AIDS, TB and Malaria

HIV/AIDS

One of the major activities of WHO in Nigeria is to support the generation, collation, processing, and dissemination of strategic information on determinants, deterrents and other factors affecting the epidemic and the responses to it. Support is provided for the conduct of sentinel sero-prevalence surveillance among women attending ANC in public facilities. The Behavioral Sentinel surveillance (BSS) and National AIDS and Reproductive Health Survey (NARHS) were also supported.

WHO has also provided technical assistance to review the national VCT guidelines. This was undertaken under the coordination of the Ministry of Health in collaboration with other partners.

WHO has also assisted in conducting a training of ART Site Coordinators, Record Officers and Pharmacists to update them with the tools and procedures for patient tracking which contributes to improved capacity at ART service delivery points.

The UN Theme Group on HIV is the coordinating mechanism for the UN agencies activities in support of the national response. WHO Representative has been the chair of the UNTG since 2004.

The country office has also provided technical support in the elaboration of proposals for various rounds of funding from Global Fund to Fight AIDS Tuberculosis and Malaria and continues to provide such assistance.

Early in 2005 the President of Nigeria gave a directive to reach 250,000 with ARV treatment by June 2006. WHO participated in the elaboration of a framework for achieving the Presidential directive. Four states, namely Oyo, Ekiti, Plateau and Benue were supported by WHO to develop their multi-sectoral action plans for HIV/AIDS.

A future thrust for the WCO will be to continue forging partnership with other UN Organizations through the UN Theme Group on HIV. WHO will also continue to play its role in the Country Implementation Support Team (CIST) which in turn will be one of the committees of the Expanded Theme Group for HIV/AIDS in Nigeria.

TB is still a major public health problem in Nigeria, with the country ranking 5th among the 22 high TB burden countries which collectively bear 80% of the global burden of TB. The number of TB cases notified in the country increased from 31,264 in 2002 to 90,307 in 2008; more than 450,000 TB cases have been successfully treated free of charge in the past 5 years in Nigeria. The TB burden in Nigeria is further compounded by the ongoing HIV/AIDS epidemic and the emergence of multi-drug resistant tuberculosis (MDR-TB).

The National Tuberculosis and Leprosy Control Programme was launched 1991. The programme operates at all three tiers of government, with each level having a well trained officer in charge of coordination in all the 774 Local Government Areas in the 36 states of the country and FCT.

The WHO/IUATLD global DOTS strategy for effective TB services was adopted since 1993 as an integral part of PHC.

With the support from partners DOTS has been extended to cover all the states of the Federation and the Federal Capital territory. Partners include WHO, CIDA, USAID, GLRA, NLR, IUATLD and DFB. More Local Government Areas (LGA) are now implementing the DOTS Strategy while there is an increase in the number of laboratory microscopic centers to improve access to diagnosis. The Nigeria Stop TB Partnership was launched in April 2009 to support Government efforts in advocacy and mobilisation of additional resources from the private sector and multilateral organizations for the control of TB in Nigeria and thus improve the chances of reaching the Stop TB and MDG targets for TB control by 2015.

WHO continues to support the government in achieving its goals. The goal of the National TB programme is to reduce, significantly, the burden of TB by 2015 in line with the Millennium Development Goals (MDGs) and the STOP TB Partnership targets which are to detect at least 70% of the estimated infectious (smear-positive) cases and to achieve a cure rate of at least 85% of the detected smear-positive cases so as to reduce TB prevalence and death rates by 50% relative to 1990 level by 2015 and to eliminate TB as a public health problem (

WHO is supporting the Government in carrying out prevalence surveys including a survey of Multi Drug Resistant TB.

Malaria is the most significant public health problem in Nigeria. The economic cost of malaria, arising from cost of treatment, loss of productivity and earning due to days lost from illness, may be as high as 1.3% of economic growth per annum. The disease is a major cause of maternal mortality and poor child development.

Traditionally, the malaria problem has been seen as a challenge for the health sector alone with little or no involvement by other sectors or the general community.

A rational review of treatment policy based on use of ACTs has been approved by national authorities. The multi-sectoral transition committee to guide implementation process, towards promoting access to effective treatment, has been inaugurated and functioning. The RBM partnership is waxing stronger by the day. Scaled up implementation of proven malarial control interventions are being intensified with resources made available by government and stakeholders with the support of RBM partners. WHO is a major player in the partnership, supporting the Secretariat as well partners’ programmes.

WHO’s strategic approach includes continued support for national authorities especially the health ministries in essential public-health functions related to malaria control; promotion of synergies with related health programmes especially those for immunizations, child and maternal health, pharmaceuticals and environmental health; promotion of the participation of communities and civil society; engagement of the private sector in the delivery of prevention and treatment; identification of best practices and financing mechanisms for extending interventions; preparation of tools and support measures for district level management;