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More than 200 experts from the Federal and State Ministries of Health, non-governmental organizations, international organizations, and funders have reaffirmed their commitment to prioritizing the integration of tuberculosis (TB) and HIV programs across the 36 states of the country and the Federal Capital Territory.

This commitment was reinforced during a five-day National Boot Camp hosted by the Institute of Human Virology Nigeria (IHVN) in Lagos State. The camp focused on discussing the integration of TB and HIV services to enhance healthcare delivery under the Global Fund Grant Cycle 7.

The experts reached a consensus to harmonize service delivery and reporting across TB and HIV implementers nationwide, with plans to evaluate progress at three and six-month intervals.

Dr. Aderonke Agbaje, IHVN Director of Programs – Special Projects, emphasized, “Integration increases the impact of interventions. It makes us more effective in implementation. As a Principal Recipient of the Global Fund Grant Cycle 7 project, IHVN is working under the leadership of the Directorate of Public Health, National Tuberculosis, Buruli Ulcer and Leprosy Control Programme (NTBLCP), National AIDS and STD Control Program (NASCP), and the National Agency for the Control of AIDS (NACA) to bolster Nigeria’s response to the epidemics of tuberculosis and HIV in the public and private sectors and the community.”

The Boot Camp featured engaging break-out and brainstorming sessions on the treatment and care cascade for HIV and TB, monitoring and evaluation requirements, and TB/HIV health and non-health product management. Additionally, guidelines and standard operating procedures were developed for HIV Testing Services among presumed pregnant women outside conventional health facilities.

Key attendees included the Director of Public Health, Dr. Chukwuma Anyaike; the Director of Health Planning, Research, and Statistics, Dr. Chris Isokpunwu; Representative of the Health Commissioners Forum, Hon. Commissioner of Health for Kwara State, Dr. Amina M. Ahmed El-Imam; and representatives from the Global Fund, PEPFAR, USAID, UNAIDS, UNODC, the Network of People Living with HIV (NEPWHAN), and the Country Coordinating Mechanism (CCM). These leaders called for collective action and the support of all stakeholders in achieving TB and HIV integration and building sustainable and resilient health systems.

The Institute of Human Virology Nigeria (IHVN) has sensitized Iddo Padda and Gwagwa communities in the Federal Capital Territory on gender-based violence(GBV).
The sensitization program involved advocacy to community leaders, a road walk within the community market and health checks.

IHVN Senior Program Officer Prevention, Care and Treatment, Mrs. Derby Collins-Kalu says that the Institute in collaboration with New Hope Agency, a community-based organization, organized the activity in these communities to prevent GBV and rape.

“The program reports we are getting from the community shows a high rate of gender-based violence, especially rape for minors. We work with health facilities to sensitize women during immunization. Rape is the most common in these communities. We presented these findings to the community leaders. The sensitization activity is to tell the people what is happening in their community and stimulate behaviour change in the areas of rape. We also want to educate people about rape and to tell them the services available to someone who has been raped in the health care center.”

Mrs, Collins-Kalu explains that timely presentation of  persons who experience rape in health facilities makes the difference.  

“This event is part of a broader effort to sensitize the community about the realities of  GBV.. IHVN has been educating residents on recognizing signs of rape, understanding the available care pathways, and emphasizing the importance of timely medical intervention. Immediate medical attention is critical to prevent the transmission of HIV, manage potential pregnancies, address sexually transmitted diseases, and mitigate the emotional trauma associated with rape.”

New Hope Agency GBV Program Manager, Ifeoma Okonkwo says that “Our collaboration with IHVN has been instrumental in bringing awareness to the community. Engaging with the public has brought a noticeable increase in community participation and willingness to discuss GBV issues.”

Mrs Okonkwo lamented the culture of silence in the society that makes people hesitant to speak about GBV. .

“Most of the cultures are very abusive, I also believe that if we can sensitize our communities, they will speak out.”

