Source: NEXT
In this interview, Faousat Dabiri, the Senior Special Assistant to the State Governor on HIV/AIDS and the chief executive officer of the Lagos State AIDS Control Agency (LSACA), discussed 25 years of HIV/AIDS in Lagos and the issues surrounding the disease in the state. Excerpts.

When was the first case of HIV reported in Lagos?

The first case of HIV was reported in 1986 in a sexually active 13 year-old girl. This also happened to be the first reported case in Nigeria.

What has been the annual mortality rate since then?

As a result of the HIV epidemic, the crude death rate in Nigeria, which was not specific to Lagos, was about 20 percent higher than in 1990. In 2009, approximately 220,000 people died from AIDS in Nigeria. With AIDS claiming so many lives, life expectancy in Nigeria declined significantly. In 1991, the average life expectancy was 54 years for women and 53 years for men. In 2009, these figures had fallen to 48 for women and 46 for men; HIV and AIDS have contributed significantly to this reduction in life expectancy.

What is the present mortality rate?

Collection of accurate data regarding cause of death is still a challenge in most health facilities. Also many people die at home of undiagnosed and unknown causes. What are the challenges of the agency? The major challenges are the weak coordination of the HIV response at the local government levels, which is largely due to the poor institutional and organisational capacities at that level as well as poor funding of HIV at the local government levels. Also, there is insufficient funding for HIV and AIDS prevention and treatment, considering the scale and complexity of the HIV epidemic in Lagos state. Many civil society organisations also do not provide information on programmes or projects implemented in the state. Then, the general lethargy of implementers towards data collection and management, especially the use for evidence based planning.

Since the first recorded case of HIV in Lagos, how would you rate the level of awareness, stigma and discrimination against persons living with HIV?

Awareness has gone up to over 90 percent due to the activities of the agency and its multi-sectoral partners. Stigma is on the way down due to the increased awareness on the mode of spread and increased sensitisation on the state anti-stigma law.

Is there a law that protects persons living with HIV and affected by AIDS in Lagos?

Yes, there is a law for the protection of persons living with HIV and affected by AIDS in Lagos State and for other connected matters which was assented to at Ikeja on 18th May, 2007 by the then governor of Lagos State, Bola Tinubu.

People living with HIV in Lagos say they still face ‘systematic stigma and discrimination,' like being denied admission and employment. What is the agency doing about this?

The agency is aware of some reported HIV related stigma and discrimination cases. In order to curb this situation, the agency has put in place a mechanism to address the issue; part of which includes the sensitisation of key stakeholders like the judiciary, the police and persons living with HIV, to sensitise them about the existence of the anti-stigma law and to solicit their support in its implementation. When there are reported cases of HIV related stigma and discrimination, the agency, through its Human Rights and Justice Workgroup, in collaboration with the Ministry of Justice takes up the case and acts within the confines on the law to protect the rights of affected persons. Also, through the Nigerian Business Coalition against AIDS (NIBUCAA), we partner with the private sector to establish and implement workplace and community-base HIV and AIDS prevention education, care and support programmes. This has contributed greatly to the reduction of HIV-related stigma in the workplace.

How would you rate the success made in the state since 1986, when HIV was first reported in Lagos?

HIV/AIDS awareness is now over 90 percent. Over the years, the agency has improved on the coordination of a sustained multi-sectoral HIV response at the state and local government level by establishing and sustaining relationships with diverse state and non-state actors at multiple levels. There are now over 56 HCT (HIV Counselling and Testing) sites where people can know their HIV status for free; over 24 sites where people requiring Anti-retroviral (ARV) drugs can get access to it for free. There are 24 PMTCT (Preventing Mother to Child Transmission) sites where HIV positive pregnant women can get access to services to help prevent transmission to their babies. Also, there is a marked behavioural change among residents of Lagos State, for example, reported male condom use in Lagos State is 48.7 percent when compared to 30.1 percent in the South-western region. We have linked over 500 people living with HIV/AIDS and their care givers with skill acquisition programmes to mitigate the impact of HIV and AIDS in their lives.

• Nigeria