WT: Could you tell us what your institute is doing in terms of capacity support for health care system in the country?
Dr. Patrick Dakum: Well, the Institute of Human Virology is providing support of a reputable development partner to some of the states like Plateau State. We are funded by the United States President’s Emergency Plan for aids relief. In Plateau State for instance, we started with the Mangu Rehabilitation Centre but now, we have moved a step further to having about three hospitals in the state.
Our idea is to create a situation where we should have children born to an HIV positive mother is prevented from the infection.
The Plateau State Virology Research Centre also houses our regional headquarters and the region now has been expanded in support not only to Plateau State but Bauchi, Gombe, Nasarawa and Benue states. The regional office provides support to a total of about 21 hospitals now. Our support also goes to non-governmental organisations that we are working with. The one that interests me a lot is the Faith Based Initiative founded by Prof. Dany Mccain of the University of Jos that provides prevention messages to colleges of education.
Again, If you take into cognisance the fact that we have four other regional offices, one in Abuja, Benin, Lagos and Kano, and you combine all that, our support extends to 106 health centres in Nigeria and we are supporting about 65,000 patients across the country who are living with HIV/AIDS and we have enrolled over a hundred thousand out of which the 65,000 are actively taking drugs now.
So, I believe the United States support for the Centre for Disease Control (CDC) in Nigeria has done a lot and we are just one out of these partners.
WT: So would you say your activities have given you that recognition from both the government and the public?
Dakum: I will start with the government. We started working together with the Minister for Health, Prof. Babatunde Osotimehin when he was the Director General of NACA. And now, being health minister, we had a number of meetings with him and he recognises the contributions of our centre a lot. He even established a task force called the ATM Task Force that is for tuberculosis and malaria. It is a wonderful initiative and we are on that Task Force to look at how Nigeria can strengthen the health sector response to HIV. And I must also state that apart from the ministry of health, NACA is also aware of what we are doing. Currently, our institute is a member of the expanded team group coordinated by NACA which have got the multi-lateral agencies made up of the US agencies and bilateral agencies of DFID and others.
There are national technical working groups. Our institute is a member of all these groups related to HIV/AIDS response. So, I believe that by including us as members of these committees, the FG has recognised our support.
Here on the Plateau, we have signed an MOU with the Plateau State government through the ministry of health and believe that the MOU recognises that partnership that we have in between the two of us.
And it is under that MOU that we are providing support to the state facilities and we have started adopting some primary healthcare functions on the Plateau.
WT: What is the prevalence rate in the state now?
Dakum: Well, definitely, I must commend all stakeholders and civil society organisations. They have contributed a lot to create awareness by ensuring that stigma is reduced. I believe that is what has resulted in the decline in prevalence was defined by the ante natal survey that is done. In Plateau the prevalence rate was almost eight percent in 1999. Now it has gone down to 2.6 while you have the prevalence going up in the South-South region of the country and even in the North Central region but we must thank God that it is going down. Remember that it is a behavioural issue and one way to strengthen behaviour is to go for a test. If you are negative, you strengthen your negative behaviour; if you are positive; you enter into care and ensure you don’t transmit the virus to others.
WT: What are the challenges in fighting the scourge?
Dakum: One of the challenges that we are facing is how to be able to provide adequate treatment floors. The numbers of sites we are supporting have already been mapped out. Unless we have government taking responsibility for the procurement of drugs, life supplies, the current sites will not be able to handle the number of patients.
The patients who come to the sites in Plateau are not only from Plateau. They are also from neighbouring states where you don’t have treatment programmes and there is a limit as to which donors would be able to provide. It means then that the active support of the state government and the local governments also would go a long way.
Another challenge is manpower. We need doctors and nurses. Every place that you have HIV/AID support going on, you need a minimum of one doctor, two nurses, for every 400 patients. So, in a place like Mangu that you have almost 2,000 people registered, we need a minimum of four physicians. The teaching hospitals have about 10,000 people enrolled which they cater for. Funding, personnel, facilities and infrastructure are some of our problems.
WT: Health workers in Plateau State have been on strike for months now. As a former commissioner, what is your advice?
Dakum: In every situation of governance, there would be demand from various stakeholders. Demand from the health sector is always constant. I believe the answer lies in continuous dialogue. Government needs to take additional steps in order to meet to some extent, the demands of health care workers.