Wigwe, the Group Managing Director of Access Bank Plc.

“We would like the private sector to work in partnership with the Federal Government on a 50-50 basis which we believe will help us eliminate Mother-to-Child transmission of HIV/AIDS in Nigeria,” he said.

Justifying the need for the Fund, the Director-General of NACA, Dr. Gambo Aliyu, maintained that providing life- long treatment to all Persons Living with HIV(PLWH) even after successfully stopping new HIV infections would require a domestically sustainable financing mechanism.

Apart from monetary funding, the private sector can be leveraged to provide HIV prevention, education, counselling and testing, care and support, and treatment services, says USAID. Also, private sector prevention and treatment efforts for other STIs can directly support HIV services which are even more cost effective.

Besides encouraging the super wealthy to donate to the HIV Trust Fund, everyday Nigerians could also be stimulated to do so by being offered tax incentives. This has boosted philanthropy in developed countries like the United States of America where eligible donations of cash, as well as items, are tax deductible.

Without a doubt, a system whereby a country’s HIV response relies heavily on foreign donors and governments is not only unsustainable in the long run but unreliable. That is why this trust fund is timely. It is also part of the larger Alignment 2.0, a revolutionary programme initiated by NACA which will ensure increased funding and participation by both the Federal Government of Nigeria and the sub- nationals.

Instead of having implementing partners executing programmes at the state, using state structures, the Alignment 2.0 will allow each state to use its own structure to implement the programme while the implementing partners would become teachers, training and showing the state what they do and what they have been doing over the past 20 years to sustain the response and to provide treatment services to people in different locations throughout the state.

At the first instance they would do it together, after one year, the implementing partner would now step aside and serve as technical advisers or technical assistants, providing the state technical guidance and technical services for the state to continue to drive the response. This is the way to go.

Research and experiences have shown that there is a clear nexus between increased funding and efficiency on the one hand and the ability to curb the spread of a disease on the other hand. This is why it is not surprising that the rate of HIV infections has continued to drop since Nigeria increased its ownership of the fight against HIV/AIDS.

According to the World Health Organisation, Nigeria has recorded a 22% decrease in new HIV infections in 2021 from 2015. The WHO adds that 90% of people living with HIV now have access to HIV treatment in the country. The downward trend in the rate of infections has also coincided with the Nigerian government’s increased funding to the HIV response which now sees 100,000 people being added to the government’s responsibility every year for the last three years in furtherance of President Buhari’s promise at a high-level side event during the 72nd United Nations General Assembly in New York.

Indeed, with an improved cooperation between the Federal Government, states and the private sector in the area of funding and expanding access to quality care for people living with HIV (PLWH) and their families, Nigeria is on course to meeting the 2030 target of bringing HIV/AIDS to an end.

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