Likely you heard the report. To some, it was spine chilling. On 14th March 2019, the President of the Federal Republic of Nigeria, President Muhammadu Buhari unveiled the findings of the Nigeria AIDS Indicator and Impact survey (NAIIS). This finding which was carried out throughout the country in the third and fourth quarter of 2018 revealed that Akwa Ibom state has a HIV prevalence of 5.5% against the National prevalence of 1.4% for the age group 15 to 64years. The value for Akwa Ibom is reported to be the highest in the country.
As expected, the media were saturated, and some members of the public grew weary of the doomsday report. Many dismissed the report as untrue. Some who believed wondered why the State had to assume the top spot in HIV/AIDS prevalence in the Country. You may also be interested in finding out the true situation of things.
But to unravel how bad AIDS is in Akwa Ibom State, you must join the statistical ride to find out how Akwa Ibom State has fared in the past and what is behind her current position.
History of HIV/AIDS prevalence in Akwa Ibom State
HIV sentinel surveillance survey started in Nigeria in 1991. It was only conducted in nine (9) states of the Federation. Akwa Ibom state was privileged to be part of the nationwide survey in 1999. The result of the survey to the surprise of many, placed Akwa Ibom State on an alarming pedestal.
According to the Technical Report from the Federal Ministry of Health, Department of Public Health, National AIDS/STDs Control Programme, Akwa Ibom State ranked second with 12.5% prevalence. Benue State which Akwa Ibom State followed had 16.8%.
In 2001, Akwa Ibom although with a slightly reduced prevalence of 10.7% maintained her Second position while Benue State she followed had 13.5% prevalence.
In 2003, with a gradual reduced prevalence, Akwa Ibom State had a 7.2% prevalence and declined in rank to fifth position while her neighbouring State, Cross River took over 1st position with a prevalence of 12.0%.
The little reduction in the prevalence did not last long. In 2005, the prevalence of HIV rose in Akwa Ibom from 7.2% to 8.0%. This leapfrogged the State back to her frequent position of second in the country. Benue returned to the top spot with 10% prevalence.
Things failed to improve. In 2012, Akwa Ibom accelerated her prevalence from 8.0% to 10.9% consequently maintaining her second position while Benue State remained in her topmost position with 12.7% prevalence.
Interestingly, in 2014, Akwa Ibom recorded a slight improvement. The State came down from second position to sixth position with 6.5% prevalence while Rivers State with 15.2% rose to the top spot.
The 2014 survey was the last survey before the much talked about 2018 survey which showed Akwa Ibom State having HIV prevalence of 5.5% with a value reported to be the highest in the country. What does this mean for the State?
How bad is the current report?
According to the Akwa Ibom State Commissioner for Health, Dr Dominic Ukpong, the history of the prevalence of HIV/AIDS in the Country vis-à-vis the State has shown that the State prevalence is on the decline hence a significant improvement on the part of the State.
He states ” The last nationally accepted HIV survey, prior to the NAIIS survey in 2018 was the ANC SENTINEL study in 2014 and the National prevalence was 3% while Akwa Ibom state prevalence was 6.5%.
“Arguably as it is being reported that the national prevalence has dropped from 3% (2014) to 1.4% (2018), similarly that of Akwa Ibom State has dropped from 6.5% (2014) to 5.5% (2018).”
Despite this improvement said to be made by the State. Can one really trust the report of the 2018 Nigeria AIDS Indicator and Impact survey about the State? The State Commissioner for Health admits that although it can be trusted, there may have been few mistakes owing to the population size used for the sampling.
Offering insight to what he mean, he states that in 2017, the State government in conjunction with FHI 360 and other partners, with funding from USAID, carried out a cross sectional population based survey, Akwa Ibom AIDS Indicator Survey (AKAIS 2017), similar to NAIIS in methodology on the prevalence and incidence of HIV in the State.
Ukpong says the result as disseminated in November 2017 showed a prevalence of 4.8% for the age group 15 to 69 years. He insists that statistically these two results 5.5%, (2018) and 4.8%, (2017) for NAIIS and AKAIS respectively are within the same 95% confidence interval ranging from 4.7 to 6.3 percent.
Giving his position he notes “Therefore the results are scientifically similar despite the little change in figures. The slight difference between the NAIIS and AKAIS prevalence can be attributed to the sample population size, about 16,000 in AKAIS 2017 and about 8000 in NAIIS 2018, making AKAIS sample size twice the size in NAIIS, making AKAIS result more precise.”
Nevertheless, despite all reductions in prevalence as compared to other years, the fact remains that Akwa Ibom State in comparison to other States still stand as the highest in prevalence. Why do other States make rapid improvement than Akwa Ibom State?
Reason for the Prevalence in Akwa Ibom State
The Akwa Ibom State Commissioner for Health states that rapid development experienced in the State turns out to be the State albatross in combating HIV/AIDS. How, you may wonder.
