Information on number of children receiving peadiatric ARV is crucial in appraising Nigeria’s performance with regards to Prevention of Mother to Child Transmission of HIV, PMTCT, strategy. The United States Government through the Centre for Disease Control on the Strategic Use of Antiretrovirals once stated that out of 1.3 million people requiring HIV treatment, only about 600,000 were receiving it. In the light of dwindling funding for HIV treatment, the targets for HIV treatment have been increasing, undescoring the need for more efficiency and effectiveness in the supply chain for HIV treatment.
Dr. Ogbanife Obinna a senior programme specialist of the CDC, in the presentation, observed that it has become necessary to be ahead of the HIV epidemic if Nigeria must achieve zero new infections. This means increasing the number of people on HIV treatment must be pursued aggressively to ensure the number matches HIV new infections. Data presented revealed that over 270,000 new HIV infections occur in Nigeria while only about 56,000 new HIV clients are put on ARVs in the same period with a ratio of 1: 4.8.
When compared to South Africa which records about 350,000 new HIV infections annually and put about 277,000 positive persons on ARVs annually, Nigeria is doing poorly for a country with a high burden of HIV. Several African countries are now ahead of their HIV epidemic because the number people put on treatment annually surpasses the rate of new HIV infections recorded in those countries. Data on PMTCT in Nigeria showed that coverage in 2012 was about 18 percent which was one of the lowest in sub-Saharan Africa. South Africa achieved over 95 percent coverage of PMTCT while Ghana has achieved over 75 percent in 2012. About 25 percent of babies born with HIV in the world are Nigerians.
For Nigeria to meet her HIV treatment goals, resources should be redirected to HIV programmes with the greatest impact. Treatment therapy should be simplified for patients while research continues towards more effective HIV treatment options. Obinna said to optimise HIV treatment to get ahead of the epidemic, it is important to eliminate ARVs not in the National Guidelines; eliminate ARV regimens that are pharmacologically more costly and those that are not as efficacious; and pick the most appropriate triple fixed dose combinations for patients. In order to optimise PMTCT in Nigeria, recommendations for first line therapy in the National Guideline for PMTCT be implemented effectively.
In the view of a PEPFAR Treatment Task Team of consultants that provided important feedback on how HIV treatment can be optimised in Nigeria, new infections could be reduced if the number of persons on HIV treatment is aggressively increased by about 100,000 in 2013, 150,000 in 2014, and 200,000 in 2015. Improved allocation for HIV treatment with additional resources from government in addition to funding of limited number of first line adult HIV therapies with a view to working towards the one tablet therapy were recommended. Decentralisation of HIV treatment and task shifting among health workers is key to success of optimising paediatric HIV treatment, it has been stated.