Test-and-treat approach to ending HIV epidemic in Nigeria: Current status and future prospects of domestic funding

Abstract

The World Health Organization (WHO) new recommendation of initiation antiretroviral therapy to every human immunodeficiency virus (HIV)-infected person regardless of the CD4 cell count or WHO clinical stage will enhance the global goal of ending the HIV epidemic. The adoption and implementation of this test-and-treat approach is imperative in high burden countries in sub-Saharan Africa, where HIV remains a huge threat to human and economic development. However, this approach requires a front-loading investment as the number of people requiring care and treatment will increase considerably. While domestic funding in the global HIV response has significantly improved over the years, a number of countries in sub-Saharan Africa are still reliant on donor support. With international funding of HIV flattening out, it is critical that donor dependent countries for HIV services begin to explore innovative and sustainable means to generate funds and complement international donors’ efforts in increasing access to HIV care and treatment. For a high burden country like Nigeria, where international support accounts for over 70% of the HIV expenditure, improving domestic funding is certainly imperative for the implementation of test-and-treat approach. This paper highlights the current status and the untapped potentials for improved domestic funding and access to antiretroviral therapy in Nigeria.