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USER FEE CHARGE: A HINDRANCE TO HIV CONTROL IN NIGERIA

Ayomide Joshua

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Over the years, a lot have been done to exterminate or reduce the spread of HIV to the barest minimum. Many drugs have been invented to treat HIV. One drug that immediately comes to mind is the anti-retro viral (ARV). The ARV has been known to be very effective in HIV treatment as constant dosage reduces the viral load to zero. What this means is that any person living with HIV who is constantly taking the ARV will continue to enjoy sound health for as long as he keeps taking the drug. Another drug that has been found to be effective is one which injection a person takes once in a year. As the HIV positive person keeps taking this injection yearly, he keeps enjoying sound health. The injection reduces the viral load in his/her body system to zero level. However, this injection is very expensive and not very much available like the ARV.

STRATEGY FOR HIV CONTROL

Prior to the invention of the ARV, especially in the 80s and 90s, the world witnessed rapid spread of HIV infections and many people died of AIDS.  During these periods, some drugs were invented which were helpful in the treatment of HIV but they were expensive and only few people afford to pay for them. As a result, the condition of majority HIV positive persons who could not afford those drugs worsened from HIV infection to full blown AIDS, leading to their eventual death. Worried by this development, the United Nations came up with two strategies for HIV response and control.The strategies are;

  1. The ARV should be made available everywhere;
  2. The ARV should be free so that every person living with HIV should obtain the drug regularly.

No doubt, these strategies have gone a long way in helping to treat and contain the spread of HIV. A front liner in the campaign for the right and welfare of persons living with HIV/AIDS once testified: “I am a living testimony to the effectiveness of the ARV. I have been taking the ARV for over 13years and I have been enjoying sound health.”

Currently, statistics shows that 63.9 million persons are living with HIV/AIDS in the world while 3.1 million persons are living with HIV/AIDS in Nigeria and of the 3.1 million persons, 28% of them are children.

 

ACCESS TO HIV TREATMENT AND THE USER FEE CHARGE

The strategies for HIV control has been effective in Nigeria. For instance, the ARV are very much available in our health institutions and PLWHIV are accessing the drug. However, there are many people living with HIV who are finding it difficult to obtain ARV regularly due to the fact that they are being compelled to pay user fee before they can obtain it.

“User fee” means an amount that a person living with HIV is asked to pay before accessing HIV treatment. Towards the end of December 2018, a large number of persons living with HIV trooped out with various banners and posters to protest against the user fee charge. One of them who was interviewed by a journalist said that the user fee that is imposed by public health institutions was worsening his condition of health. He said each time he went to the public health institution where he normally obtain ARV, they would ask him to pay N1, 000 and sometimes N500 before giving him the ARV. He said further that anytime he didn’t have money to pay for the treatment, they will not give him the ARV. And once there is no ARV for him to take, his condition of health would start deteriorating. While they kept demonstrating against the user fee charge, the person living with HIV appealed to the government to remove the user fee charge so that they could have access to HIV treatment and enjoy sound health.

REMOVING HINDRANCE TO HIV CONTROL

The fact is, if we are going to make any head way in our national HIV response, we must remove anything that will act as a cog in the wheel of our progress

In Nigeria, we are very good at shooting ourselves in the foot or working agent our self. We always want to make things difficult for ourselves. HIV treatment have been made available for fee, yet our public health institutions have made user free mandatory for persons living with HIV to pay before obtaining the drugs.

Whatever may be the reason for introducing the user fee, the fact is that persons living with HIV are finding it difficult to access HIV treatment. Even the little amount of N500 and/or N1,000 they are been asked to pay before accessing treatment, are amounts which persons living with HIV/AIDS find it difficult to pay.

If persons living with HIV/AIDS cannot access treatment because of the user fee, how then will we be able to achieve our goal of controlling HIV infection come 2020? Obviously the user fee charge is a hindrance to our national HIVresponse. If we are really serious about controlling the spread of HIV infection, we should not hesitate to remove the user fee charge.

WAY FORWARD

Lawyers Alert is therefore appealing to the Federal Government, the 36 States Government, the Federal Capital Territory, Abuja, the NACA (National Agency for the Control of AIDS), the SACA (States Governments for the Control of AIDS),Ministries of Health and other relevant agencies and institutions to expedite action to remove the user fee charge so that persons living with HIV can access treatment and enjoy sound health. It is when this is done that we can hope to achieve our goal of controlling HIV infection come 2020.

