…FG responds, allocates N4.5bn for HIV treatment
Nigeria has been left to fund its own health challenges largely unaided as the United States President Donald Trump scales back aid for HIV/AIDS and other deadly diseases in poorer nations.
Trump signed an executive order five days ago suspending foreign aid for 90 days, including funding support to Africa, arguing that the practice doesn’t align with American values and interests.
The U.S president approved limited access to life-saving medicines and medical services, allowing the continuation of U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)-supported medical services in Nigeria and other countries.
But the situation has left Nigeria scrambling for funds to meet the needs of 68 million malaria and 1.9 million HIV patients, some of who survive on U.S aid.
Jean Kaseya, director general, Africa Centre for Disease Control and Prevention, said the trend poses a major threat to Africa.
In an interview on CNN, Kaseya said Africa received $8 billion support from the US in 2024, 73 percent going to the health sector.
About $6.2 billion was spent on HIV response in Nigeria between 2005 and 2020, with about 80 percent of the funds sourced from external donors, mainly from PEPFAR and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
While this happened, the Nigerian government funding for HIV declined gradually from 11 percent in 2007 to 3.9 percent in 2021, according to data from the National Agency for the Control of AIDS (NACA).
Read also: Nigerians to continue accessing HIV Treatment despite US aid cut
Government expenditure focused on prevention services and human resources required to provide care and treatment – from doctors to nurses, laboratory workers, and pharmacists.
As of 2011, the government had spent over N10.5 billion (over $65.8 million) on human resources alone as part of its contribution.
With the U.S. cutting funding, Nigerian government health officials told BusinessDay that they are seeking local donors and exploring how to fight the diseases domestically.
“We are working on taking over the funding of HIV/AIDS, malaria and other aid-reliant diseases. It is quite expensive and we can’t afford all of them, but we need to save lives,” a senior government official told BusinessDay.
U.S support through PEPFAR
Meanwhile, PEPFAR has pumped more than $6 billion into Nigeria’s national HIV/AIDS response. The outcomes included placing over one million women and children on HIV treatment.
Counselling and testing services were offered to over 1.2 million pregnant women toward prevention of mother-to-child transmission of HIV.
The scheme also supports key areas of health systems’ strengthening such as laboratories, pharmaceutical logistics and supply chains, policy, and human capacity development.
The culmination of US support and other donors helped Nigeria to almost triple support for people living with HIV from 360,000 in 2010 to over 1 million in 2018. The support helped them to have access to antiretroviral therapy, according to the USAID.
If funding support continues to dry up, the Africa Centre for Disease Control and Prevention projects there could be two to four million additional deaths annually and increases in pandemic occurrences.
The far-reaching implications are also that many poor people who have been aided in accessing treatment now risk losing these treatments.
Read also: US aid freeze threatens 90% HIV treatment coverage in Nigeria NACA
They could be forced to pay higher costs out-of-pocket for screening and treatment services, adding to the economic burden already facing most Nigerian sufferers.
Nigeria ranks fourth on the global burden of HIV with approximately 1.9 million individuals living with the virus, according to the United Nations Programme on HIV/AIDS (UNAIDS) in 2023.
Chinonso Egemba, a medical doctor and Nigerian health advocate, said almost all affected individuals could develop AIDS – without treatment.
Meanwhile, effective antiretroviral therapy can suppress the virus to the point where it is no longer transmissible, but these medications are costly, and much of Nigeria’s supply has historically come from donations, he explained.
“If Nigeria doesn’t rise to the occasion and take charge, infections will rise. Currently, it’s close to 200, 000 infections every year. People will die from AIDS, drugs are not available.” Egemba said.
“Our already burdened healthcare system will be burdened further. Now is the time to take our health system seriously. Nigeria cannot continue to depend on donations for its healthcare.”
Temitope Ilori, director general, the National Agency for the Control of AIDS (NACA), in an official reaction on Thursday, said the Nigerian government would intensify domestic resource mobilisation strategies towards ownership and sustainability of the HIV response in the country.
She said the government aims to reduce the risks of donor aid and policy shifts to the HIV response while ensuring that the country’s goals and targets in the fight against HIV are achieved.
“We encourage the patient community to continue accessing HIV treatment services in service delivery points across the country and appeal to all our state governors, private sector partners, all the honourable members of the National Assembly and State Houses of Assembly, civil society organizations, the media, and all other relevant stakeholders, to continue in their commitment and support to the fight against HIV/AIDS in Nigeria,” Ilori said.
Patients’ economic status and HIV
In an assessment of the sustainability of HIV treatment services and patients’ willingness to pay, Olawale Durosinmi-Etti, Nigeria’s chief representative and head of operations of John Snow Inc., a global non-profit, found that the socioeconomic statuses of patients have a key influence on their purchasing power.
Read also: Healthcare costs push Nigerians into poverty
He and coauthors are convinced that most people living with HIV receiving free treatment services are willing to pay for the services if it ceases to be free.
“We found that 92 percent of patients were willing to pay for HIV treatment. The mean amount patients were willing to pay was N3,000 naira ($7.5) per month with about 18 percent of patients willing to pay the current monthly price of N5,000 ($12.50). The availability of financial support from family and friends, lack of employment, monthly income, and change in monthly income were associated with willingness to pay,” they explained.
“Measures must be put in place to reduce the cost of accessing HIV treatment and promote financial empowerment of people living with HIV to improve willingness to pay for treatment.”
FEC approves N4.5bn for health
In response to Trump’s funding freeze, the Federal Executive Council (FEC) on Monday approved an allocation of N4.5 billion for the procurement of HIV treatment packs to support Nigerians living with HIV/AIDS.
The approved budget will fund the procurement of 150,000 treatment packs over the next four months, providing immediate relief while demonstrating Nigeria’s commitment to building a more sustainable domestic health financing model.
During a press briefing on Monday, after the FEC meeting, Ali Pate, minister of health and social welfare, emphasised that this allocation is crucial to ensuring uninterrupted access to life-saving treatment for those affected by HIV/AIDS.
He also revealed that the FEC has established a committee, with representatives from the ministries of finance, budget, defense, environment, and the Nigeria Governors Forum (NGF), to develop a sustainability plan.
“This is about ensuring that no Nigerian loses access to treatment during this adjustment period,” Pate explained.
Regarding the recent shift in U.S. policy, Pate expressed appreciation for the American government’s contributions over the past 20 years but stressed that Nigeria is now focused on transforming its health sector through national systems and domestic financing.
