Not Free For All
By Adedeji Ademigbuji

In January when the federal government commenced fulfillment of its earlier promise to give people living with HIV free treatment, the atmosphere was enveloped with jubilation. After many years of striving to live positively, many believed that such an initiative by the government would provide respite for the estimated half a million people in need of treatment in Nigeria. But, the hope seems to have dwindled for some who are still being forced to pay for their treatment.

At the Lagos State Teaching Hospital (LASUTH) Heamatology Clinic last week, investigations revealed that those on anti-retroviral treatment were still paying between N4, 000 and N7, 000. The anti retroviral drug prevents the multiplication of the HIV virus in the system; while this gives the immune system the opportunity to rebuild itself. A rebuilt immune system is able to ward off the legion of opportunistic infection that comes with being HIV positive. With the advancement in treatment, it is now possible for HIV positive individuals to live prolonged, normal and productive lives.

 Dr (Mrs) Taiwo Balogun is working with the Heamatology Clinic of LASUTH. While reacting to allegations of commercializing drugs in the hospital, she said that LASUTH is not under the federal government’s free drug and treatment program for PLWHA. She argued that, as such, their directive should be binding on them. “This is a state hospital being managed by the state government. We are not in any way affected by the federal government directive. It is only the federal treatment sites such as Nigeria Institute of Medical Research (NAIMA) that does the free treatment. But in LASUTH, you pay except children. For the adults, it costs between N4,000 and N7,000 to get treated.”

The Federal government of Nigeria in January this year announced a comprehensive treatment program. Presently, estimated number of people who are supposed to be on this program is about 12,000, although at the moment there are controversies on this figure. There is an ambitious projection to get 250,000 people on the program from the almost half a million people who require treatment in Nigeria.

While Lagos state has refused to follow suit with the FG initiative, their counterparts in Borno state are attempting to provide a similar free treatment program. But such an initiative has already been criticized for irregularities. Officials in Borno state, which is home to the highest prevalence of HIV/AIDS in Nigeria, were recently accused of favouring other government officials whose friends or family are living with the virus. The government rose in defence upon the widespread allegations that the federal government's programme on HIV/AIDS, which provides access to ARV treatment free of charge.

The programme manager of the state HIV/AIDS programme development project, Mrs Victoria Kuwua Ugor, in an interview with a northern daily newspaper denied the allegation. She said selection of beneficiaries was based on the level of infection and not on their connections to the state government.

"Only those with AIDS are given ARVs, not whether one has links with the government," said Mrs. Ugor, who however admitted that some highly placed persons in the state were given special privileges in the distribution of ARVs. According to the State Coordinator of the Action Committee on AIDS (BOSACA), Ba'abba Ibrahim Goni, over N40 million was budgeted by the state government for HIV/AIDS related campaign activities in the 2006 fiscal year. Much of that money, he said, will go to the provision of freeanti-retroviral drugs to patients as per the federal government’s national policy.  

At other federal treatment sites, the same allegation trailed the free ARV and treatment program. The Executive Director of the Coalition of Enugu State Support Groups Organization (CESSGO) laments about the University of Nigeria Teaching Hospitals refusal to participate in the federal program. According to him, “we still pay N1,000 to get drugs in Enugu.”

He said both the state and the federal medical centers are still selling the drugs instead of providing them for free. In Kaduna, Adangba Muhammad Adamu of Living with Hope Foundation (LHF) said the situation is no different. Most people continue to pay N1,000 for treatment, except at the 44 Reference Hospital, a military hospital in Kaduna, ARVs are being administered at no charge. Even there, Adamu said, the supply is limited and drugs are given out selectively. “Only 300 PLWH receive ARV at the center,” said Adamu.

In Osun state, investigation revealed that the Obafemi Awolowo University Teaching Hospital, a federal government treatment site is the only facility that has the CD4 count machine in the state. According to our investigation, for a patient to get a routine measure of their CD4 count and viral load test it costs N13, 000. It was gathered that most people are forced to travel from Osun to Lagos state for free treatment including tuberculosis at the Nigeria Institute for Medical Research (NAIMA), and we can guess the lot of a larger number who can’t make it to Lagos.
 
With the situation, the question to ask is when will Nigeria move closer to achieving the Millennium Development Goals of which the reduction of the spread of HIV/AIDS is one.

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