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Employers of labour must comply with HIV/AIDS non discrimination Act

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A Civil Society Organisation in Nigeria, Lawyers Alert has insisted that employers of labour in the public and private sector must comply with the HIV/AIDS non discrimination Act to protect workers who that are infected with Acquired immunodeficiency syndrome (AIDS), a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV).

The President of Lawyers Alert, Mr Rommy Mom told Daily Trust that the HIV/AIDS non discrimination Act that was passed into law in Nigeria five years ago was not implemented and that his organization has dragged the Minister of Justice and Attorney General of the Federation, Abubakar Malami to court to demand full implementation and total adherence to the law.

He said the HIV/AIDS non discrimination Act mandates the Attorney General of the Federation to ensure that work places have HIV/AIDS policies to protect workers that are HIV positive.

He said the law was passed in 2014 and that it mandates the AGF to ensure that employers of labour in public and private sector in Nigeria have the policy within three months.

Mr Rommy expressed concern that the law was not implemented five years after and that no policy in work places to protect people living with HIV.

He lamented that majority of workers that are HIV positive are facing all forms of discrimination and stigmatization in their places of work.

 

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Fire Outbreaks and Need for Action.

By Mbakaan Linus

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Billows of smoke becloud the skylines creating a fuzzy and hazy atmosphere. At a closer look, a high rise is engulfed in a wild inferno. Nothing could be salvaged. Three lives are reportedly lost and properties worth millions destroyed in the process.  The victims are crying, mourning and helpless.  Neighbors and a few good people are helping to salvage the situation. It is useless. A loud explosion is heard. The building is finally engulfed in unquenchable flames.  An hour into this bizarre and solemn atmosphere, the fire service truck pulls up whirling its red lights accompanied by siren. The crowds boo them as they jostle to fight an outbreak that is an hour too late. This scene describes a typical fire outbreak on any given day in Nigeria.

What is a fire outbreak and how can it be prevented? What preparations have we put in place as a people to contain fire outbreaks in Nigeria?

Fire outbreak is a dual word description for a single incidence; Fire on one hand and outbreak on the other. Fire is defined as the rapid oxidation of a material in the exothermic chemical process of combustion releasing heat, light and various reaction products. Outbreak on the other hand is defined as a sudden violent spontaneous occurrence usually of an undesirable nature.

Put together, technically, fire outbreak can be defined as a sudden violent and spontaneous occurrence of rapid oxidation of a material in the exothermic chemical process leading to the release of excessive combustible heat.

 

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Fire outbreaks occur for various reasons. They could be natural or unnatural. Natural fire outbreaks arise through Acts of God like lightning and thunderstorms, upsurge in electricity, volcanic eruptions etc. Unnatural causes could be attributed to Arson, carelessness and negligence or a fault in electrical connections etc.

Regardless of the cause of fire outbreaks, their occurrences are a dozen for a dime in Nigeria. A day hardly passes without one hearing of one case of fire outbreak or the other. The media is awash with stories of deadly fire outbreaks often caused by most avoidable reasons.

In Kano State alone, no fewer than 123 lives were lost and 1, 721 lives were saved from the 660 fire outbreaks recorded across the state from January to December of 2017.

According to the  Fire Disaster Prevention and Safety Awareness Association of Nigeria Incessant fire outbreaks has cost the national economy about N6 trillion in the last five years, with major cities like Lagos, Kano, Port Harcourt , Abuja experiencing serious consequences of the scourge.

Experts in Fire and Disaster Management say the losses could be more as no valid Fire Statistics Database exists. For instance, the Kano market fire alone was estimated at about N2 trillion worth of goods which was lost to a single fire incidence”.

These perennial fire outbreaks poses serious threat to the national economy, as it leaves enormous material damage, injury to persons and disruption of economic and commercial activities of the people affected.

The economic implications of fire outbreaks to investment and growth of the nation cannot be over emphasized. The high incident rate of market fire in particular has serious economic consequences of depriving families of shelters, trader’s means of livelihood, investors of properties, lives lost etc.

Fire fighting in Nigeria and the present efforts in containing fire outbreaks is significantly challenged at all levels. These challenges include poor firefighting equipment and vehicles, weak and sub standard training, infrastructural decay including bad roads, low safety awareness on the part of citizens etc.

At the federal level, there is tremendous improvement in the funding and equipment holding of the federal fire service, the present administration under President Muhammadu Buhari has for the first time invested substantially in the infrastructure and equipment for the federal Fire service.

The State and Local level fire service is clogged in the old ways. Fire service is more or less placed at concurrent list, which mandates the Fire service to be under the jurisdiction and control of the states.

