Cablegate: Nigeria Commemorates World Aids Day

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1. Summary: The HIV infection rate in Nigeria is estimated to be
4.4% or 3.9 million inhabitants with the most vulnerable the 20-24
year age group along with an estimated 930,000 orphans. The USG is
the largest bilateral donor at $304 million for 2007 and holds the
donor coordination chairmanship in Nigeria. The USG HIV/AIDS Team
and its development partners held activities throughout Nigeria to
commemorate World AIDS Day on December 1, 2007 and the team looks to
exceed its targets as it prepares to implement the 2008 Country
Operational Plan. End Summary

2. The primary HIV/AIDS coordinating body for the Government of
Nigeria (GON) is the National Agency for the Control of AIDS (NACA)
along with the Federal Ministry of Health. The HIV infection rate
in Nigeria is estimated at 4.4% of the population (Federal Ministry
of Health, 2005) or about 3.9 million inhabitants infected with HIV
and an estimated 930,000 AIDS orphans. In addition, Nigeria has one
of the highest tuberculosis (TB) rates (290/100,000 population, WHO
2006) in the world and the largest TB burden in Africa. Many TB
cases go undetected despite increasing TB detection rates and TB
program coverage.

3. Nigeria's HIV/AIDS epidemic is largely confined to heterosexual
transmission and mother-to-child transmission, but there are clearly
identifiable risk groups such as girls who marry at a young age. By
2015, an estimated 16.2% of the total population under 15 years of
age will be orphaned, up from only 5.2% in 2000. The current HIV
prevalence peaks in the 20 to 24 year age group which implies that
people are becoming infected at an early age. With over half of the
infected population under 25 years of age, Nigeria was classified as
a "second wave" country by the U.S. Office of the Director of
National Intelligence's National Intelligence Council. While
prevalence estimates imply that the stage is set for the next and
larger wave of the epidemic to transpire over the next decade, the
USG will work to counter such a situation with intensified and
targeted prevention activities.
USG efforts
4. The United States is the largest bilateral donor to the Nigeria
HIV/AIDS sector, having provided a total of $304 million in support
in 2007. The USG in-country agencies include USAID, HHS/CDC,
HHS/NIH, Department of State, and Department of Defense.

5. Funding in Nigeria is focused on treatment, prevention, and basic
care and support. Treatment activities include the provision of
antiretroviral drugs and services to eligible patients as well as
laboratory support for the diagnosis and monitoring of HIV positive
patients identified through USG Nigeria activities. Prevention
activities include prevention of mother to child transmission
(PMTCT), abstinence and be faithful (AB) programs, blood and
injection safety, and other prevention initiatives (focused on high
risk populations). Care activities in Nigeria include HIV
counseling and testing (HCT), palliative care, TB/HIV, and support
for orphans/vulnerable children (OVC).

6. In addition to our regular planning with NACA and the Federal
Ministry of Health, the USG team holds one of two bilateral seats on
the Country Coordinating Mechanism for the Global Fund and is the
current Chair of the Development Partners Group for HIV/AIDS, which
is the primary donor coordination body for multilateral and
bilateral organizations providing HIV support.

7. In addition to USG agencies, development partners include the
Global Fund; World Bank; the Clinton Foundation and UNAIDS; DFID;
JICA; CIDA; WHO; and UNICEF. Others include the African Development
Bank, International Labor Organization (ILO), Italian Cooperation,
UNDP, UNDCP, UNFPA, and UNIFEM. The USG will continue to leverage
funding from both the Global Fund and the Clinton Foundation. The
Global Fund has approved five HIV/AIDS and TB grants for Nigeria,
totaling approximately $100 million in lifetime awards to support
the expansion of TB services, Anti-Retroviral Treatment, PMTCT and
the promotion of civil society's role in the HIV/AIDS response.
USG World AIDS Day Activities
8. Public Affairs Office (PAO) commemorated World AIDS Day at
American Corners venues from December 3-5 in twelve states (Lagos,
Ogun, Oyo, Enugu, Port Harcourt, Calabar, Kaduna, Kano, Jos,
Maiduguri, Bauchi and Sokoto) highlighting the theme, "Leadership
and HIV/AIDS Prevention in Nigeria." The programs entailed
discussion around issues in HIV/AIDS such as mitigation, diversity
of the epidemic context and the prevention needs for each state, and
leadership on AIDS. Personal testimonials from PEPFAR program
beneficiaries gave a human face to USG activities in Nigeria.

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9. In partnership with the University of Lagos Medical Center, PAO
Lagos conducted a World AIDS Day march and rally with more than 2000
students to raise awareness about HIV/AIDS. There was also a
three-day workshop for 29 Imams from Lagos State on HIV/AIDS
prevention and awareness. The event was organized by the NGO
Muslims Against AIDS (MAIDS) from November 27 to 29. The workshop,
specifically timed to focus attention on World AIDS Day, prepared
participants to educate members of their communities. Dr. Nasir
Sani-Gwarzo, a medical epidemiologist with the Centers for Disease
Control (CDC), addressed technical aspects of HIV and AIDS. MAIDS,
in turn, identified Islamic scholars and other medical practitioners
to address the implications of HIV/AIDS in the context of Islamic
USG Development Partners Activities
10. USG partners activities included:

-Enabling HIV/AIDS, TB and Social Sector Environments (ENHANSE)
activities supported in Abuja included TV/Radio talk shows, a media
roundtable on the leadership theme, and an advocacy march by People
Living with AIDs (PLWAs) to the National Assembly to demand early
passage of the bill on Stigma and Discrimination.

-In the week leading up to World AIDS Day, Safe Blood for Africa
(SBFAF), conducted a blood drive at the offices of CDC/Nigeria in
Abuja and used the cellular telephone network to initiate text
messaging on the importance of "knowing your status".

-The Defense Headquarters Medical Center, a Nigerian Ministry of
Defense - U.S. Department of Defense HIV Program PEPFAR site
supported activities at Mogadishu Barracks in Abuja. This included
HIV prevention education and awareness activities, the initiation of
a peer education training program for PLWAs, and a candlelight

11. NACA held a week long program leading up to World AIDS Day in
Abuja. This included radio jingles, newspaper advertisements,
community outreach activities, round table discussions and blood
drives. On December 1, NACA sponsored an advocacy walk and rally.
Participants included the UN Resident Coordinator and the USAID
General Development Officer on behalf of the Development Partners
Group which includes USG/Nigeria.
Looking to the future
12. Post anticipates receiving approval for its 2008 Country
Operational Plan in early 2008. With President Bush continuing his
support by committing an additional five year commitment of $30
billion, post expects to exceed its 2007 targets in the three areas
of treatment, prevention, and basic care and support.


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