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. 
 
 
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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