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Cablegate: Nigeria Celebrates World Aids Day with Focus On Hiv/Aids

VZCZCXRO0106
PP RUEHMA RUEHPA
DE RUEHUJA #2218/01 3420633
ZNR UUUUU ZZH
P 080633Z DEC 09
FM AMEMBASSY ABUJA
TO RUEHC/SECSTATE WASHDC PRIORITY 7697
INFO RUEHOS/AMCONSUL LAGOS PRIORITY 2459
RUEHZK/ECOWAS COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS SECTION 01 OF 03 ABUJA 002218

SENSITIVE
SIPDIS

DEPARTMENT FOR OGAC RYAN, OES/IHA WILUSZ
PASS USAID FOR GH/OHA RCLAY, CHAWKINS
PASS FOR USAID FOR AFR/SD HSUKIN
CDC FOR NCIRD/GID/DEEB RJSIMOND

E.O. 12958: N/A
TAGS: TBIO KISL PGOV SOCI ECON KOCI EAID NI
SUBJECT: NIGERIA CELEBRATES WORLD AIDS DAY WITH FOCUS ON HIV/AIDS
SERVICES COVERAGE

SENSITIVE BUT UNCLASSIFIED - NOT FOR DISTRIBUTION OUTSIDE USG.

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SUMMARY
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1. (SBU) Nigeria commemorated World AIDS Day on December 1 with a
symposium on bridging the gap between the current coverage of 11
percent and its target of achieving 80 percent in the prevention of
mother-to-child transmission (PMTCT). Nigeria has a 4.6 percent
HIV/AIDS prevalence rate. It has an estimated 2.6 million persons
infected with the virus and approximately 1.2 million HIV/AIDS
orphans, making Nigeria the second highest HIV-burdened country in
the world after South Africa. It has the highest percentage of
pregnant women (30 percent) in need of antiretroviral treatment to
prevent mother-to-child transmission among 20 highly HIV-burdened
countries. The Director General of the National Agency for the
Control of AIDS (NACA) promised to close the gap in PMTCT coverage
through its new National HIV/AIDS Strategic Framework for 2010-2015.
He thanked the USG and other donors for their support. The
Chairmen of the House and Senate Committees with oversight on health
matters promised more funding for HIV Testing and Counseling (HTC)
and PMTCT services and hoped for the passage of an
anti-stigmatization and discrimination bill by early next year. The
Ambassador highlighted the need to close the gap between current and
targeted PMTCT coverage. The Ambassador visited a USG-funded PMTCT
clinic in Abuja on December 3 and emphasized the importance of
women's leadership in the fight against HIV/AIDS. END SUMMARY.


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WORLD AIDS DAY AND AN OVERVIEW OF HIV/AIDS IN NIGERIA
--------------------------------------------- --------

2. (U) The GON commemorated World AIDS Day with a symposium on PMTCT
on December 1. Invited guests, donor and civil society partners,
and representatives of people living with HIV/AIDS (PLWHA) attended
the symposium. The first case of HIV/AIDS in Nigeria was reported
in 1986. Since then, the epidemic has steadily grown with a
concomitant drop in life expectancy from 53 years in 1990 to 46.5
years in 2008, negating positive effects that might have occurred as
a result of any improvements in living standards and health care.
Nigeria, with an estimated 2.6 million persons infected with the
virus and 800,000 people requiring anti-retroviral drugs, has the
second-highest burden of HIV infection in the world, surpassed only
by South Africa. The USG PEPFAR program provides roughly a third
of the required retroviral drugs in the country. The epidemic has
already claimed approximately three million lives and left around
1.2 million orphans to be cared for. With the epidemic many more
people face physical, social, financial, and emotional problems.

3. (U) The national HIV-prevalence rate increased from 4.4 percent
in 2005 to 4.6 percent in 2008, according to the latest GON survey
conducted in 2008. (NOTE: The 2009 data of the Joint United
Nations Program on HIV/AIDS indicates the prevalence rate to be 3.1
percent. END NOTE). The GON survey indicated that all states are
affected, with Ekiti State registering one percent and Benue State -
a major transport corridor - showing 10.8 percent. The GON states
that unsafe heterosexual sex practices and blood transfusion,
mother-to-child transmissions, and unsafe injections are the key
Qmother-to-child transmissions, and unsafe injections are the key
drivers of HIV transmission in the country. Nigerians living with
HIV/AIDS suffer from stigma and discrimination and have little or no
legal recourse.


