Another International Conference on AIDS

Today – July 22 the 19th International Conference on AIDS opens in Washington DC. 

NHW will miss this year’s conference, BUT we thought that a good way to reflect on it would be to bring you the summary of proceedings of the meeting of Nigerian delegates in attendance at the 13th International AIDS Conference, Durban, South Africa on Wednesday 12 July 2000.

12 Years ago…this is what we talked about! Judge for yourself how much has changed.

Venue: Chamber of Commerce Building (Indaba 1), Stanger Street, Durban 

The meeting was declared open on the dot of 3.30 pm by Prof (Mrs) Ibironke Akinsete, the National Coordinator of the National Action Committee on HIV/AIDS (NACA). She welcomed everyone in attendance and thanked delegates for attending. There was a large turn out of Nigerians both from Nigeria and in the Diaspora. Akinsete apologised for the inadequacy of seats at the venue, as this problem was not foreseen at the planning stages of this meeting. She also noted that she had indeed started making parallel arrangements for a meeting at another venue but conceded to this venue arranged at the initiative of Mr Omololu Falobi (RIP) and signalled that this was a sign of the new spirit of dialogue within the renewed efforts by the Federal Government in its fight against HIV/AIDS. All delegates present were then asked to introduce themselves. Characteristic of most gatherings of Nigerians, this was filled with humour as all those present were immediately categorised into “expatriates” and “inpatriates”. There was indeed a wide spectrum of Nigerian professionals in attendance including students, clinicians, public health professionals, journalists and people living with AIDS (PLWAs). Affiliations ranged from government, non- governmental organisations, and the pharmaceutical industry to the press and academia.

Akinsete then opened the session by giving an account of the activities of NACA since it was set up by the present administration. Highlights of her speech include: 1. That the one single, most important aspect that has been missing in attempts by previous administrations over the years in the battle against HIV/AIDS has been a lack of political will. She stated that this has indeed changed for the better and is self evident in the present administration as the President himself has taken charge of the inter-ministerial committee on HIV/AIDS. 2. That the approach to fighting the epidemic would be a multi- sectoral one as manifested in the constitution of various committees set up. This is to emphasise that HIV/AIDS should no longer be seen as a purely medical problem but as one that is presently affecting almost all spheres of human existence. 3. That the new approach to the epidemic will involve strategic planning. This will prioritise different aspects of the epidemic to be handled and would assure the help does get to areas where it is most needed. In this regard a Strategic Action Plan is presently being formulated. Since this will involve a detailed outline of activities and considering the urgency of the situation, an Interim Action Plan is also at the final stages of formulation presently and will soon be made public. 4. That the Government has released N52 million to her committee to date. 5. She rounded up by noting the large pool of human resources available both within and outside the country and appealed to all those in attendance to contribute whatever they can to the battle against HIV/AIDS in Nigeria. She emphasised her commitment to efforts in this regard and looked forward to a new era of communication and cooperation. The UNAIDS representatives were then asked to address the meeting. The UNAIDS rep opened by noting the large number of Nigerian delegates in attendance. She said that she had attended meetings of delegates from other African countries at the conference and that Nigeria had by far the most delegates among African countries outside the host country. She congratulated Nigerians on their turn out and their new-found zeal. Nigeria’s’ exclusion from the main stream of activities over the past few years was noted with disappointment. She however stressed that that she had been in active consultation with the new Government and acknowledged the efforts of the President in his campaign for debt relief for African countries. She announced that Nigeria was in the next set of countries for which a new dept relief package was being arranged through which money saved by such efforts will be directly channelled into funding anti-AIDS programmes…the “Debt-for-AIDS” programme. She encouraged the removal of the barriers that exist to a large-scale response to the epidemic and commended the renewed efforts in this direction.

The meeting then proceeded on a question and answer mode: All answers are by Akinsete.

1. Poor access to test kits, drugs, etc at the community level. (Raised by a community worker for an NGO). Was a major theme throughout the conference! Answer: The issue of drugs was not as simple as it sounds as the provision of anti-retroviral drugs must be accompanied by adequate infrastructure and trained personnel for pre- and post test counselling, on-going management, emergency responses etc. However that pilot projects are going on in a few centres including the Lagos University Teaching Hospital (LUTH). On test kits, it was remarked that Government’s policy would be outlined within the Interim action plan soon to be released to ensure a steady flow of high quality kits into the country in a structured and controlled manner. This will lead to the avoidance situations such as the scandal associated with the importation of kits close to their expiratory dates by the previous administration.

