HIV Trust Fund of Nigeria, HTFN is for launch today in Abuja by President Muhammadu Buhari with aim of raising N62b to further curb HIV prevalence in Nigeria by tackling mother -to- child transmission. This is a private sector initiative to boost international yearly funding since 2001 which has reduced HIV/AIDS prevalence from 5.8 percent to 1.3 percent. Jekwu Ozoemene, the MD/CEO of HTFN whose background covers investment, development banking and finance with doctorate degree in banking and finance, in this interview throws more light on the five- year mother-child intervention initiative and HIV rate in Nigeria. He said as at 2021, one in seven children born with HIV in the world is Nigerian. Daniel Obi provides excerpts
Could you tell us more about the HIV Trust Fund and why it was established?
HIV intervention in Nigeria has largely been funded by international donor agencies with total spend of about $500m yearly. This means that the global donors and US President’s Emergency Plan for AIDS Relief (PEPFAR) are supporting with about 80% while Nigerian government is supporting by about 19% and private sector by 1%.
This amount is required because one of the first things in such interventions is to identify those who are HIV positive and place them on Anti-Retroviral therapy. Once they are on this medication, the persons living with HIV can achieve viral load suppression. This means that the person, though has the virus but will not test positive. With Viral Load Suppression, the individual stops transmitting the virus and these individuals will no longer be open to infections. They will live a normal life but they will be on the Anti-Retroviral therapy for the rest of their life that costs about N50,000 yearly.
From 2001 to 2021, Nigeria’s prevalence rate dropped from about 5.8 % to 1.3 %. But the challenge is that the donor agencies are saying they have done this intervention for 20 years and Nigerian sponsors should step up and take responsibility. Besides, there is Covid 19 which has led to diversion of resources that the donor agencies have been spending addressing HIV. They also said that the fortunes have improved and the prevalence rate has dropped as there are other countries that have much more prevalence rate than Nigeria. The argument is sound but the problem with it is that because of our population size, at 1.3 percent prevalence rate, there are about 1.9 million people living with HIV. The second leg and that is where HIV Trust Fund has decided to focus on is the prevention of mother-child transmission of the virus.
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As at 2021, one out of every seven children born with HIV in the world is in Nigeria. Of about 300,000 children that were born with HIV in 2021, over 20,000 are Nigerians. Once they are born, they need to be managed for the rest of their lives and there is significant cost to that. National Agency for the Control of Aids, NACA, therefore, met with the private sector, presented the statistics and asked for help as government can no longer tackle the challenge. Immediately, the Nigeria Business Coalition Against AIDS agreed that this is something that needs private sector intervention. It agreed to aggregate private sector competences and capital market tools to solve this problem as it believed that programme funding is a major aspect to prevent the mother-child transmission. What this implies is that every pregnant mother will be tested for HIV.
The challenge here is that not all pregnant women come to regular hospitals but we should find a way of bringing them into the stream, test them. Those who are positive will be placed on Anti-Retroviral Therapy. And those who are negative we will have their spouses tested. If the child is eventually born with HIV, the child will be taken care of medically.
In the programmes presented by NACA, HTFN extracted the aspect of mother-child transmission to focus on. We believe that if we prevent the mother-child transmission, we can then manage the other group living with HIV and it will reduce the burden on the government. In Nigeria, there are about 1.9 living with HIV and about 1.6 m on Anti-Retroviral Therapy which costs about N50,000 per year per person.
Now that HTFN is coming on stream to tackle mother-child transmission, which other areas will NACA and donor agencies focus on?
NACA is government representative. They are not going anywhere. HTFN is not coming to take over the role of NACA neither is it coming to take over the role of global fund or PEPFAR. We are not going to build any new deployment channels. What we are bringing in is private sector competence. Today there is a pool of HIV interventions in Nigeria, so that we don’t have duplication of programmes. We are going to channel our efforts through the established pool. However, we have specified where the funding will go to. We are going to bring private sector and government hospitals to participate, and another value chain to ensure that every single pregnant woman must be tested for HIV and those that are positive will be immediately be placed on Anti-Retroviral Therapy.
Who are these global donors?
They are Global funds for the fight against Tuberculosis, Malaria and AIDS; PEPFAR is US President’s committee for AIDS reform. They are the biggest players and between them, they do about $400 m every year from 2001 till today. HTFN is not a programme implementer instead we are raising the fund for the programme implementers. There are channels, but they are incapacitated by funding and competencies we have as a private sector. We are galvanising the private sector to raise the funds needed.
The board of HTFN is chaired by Herbert Wigwe, the Group Managing Director of Access Bank; Aliko Dangote, Chairman of Dangoge Group of Companies; Samba Seye, Managing Director of Total Nigeria Plc; Osagie Ogunbo, Chairman of Shell and MD of SPDC; Lars Richter, Managing Director, Julius Berger Nigeria PLC; Gambo Aliu, Director General of NACA and Sanni Aliu, former DG of NACA. They are interested in putting an end to this problem and they head hunted me to manage the process. They believe that what is required is finance and general administration perspective.
As you approach the private sector for fund assistance, what is your target budget?
The total fund we are looking for is about N62 billion (about $150m) to tackle mother-child HIV transmission in the next five years. There is a national strategic funding scheme for HIV /AIDS that defines what is required to address each thematic space in the fight against HIV/ AIDS. We have therefore singled out the mother-child aspect and that is what we are focusing on.
What is the step by step plan to raise the fund?
We are starting with the launch today, February 1, 2022 in Abuja by President Buhari. Others have been invited. Don’t forget that this is a national initiative but driven by the private sector. The second leg is that the HTFN was presented to the private sector by NACA for assistance to solve the problem. The first set of people we are approaching are members of Nigeria Business Coalition Against AIDS, NIBUCA. But we have gone beyond that to look at the entirety of the private sector. There will be a road show to present this burning platform to the private sector. An explosion in HIV prevalent rate has an impact on the labour force and existing medical facilities and resources.
Some people think HIV has disappeared. Why people don’t hear about it is because somebody has been spending $500m yearly to tackle it. When this funding stops, there will be explosion in a short time.
Where is the role of the public sector in raising the N62 billion intervention fund?
We hope that the President will make a commitment at the launch today to support the fund over the five- year period to tackle the challenge. However we will continue to engage the public and private sector as it is a national issue. We will also put together a transparent and robust governance framework that will make it easier for trust and people who require the drugs to get it for free. With this, stakeholders will be interested to donate.
What informed the reduction in number of people with HIV?
There is no virus that has a cure. HIV will stay with a person for the rest of life. What we are ensuring is to checkmate more people contracting the virus. If the prevalence rate is dropping and the population is growing, it means that more people are not contracting the virus. This is why prevention of mother to child is important.
