Home Feature HIV/AIDS: Grappling with poor funding, stigmatisation

HIV/AIDS: Grappling with poor funding, stigmatisation

CHARLES OKOH, with agency report

The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) remains one of the biggest health issues that have plagued man. Until Ebola virus arrested the attention of humanity and brought focus on Africa with the outbreaks in Guinea, Sierra Leone, Liberia and Nigeria, HIV/AIDS remained the most dreaded disease known to man.
Unlike Ebola, however, HIV/AIDS allows victims to live a healthy life if only they maintain healthy relationships and remain dedicated to their medication regimen.
Remarkable progress has been made in the fight against HIV/AIDS since the first annual World AIDS Day was commemorated 26 years ago. Yet, we are still far from achieving our goal of a world without AIDS.
According to the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services, in 2013, more than two million people globally became newly infected with HIV, and 1.5 million people died from AIDS-related causes.
The number of new HIV infections and AIDS-related deaths has dropped by more than one-third in the past decade largely because of advances in HIV prevention and greater access to antiretroviral therapy. However, according to NIH, far too many adults and children continue to become HIV-infected and die from the effects of the virus.
Thanks to the work of NIH-funded researchers and partners in academia and the biotechnology and pharmaceutical industries, we now have more than 30 lifesaving antiretroviral drugs and drug combinations for treating HIV infection.
Antiretroviral medications not only have lifesaving therapeutic value; they also help prevent HIV transmission by lowering virus levels in infected individuals. As an example, an NIH-funded study, called PROMISE, recently demonstrated that a particular three-drug antiretroviral regimen is more effective than a commonly used one-drug regimen in preventing mother-to-child HIV transmission.
Scaling up access to HIV medicines is of little benefit, however, if HIV-infected individuals do not know they are infected, lack access to medical care, or do not adequately control their virus levels by adhering to treatment regimens.
Additionally, NIH continues to investigate new HIV prevention tools for those most at risk for HIV infection, including heterosexual women in high-prevalence settings, and men who have sex with men.
Despite effective treatment and prevention tools that have made a significant impact in the fight against HIV/AIDS, the goal to end AIDS would likely be achieved faster and be more sustainable with an effective vaccine or cure.
With regard to vaccines, scientists are making progress in the laboratory and in animal studies to better understand the human immune responses and other factors needed to develop a protective HIV vaccine.
In 2014, NIH-funded researchers described the regions of HIV where antibodies bind to block infection and found the mechanism responsible for stabilizing key HIV proteins and hiding sites where some HIV neutralizing antibodies attach themselves. Furthermore, researchers continue to learn more details that may explain why the RV 144 investigational HIV vaccine regimen provided a modest level of protection against HIV acquisition among 16,000 Thai adults. For example, by looking at serum samples from the RV 144 participants, scientists have identified previously unrecognized attributes of the antibodies that may have helped protect certain vaccinees.
As researchers continue to glean key information from the RV 144 study, efforts are under way to test a modified and potentially improved version of the same investigational vaccine regimen in South Africa beginning in 2015. When tested among a small number of healthy South Africans in a Phase 1 clinical trial called HVTN 097, the RV 144 investigational vaccine regimen proved safe and elicited comparable if not stronger immune responses than among the Thai participants.
An important goal for HIV/AIDS research continues to be finding a cure, whether by eradicating the virus from an infected individual or maintaining sustained virologic remission in the absence of therapy in a substantial portion of people infected with HIV. To that end, this year, NIH issued several major requests for applications designed to fund innovative approaches to an HIV cure. However, the field is still in the early discovery phase and is facing a number of challenges. A major challenge is HIV’s ability to rapidly establish hidden reservoirs in the body. NIH-funded scientists are working to characterize and quantify these reservoirs and develop biomarkers to identify and track their development.
