A Nation Responds

May 2004 - The bad news carried good news as well: an estimated 5,000 people showed up for the 4th National Conference on HIV/AIDS in Nigeria—3,000 more than had been expected. Although their attendance created a logistical nightmare, their swelled numbers also revealed the seriousness with which the country is responding to the epidemic.

"Nigeria has the world's third largest burden of HIV and AIDS, right behind South Africa and India," stated Professor John Idoko, chair of the conference and director of the APIN Laboratory at Jos University Teaching Hospital. "It is also one of the most populous nations to cross the 5 percent prevalence threshold, which usually signals that a country is entering the explosive phase of the epidemic. Despite the recognized impact of the epidemic on Nigeria, the opportunities for stakeholders to share experiences and scientific knowledge have been few. This conference was designed to fill that gap."

Held in Abuja in early May 2004, the four-day conference focused on the nation's HIV research achievements and future challenges. A range of stakeholders—including researchers, physicians, people living with HIV/AIDS, political leaders, public health experts, and community workers—gathered to share experiences and renew their commitment to ending the epidemic.

In opening the conference, Professor Eyitayo Lambo, the minister of health, read a statement by President Olusegun Obasanjo, in which the president announced that the pilot program for the mass provision of antiretrovirals to Nigerians living with HIV/AIDS would soon be expanded. Negotiations for the local production of antiretrovirals have been concluded, with the aim of increasing program enrollment beyond the current level of more than 13,000 people.

The president added that the federal government has substantially raised its budgetary allocations to HIV/AIDS control and decreased import duties on antiretrovirals. He also noted that the government is seeking to implement strategies aimed at reducing the national HIV prevalence rate to below 2 percent.

Professor Lambo added his own ministerial message to the conference. After referring to a decline in the national seroprevalence rate from 5.8 percent in 2001 to 5 percent in 2003, he noted that the apparent reduction—a decline not considered statistically significant—conceals disturbing trends in some zones and states.

"To check the spread of the virus and mitigate the impact of this epidemic," Professor Lambo stated, "we have to continue with our intensive prevention, care, and support programs." The minister emphasized that a number of African nations that have made research an important component of their HIV control strategies have succeeded in bringing down the rate of spread while expending fewer resources.

In the spirit of a multisectoral involvement, the conference was organized into three "villages" to represent science, community, and youth. As part of the scientific village, researchers offered more than 200 oral and poster presentations on basic, clinical, and behavioral science issues. Plenary sessions, invited lectures, roundtable discussions, and satellite meetings provided participants with additional opportunities to learn from national and international experts.

The community village provided an interface between science and community efforts, highlighting various initiatives by women, youth, people living with HIV/AIDS, members of faith-based groups, female sex workers, men who have sex with men, traditional leaders, legislators, media representatives, and military leaders. The youth village focused on the special vulnerability of young people to HIV infection and strategies for expanding their participation in the national response.

"The need for stakeholders to come together and share experiences cannot be overemphasized," says Dr. Oluwole Odutolu, senior program manager of APIN, which cosponsored the conference. "This conference provided stakeholders with an important opportunity to expand their knowledge, share best practices, learn lessons from other regions and nations, and forge key partnerships."