Women who received testing services during the sensitization program expressed appreciation for the activity. 22-year-old housewife, Sekinah Ilasu says, “I am grateful for this initiative to tell women to speak up about Gender Based Violence because a lot of people in our community today are facing violence from their husbands and they are afraid to speak up because it will only make the situation worst.”

Another participant, a petty trader, Zainab Daro, called for participation of men in sensitization programs too.  “I wish our husbands were here to hear this so that those who beat their wives can know that it is bad and stop,”

To equip healthcare workers with the knowledge and skills for prevention and management of cervical pre-cancerous lesions, the Institute of Human Virology Nigeria (IHVN) has trained 63 health workers in the FCT, Katsina, Nasarawa, and Rivers States.

During the three-day training, participants engaged in practical demonstrations on the use of Loop Electrosurgical Excision Procedure (LEEP) machine in managing pre-cancerous cervical lesions. Trainees, including doctors and nurses, built their capacity on cervical cancer treatment methods and screening in a see-and-treat program, infection prevention, as well as sterilization. They are to step down the training to others in their health facilities for improved screening and treatment of precancerous lesions among Women Living with HIV (WLHIV)

IHVN Program Manager, Dr. Victoria Igbinomwanhia said that the training is important in building the capacity of health care workers in facilities supported by IHVN across all four States in the screening and treatment of WLHIV.

“Women Living with HIV are six times more predisposed to cervical cancer compared to non-WLHIV. The training provided these professionals with the required skills to identify precancerous lesions and promptly treat using either the thermo-ablation or LEEP machine depending on the location and extent of the lesion. This ensures that eligible WLHIV between the ages of 25 and 49 years who receive care and treatment at the ART clinics are provided screening yearly. This Is a component of the HIV comprehensive care package to improve the quality of life and reduce mortality in already stable WLHIV,” she said.

According to Dr. Igbinomwanhia, the next steps following the training include distribution of LEEP machines to all four States, step-down training to other facility staff championed by the trained participants, continued onsite mentoring and supervision  and immediate treatment of all clients identified with precancerous lesions amenable for treatment with the LEEP machine.

Dr. Oluseyi Asaolu, who participated in the FCT training, said that the training was beneficial and looks forward to stepping it down to resident doctors “The most important thing is scaling it down to others who can use the equipment regardless of who is on duty.” Another participant, Mrs. Aisha Haladu from Kastina State, said that utilizing the LEEP machine would benefit clients who would ordinarily be unable to afford cervical cancer screening.

One of the services that the Institute of Human Virology Nigeria (IHVN) supports in 368 health facilities in FCT, Rivers, Nasarawa, and Kastina states is the prevention of mother-to-child transmission of HIV (PMTCT) services. This involves the provision of HIV diagnosis, care, and treatment for mothers and babies and results in HIV-free babies.

From 2004 to June 2023, IHVN has provided HIV counseling and testing to 5.5 million pregnant women and PMTCT services to more than 126,000 women who tested HIV positive.

Blessing, a petty trader, is one of the women who have received PMTCT services in Rivers State University Teaching Hospital in Port Harcourt, Nigeria. She recalls that when she discovered her HIV status in 2013, one of her greatest fears was that she would not be able to get married or give birth to HIV-free children.

“I thought that being HIV positive was a death sentence but the doctor who counseled me assured me that I could live long, get married, and have my own children. He gave me medications and guided me on how to take them,” she said.

It was a dream come true for Blessing when she married in 2019 and got pregnant afterward.

“At the antenatal clinic, the healthcare workers welcomed me like everyone else. I was not stigmatized. I was impressed and happy. When I was in labour, they gave me VIP treatment, I delivered safely,” she said.

Blessing and her baby were given medications and supported by a peer mentor who assisted her with hospital processes during pregnancy, delivery, and after delivery. Her baby was tested at six weeks and 18 months.

“I was happy when the test showed that my baby is HIV negative,” Blessing said. She has also received PMTCT services for her two-month-old baby who she is currently breastfeeding.