He explains ” The location of the state with a large coastal front of 129 Km stretching from Ikot Abasi to Oron, an airport, good road net work peaceful atmosphere, friendly disposition of our people, good cuisines and fast developing economy have made our state the destination of choice for both national and international visitors.
” All these are not without attendant public health consequences, like
transmission of communicable diseases which HIV/AIDS cannot be excluded.”
However, the reason given by the State Government is not exhaustive. Health experts opine that reduction in financial commitment can affect the fight of the epidemic. Checks into the Budgetary data of Akwa Ibom State Government indicts the State Government of reduction in financial commitment towards the fight against HIV/ AIDS in the State.
In Akwa Ibom State, the agency responsible for the fight against HIV/AIDS is the State Agency for the Control of AIDS, SACA. Since the current administration of Governor Udom Emmanuel came on board, budgetary provisions to the agency has been on the decline.
In 2015, the administration of Governor Udom Emmanuel inherited a budget of N500m for SACA. In 2016, N273.5m was budgeted. In 2017, N100m was budgeted while N120m was budgeted in 2018. However, Implementation Report of 2018 shows that N30m was the actual fund released thus placing it at 25% performance rate. In the 2019 budget, N160m has been budgeted for SACA.
According to Policy Alert, an Organization which mine data in budget and the economy, from 2017 to 2019, the budget for SACA has remained at 0.2 per cent. This, the organization says is poor in the combat against HIV/AIDS prevalence in the State.
Reacting to the assertion that the State Government has recently not put in much in the fight against HIV/AIDS, the Akwa Ibom State Commissioner for Health notes that the position is not entirely correct.
He explains ” statistics may show that we have gradually come down but we are simply cutting our coat according to our size. In time past, we didn’t have Ebola and Lassa Fever. Now, there are more infectious diseases and they even kill faster. So, we have to use available funds to tackle other pressing indices of health. But we won’t neglect the fight against HIV/AIDS”.
State Government plan to fight the prevalence
To combat HIV/AIDS, the Commissioner for Health notes that already the State Government has laid foundation for the war, through what he describes as huge resources being committed towards improving the health care delivery system of the state.
However, he points out that the current HIV/AIDS situation in the state calls for a more robust multi-sectoral response towards curbing the epidemic in the state.
Consequently, Dr Ukpong states that the State government will step up collaboration through Akwa Ibom State Agency for the Control of AIDS (AKSACA)and Akwa Ibom State HIV /AIDS and STI Control Progamme (SASCP) with Implementing Partners, Faith Based Organizations, People Living with HIV / AIDs, (PLHIV) and other stakeholders towards proffering immediate and long term interventions for the state.
The Commissioner notes that the immediate measures that will follow, will be Increasing access to HIV testing services, by providing enough rapid test kits whereby all primary health centers and secondary health facilities in the state will be able to provide free HIV testing services to its citizens.
He adds that there will be Increasing access to treatment by creating three new comprehensive treatment centres, one per senatorial district to be fully supported by the state government as these will compliment other comprehensive treatment centres supported by international partners.
The State heath Boss further notes that the State Primary Health Care Development Board, inaugurated by the Executive Governor recently is working to kick start its activities, which includes management of primary health centres explaining that this will impact positively on the service delivery in these health facilities.
Dr Ukpong offers insight to the fact that the State Government will also embark on state wide community outreaches and enlightenment campaigns to create demand for the uptake of HIV services.
He adds “I therefore appeal to the media to be partners in this project by incorporating jingles, news promo and talk shows and media chats on HIV at no cost, to support the fight against the transmission of the virus.
“We will lead advocacy to the local government councils in the state to lend regular and dedicated support for HIV intervention and other health programmes in their respective local Government Areas.
“We will also lead advocacy to the legislative arm of government to put in place laws to protect people living with HIV and to curb transmission of new infections, by expeditiously deliberating and passing the bill on Anti Stigma and Discrimination against people living with HIV and Aids.
“Secondly initiate the process of developing a bill to prosecute persons found to willfully infector transmit the virus to other people.”
Despite government plans, the Commissioner for Health insists that since HIV is transmitted mainly by unprotected sexual contact with infected persons, the key to combating HIV/AIDS prevalence in the State lies in the determination by Akwa Ibom people among other residents in the State to imbibe the simple ABCs of HIV prevention, namely: Abstinence, Being faithful to one’s Partner, Correct and Consistence Condom Use and Refraining from the use of illicit Drugs.
Certainly, Akwa Ibom people yearn to see the state fall drastically in her ranking of HIV/AIDS prevalence in the Country. But the key lies in heeding to the heartwarming call of the Commissioner for Health ” Stand up and fight to stop the transmission of HIV virus, we all have a part to play no matter how little.” Will we heed the call?