How donor funding cuts can strengthen Nigeria’s health response – APIN CEO

Prosper Okonkwo, Chief Executive Officer of APIN Public Health Initiatives, on Friday said donor funding cuts present an opportunity for Nigeria to mobilise domestic resources and strengthen the sustainability of its public health response.

Speaking in Abuja during a press briefing and activities marking APIN’s 25th anniversary, Okonkwo said Nigeria had demonstrated in the past that it could pull resources together to address a health crisis.

“When they say funding cut, as a nation, why does it seem to be like a challenge? Let’s begin to see it as an opportunity,” he said.

“One of the reasons why people do not want to support Nigeria is that they know that there are some people who have resources in this country that is more than what they are bringing,” he added.

Okonkwo pointed to efforts by the National Agency for the Control of AIDS to mobilise resources and recalled how the private sector coalition, CACCOVID, came together during the COVID-19 pandemic to support the national response.

“APIN is interested in how we can help the government of Nigeria. How can we pull resources together to ensure continuation of intervention,” he noted. Okonkwo said stakeholders were increasing advocacy through NACA to ensure that donor withdrawal becomes “an opportunity”. “We’ve done it in other areas, and I believe that we can do it,” he added.

Reflecting on APIN’s journey since 2000, Okonkwo described how people living with HIV at the time often faced what amounted to a death sentence due to the lack of access to treatment. He said Nigeria was at that time battling one of the most severe public health crises in its history. “HIV AIDS was claiming lives faster than the health system could respond. Patients were literally waiting for another to die before they could be placed on treatment, due to the limited resources that were available at the time,” he said.

“The idea that a woman living with HIV could carry a pregnancy, deliver a healthy child, breastfeed that child, and watch that child grow up free of the virus was not a reality people believed was possible at the time,” he further said.

He added that tuberculosis remained undertreated while maternal and child mortality figures were among the highest globally.

The CEO said APIN, which began as the AIDS Prevention Initiative in Nigeria under the Harvard T.H. Chan School of Public Health with funding support from the Bill & Melinda Gates Foundation, was created to help Nigeria respond to one of Africa’s worst public health crises.

According to him, the organisation has over the past 25 years expanded its footprint to 30 states, supported 434 health facilities and currently delivers comprehensive HIV treatment services to more than 319,000 people living with HIV.

He said APIN had also built laboratory networks that process millions of samples annually, trained healthcare workers, and partnered with government agencies, traditional and religious institutions, and community leaders to strengthen health systems across the country.

Okonkwo, however, said major challenges remained, including persistent HIV burdens in some states, rising drug-resistant tuberculosis and fragile health financing systems. “We will continue to do what we do best, which is building systems, generating evidence, training people, and working alongside government and partners to make this health system more capable,” he said.

Also speaking, Uche Okezie, APIN’s Director for Strategic Information, said Nigeria had made significant progress in HIV control over the years, due to APIN’s impact.

He said HIV prevalence had declined from 4.1% to about 1.4% nationally, while more than 1.6 million people were currently receiving antiretroviral therapy.

According to him, APIN alone accounts for about 36 to 37% of Nigeria’s HIV burden. Okezie added that over 89% of Nigerians now know their HIV status, while about 95% of people enrolled in APIN-supported programmes had achieved viral suppression.

“When people are virally suppressed, we use that as a gold standard for the treatment of HIV programme,” he said.