By Chioma Umeha
To
promote effective access to Antiretroviral (ARV) drugs for People Living With
HIV (PLWH), experts have stressed the need for the Federal Government to
restore free baseline evaluations.
Some
of the experts who spoke were those from the National AIDS/STI Control
Programme (NASCAP).
They
were making presentations at the opening of a two-day communication strategic
review workshop by Journalists Alliance for Prevention of Mother to Child
transmission of HIV (JAPiN) in Lagos state, recently.
According
to them, the goals of the initial evaluation are to confirm the diagnosis of
HIV infection, obtain appropriate baseline historical and laboratory data,
ensure PLWH understanding about HIV infection and its transmission.
Others
are to initiate care as recommended in HIV primary care guidelines and
guidelines for prevention and treatment of HIV-associated opportunistic
infections.
Research
has shown that every HIV-infected person entering into care should have a
complete medical history, physical examination, and laboratory evaluation and
should be counseled regarding the implications of HIV infection.
The
experts further said that the initial evaluation also should include
introductory discussion on the benefits of antiretroviral therapy (ART) for the
PLWH health and to prevent HIV transmission.
According
to them, “Baseline information then can be used to define management goals and
plans.
“In
the case of previously treated PLWH who present for an initial evaluation with
a new health care provider, it is critical to obtain a complete antiretroviral
(ARV) history – including drug resistance testing results, if available,
preferably through the review of past medical records.
“Newly
diagnosed persons living with HIV should also be asked about any
prior use of ARV agents for prevention of HIV infection.”
They
reasoned that many of the PLWH cannot afford cost of
transportation more so the charges for baseline
investigations which is between N5,000 and
N6,000.
The
experts therefore urged the Federal Government and donors, specifically the
U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to make baseline
investigations for HIV free.
“Nigerian
government and the US PEPFAR should look into the idea of
bringing back free baseline investigations before starting new PLWH on ARV
drugs. Many of them cannot afford cost of transportation talk less of paying
for baseline investigations that amount to about N5,000 and N6,000,”
NASCAP said.
According
to the experts, one of the reasons new Persons Living With HIV do not start ART
is due to lack of fund for the payment of baseline investigations.
Corroborating
these views, Dr. Sunday Aboje, National Coordinator, National AIDS/STI Control
Programme (NASCAP), in a related development said that baseline investigations
and effectiveness of ARV drugs usage is critical to the elimination of Mother
to Child transmission (eMTCT).
Aboje
stated that currently, 380,000 children are HIV positive in the country and
added that the country is committed to the goal of eliminating new HIV
infections among children and keeping their mothers alive by 2020.
The
National Coordinator, who spoke recently at JAPiN strategic meeting in Calabar,
Cross River state was optimistic that there is a renewed hope of viral
suppression that would provide the potency to stop further transmission as a
prevention tool while prolonging the lives of the infected persons.
Dr
Aboje, who was represented by Assistant Chief Scientific Officer of the agency,
Taiwo Olakunle, stressed that free baseline investigations coupled with
improved access of ARV drugs would fast-track the achievement of e-MTCT goals.
“The
country has come a long way in its effort to control the HIV/AIDS epidemic,
particularly in PMTCT. Beginning with the pioneer 11 PMTCT-provider tertiary
health facilities in 2002, the country now has 7,265 health facilities
providing PMTCT services at all levels of the health care system.”
Aboje,
however, stated that Nigeria’s target on eliminating new HIV cases in children
among other things for 2018 was to ensure 50 per cent of HIV-exposed children
have access to HIV prophylaxis treatment and early infant diagnosis services.
He
also identified inadequate political commitment, and funding at federal, state
and LGA levels as well as weak health infrastructure as some challenges against
eliminating new HIV cases in children. Prompt release of 100 percent budget for
AIDS control, prevention, and treatment for the relevant Ministries,
Departments and Agencies (MDAs) would make a difference in the lives of people
living with the disease, Dr. Aboje stressed.
In a
related development, Mrs. Kadiri Oluseyi, Executive Director, Centre for
Positive Health Organisation, Lagos State under the platform of Abidjan – Lagos
– Corridor, tasked government to increase funding for child HIV elimination
programmes.
Oluseyi
called on government to support People Living with HIV/AIDS (PLWHA),
non-governmental organisations (NGOs) and partners working on HIV awareness in
line with the global campaign for safer motherhood and HIV-free babies.
According
to her, support from the government through increased funding and access to
anti-retroviral (ARV) drugs will help to ameliorate the challenges of PLWHA,
especially pregnant mothers and help in actualising the eMTCT of HIV.
Oluseyi
spoke when members of Journalists Alliance for Prevention of Mother-To-Child
Transmission of HIV in Nigeria (JAPiN), Lagos state Chapter made the special
investigative visit to the office of Abidjan-Lagos Corridor Organisation, in
Badagry General Hospital, Lagos, recently.
