The HIV Research for Prevention (HIVR4P) conference began on the 16th of October 2016 in Chicago, USA. Unlike many other related conferences on HIV, AIDS, STIs, etc, the HIVR4P is very specific. It is the only global scientific conference that is dedicated exclusively to cutting-edge and up-to-date research on all forms of biomedical HIV prevention which include & not limited to HIV vaccines, Pre Exposure Prophylaxis (PrEP), Microbicides, treatment as prevention (TasP), and other biomedical prevention approaches. This year’s HIVR4P brought about 1,400 leaders in HIV prevention research, programs and policy makers to build on the successes of its inaugural to respond to a growing agreement that effective HIV prevention will require a combination of approaches.
Nigeria(ns) and the Demand for PrEP (#LeNNiB).
PrEP; Pre-Exposure Prophylaxis, is the use of anti-HIV medication that keeps HIV negative people from becoming infected. When used as prescribed, a single pill taken once daily will interfere with HIV’s ability to copy itself in the body after it has been exposed. Although approved by the Food and Drugs Administration (FDA), having shown safety and effectiveness, and been around in the U.S. for over a year, not a lot of people know about it.
The New HIV Vaccine and Microbicides Advocacy Society (NHVMAS) in the past months has mobilized civil society organizations and advocates in Nigeria and other partners to demand for PrEP through the; Leave No Nigerians Behind, #LeNNiB campaign.
Nigeria is a high burden country for many diseases. We (Nigeria) currently housed the second largest population of people living with HIV globally and have the largest number of new HIV infection each year. In 2015 alone, 210,000 persons were infected with HIV, despite the availability of condoms and other prevention options. This was one of the world’s highest figures. Yet, HIV infection is avoidable if all persons at substantial risk for HIV – Women, Young Girls, Adolescents, MSMs, FSWs, IDUs, Sero-discordant couples and Men with multiple sex partners who find it difficult to use condoms – have access to varieties of HIV prevention tools.
Despite several pleas to GILEAD Sciences; an American biopharmaceutical company that developed and commercialized Truvada since 2004, which is the major prescription medicine that is used as PrEP to help reduce the risk of getting HIV-1 infection when used together with safer sex practices, their failure to register Truvada for use as PrEP in Nigeria is a denial of access to persons at substantial risk of HIV and finds the use of condoms challenging as a HIV prevention tool for HIV. This makes a layman to wonder if truly the world is fighting HIV/AIDS in one accord and that we are helping ourselves to end the epidemic that has being around for the past 34-35 years. Or maybe Nigeria has been left behind in the global response to tackle the HIV epidemic.
Many have argued that the use of PrEP in Nigeria will promote promiscuity and other social vices. Others claimed it would limit the use of condoms and increase STIs. Also, there are claims of insufficient funding to foster the processes and use of PrEP but we forgot the sero-discordant couples. We have forgotten the limited powers of the condom being contraceptives and also not 100% safe in the case of miss-use, leakage or sudden burst.
Lest we forget our scores and deliberately not seize this moment as a nation, Nigeria has the second highest number of people living with HIV in the world. We are making poor progress with prevention of mother to child transmission of HIV as this has tagged us “the country that leads the global manufacturers of children infected with HIV”. Opportunistic infection such as Tuberculosis also remain a challenging problem and a growing public health hazard in Nigeria as the country is identified as one of the 10 high burden countries in the world. With the high number of new infections, Nigeria is racing towards being a country with the highest number of people living with HIV in the world….”I believe this will be a very nice award and a place to clap for ourselves having achieved this feat”… Truth is, we need to stop this trend. We need to ensure effective HIV prevention tools are available to person who needs them.
Also, we should note that despite the low incidence of HIV in countries such as Kenya, France, Canada, USA, Australia, they already got PrEP approved and being served as part of their HIV prevention spectrum.
Our Ministry of Science and Technology has kept quiet, maybe because they lack funds to support life saving health researches and are preparing for their proposed invention of “pencils” by 2018; The Nigerian Centre for Disease Control (NCDC) is not seen doing anything feasible on securing or sounding the alarm for the urgent need for PrEP; Our National Academy of Science is now a place where nothing happens except to celebrate international day of blahblahblah…. The National Agency for the Control of AIDS (NACA) has done so much but in the coordination of the AIDS response than turning the tides in search for an AIDS vaccine and alternative prevention tools. Despite coordinating the PrEP demonstration project, they are foreseen to be comfortable with the present status-quo of not having enough innovative prevention tools.
The fate of the nation’s health and her citizens has now being left in the hands of Civil Society Organizations (CSO), who are advocating & fighting for the masses and vulnerable people. The Ministry of Health is now a playing ground where policies abound, rebound, etc without implementations.
Gilead’s efforts to quickly register Truvada for use as PrEP in Nigeria should commence before the conclusion of the ongoing PrEP demonstration project in Nigeria. This is a call on behalf of the many people already asking for PrEP in Nigeria. Nigeria have to stop this trend of new infections as there are individuals already asking for PrEP, yet doctors cannot prescribe. We need/must meet the global targets of ending HIV as Nigerians cannot and must not be left behind. NAFDAC is already waiting for Gilead Sciences to register Truvada for use as PrEP in Nigeria, so also the over 174 million Nigerians are also waiting for new HIV infection to stop.
There are evidences that PrEP works when taken. Also, data from various demonstration projects has provided some information on what the “real-world” implementation of PrEP will be. Although, there may not be answers and truly do not need any, but Nigeria really should IMPLEMENT PrEP NOW!!!
Gabriel is a Public Health Analyst and HIV/AIDS Advocate.
Follow him on Twitter via @vinnydrey @s4mnigeria
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