“The major challenge is how to redirect the mindset of the state governors and their Parliaments to also see the need to invest in the fire sector. Unfortunately, all attempts to make this possible have never been successful except for some few states that are making some efforts.

In view of the above, the following are the recommendations:

  • There is need for the Fire Service in Nigeria to be overhauled, re-engineered and repackaged and to actualize this phenomenon, a situation whereby all Fire Services in Nigeria (states and federal) come together as one unified body and under one umbrella would be a step in the right direction as it will enhance uniformity as well as ensuring standard in the service.
  • State Parliaments increase budgetary allocations to State Fire Service in order to improve service delivery across Nigeria
  • Amend the legal framework to allow Private Fire Service providers to intervene in fire service delivery across Nigeria
  • Constant training and retraining of fire service personnel across Nigeria
  • The need to involve the Civil Society intervening in Fire and Disaster management towards the  sensitization and awareness creation of the masses on safety measures

In conclusion, fire outbreaks in Nigeria have assumed a disastrous proportion which can be described as an emergency situation. All hands must be on deck to reduce to the barest minimum the incidences of fire outbreaks and its attendant losses.

 

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Effect Of Rape On Women/Girls

By Yua Miriam

 

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A taxi driver on his way to the motor park was attracted to a young lady who is a newspaper vendor. He decided to stop by and purchase a newspaper, telling her that he is not in the habit of buying newspaper but for her sake he would buy. The young lady smiled and said “that’s good of you Mr”. The taxi driver asked her to give him any newspaper of her choice and she did. On the first page, the taxi driver saw A father of 46 raped his 16 year old daughter for a virginity test. He was shocked and shouted Jesus Christ! “Is this a myth or what?” the taxi driver asked. The young lady asked why he was shouting, as the news had been all over town for two weeks then.

As the driver arrived the park, he was moody and decided to explain the sad news to his colleagues, where are you getting your news from? His colleagues asked, he shook his head full of tears in his eyes and at the same time smiled in amusement. He picked up the newspaper and threw it at them and started shouting, how can a father rape his own daughter for a virginity test?  What a wicked world we are living in, he said. The 15 year old girl who was selling oranges in the park felt a tinge of pity for the taxi driver.

Globally, rape is an everyday violent occurrence affecting millions of women and girls all over the world.

According to Wikipedia, rape is a type of sexual assault usually involving sexual penetration carried out against a person without that person’s consent. The act may be carried out by physical force, coercion, abuse of authority, or against a person who is incapable of giving valid consent, such as one who is unconscious, incapacitated, has an intellectual disability or is below the legal age of consent.

The effect of rape varies for each individual as each individual responds differently to traumatic experiences and recovers at different rates. However with the information from survivors, we know that there are some common responses from rape and sexual violence. These effects can last many years and can take many years to show themselves.

Physical effects may be instantly obvious if the assailant had used violence during the assault, and may need immediate hospital treatment. However, it is also worthy of note to consider other physical effects, that might arise in the future such as sexually transmitted diseases or infections.

A significant number of people who have been sexually assaulted feel embarrassed or shameful about what happened. Most people find it difficult to discuss intimate issues, this makes it difficult for such people to open up about what has happened to them. In this case it is sometimes easier to talk to someone on a telephone helpline who should take things at the victim’s pace.

For many, an initial reaction to being raped is one of shock and emotional numbness. Many people initially feel calm and shut off from what happened to them. This reaction can sometimes surprise friends and family members who expect the victim to be distraught immediately after an assault. However, disassociation is a natural defence mechanism and is perfectly normal. Usually after a few days or weeks the victim may begin to have a range of other reactions like anger, shock and fear. Fear of becoming pregnant or contracting HIV/AIDS or STD. Subsequently, the victim may worry about not being able to be in an intimate or sexual relationship, but all these fears are absolutely normal and common and given time and support they can be overcome. Discussing them with a friend or counsellor will help a lot. Research on women in shelters has shown that women who experience both sexual and physical abuse from intimate partners are more likely to have had sexually transmitted diseases. In 1991, a study in a maternity hospital in Lima found that 90% of new mothers aged 12-16 had become pregnant from being raped, the majority by their father, stepfather or other close relative.

If a victim does not want to report a rape incident or doesn’t want to be attended to by their local doctor, they can visit a local Genito-urinary medicine clinic (GUM) to check for infections.

A father in Swaziland raped his 16-year-old daughter to test if she was still a virgin, a court has been told. The times of Swaziland reported on Monday 21st May, 2018 that, a man aged 46 from the Lubombo region in the east of the kingdom made a statement to a judicial officer at Siteki Magistrate Court. He said, he had argued with his daughter because he believed she had been sleeping with boys. He asked if she was still a virgin and she told him she was. The news paper reported however, that the man confessed that he did not believe his daughter, hence he suggested that he should test her virginity. He unashamedly told the judicial officer that he forcefully had sexual intercourse with his daughter as a way of “testing” her virginity’.