--------------------------------------------- --------
CLOSING THE GAP BETWEEN CURRENT AND TARGETED COVERAGE
--------------------------------------------- --------

4. (U) The GON's response to HIV/AIDS has been guided by the
National HIV/AIDS Strategic Framework (2004-2009), which is
currently under revision with assistance from the President's
Emergency Plan for AIDS Relief (PEPFAR) for a new six-year period of
2010-2015. The previous plan aimed to reduce mother-to-child
transmission by 50 percent in 2009; provide 50 percent of Nigerians
access with quality HTC services by 2009; provide Anti-retroviral
(ART) treatment to one million PLWHA by 2009; universal access to
HTC service and ART drugs by 2010; 50 percent reduction in the
prevalence of sexually-transmitted diseases by 2009; and zero
percent HIV transmission through transfusion of blood and blood
products by 2009. Achievements under the plan have fallen far short
of these goals. The period corresponds with a substantial scale-up
of PEPFAR resources but GON resources have been consistently lower

ABUJA 00002218 002 OF 003


than needed.

5. (U) A 2009 World Health Organization (WHO) report indicated that
Nigeria accounts for the highest percentage of pregnant women (30
percent) in need of antiretroviral treatment to prevent
mother-to-child transmission among 20 HIV-burdened countries. More
than 90 percent of HIV infection in children occurs through
mother-to-child transmission during pregnancy, childbirth or
breastfeeding. The current PMTCT coverage in Nigeria is estimated
to be 11 percent, but the GON wants to raise this level to 80
percent by 2015. The symposium discussed various measures that will
be needed to bridge the gap, including enhancing awareness among
vulnerable groups and the general public, strengthening the
country's weak health system infrastructure, and scaling up and
publicizing HIV/AIDS prevention and treatment services.

6. (U) The overall goal of the PMCT program is to reduce the
transmission of HIV infection from positive mothers to their
infants. The national PMTCT program began in 2002 and since then
has grown from 11 delivery points at tertiary institutions to 600
sites in 2009, largely supported by the PEPFAR program. NACA
Director General Dr. John Idoko blamed lack of awareness at the
community level, a poor health care delivery system, gender
discrimination and relatively low demand for HIV/AIDS services, and
stigmatization and discrimination against PLWHA for the low PMTCT
coverage and promised to enhance the coverage through the new
National HIV/AIDS Strategic Framework for 2010-2015. Ambassador
Sanders, in her address to the symposium, expressed USG support for
Nigeria's fight against HIV/AIDS through PEPFAR and highlighted the
need for the GON to scale up its funding and activities against the
epidemic.

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NATIONAL ASSEMBLY CONSIDERS ANTI-STIGMA DRAFT LAW
--------------------------------------------- ----

7. (SBU) Senate Committee on Health Chairman Senator Iyabo
Obasanjo-Bello and House Committee on HIV/AIDS, TB, and Malaria
Chairman Honorable Oluwwole Olakunde outlined the activities of the
National Assembly in strengthening the GON's response to the HIV
epidemic. They pointed to an HIV Anti-Stigma Bill, currently being
debated in the National Assembly, as essential to protect the rights
of PLWHA and hoped that it will pass early next year. They said the
bill, if passed, will repeal laws that discriminate against PLWHA
and institute provisions that will protect the rights of such
people. They also promised to support an increased budget for HTC
and PMTCT activities. The ceremony attracted a group of persons
living with HIV/AIDS that threatened to disrupt the event claiming
that they have been excluded and neglected by NACA. The agency's
officials countered that claim by saying they had invited
representatives of PLWHA to the symposium, questioned the motives of
the protest organizers, and doubted the HIV/AIDS status of the
protesters. The protest nonetheless brought to light the distrust
some have for NACA, due to its lack of an effective communication
strategy.

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THE AMBASSADOR VISITS A PMTCT CLINIC
------------------------------------

8. (U) The Ambassador visited the Asokoro District Hospital in Abuja
to highlight USG PEPFAR support for PMTCT programs in Nigeria on
Qto highlight USG PEPFAR support for PMTCT programs in Nigeria on
December 3, as part of the Mission's World AIDS Day outreach. She
toured the PMTCT clinic and the training laboratory housed at the
hospital and engaged a mother-to-mother support group that receives
services through the clinic. (NOTE: The PMTCT clinic is supported
via a Health and Human Services and Centers for Disease Control and
Prevention partner, the Institute for Human Virology in Nigeria.
END NOTE). The visit also included the Early Infant Diagnosis (EID)
program, an important piece of the country's overall PMTCT strategy.
The Ambassador praised the women for providing a life free of HIV
for their children and encouraged them to be leaders in promoting
PMTCT services in their communities. The women expressed their
appreciation for USG support and raised key issues and challenges
they daily face, including lack of income generation activities,
mentoring programs, community outreach, and infant feeding support.


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COMMENT
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9. (SBU) The Minister of Health and the Minister of Women's Affairs

ABUJA 00002218 003 OF 003


were notably absent but were represented at the director's level at
the World AIDS Day event. The commemoration was not well-organized
and compared poorly to similar World AIDS Day events in previous
years. Lack of effective communication and coordination between the
Ministry of Health and NACA and other ministries and lack of
communication with the public in general and PLWHA in particular are
key hurdles that need to be overcome to advance prevention and
treatment efforts in Nigeria. Inadequate GON financing of HIV/AIDS
activities also continues to plague the response in Nigeria.

SANDERS

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