Additionally, researchers are pursuing a number of strategies designed to eradicate the HIV reservoir in the body, such as activating dormant infected cells to make the virus vulnerable to antiretroviral drugs, using gene therapy to make a patient’s cells resistant to HIV infection, and using stem cell transplants. To date, the science suggests that very early antiretroviral treatment, given when the HIV reservoir in the body is small, could be crucial to eradicating the virus in an infected individual or making it more likely for an infected individual to remain off antiretroviral treatment without evidence of viral load or anti-HIV immune response (called sustained virologic remission).
However, some salient issues like inadequate drugs and discrimination against victims have continued to remain obstacles to effort in arresting the dreaded disease in Nigeria.
As Nigeria joined other countries to celebrate the World AIDS Day December 1, people living with HIV/AIDS have continued to express concern over unavailability of drugs to them.
They said HIV drugs have not been adequately provided by some of the public hospitals recommended to give the drug free, but were purchased with money.
According to them, the drugs could not be found in the hospitals and when they were found, they were sold to only those that could afford to buy.
Speaking in Abuja while  commemorating the day, Secretary of Network of People Living with HIV in Nigeria, FCT chapter, Mr. Olowu Joseph, said the Federal Government through the National Agency for the Control of AIDS (NACA) needs to pay more attention to the challenges facing people with HIV/AIDS in the country.
He observed that for the HIV stigma to end there is need for government to do more than what it is doing presently to assist people with HIV/AIDS.
Also speaking at the event, the Coordinator of Talent Initiative Support Group, Mr. Mathew Orhena, noted that before now, about 80 per cent of assistance to run HIV/AIDS programmes in Nigeria came from developed partners but now, the assistance is no longer been given.
He said “NACA before now was depending on foreign currency not Nigerian money in running its affairs”.
Orhena prayed that the recent launch of the Presidential Comprehensive Plan on HIV which takes effect in 2015, challenges facing people with HIV would be addressed.
He also said government alone could not tackle the problem facing people with HIV and called on Nigerians to contribute their own quota to the survival of people with HIV.
Also, the issue of stigma and discrimination came into focus. With various sections of the Nigerian society increasingly embracing the prospects of ending AIDS, the preponderance of views is that the conditions of those living with the virus could be better enhanced by giving them a fair chance to life.
As concerted effort are being made across board to halt further cases of HIV and stop AIDS-related deaths, equal emphasis should be accorded the issue of stigma and discrimination against those living positively with HIV. This is why the theme of the World AIDS Day celebration in Nigeria: Closing the Gap Against Stigma and Discrimination becomes the more timely.
However, to mitigate the impact of zero-funding from strategic partners like USAID and the US President’s Emergency Relief Fund for Africa, PERPFAR, other perspectives in the fight against HIV/AIDS must be explored including addressing the issue discrimination against those living with the virus through urging President Goodluck  Jonathan to sign the Anti-Discriminatory Bill already passed by both chambers of the national Assembly and making HIV Counselling and Treatment services a human right issue to meet the desires of the Network of People Living With HIV/AIDS in Nigeria (NEPWHAN).
Recent reports on HIV/AIDS scourge in the country have shown that Nigeria accounts for about nine per cent of the population of those living with HIV/AIDS disease globally. This was disclosed by Dr. Nyemenim Michael, a Technical Assistant to the Rivers State Commissioner for Health, Dr. Sampson Parker on HIV/AIDS.
He stated this in Port Harcourt at a workshop to mark the 2014 World HIV/AIDS Day.  Michael said that there was urgent need to give adequate care and treatment to people living with HIV/AIDS to avoid depletion of the country’s labour force, adding that sick persons cannot work.
According to him, the care and treatment of the people living with the virus should be taken seriously if the nation’s economy must remain strong, noting that there was no cure for the virus yet.
Though it is heart-warming to note that the government of Nigeria has begun to show some commitment towards dealing with the menace of HIV/AIDS, more needs to be done especially in augmenting the gap arising from the shortfalls in funding so as to expand the frontiers of treatment for those in urgent need.
Ultimately, the National Agency for the Control of AIDS (NACA), headed by Director General, Professor John Idoko has a leading role to play in ensuring that those who live with HIV are given adequate care and protected from stigma and any form of discrimination

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