“My advice to others is not to be scared about HIV. You are not alone, don’t die like a chicken. Since I started taking HIV medications in 2013, I rarely fall sick. I am strong and healthy. You can eat well and live your normal life even when taking medications. You can even live to see your great-grandchildren,” she said.

Another mother with HIV-free children is Bomi A., who was thrilled after an Early Infant Diagnosis test at six weeks and a rapid test at 18 months showed that her babies were HIV-free.

“My first child is four years old and my second is two years old.  For the first child, I was worried when I came to the hospital. I asked the doctor if everything would go well, and he assured me that it was well. For the second one, I was not worried. Antenatal services are given free by the Rivers State government. I did not pay for the PMTCT services in the hospital either.”

 “My mentor mother often calls me to ask how I’m feeling and if I am facing any challenges. She also updates me with relevant information. When I come to the clinic, she checks to see that I’m alright,” she said.

Bomi added that during her facility visits, she interacts with other women living with HIV and is encouraged by their resilience.

“I’m excited to tell others to try their best to take their medications as prescribed,” Bomi said.

IHVN Rivers State ASPIRE Project Manager, Dr. Stanley Idakwo, noted that between April 2019 to September 2023, IHVN supported the testing of 7,122 antenatal clients and placed 69 newly identified HIV pregnant women on anti-retroviral treatment at Rivers State University Teaching Hospital (RSUTH). “More than 500 babies have been delivered HIV-free from HIV-positive mothers who have benefitted from PMTCT services. RSUTH is one of the largest facilities providing PMTCT services in Rivers state, hence its reach cut across communities all over the state,” he said.

IHVN Program Manager Prevention Care and Treatment, Dr. Victoria Igbinomwanhia said that IHVN provides PMTCT services in both health facilities and in the community to improve access to the services.

“We are collaborating with Traditional Birth Attendants (TBAs) and faith-based homes to offer PMTCT services. We provide them with HIV test kits; we have trained the TBAs to conduct HIV testing, referring those who are identified positive to designated supported facilities to commence ART. We have hub and spoke models where TBAs are mapped to supported health facilities. If clients are tested in the community, we find out whether they prefer to access PMTCT in the community or facility.” she said.

In line with the theme of the 2024 World Tuberculosis Day, “Yes! We can end TB and slogan: No gree for TB! Check Am O,” Institute of Human Virology Nigeria (IHVN) has sensitized the public about tuberculosis and efforts to address the disease in the country.

During a pre-World TB Day ministerial press briefing to commemorate the day, IHVN Senior Manager, Dr Temitope Adetiba stated that in collaboration with the National Tuberculosis, Leprosy and Buruli Ulcer Control Program (NTBLCP), and other partners, IHVN has notified over 200,000 people affected by tuberculosis across 31 states.

“Not all Nigerians have access to tuberculosis services, and this gave rise to our foray into the private sector because data shows that more than 60% of Nigerians access health care first in the private sector. We engaged with patent medicine vendors, community pharmacists, and traditional healers, and can reach more Nigerians,” he said.

He added that the new phase of the Global Fund grant in Nigeria involves scaling up tuberculosis services to all states of the federation.

“I am happy that the members of the press here can take this message out there, that people in the community can go to the nearest patent medicine vendor, traditional birth attendants for tuberculosis services. We have trained these people across the country to be able to provide quality assured tuberculosis services.

Also, through the support of the Global Fund, we have optimized the Gene Xpert platforms. To be able to conduct tests round the clock, they have been equipped with solar panels, batteries and inverter systems so that whenever tuberculosis specimens are sent for test, the results can be available within 24 hours,” he added. 

IHVN also participated in road walks in Abuja and Lagos to create awareness about the disease. In Abuja, the walk was from Garki Ultra-Modern Market to Garki Old Market while in Lagos State, the walk held in Ikeja – from the Ministry of Health to the House of Assembly and Shoprite.

Every year, the world commemorates World Tuberculosis Day on March 24th to raise awareness about tuberculosis and efforts to eliminate the disease