Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

NigeriaBy Olayide Akanni, Journalists Against AIDS (JAAIDS) Nigeria,and Bede Eziefule, Centre for the Right to Health (CRH)Nigeria’s HIV treatment program commenced with 25 sites in 2001. As of June2007, 210 sites were providing ART across the country.Nigeria’s program is supported by three principal actors: the government, PEPFAR,and the Global Fund. All three have supported the establishment of ART and PMTCTsites across the country. Other actors include MSF.Given the rapid scale-up of treatment embarked upon by the three key actors,first-line treatment is now available across the country. However, sites are still notequitably distributed within the 36 states of the Federation and many PLWHA stillhave to travel long distances in order to access treatment. In addition, monitoringtests are not free in all centers.In 2001, the Nigerian Government initiated provision of affordable ARVs to themany Nigerians living with HIV/AIDS. From 2002 to 2005, the federal governmentprovided them with a 75 percent subsidy, which meant that patients were requiredto pay the remaining 25 percent. Since 2006, however, all ARVs have beenprovided free of charge through the public sector and at PEPFAR-supported sites,after former Nigerian President Olusegun Obasanjo announced (in December2005) a free treatment policy for HIV-positive individuals.ARVs provided at tertiary institutions run by the federal government are centrallyprocured by the National AIDS and STD Control Program (NASCAP), a programunder the Department of Primary Health Care and Disease Control of the FederalMinistry of Health (FMoH). Three other parastatals are involved in procuring drugsunder the government program: the federal Ministry of Finance, which facilitatesthe procurement of ARVs; pharmaceutical companies; and Federal Central MedicalStores (FCMS), a government agency that receives and stores the drugs. Drugsare then distributed from the FCMS to the treatment centers across the country.In 2001, drugs were being procured from Cipla (at an average cost of $350per patient per year); and Ranbaxy ($320 per patient per year). 1 By 2004, thegovernment was also procuring ARVs from Ranbaxy at a cost of $300 per patientper year.1 Journalists Against AIDS Nigeria. “Saving the Nigerian ARV Programe: Options for sustainability.”January 8, 2004. www.nigeria-aids.org/eforum/msgRead.cfm?ID=220786