National Policy on HIV/AIDS

Objectives

Nigeria’s National HIV/AIDS Policy establishes a comprehensive, rights-based and multisectoral framework to halt and reverse HIV transmission, mitigate the epidemic’s social and economic effects, and advance universal access to prevention, treatment, care and support by 2015.[1][2][3]It seeks to reduce new infections, ensure equitable and quality services for people living with and affected by HIV, and enable healthy, socially and economically productive lives.[4][3]

• Prevent new HIV infections through behaviour change, safer sexual practices, correct and consistent condom and lubricant use, biomedical prevention, HIV counselling and testing, prevention of mother-to-child transmission, blood and injection safety, and diagnosis and treatment of sexually transmitted infections.[5][6][7]
• Provide accessible, affordable and non-discriminatory treatment, including antiretroviral therapy, management of opportunistic infections, tuberculosis and HIV collaborative services, early infant diagnosis, nutritional counselling and comprehensive clinical care.[8][9][10]
• Strengthen care, support and impact mitigation for people living with HIV, affected families, and orphans and vulnerable children through psychosocial, palliative, legal, social-protection and economic-empowerment measures.[11][12][13]
• Protect human rights, dignity, confidentiality and participation, while reducing stigma, discrimination, gender inequality and the social, cultural and economic factors that increase HIV vulnerability.[1][14][15]
• Prioritise women and girls, children, young people, mobile and marginalised populations, people with disabilities, people affected by conflict, and populations at increased risk, including people engaged in transactional sex, men who have sex with men, injecting drug users, prisoners and prison staff.[4][3][6][16]
• Build sustainable institutional architecture, resource mobilisation, monitoring and evaluation, research and knowledge-management systems as core strategic thrusts of the national response.[17][5][18][19]

Implementation

The policy adopts a coordinated, community-based, gender-responsive and multisectoral delivery model, combining national leadership with state, local government, health-sector, civil-society, private-sector and community action.[4][20]National coordination is led by the National Agency for the Control of AIDS (NACA), supported by State Agencies for the Control of AIDS and Local Government Agencies for the Control of AIDS within the federal system.[21][20]The response follows the “Three Ones” principle of one coordinating agency, one strategic plan and one national monitoring and evaluation framework.[21]

• Coordinate government ministries, departments and agencies, state and local institutions, legislatures, civil society organisations, faith-based organisations, traditional and religious leaders, professional bodies, employers, development partners and people living with HIV in planning, implementation and evaluation.[22][20][23]
• Integrate prevention, testing, treatment, care and support across primary, secondary and tertiary health services, reproductive and maternal health services, tuberculosis and malaria programmes, schools, workplaces and community structures.[24][8][9][10]
• Certify HIV counselling and testing centres, apply national testing protocols, protect informed consent and confidentiality, and integrate both client-initiated and provider-initiated testing into relevant health services.[24]
• Regulate blood-banking, laboratories and health-care institutions; require screening of blood and related products; establish infection-control functions; and monitor compliance with professional safety standards.[25]
• Deliver prevention of mother-to-child transmission through maternal health, family-planning, well-woman and community-outreach services, including partnerships with traditional birth attendants and measures to increase male participation.[8]
• Develop gender-sensitive referral networks connecting facility-based, home-based, palliative, counselling and community support, and link HIV services with poverty alleviation, social protection and wider development programmes.[11][12]
• Strengthen NACA’s capacity to harmonise collaboration and reporting, clarify stakeholder roles, support state and local coordination, mobilise resources and track their allocation and use transparently.[20][14]
• Maintain one national monitoring and evaluation plan, strengthen national and state databases, establish core indicators and data submissions to NACA, use surveillance and surveys to track epidemic trends, and disseminate findings for planning, accountability and continuous improvement.[18][26]
• Allocate at least 8% of each implementing institution’s HIV/AIDS programme budget to monitoring and evaluation, as advocated by the Federal Government through NACA.[26]
• Support nationally driven, ethically sound biomedical, operational, social-science and economic-impact research, and apply findings to policy and programme decisions.[19]

Monitoring & Evaluation

Nigeria’s HIV/AIDS policy establishes a coordinated national monitoring, evaluation and knowledge-management system intended to track epidemic trends, assess programme performance and gaps, inform decisions, and strengthen accountability across the multisectoral response.[18]The Nigeria National Response Information Management System forms the monitoring and evaluation framework within the “Three Ones” arrangement of one coordinating agency, one strategic plan and one monitoring and evaluation framework.[21]

