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Winning the HIV/AIDS war

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The world marked the 2012 World AIDS Day a few days ago. The celebration brought mankind, once again, to the challenges ahead in the fight against the dreaded human immune deficiency virus that causes Acquired Immune Deficiency Syndrome (AIDS). The first two cases of HIV and AIDS in Nigeria were said to have been identified in 1985 and reported at an international AIDS conference in 1986. In 1987, the Nigerian health sector established the National AIDS Advisory Committee, followed shortly by the establishment of the National Expert Advisory Committee on AIDS (NEACA).

Between 1986 and 1991, government and individual attitude to the disease was poor. The Nigerian government was slow to respond to the increasing rate of HIV transmission and the citizens were either denying its existence or associating the disease with myth, borne out of ignorance. And that attitude never helped to adequately tackle it. As far as some Nigerians were concerned, AIDS was caused by evil spirits and witchcraft.

By 1991 when the Federal Ministry of Health made its first attempt to assess the situation with HIV and AIDS in Nigeria, the results showed an alarming 1.8 per cent prevalence, meaning that over one million Nigerians had contracted the virus.

The prevalence rose to 4.5 per cent in 1995/96, and peaked at 5.8 per cent in 2001. Since then, the prevalence has been on the decline, such that the current evidence from the 2010 HIV survey indicates that the rate came down to 4.1 per cent. The current overall National HIV prevalence for 2010 ranges from 1.0 per cent in Kebbi to 12.7 per cent in Benue State. The prevalence is said to be generally higher in urban than rural areas.

The North Central, South East and the South-South zones are worst affected. The cheering news is that the HIV prevalence among youths aged 15-24 years which is seen as a crude index of new infection showed a sustained decline from 2001 to 2010 ( 6.0 per cent in 2001, 5.3 per cent in 2003, 4.3 per cent in 2005, 4.2 per cent in 2008 and 4.1 per cent in 2010). At least, the future of this country is not as threatened as many people feared, given the reckless sex life the youth indulge in. This has given us some ray of hope that the country’s prevention/ intervention strategies are working particularly among this sexually active segment of the population.

It should be borne in mind that even with the good news, the challenges still facing the country are daunting. With a prevalence rate of 4.1 per cent, there is no doubt that in statistical terms, the prevalence rate means that about 3.1 million Nigerians are still carrying the virus. That figure, by any standard of measurement, is huge. It is more than the whole population of some states in Nigeria.

It is estimated that approximately 220,000 people died of AIDS in Nigeria in 2009 and the disease has also been associated with Nigeria’s declining life expectancy which in 2010 was only 52 years. If new infections are not curtailed and existing carriers are not prevented from developing full blown AIDS and ultimately dying, the AIDS scourge could combine with worsening economic hardship to further reduce life expectancy in the country. It would also worsen the country’s declining productivity because it is established that the greatest victims of AIDS fall within the socially and economically active age brackets. They have the physical strength to pursue sex pleasure and are also highly mobile in economic pursuits which expose them to locations they could contract the virus.

Again, we caution that the decline in prevalence does not necessarily mean that all parts of the country are recording lower infection at the same rate. A startling discovery from the 2010 survey showed that in a particular rural village in Benue State called Wannume, prevalence was as high as 21.3 per cent.

These carriers need regular counseling to continuously assure them that it is not the end of life and to discourage victims from committing suicide. They equally need medicines to manage the virus and live a normal productive life. All efforts must be made to minimise the stigmatisation of HIV carriers. The scientific and medical world is already looking at the HIV/AIDS war as one that will be won very soon. Nigeria must join in this by making sure that new infections are reduced and the decline in the prevalence of the disease is sustained.

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