ACCOUNTABILITY NEEDED FOR THE HIV RESPONSE, By Morenike Folayan

By Morenike Oluwatoyin Folayan

Civil Societies in Nigeria, under the aegis of the Civil Society for HIV/AIDS in Nigeria (CiSHAN), Treatment Action Movement (TAM), Network of People Living with HIV and AIDS in Nigeria (NEPWHAN), New HIV Vaccine and Microbicide Advocacy Society (NHVMAS) – came together to host a 2 days meeting focused on promoting accountability of stakeholders, including that of civil society organisations – to the HIV response. This was the second of these annual event. For 2017, the theme was Integrated HIV-TB Response in Nigeria: Moving from Rhetorics to Action. The meeting held on the 12th and 13th of November, 2017 at the Rockview Hotel, Abuja

The meeting had in attendance over 350 participants. The national government, the US government, Non-governmental organisations working in the HIV and TB field, and implementing partners were asked hard questions about the HIV response. One of the main debates – sadly a carry over from the 2016 accountability forum – is the need to remove the user fee associated with access to life saving antiretroviral drugs. The community of people living with HIV highlight the significant limiting impact of these user fees on access to care. There are also reports on large numbers of people living with HIV starting to fail their first and second line drugs with no hope of access to salvage therapies simply because the user fees hinder their access to HIV services.

The Director General of the National Agency for the Control of AIDS noted that HIV treatment is not considered an act of kindness or charity; the Nigeria government considers it an obligation and responsibility. The Federal Government through the Ministry of Health, had committed to the removal of user fees following advocacy to his office as an outcome of the 2016 CSO Accountability Forum. The US Government in the person Mr. David Young (US Ambassador) also acknowledged the importance of eliminating barriers to access to HIV treatment including removal of the user fees. It therefore remains unclear why implementing partners continue to hinder access of clients to HIV treatment by imposing fees. One thing was clear at the forum – personal bias seem to influence the national response. One of the speakers felt strongly that user fees should continue as what was free was not appreciated. This caused a major uproar at the meeting.

Domestic funding needs to be mobilized to improve the current response. The Nigeria government also has to be held accountable for the $66 million dollars to be invested in Nigeria by the US Government over the next 2 years – inclusive of the $6million to be spent on the population based survey to rebase the HIV epidemic in Nigeria - towards eradicating the HIV epidemic in Nigeria. There was consensus that CSO have roles to play as whistle blowers. They also should be demanding that the government increase investment in national development inclusive of strengthening the national health systems, and holding stakeholders accountable as independent organisations who serve as the conscience of the HIV response.