2. The “Dr Abalaka Issue” (Raised by a Secure-the-Future scholar in South Africa) The fact that this was not mentioned in the address by Prof Akinsete was noted. It was demanded that the government clarify its stand on this issue. Answer: Just prior to the Durban conference, the Nigerian Academy of Science, the highest academic body in the country had issued and published its findings into this issue. This report stated that it found no evidence to support the claims that Dr Abalaka was making. Akinsete said that Government has learnt from this experience and will handle such cases better in the future. Delegates wondered why Abalaka was absent from this conference and expressed their concern over the plight of Nigerians on his “vaccine”. Government was asked to take a clear and unambiguous stand on this matter.

3. Negligence both by Government and NGOs of People living with HIV/AIDS in the planning and implementation of AIDS programmes. (Raised by a PLWA) He noted that despite the large number of NGOs in attendance here, none financed a person living with HIV/AIDS to the c
onference. Answer: Government was addressing this issue. A plea was again made to Nigerians living with HIV/AIDS to organise themselves. The UNAIDS rep noted that unlike in the Northern hemisphere where People living with HIV/AIDS were the major drivers of responses to the epidemic, this was sadly not the case in Africa probably as a result of the high level of stigma associated with the epidemic. She encouraged PLWAs to engage in activism and advocacy in directing the Government’s response to AIDS.

4. NGO networking It was noted that the previous arrangement in which any NGO could start activities anywhere in the country without any relationship to needs assessment and without any form of control, monitoring and evaluation could no longer continue. It was accepted that there was of a lack of organisation, communication and rivalry among NGOs operating in the country. Different options on how NGOs could organise themselves and elect a representative into NACA were discussed and abandoned as impracticable within this forum. It was however agreed to that the NGOs should organise themselves along the lines of the 6 geo-political zones in the country. These zonal representatives will then communicate directly with an NGO liaison officer within NACA

5. Costs of Anti-Retroviral Drugs. (Raised by a delegate from Glaxo- Wellcome Nigeria) High tariffs on anti-retroviral drugs were apparently keeping the costs of drugs high. Answer: Government is presently looking at different options on how to bring down the prices of anti-retroviral drugs. These include the concepts of compulsory licensing and parallel importing. Delegates in attendance however implored Glaxo-Wellcome to seek ways of manufacturing these drugs in Nigeria rather than importation, as is the practice in some other countries.

6. Negligence of the Youth in anti-AIDS efforts. (Moses Imayi, Nigerian Youth Action Rangers) It was alleged that the youth felt marginalized and used in the anti-AIDS efforts. Answer: It was agreed that this was the case in the past but that this will change in the present dispensation.

7. Lack of research in Nigeria, lack of funding for research and lack of communication among researchers and research institutions. (Prof. Maurice Iwu, Prof. John Idoko) Answer: It was agreed to that the problem of inadequate research into the AIDS situation in Nigeria was definitely not due to lack of the human resources as is evident by the participants in this forum. However there was a large ignorance of each other and their activities. This meeting at which a resource bank is being compiled should be a starting point for a change of attitude. Names, addresses and affiliations of those in attendance were collected by the facilitator of this meeting and will be compiled and made available as soon as possible. NGOs were also encouraged to fund research or to source funds for research. The roles of further research into traditional remedies especially those for the opportunistic infections associated with HIV were stressed. An appeal was made to various academics to work together, and to form partnerships especially with foreign-based colleagues and institutions. There was a consensus for a dire need for improved networking. Post Durban The need for a post-Durban meeting of all the stakeholders in this epidemic was emphasised. This is to assess progress on all the issues raised here. Akinsete highlighted the logistic difficulties involved in the arrangement of such a meeting as she pointed out that in previous attempts, many addresses of NGOs were found to be non- existing. However despite the difficulties, it was agreed that there was an overwhelming need for this meeting and it was scheduled for about the end of August or early September. This is hoped will coincide with the release of the Interim action plan by NACA. Family Health International (FHI) volunteered to help with the logistics involved in arranging this meeting.

Prof Akinsete then congratulated the co-facilitator of this meeting, Mr Omololu Falobi for his initiative and tireless efforts towards improving communication among Nigerians involved in different aspects of AIDS-related activities. He also received a rousing applause from delegates present and a passionate appeal was made to him to not relent in his efforts. The meeting ended punctually at 5.30 pm.

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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