The taxi driver with distaste, informed his colleagues that he had lost his zeal for working on the road that day. It would be better for him to go and rest at home, he left the park and said goodbye to his colleagues.

 

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2019 ELECTIONS: As the Clock Ticks …

By Laz Ahangba

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The loud music blares out in the quiet night. Tarkule, a middle aged Man of about 43 is awakened from his hard narrow bed. He stands up and peers out of his small window. He sees a number of cars parked at Chief’s residence across the road. Chief is a political godfather and a Party Chieftain of note. All political aspirants pay him homage to smoothen their path to victory.  Tonight, scores of aspirants have come to do him obeisance as usual. Tarkule hisses, looks at the time on his wall clock to discover it is past 2.00 am. He slowly walks back to bed and lies down to endure the noise and nuisance.

These are the days of politicking. Scenarios like the one described above are common place. Politicians are busy crisscrossing every nook and cranny of Nigeria soliciting for votes. They are selling their candidatures under the auspices of the different political parties. The political aspirants have different slogans, different songs, but same nothingness, full of promises but short of issues.

Elections in Nigeria and their processes have been this way from time immemorial. Political party structures are hijacked by godfathers and moneybags made of all shades of people, usually deficient in civility and accountability. These ones manipulate the party systems to throw up candidates of their choice. The chosen candidates are forced on the electorate into office. Once elected, the apparatus of government becomes the joystick of the godfathers and moneybags.  They play around the system to milk out their investments in terms of contracts, appointments and other compensations. This system plays out at all levels of governance. The consequences of this age-long tradition is poverty, lack of accountability, impunity, gross corruption, violations of the rights of citizens and worst of all, loss of democratic values. Political aspirants, rather than sell themselves to the electorate, mortgage themselves to the political godfathers knowing that without them, their victories at the polls are not guaranteed. How wrong!

The electoral process is likened to two-parallel lines but arriving at the same destination. It is between the election candidate on one line soliciting for votes from the electorate and the electorate demanding that his issues be addressed by the candidate on the other line, thereby leading all to the same destination called good governance. This process is only made possible through issue-based campaigns and issue-based voting. The election candidates should strictly carry out campaigns based on issues while the electorate vote based on the issues, quid pro quo.

The quality of electoral campaigns is a forerunner to the quality of governance after a winner has emerged and vice versa.  As the 2019 general elections draws near, has there been any issue-based campaigns from any of the candidates across political parties yet? Has the electorate positioned itself for issue-based voting across Nigeria? Have there been any tangible moves by citizen-groups to begin to engage elections candidates on issues bothering them and their communities? A brief environmental scan on the political Eco-system at all levels of governance across Nigeria shows little or no active issue-based campaigns from the candidates and there has not been strong body language from the electorate towards making demands for same. At the national level, for example, of the over 75 presidential candidates, only very few have plans that could culminate into issue-based campaigns. What has dominated the media (especially the social media) space is mudslinging and gutter-language campaigns. The same scenario is playing out at the sub national levels. Rather than base their campaigns on issues, most governorship candidates across the country are busy mudslinging one another while also employing unsavory propaganda.

The electorate, especially the youth are also culpable. Rather than engage the election candidates on common issues bedeviling their communities, they resort to real and cyber thuggery. Social media platforms which should ordinarily serve as a useful resource for the youths and other electorate have become a battle ground of some sorts. Any question, or comment directed at any election candidate is viewed by his supporters as an attack worthy of reprisal often in very harsh and derogatory language. This attitude is denying the electorate the opportunity to objectively engage the election candidates on issue-based campaigns which this election cycle desperately needs.

As we approach the 2019 general elections, the following are recommended as measures we should endeavor to put in place in order to bring about the change Nigeria desperately needs:

  • Profile all our election candidates across all political parties at all levels of governance
  • Undertake a study of the most pressing issues confronting our communities, state and country in general
  • Demand for issue-based campaigns from election candidates and vote candidates whose campaigns issues resonate with those of our communities, states and country
  • Present to electoral candidates citizens’ charter of demands based on the prevailing issues across communities, states and country with monitoring and evaluation indicators
  • Vote based on issues contained in the citizens’ charter of demand
  • Monitor and implement evaluation indicators.