• Maintain a comprehensive national monitoring and evaluation framework incorporating public-health surveillance, population-based and special surveys, behavioural surveillance, regular HIV expenditure tracking, research and routine programme data.[21][18][19]
• Use data to document results and service coverage, identify gaps, guide planning and future interventions, and support evidence-based policy-making and programming.[5][18]
• Harmonise national and state monitoring and evaluation plans, databases, stakeholder networks and reporting relationships, with an agreed core set of indicators and data submitted regularly to the National Agency for the Control of AIDS (NACA).[26]
• Disseminate monitoring and evaluation findings, national study results, epidemiological information, research and surveillance information to government, sectors, development partners and the public.[26][23]
• Strengthen data quality through quality-assurance mechanisms and continuous data-quality improvement, alongside a national framework for quality assessment and continuous improvement in HIV diagnostic and treatment services.[10][26]
• Monitor biomedical prevention through continuous quality oversight of blood-banking services, laboratory and health-institution compliance, and infection-control units that monitor and report on prevention practices.[25]
• Track tuberculosis and HIV scale-up through rapid HIV testing among tuberculosis patients, tuberculosis screening among people living with HIV and other groups, contact tracing, child tuberculosis screening, and a joint monitoring and evaluation plan.[11]
• Require transparent and accountable financial and programme management systems at national and state levels to track resource allocation and utilisation, while strengthening coordination and reporting among implementing institutions.[20][14]

Reported evidence includes sero-prevalence, demographic, behavioural and integrated biological and behavioural surveys, which examine prevalence, awareness, testing, prevention knowledge, risk behaviour, stigma and service access.[21][27]Selected results include HIV testing among females increasing from 6.6% in 2003 to 14.4% in 2007, and among males from 7.7% to 14.7%; 675,555 pregnant women receiving counselling and testing for prevention of mother-to-child transmission by December 2008; and about 269,000 people accessing antiretroviral therapy by March 2009.[27]

NACA is responsible for national coordination, monitoring and evaluation, while ministries, departments and agencies are expected to monitor and evaluate sector-specific programmes.[20][28]People living with HIV are to participate in community action, decision-making and evaluation.[12]Although the policy describes extensive monitoring functions, the supplied material does not provide a single consolidated indicator matrix, indicator definitions, reporting timetable, evaluation methodology, surveillance targets or independent accountability mechanism.[25][20][19]

Costing & Financing

The policy frames financing as essential to a sustainable, multisectoral HIV/AIDS response, combining government ownership, resource mobilisation, transparent management and development-partner support.[13]It identifies significant funding and resource gaps, particularly weak state-level political and financial commitment, substantial dependence on external resources, and the risk posed by reductions in development-partner contributions.[13]

• Mobilise and diversify funding through federal, state and local government contributions, public-private partnerships, external bilateral and multilateral support, and potential HIV/AIDS tax or derivation funding.[20]
• Develop and cost national, state and sectoral plans, including plans involving line ministries and civil-society platforms.[1]
• Strengthen resource allocation, mobilisation, management, accountability and sustainability at national and sub-national levels.[5][13]
• Release budgeted funds and promote their accountable, transparent utilisation through the Ministry of Finance, alongside fulfilment of government obligations under bilateral and multilateral support arrangements.[28]
• Provide direct programme funding, reduce administrative bottlenecks and strengthen capacity to track allocation and utilisation across the national response.[20][14]
• Support human resources, infrastructure, reliable commodity supplies and equitable distribution of health professionals, recognising pressure on already overstretched health systems and regional workforce disparities.[9][13]
• Mobilise adequate resources for monitoring and evaluation, including surveillance, surveys and expenditure tracking.[18]
• Allocate at least 8% of each implementing institution’s HIV/AIDS programme budget to monitoring and evaluation, as advocated by the Federal Government through NACA in line with the international Monitoring and Evaluation Reference Group recommendation.[26]

Resourcing priorities include affordable access to treatment, care, support, condoms and lubricants, as well as sustainable supplies of medicines, laboratory materials and other commodities.[29][9]The policy also links HIV/AIDS programming with poverty alleviation, social protection and economic empowerment, and presents care and support as an investment in quality of life and continued productivity rather than an economic drain.[11][12]

The supplied material does not provide total budgets, monetary allocations, unit costs, quantified funding requirements, expenditure amounts, financing proportions, funding-gap values or economic projections.[13][19][28]