Nigeria and Global Fund

May 11, 2006 :: Editorial Thisday,Lagos

Following its failure to meet targets on efforts to eradicate the Acquired Immune Deficiency Syndrome (AIDS), Nigeria has been suspended by Global Funds for AIDS, Tuberculosis and Malaria (GFATM). But in a dramatic twist, the country almost immediately received two grants of $180 million and $68 million from the same agency to fight AIDS and tuberculosis. This mixed fortune tells a story of both failure and possibilities.

To start with, why were the funds withdrawn to the extent that the country had to forfeit all of $150 million? The technical review panel of Global Funds was categorical in the letter it wrote to the Chairman of the National Action Committee on AIDS (NACA), Professor Babatunde Sotimehin, announcing the cancellation of the grant. "Nigeria" it said, "has not demonstrated sufficient capacity to achieve the goal of the grant as a result of low disbursement of funds meant for the Prevention of Mother-to-Child Transmission (PMTCT) and Anti-retroviral (ARV) programmes and non-production of sufficient and reliable data." Nigeria is also accused of delayed and inadequate reporting, as well as, mediocre monitoring and appraisal of activities. There is no doubt that the utilisation of only 23 percent of the budget for PMTCT and ARV by NACA, despite the generous resources made available to it, is an under-achievement. When the relationship between the two bodies began, the Nigerian opera tors had promised to treat 250,000 persons living with HIV/AIDS (PLWHA) by June this year. By last January, however, only 40,000 cases had been handled.

What makes the forfeiture inexcusable is that the hammer fell after consideable warnings late last year that the funds would be withdrawn if Nigeria did not buckle up. The country's largest funding partners of the HIV/AIDS programme had indicted NACA for being non-transparent and ineffective in its campaigns and for failing to utilise credibly the $201 million made available since 2000. Global Funds particularly condemned NACA for its inability to submit a realistic plan of action in conformity with laid-down rules.

Unfortunately, NACA's defence could not convince the donors. It blamed its failure to act promptly on the Funds' late approval of its plan. NACA also claimed that it went beyond Global Funds' recommendation of 25 treatment centres to establish 33.

This attempt at self-justification is a moral burden in view of the ravaging effect of the pandemic across the nation. Statistics show that five percent of the population, translating to more than three million people, including children and pregnant women, is already infected with the deadly virus. Worse still, most of those affected are too poor to afford anti-retroviral drugs. To buttress this point, during the African Union Special Summit on AIDS, Tuberculosis and Malaria (ATM) in Abuja last year, some patients demanded free anti-retroviral drugs, like what obtains in other poor African countries.

The irony of the situation is that Nigeria is supposed to lead this campaign on the continent. But while others have seized the opportunity provided by Global Funds with enthusiasm, the campaign is bogged down in Nigeria by administrative and technical deficiencies.

The government should, therefore, not squander another chance to contain the spread of HIV/AIDS and eradicate TB and malaria from the country. Campaign strategies should be re-ordered to make them result-oriented. Being vast and highly populated, Nigeria deserves more treatment centres. And, in addition to working out the accessibility and affordability of the much needed drugs, the ultimate goal should be to make them free. Also, the conventional wisdom of prevention being better than cure applies here. Enlightenment activities in that regard should be intensified.

All said, there should be a radical departure by NACA and other agencies connected with the containment of these deadly diseases from the tardiness of the past. And the place to start that is the prompt and transparent utilisation of the fresh grants from Global Funds. It would be a double tragedy if the new funds are again forfeited for our inability to use them according to the rules.