Stakeholders in Nigeria’s HIV response have renewed calls for sustainable domestic financing and more government–civil society collaboration following the disruption caused by the United States Government’s temporary freeze on HIV funding earlier this year.
The stakeholders said that the US Government’s decision exposed deep vulnerabilities in the Nigeria’s dependence on foreign aid.
They raised the concerns at a two-day Government–CSO Dialogue Workshop on HIV Transition, Sustainability, and Domestic Resource Mobilisation, convened by Education as a Vaccine (EVA) and the United for Prevention Coalition (U4PC) in collaboration with the National Agency for the Control of AIDS (NACA) in Abuja.
Early this year, an executive order in the United States triggered a temporary halt in funding for several HIV prevention and community-based activities, though treatment commodities such as antiretrovirals (ARVs) were covered under special waivers.
Deputy Director and HIV Prevention Co-lead at NACA, Ezinne Oke-Uchendu, said the freeze disrupted outreach, prevention, and community-led services, most of which are implemented by CSOs. She added that the agency immediately began assessing the fallout.
“Earlier in the year, we got information about the USA funding freeze. A lot of our partners were affected and work at different community levels was also affected. We got support from EVA to help assess the effects of the stop-work order and how it affected HIV programmes in the country,” she said.
She added that the workshop coincided with the launch of a new CSO assessment report, which captured key service disruptions and offered policy recommendations. One recommendation; reducing the age of consent for HIV testing and services, was approved during the meeting, she revealed.
She said the government is developing measures to shore up financing and maintain service stability. “At the moment, we are focusing on domestic resource mobilization and seeing what additional help partners can provide,” Oke-Uchendu stated.
Oke-Uchendu explained that Nigeria’s newly finalised National Prevention Plan and population-specific guidelines will guide all implementing partners going forward, ensuring policy alignment across states.
She added that CSOs remain integral to planning and service delivery through state-level AIDS control agencies and national networks representing youth, key populations, and people living with HIV.
CSO representatives used the platform to present findings from months of community consultations and monitoring.
Senior Programme Officer with EVA, Idoko Philip, said dwindling donor funding makes it imperative for Nigeria to integrate specialised HIV services into mainstream health facilities. “With funding declining, business is not as usual anymore. Services need to be integrated,” he noted.
He urged government to train general healthcare workers to competently serve key populations and marginalised groups who previously relied on targeted donor-funded programmes.
Philip also warned that young people and other vulnerable groups are already experiencing reduced access to preventive services such as PrEP (pre-exposure prophylaxis) due to the freeze.
“The Nigerian government needs to step up and fund prevention programmes, including HIV testing and PrEP,” Philip said.
He cited gaps in legal protection and limited implementation of Nigeria’s HIV anti-stigma law as barriers that further discourage affected groups from seeking care.
Presenting findings from community-led monitoring, Monitoring and Evaluating Lead, Network of People Living with HIV and AIDS in Nigeria (NEPWAN), Femi James Medeyese, highlighted significant delays in viral load testing in some states.
He said Imo and Abia states currently rely on transporting samples to neighbouring states due to lack of functional viral load machines, resulting in long turnaround times and even missing samples.
“In Abia, the machine is available but in bad condition. The environment where it is kept is also not conducive,” he explained, noting that NEPWAN has begun advocating for repairs or replacement.
He also confirmed that the U.S. funding freeze contributed to ARV stock-outs, with some patients forced to move across multiple facilities to get as little as a one-month refill.
“It impacted medication availability and even the number of healthcare workers supported by the US government who were available to provide care,” he said.
He stressed that community-led monitoring is not intended to “find faults” but to help government and partners address service gaps and improve quality of care.
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