Abubakar Muhammed Kurfi (EV 2013; public health physician who works with the National Health Insurance Scheme in Nigeria) firstname.lastname@example.org
The HIV/AIDS implementation landscape in Nigeria is rapidly expanding and changing with more donors and implementing partners getting involved in the provision of the various forms of HIV and AIDS services. These partners include bilateral and multilateral institutions and other key stakeholders like the civil society organizations, the private sector all working to ensure the overall improvement in the lives of people infected and affected by AIDS and HIV. The activities of this wide range of stakeholders require to be technically and geographically organized for effective coverage in service delivery. If well harnessed donor support could be a tool for good; the reverse is also the case, as for nations that fail to properly streamline and coordinate the activities of donor agencies (like Nigeria), the systems become polarized; fragmented, heavily verticalized with widening inequity and significant missed opportunities in service delivery due to inadequate planning; duplication of efforts; heavy administrative burden, unclear leadership and waste of resources.
Giant strides have been made globally in the fight against HIV/AIDS. According to UNAIDS, 2011 was a game changing year for the global AIDS response with unprecedented progress in science, political leadership and results. New HIV infections and AIDS-related deaths have fallen to their lowest levels since the peak of the epidemic and deaths from AIDS-related illnesses have decreased by 21%. This unfortunately is not the story in Nigeria which contributes 22% of global new infections; 32% of the global PMTCT gap and 10% of the global HIV burden despite the multiplicity of donor agencies and other stakeholders working on the response. In order for Nigeria as a nation to reposition herself and get the maximum benefit out of these significant global strides, there is a need for the development and implementation of a clear blueprint for harmonizing and coordinating donor activities towards the development of a common platform for planning, managing and delivering HIV/AIDS services so as to ensure complementarities in activities for rapid achievement of desired outcomes with the scarce human and material resources available.
Only when donor agencies have been properly coordinated at all levels in line with global declarations like the Paris declaration and the Accra agreement can Nigeria have total alignment of its HIV/AIDS with its national development plan and hence ensure consistency of government policies and standards. The present hazy and sometimes haphazard attempt at bringing donors and implementing partners on a need arise basis, is not only inimical to the national response but capable of undermining the progress made by the nation in curtailing the mortality and morbidity arising from this preventable disease.
I believe, with increasing political commitment and proper donor coordination the future of global public health is bright.