A Nigerian government programme to provide antiretroviral treatment at subsidised prices for people living with HIV/AIDS is under threat because the initial stock of drugs is running out and has not been replenished, officials said.
The programme was launched in January 2002 by President Olusegun Obasanjo with the aim of providing more affordable antiretroviral treatment for 10,000 people at 25 designated centres across the country.
The government charged just over US $7 per month for the treatment which can improve the health of people living with AIDS and extend their life, but cannot cure them. It costs about $300 per month at commercial prices.
The uptake was very slow at first, but Health Ministry officials told IRIN on Wednesday that it improved as awareness of the programme grew. But the final quarter of last year, the full quota of 10,000 people had signed up to receive the drugs, they added.
But it was then that the problems started.
“At the start of the programme only about one year’s stock of antiretrovirals was bought,” a senior official of Nigeria’s ministry of health told IRIN. “And as the stock was being depleted, no replenishments came in.”
He said the problem stemmed from expectations that a $US 70 million grant to Nigeria from The Global Fund to Fight AIDS, Tuberculosis and Malaria would be disbursed in time to take care of re-stocking the drugs. However, that money had been held up by bureaucratic hurdles.
The Global Fund is a partnership between governments, civil society, the private sector and affected communities.
The government's management of the programme has also been criticised since most of the antiretroviral drugs, which were purchased from India, were manufactured in 2001 and due to expire in 2003.
By August many people were being given drugs that were due to expire by October.
In an internet newsletter posted on January 6, the activist group Journalists Against Aids Nigeria (www.nigeria-aids) quoted health officials as saying the only option they had to breaking the treatment regime was to continue giving patients the expired drugs.
The newsletter quoted Dr. Oni Idigbe, head of the Nigerian Institute for Medical Research, one of the HIV/AIDS treatment centres, as saying it was safe to continue using the drugs up to three months after their expiry date.
“Distributing the drugs is the only option we have now… If we don't, we will have to stop administering drugs completely, which would be a worse option,” said Idigbe. “Some of the drugs expired in October, but they are still safe for consumption for now,” he added.
The concern of the health officials is that any break in the use of antiretrovirals could lead to resistance of that particular drug by the virus when use is resumed, Idigbe said.
Last week Obasanjo announced his government had ordered new consignments of antiretroviral drugs worth 500 million naira (US $3.6 million) to replenish depleted stocks for the treatment programme.
However, it remains unclear when the drugs will be delivered. That has left people living with AIDS who cannot afford to buy the antiretrovirals at free market prices in despair.
“So much has been heard about Obasanjo’s commitment...we want to see that commitment,” Rolake Nwagwu, who lives with HIV, told the Vanguard newspaper. “If the government has said it is going to provide antiretrovirals for 10,000 people, then the government should fulfil that pledge.”
Though 5.8 percent of Nigeria’s over 120 million population was estimated to be infected with the virus that causes AIDS, the initial response to the programme was lukewarm.