HIV\AIDS: Losing To Poverty
By Folashade Oladipo

Georgina Ahamefule, a nurse with Imperial Medical Centre, Lagos used to be employed. But that ended when she tested positive to HIV and was fired by the management of the hospital in 2002. Four years on, Ahamefule is still seeking redress in the law court. For many people living with HIV/AIDS (PLWHA), they are in no financial position to access treatment and manage the virus. And according to estimates by the International Labour Organization, ILO, Ahamefule is just one of the 23 million workers worldwide in the prime labour forces (15-49 years of age) who are HIV positive. In Nigeria, many of these people are now unemployed, having been sacked or denied employment based on their HIV status. 

Examples abound of the millions of people living with HIV/AIDS (PLWHA) battling extreme poverty. According to the Medicines Sans Frontiers, an international medical humanitarian organization, poverty accounts for 70 per cent of the reasons why PLWHA do not adhere to their drugs.

Even in places where the drugs are given out free, Kingsley Obom- Egbulem, senior project officer, Journalists Against AIDS (JAAIDS) says unemployment and poverty affects PLWHA capacity to undergo routine tests, eat good food and transport themselves to care centres.

"The average PLWHA is poor. I use the word average because of the bills involved. Even when you are not paying for the drugs, you need to move yourself to the point of treatment. You also need the nutritional support, which is the core component of any antiretroviral therapy. If you are not eating well, no matter all the treatment, it is not going to have any impact," he said.

According to statistics released by the Federal Ministry of Health, about 75,000 HIV-positive people are currently benefiting from both public and private ARV therapy. This is a far cry from the 250,000 people projected to be on treatment by the end of June 2006 by the National Action Committee on AIDS, or the 500,000 people that are said to be in need of ARV therapy. The problem with access to treatment is not because there is a shortage of antiretroviral therapy but because many cannot afford drugs.

But for Faith Olawale, an openly positive HIV social worker, poverty as it affects PLWHA is a reflection of the larger society, which suffers from widespread poverty. "Majority of Nigerians, including PLWHA, are hungry. Some people are referring to the huge oil reserve, but you cannot say it should be for PLWHA alone. If you empower Nigerians, PLWHA will benefit also."

Olawale’s assertion tallies with the United Nations projections, which rate Nigeria as the 26th poorest nation on earth. Ironically, the United Nations' Human Development Index of Social Indicators has also rated Nigeria as the 146th out of 162 countries with the highest cost of living. Market surveys conducted by the reporter also indicated an alarming inflationary trend in the cost of living. A bag of rice that used to cost N2,200 some few years back now sells for N6,000, while a bag of Garri that was N1,200 in 1999 now goes for N4,500. The same goes for Soya beans, Maize, Yam flour, Vegetable, confectionaries and other food items.

According to Chinua Akukwe, former vice chairman, National Council for International Health, poverty does not just affect the management of HIV/AIDS, it "is the second cousin of HIV infection."

"Poor countries, poor neighbourhoods and communities are more likely to have high rates of infection, and less likely to have any resources to combat the disease. Once HIV/AIDS establishes a foothold in a poor country, that community is on a slow but progessive economic, social and cultural decline."

The trend of mandatory health tests as a pre-employment screening mechniasm has further impoverished PLWHA who could have made use of the salaries to enhance their health status. Even in a situation where the PLWHA is qualified for the post, this test gives means for the private sector to discriminate against positive people by denying their right to employment.

This happened to Seyi Owolade, who applied to a work as an accountant with an oil company in Lagos. "I applied just like any other person and was sucessful until the point they asked us to do some medical test which they said was in line with the company's employment policy," recalls Owolade, who is HIV positive. Owolade was not given the job.

While South Africa and Kenya have adopted a legal policy that protects PLWHA from all forms of discrimination in the work environment, the National HIV/AIDS Policy bill still hangs in limbo before the National Assembly in Nigeria. The bill is meant to, amongst other things, put in place a sort of tribunal which will try any erring company.

 Whenever that happens, it will gladden Denja Yaqub, assistant secretary, Nigeria Labour Congress NLC. "We have always argued that the HIV status of a person whether positive or negative does not hamper an employee's productivity. Employers need not sack or refuse to employ people as a result of a person's HIV status."

For Olawale, another way out of the woods is for every non-governmental organization to adopt the greater involvement of people living with HIV/AIDS principle. This, he stresses, will help provide stable jobs for PLWHA, reduce poverty and diminish the effects of HIV/AIDS on the Nigerian population.

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