Expanding Prevention Options & Shrinking Global Financing: - - PowerPoint PPT Presentation

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Society for Family Health, Nigeria

Expanding Prevention Options & Shrinking Global Financing: Making Balanced Choices

Sir Bright Ekweremadu

HIV & AIDS in Nigeria – Quick overview

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• Nigeria has the 2nd highest burden of HIV & AIDS in the world
• Young people 15 – 29 have the highest rate of infection in the country
• Priority populations include women and children
• HIV prevalence is still high among MARPs, widowed, separated or divorced

women

• Establishing priority populations to be targeted and identifying appropriate

intervention strategies to reach them are among the primary mandates for HIV prevention funding

• In 2008, the total spending for HIV and AIDS tracked by funding sources was

$394,963,881.00 (N45, 420,846,315.00) .

• Percentage for public funds at that time was only 7.6%
• 92.3% of the funding was external; a 6.9% increase from 2007

Scientific Advances: Policy Implications

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• Interventions to promote accelerated ART remains one of the most important

scientific advances in HIV program interventions

• Translation into policy largely means implementing a series of interventions to

promote accelerated antiretroviral therapy, some of which are:

• Timely ART: initiating treatment at an early stage of the disease (CD4

<350 or higher), in order to help prevent opportunistic infections

• Treatment as Prevention: early initiation of treatment for HIV-positive

people with HIV negative partners (“treatment as prevention” for sero- discordant couples, regardless of CD4 count), as well as all HIV+ pregnant and breastfeeding mothers.

• PMTCT Option B+: immediate initiation of life-long treatment for HIV-

positive pregnant and breastfeeding mothers, regardless of CD4 count, which provides increased protection for mothers and babies.

• TB ART: immediate initiation of treatment for HIV-positive patients with

active TB

HIV & AIDS spending in Nigeria

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Figures culled from NASA 2010

Prevention

12.45%

Care & Treatment

37.44%

OVC activities

1.43%

Programme Management

24.52%

Human Resources

19.30%

Social Protection

0.04%

Research

0.42%

HIV & AIDS financing in Nigeria – an overview

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Society for Family Health, Nigeria

culled from NASA 2010

Financing Sources in 2009 and 2010

Top recipients of donor funding for global health – Nigeria #2

Options for increased government spending for HIV & AIDS interventions in Nigeria

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• Government must be at the driving seat for HIV & AIDS programming in Nigeria
• To do this effectively, government must increase its funding contribution .
• Suggested options include:
• Increased national and state budgets – respect Abuja Commitment
• Improve efficient use of available resources
• Targeted intervention with focus on service delivery for priority groups
• Set up HIV Trust fund – involve private sector and high net-worth

individuals

• Specific tax on some products and services which will be dedicated to

HIV&AIDS programming

Preventing HIV & AIDS in Nigeria – our options

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• Priority populations must be dealt with at the system level; and funding

made available

• Priority-setting is not an isolated event but takes place within the larger framework
• f the planning process, which includes
• Ongoing examination of trends in the epidemic through an analysis of the data

available to identify the populations at greatest risk,

• assessing the nation’s need for HIV testing with emphasis on the communities

and their needs for prevention services,

• Identifying effective strategies to address those identified needs, and
• Compiling an inventory of the available resources in order to identify funding

and service gaps.

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• To ensure a sustainable health system, the sector cannot continue to

depend on donors

• Correct targeting is also of high importance
• Testing amongst MARPs and other priority populations must be

scaled up

• Treatment As Prevention, Test and Treat
• Scale up PMTCT services using and integrated systems approach
• Innovations in funding

Conclusions

Thank You

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Society for Family Health, Nigeria