NIGERIA: Patient fees preventing access to AIDS drugs, activists
[This report does not necessarily reflect the views of the United Nations]
LAGOS, 13 June (PLUSNEWS) - Patient fees are deterring poverty-stricken Nigerians from participating in a government-subsidised scheme to provide HIV/AIDS medication, according to a coalition campaigning for free access to the life prolonging drugs.
According to the coalition, which includes French NGO Médecins Sans Frontières (MSF) and representatives of people living with HIV/AIDS, the monthly charge of 1,000 Naira (US $7.50) for the antiretroviral (ARV) medication is more than many Nigerians can afford.
Participants to the programme - run by the government with the Global Fund to Fight AIDS, Tuberculosis and Malaria and the US government - also have to find cash for regular laboratory tests, treatment of opportunistic infections and transport to health centres.
"These costs are far beyond what many of the thousands of people living with HIV in Nigeria, who are on antiretroviral drugs, can afford," the group said in a jointly signed petition to President Olusegun Obasanjo, dated 8 April but released to reporters last week.
The 11 member coalition want Obasanjo to scrap the fees.
"If people living with HIV have to pay for their treatment, they will have to sell their property and cut down on education, food and other essential needs to be able to afford it," the petition said.
The coalition said HIV-patients had been forced to interrupt their drug regimes or cut down on the number of laboratory tests needed for treatment because of the costs.
Nigeria had previously set a goal of providing subsidised treatment to 100,000 people by 2005 but later scaled it up to a target of 250,000 by mid-2006, using more than US $300 million of funds provided by the Global Fund, the World Bank and the US President's Emergency Plan for AIDS Relief (PEPFAR) - a US $15 billion programme launched by President George W Bush in 2003 to tackle HIV/AIDS in 12 African countries and the Caribbean region over five years.
By adding a policy of charging what it considered minimal fees, the Nigerian government said it hoped to raise funds to help sustain the schemes when international donor-funding dried up.
However, AIDS activists see this policy as a serious impediment to efforts to curb the spread of the virus and consequent fatalities and are pushing for a completely free treatment programme targeting the very poor.
"A political decision was taken that 1,000 Naira must be charged and the only thing preventing its removal is lack of political will," said Pat Matemilola, president of the Network of People Living with HIV in Nigeria and spokesman of the coalition.
"Poverty and HIV can't be separated. If poverty accentuates the spread of the virus, it is very clear what the situation of poor people living with HIV will be," he added.
Matemilola expressed disappointment that neither Obasanjo nor Education Minister Eyitayo Lambo had responded to their petition asking for free treatment.
Government officials, contacted by IRIN, were unavailable for comment.
Tobias Luppe of MSF said his group set up a free treatment centre in Lagos, where more than 800 people are currently enrolled to demonstrate that it is possible to provide such access without charging money.
MSF-Netherlands launched this HIV/AIDS care and support project at Lagos General Hospital last August to offer a comprehensive programme of treatment to people with HIV/AIDS.
Of the 800, Luppe said 330 people living with AIDS were receiving ARVs. The others have not reached the stage where treatment is deemed to be beneficial.
"Treatment is not necessarily a financial problem in Nigeria, it is a political problem," Luppe said. "The Nigerian government is not necessarily poor, it's only its people that are poor."
More than 70 percent of Nigerians live on less than one dollar a day, according to government figures. Nigeria, the Africa's most populous country, has the largest number of people living with HIV/AIDS in the world after South Africa and India. The authorities estimate that five percent of the country's more than 126 million people are HIV-positive.
MSF said roughly 500,000 are in desperate need of ARV treatment to prolong their life, but less than 15,000 were currently receiving the therapy.