VZCZCXRO3316
PP RUEHMA RUEHPA
DE RUEHUJA #2262/01 3230658
ZNR UUUUU ZZH
P 180658Z NOV 08
FM AMEMBASSY ABUJA
TO RUEHC/SECSTATE WASHDC PRIORITY 4475
INFO RUEHOS/AMCONSUL LAGOS PRIORITY 0273
RUEHZK/ECOWAS COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS SECTION 01 OF 02 ABUJA 002262 
 
SENSITIVE 
SIPDIS 
 
DEPARTMENT FOR OGAC RYAN, OES/IHA WILUSZ 
PASS USAID GH/HIDN OGDEN AND GREENE 
AFR/SD FOR HARVEY 
CDC FOR NCIRD/GID/DEEB SUE GERBER 
 
E.O. 12958: N/A 
TAGS: TBIO KISL PGOV SOCI ECON KOCI EAID NI
SUBJECT: NIGERIA: LAUNCHING NATIONAL HIV/AIDS COUNSELING AND TESTING 
PROGRAM 
 
SENSITIVE BUT UNCLASSIFIED - NOT FOR DISTRIBUTION OUTSIDE USG. 
 
¶1. (SBU) SUMMARY.  From October 9 - 11 the Government of Nigeria 
hosted a forum to discuss and develop a national HIV/AIDS Counseling 
and Testing (HCT) initiative.  The event provided a rare and useful 
platform for HIV/AIDS advocacy and frank discussions.  The GON 
appears to view a new massive national HCT program as a principal 
mechanism for expanding prevention, outreach and behavioral change, 
although such a campaign seems more appropriate for a country with a 
generalized HIV/AIDS epidemic (such as those in southern Africa). 
Nigeria faces a complex mix of several localized and concentrated 
epidemics, with significantly higher seroprevalence rates in 
most-at-risk populations (MARPs), which calls for a more targeted 
anti-HIV/AIDS response.  Moreover, the GON showed little evidence 
that it has thought through the logistical, technical, and financial 
inputs that will be required to undertake such a massive nationwide 
campaign (which could conceivably involve close to 59 million 
Nigerians) and how it plans to treat and care for those that will be 
diagnosed as seropositives.  END SUMMARY 
 
¶2. (U) The Nigerian National Agency for the Control of AIDS (NACA) 
held a national forum to discuss and develop a national HIV/AIDS 
Counseling and Testing (HCT) initiative from October 9 - 11.  The 
forum was officially inaugurated by the Vice President of the 
Federal Government of Nigeria, Goodluck Jonathan, and brought 
together a wide and influential array of federal, state, and local 
government officials and representatives of civil society, people 
living with HIV/AIDS, and partners from the private sector and the 
international community. 
. 
SECOND HIGHEST GLOBAL HIV/AIDS POPULATION 
----------------------------------------- 
. 
¶3. (U) According to a survey conducted in 2005, Nigeria's HIV 
prevalence rate dropped from 5.2% in 2003 to 4.4% in 2005. (Note: 
The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates the 
generalized prevalence rate to be 3.1%, the rate also used by the 
U.S. President's Emergency Plan for AIDS Relief (PEPFAR).  Data 
stemming from the GON's 2008 HIV prevalence survey among pregnant 
women is currently being analyzed, which will be used to project a 
more accurate HIV prevalence rate among the general population by 
early 2009.  End Note).  Based on the GON's data, Ekiti state has 
the lowest infection rate, 1.6, while Benue state has the highest, 
10%.  Fifteen states including the Federal Capital Territory (FCT) 
have greater infection rates than the national average of 4.4%, with 
slightly higher rates in urban areas.  The GON states that unsafe 
heterosexual sex practices, blood transfusion, and unsafe injection 
are the key drivers of HIV/AIDS transmission in the country. 
Nigerians living with HIV/AIDS suffer from stigma and 
discrimination. 
 
¶4. (U) NACA officials estimate 2.9 million Nigerians are living with 
HIV/AIDS, the second largest number in the world after South Africa. 
 Of these, 540,000 need Anti-retroviral (ARV) treatment.  Nearly 
200,000 individuals are receiving ARV treatment funded through USG 
PEPFAR programs.  NACA calculates that there are 58.4 million 
Nigerians who need to be reached with prevention messages through an 
HCT program.  This figure is composed of people who are in the 
active reproductive age range and vulnerable groups such as female 
sex workers, transportation workers, and populations living in 
junction towns.  (Note:  There are important risk differences 
between all Nigerian adults of reproductive age and those belonging 
to vulnerable groups such as the aforementioned.  End Note).  So 
far, only 10.8% of the target 58.4 million have undergone HIV tests 
because of shortage of testing services, the stigma associated with 
the disease, or poor awareness of testing benefits and counseling. 
 
