Nigeria – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
The combination of Nigeria’s large population and estimated HIV prevalence results in the second highest burden of HIV/AIDS worldwide, with an estimated 2.6 million PLWHA. Adding to this burden are 1.2 million children orphaned by HIV/AIDS and millions more affected by the epidemic. In addition, Nigeria has one of the highest TB burdens in the world and the largest in Africa. Nigeria has a generalized/mixed HIV epidemic; however, prevalence varies widely across states and rural and urban areas. Nigeria’s epidemic is largely fueled by heterosexual and mother-to-child transmission. Despite the rapid expansion of HIV services across the country, coverage of essential prevention and treatment interventions remains low, and the level of unmet demand is high.
The Government of Nigeria is currently finalizing its National Strategic Framework 2 which will then in turn, be used to guide the development of the Partnership Framework ensuring that PEPFAR support and resources are used in ways that support country leadership and potentiate local inputs and resources. The Partnership Framework was signed in August 2010 and is avaible at http://www.pepfar.gov/frameworks/nigeria/index.htm.
As PEPFAR shifts its emphasis from an emergency response to a more sustainable HSS approach, prevention activities, which include PMTCT, prevention of sexual transmission, and prevention of medical transmission (blood and injection safety) as well as HCT, will also focus on systems strengthening models. PEPFAR PMTCT service provision will emphasize strengthening diagnostic services for exposed infants, linkages to family planning services, referral networks to reduce loss to follow-up, and infant feeding counseling to support appropriate feeding choices. PEPFAR will also continue training health workers, and to some extent traditional birth attendants, to provide PMTCT services in line with the national guidelines as well as internationally accepted best practices.
Prevention activities will be integrated into all care and treatment activities, including HCT services. The blood transfusion services in Nigeria still remain a source of transmission of HIV and other pathogens despite the gains made by the National Blood Transfusion Service (NBTS) since 2007. In FY 2010, PEPFAR continues its commitment towards ensuring that linkages between NBTS and implementing partner-supported clinical sites are improved, thereby resulting in an increase in hospital utilization of NBTS-screened blood and a reduction in emergency transfusions at supported sites.
Care activities in Nigeria include adult and pediatric care and support, TB/HIV, and support for OVC. With the shift in emphasis from a rapid scale-up emergency response to a sustainability response, PEPFAR, in line with the National Strategic Framework 2 (NSF 2) is focused on ensuring maintenance of all supported clients receiving care, OVC, and treatment services. Strategies will include minimal expansion with greater focus on improved quality, sustainability, pooled procurements, cost efficiencies, and HSS.
Harmonization, quality of service, reduced target costs and cost leveraging continue to be mainstays of the Nigeria treatment program, with standardized services and health care worker training provided across all implementing partners. Pediatric treatment services also remain a priority in FY 2010. PEPFAR will continue its efforts to leverage the Government of Nigeria, Global Fund, and other development partners for ARVs as these commodities account for a significant percentage of the PEPFAR budget.
Integral to the provision of treatment services, laboratories will focus on maintaining services through the implementation of expanded and harmonized lab QA systems. PEPFAR-supported labs will continue to scale-up support for the implementation of a national network for EID. Improved cost efficiencies in PEPFAR approach could result in reducing overall treatment costs and making routine monitoring available to all antiretroviral treatment patients.
In FY 2010, there will be a greater emphasis on health systems strengthening activities, with particular emphasis placed on the sustainability of current and previous PEPFAR investments. The strategy will also focus on governance and supporting national ownership and leadership.
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