As Tarkule finally drifts into sleep, the campaign vehicles begin to drive away. Again, he startles out of sleep and hisses in anger. He could hear the singer praise singing the candidate. He calls him the sun, the moon and star of his community. “What rubbish!” He thinks out loud. As the sound of the campaign songs fades away, Tarkule wonders if the singer and his ilk bother about improvement in power supply, job creation, heath care system, infrastructural development, agriculture and all the other challenges bedeviling the society. With these thoughts, he slowly drifts back into sleep

 

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Bringing Hope to Prisoners in Nigeria

By Sunday Adaji Esq

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One fact about prisoners is that one after the other, virtually all of them will be out of prison and back into the society, breathing the air of freedom. What is therefore worthy of consideration is the life they live in prison and the life they will be living when they return to the society.

As it were, prisons are built not just to incarcerate and punish criminals but to reform them. “Reform” here implies putting facilities in place which will help to bring out the best in the prisoners and make them responsible citizens, so that instead of becoming hardened criminals; they become law abiding citizens. This way, the society becomes the better for it.

Although prisons are meant to reform prisoners, the ones in Nigeria rarely serve this function. Experience has shown that prisoners return from prisons in Nigeria to become hardened criminals. In this country, available statistics point to the fact that many prisoners who have completed their prison terms go back to the same acts of criminalities that took them to prison in the first place, and may even become worse than ever.

Perhaps, one of the reasons prisoners are hardly reformed is that the government has not put proper structures in place for the desired reformation and rehabilitation. Visits to our prisons will reveal that the conditions in them are deplorable. Apart from the fact that our prisons are congested, there are no adequate social amenities. There is poor ventilation, poor medical facilities and little or no sports facilities. The inadequacy or complete absence of these facilities make life unbearable to prisoners and even defeat the whole essence of the exercise.

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It is important we remind ourselves that prisoners have rights and are entitled to enjoy these rights even while in prison. In the United States and other civilized societies, prisoners enjoy their rights to education, to medical treatment, to conducive accommodation and to good ventilation. In such climes, prisoners come out of prisons to become better citizens, principally because of the quality of facilities in place. In the U.S, it is easy to recall the likes of great motivational blogger, Steve Pavlina and the former world heavy weight boxing champions, Sony Liston and Mike Tyson. These men were jailed at different times for some offences they committed and while in prison developed their talents that eventually made them become better American citizens. If these were Nigerians and kept in Nigerian prisons, they would have ended up as hardened criminals.

 Bettering the Lots of Prisoners in Nigeria

Within every human being is the capacity to be good and to be better. The first step to bringing the best out of prisoners and making them responsible citizens is to put in place frameworks, structures and facilities required for their reformation and rehabilitation. If all a prisoners is required to do is to serve his prison terms, then, we are far from making him a better citizen. The secret to reforming and rehabilitating prisoners is to invest in them. And to do this, we must stop seeing them as criminals who are not fit to live in society; and start seeing them as citizens who need reorientation and reformation. It is when we start doing this that we will be prepared to put in place frameworks and facilities that will enable them become better citizens. It is interesting to note that a Bill on prison reforms is already before the current National Assembly, waiting to be passed into law. When and if passed, the law will go a long way to solving most of the problems bedeviling this institution.

In the meantime, for any reforms to achieve tangible results, adequate attention must be paid to the issues below:

  1. Provision of Adequate Social Amenities in Prisons

Currently, only few prisons in Nigeria can boast of any medical, housing and sports facilities. And even where these are available, they are in a state of comatose. If we are going to bring hope to prisoners, we must be ready to make their welfare and future a priority. Prisoners are human beings and not animals. Even animals have rights and in civilized societies, the rights being respected and enforced. It is instructive that under our Criminal and Penal Codes, it is an offence to maltreat animals, much more human beings. Government should take a cue from international best practices all over the world and do something urgent on the state of our prisons.

  1. Provision of Educational and Training Facilities in Prisons

It is pathetic and embarrassing that only few Nigerian prisons (Lagos, Onitsha and Jos) have educational facilities for prisoners. Education is, perhaps, the greatest investment we can make on the prisoners. If schools are built in prisons and prisoners are trained, their capacity to become better citizens is enhanced and the society at large will be better for it.

Conclusion

The recent report that 35 inmates in Jos prison would be participating in the November/December 2018 WASSCE (West African Senior School Certificate of Education) examinations having been sponsored by the National Industrial Training Fund came as a big relief. More heart gladdening is also the disclosure that the prison in Onitsha has vocational training facilities for prisoners. It is hoped that these developments will be replicated in the other prisons in Nigeria so that inmates can start benefitting immensely from them.

 

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