Country update from Nigeria: current impact on HIV services
22 February 2025. Related: Special reports, Treatment access.
Simon Collins, HIV i-Base
This is an informal community reports on the current impact in Nigeria on services since 20 January. It is compiled from several discussions by activists in CHANGE.
Similar updates from other PEPFAR countries will be added as they become available.
If you would like to report from your country, please email the HTB editor. Posts can be published anonymously.
Nigeria update: 20 February 2025
The statement (on 3 Feb) by the Nigerian Government on release of funds as a palliative measure to ensure continuity of HIV services regarding the current PEPFAR work stop on HIV programmes so far only exists only on paper. This is because we have yet to see emergency HIV services reach clients with ART refills, PREP and PEP services (at least not in Makurdi, the capital of Benue State, in north central Nigeria).
A history of corruption, impunity, bureaucracy, nepotism, ethnicity, religion are critical indicators which bedevil the Nigerian government in the provision of health services. These factors also stand in the way of government’s intention via release of funds by ensuring, in more ways than one, that emergency aid meant for the continuity of HIV service provision is never received by relevant partners.
There is also a bias in HIV service provision between general populations and key populations who are vulnerable, suffer stigma and indeed, a minority at the margins. These considerations informed the establishment of the One Stop Shop (OSS) which were medical facilities devoted to providing HIV services to key populations. Unfortunately, these OSS and medical outreaches to key populations in Benue State are now closed indefinitely.
The situation is similar for most of Nigeria. I have a client who relocated from Makurdi (north central) to the south east of Nigeria and required an ART refil by proxy. However, we cannot fulfil this request due the current status quo.
In Benue State Nigeria, there are two HIV clinics for Key Populations: The Centre of Excellence (C of E) OSS, Judges Quarters, Makurdi and the BENSACA OSS, located in the same premises as the Benue State Agency for the Control of HIV/AIDs (BENSACA).
Regrettably, both OSS/clinics are now still shut and medical outreaches are discontinued. Doctors, nurses, laboratory staff and everyone else have been asked to go home, indefinitely. This simply means there no HIV services to key population in Benue State and indeed Nigeria.
RURCHEDI is a community based organisation led by and working with Men who have sex with men MSM, transgender person is and people who struggle people who use drugs. RURCHEDI Is a Local Implementing Partner (LIP) with APIN Public Health Initiative Nigeria sub-granted on the ACARES project (with the priority for FY25 being Accelerated Case finding) Sponsored PEPFAR USA.
The situation here is very desperate. Last week APIN Public Health Initiatives, Nigeria closed the two HIV clinic in Benue State and the regular HIV outreach services to Key Populations which ensure that clinic teams reach out to clients located in the 23 Local Government Areas of Benue State with HIV services. These include prevention services (distribution of condoms and lubricants) confirmatory HIV testing services and enrollment into care. Rhey also include ARV refills, PrEP enrollment and refills and PEP services, etc.
As of 20 February, HIV services to Key Populations in Benue State are shut indefinitely due to the PEPFAR work stop order.
This is indeed a state of emergency, with potentially undesired and disastrous outcomes for Public Health.
in general and HIV interventions for Key Populations over the years which have taken years of hard work, achieving remarkable strides to present day levels of epidemic control.
Since inception in 2017 to date, RURCHEDI has over 800 clients in HIV care needing ART refills and about 450 clients enrolled on PrEP. With this total “blackout” on HIV services in Nigeria, how can we continue serving members of our community, namely: MSM, transgender people (TG) and people who use drugs (PWUDs)?
Another important question concerns the status on the database that was being created to track clinic level ART delivery? In this case the database created to track ART delivery at a clinic level exists and remains with both RURCHEDI and the Programmes/M&E units at APIN Public Health Initiatives Nigeria, Benue Field Office, Makurdi.
In its capacity as a Community Based Organisation, led by and focused on MSM, TG and PWUD, RURCHEDI is responsible for ensuring that clients turn up for HIV medicines (ART/ARVs) and PrEP refills and viral load tests every six months. This ensures retention in care and reduces people becoming disconnected from care and lost to follow up (LTFU) or taking interruption in treatment (IIT).