 
THE GOAL OF A NATIONAL HCT PROGRAM 
---------------------------------- 
. 
¶5. (U) At the HCT forum, Vice President Jonathan noted Nigeria's 
comparatively low infection rate (compared to other African 
countries) and acknowledged the significantly higher number of 
Nigerians living with HIV/AIDs.  He said given Nigeria's sizable HIV 
burden and population, more needs to be done to arrest the expansion 
of the disease.  He underscored the GON's commitment to combating 
HIV/AIDS and identified HCT as a key link in an effective 
anti-HIV/AIDS strategy.  The Vice President reaffirmed the federal 
government's "non-revocable commitment" to protect and develop its 
human resources and said "we are all commanders and generals and 
cannot afford to lose the war against HIV/AIDS."  He also 
specifically acknowledged and thanked the USG for its "significant 
 
ABUJA 00002262  002 OF 002 
 
 
assistance in curbing the ravages of HIV/AIDS through PEPFAR and the 
Global Fund." 
 
¶6. (U) NACA Director General Professor Babatunde Osotimehin 
described the HCT program as "a clear entry point to a successful 
prevention, treatment, care, and support regime" and announced the 
GON's plan to launch such an initiative shortly.  He said in 
recognition of HCT's importance and in collaboration with partners, 
the GON plans to expand access to HCT services by integrating them 
into existing public and private health facilities and by 
establishing standalone HCT sites.  The plan will scale-up HCT 
services by establishing at least five HCT delivery points in all 
774 Local Government Areas (LGAs) by 2010 and support targeted 
public outreach efforts.  According to the NACA Director General, 
those that test positive will receive treatment, counseling and care 
and those that test negative will receive prevention counseling. 
 
¶7. (U) To implement the program NACA will request greater commitment 
from the GON and mobilize support (financial and technical) from the 
private sector, civil society, and multilateral and bilateral 
donors.  The HCT forum established a committee composed of various 
players to develop an action plan to launch a national HCT program. 
Speaking on behalf of the Development Partners Group against 
HIV/AIDS (DPG), a donor committee that includes both USAID and CDC, 
the World Bank representative applauded the GON for its 
anti-HIV/AIDS efforts, stated the significant assistance by the 
international community, and urged the GON to show its commitment by 
providing the funds necessary to undertake the proposed HCT program. 
 
. 
IMPLEMENTATION IS KEY 
--------------------- 
. 
¶8. (SBU) COMMENT:  To reach close to 59 million Nigerians with HCT 
service, the GON must come up with sufficient funds to mainstream 
HCT services into existing health facilities, establish additional 
HCT sites and train the personnel that will staff them while 
overcoming very low level of public awareness and negative 
perception against those infected with the virus.  It also needs to 
formulate a strategy on how it is going to care for and treat those 
that will be diagnosed with the disease. 
 
¶9. (SBU) The GON's proposal to use HCT as a principal measure for 
boosting prevention and behavioral change is challenged by the DPG's 
consensus that a nationwide HCT campaign may be more appropriate for 
countries with a generalized epidemic, such as those in southern 
Africa.   Nigeria essentially suffers from a more localized threat 
among MARPs and therefore a nationwide campaign for HCT is unlikely 
to receive much donor and development partners' support.  It will 
fall upon the GON to appropriate funds, and create the technical and 
logistical framework that will be needed to launch and sustain such 
a massive campaign. 
 
¶10. (SBU) Apart from funding the HCT initiative, the issue of 
treatment and care for those that will test positive needs to be far 
more clearly outlined.  In a separate follow-on meeting with AIDOff, 
the NACA Director General said a more realistic target for HCT over 
a 3-5 year period might be testing 15 million people, as per the 
recent Global Fund Round 8 application.  The U.S. Mission will 
continue to engage the GON with the goal of shaping a more 
appropriate HCT program.  END COMMENT. 
 
¶11.  (U) This cable has been coordinated with Consulate Lagos. 
 
SANDERS