By Vivian Onyebukwa
The Trump administration in the United States government recently suspended financial support for HIV treatment programmes, not only in Nigeria but also in other developing countries.
The move following an executive order issued by President Donald Trump on his first day in office when he directed all government agencies managing foreign development aid to freeze all aid.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), with an annual budget of $6.5 billion, delivers life-saving HIV/AIDS treatment to over 20.6 million people globally. Since its inception, the programme has reportedly saved 26 million lives, making it a cornerstone of global health efforts.
But with the order by President Trump, US State Department spokesperson Tammy Bruce was quoted as saying the US “is no longer going to blindly dole out money with no return for the American people.”
Nigeria is one of the countries most affected by HIV globally, with approximately two million Nigerians living with HIV. This means that the country stands to be significantly impacted by this suspension. This could cause millions more AIDS deaths, according to UN agency.
However, in response to the recent suspension of U.S. development assistance, the Federal Executive Council (FEC) approved a N4.8 billion funding package to sustain HIV treatment programs across the country.
According to the Nigeria’s Coordinating Minister of Health and Social Welfare, Muhammad Ali Pate, the approved funds will cover the procurement of 150,000 treatment packs for HIV patients over the next four months.
This move, he said, reflects the government’s commitment to safeguarding the health of vulnerable populations, even as Nigeria navigates the challenges posed by shifting international support, describing it as an important signal that the federal government is committed to ensuring that life-saving treatments remain accessible, despite the changing dynamics in external support.
According to Pate, even before the US government’s aid suspension, and as Nigeria continued to receive support from international partners in the fight against HIV, tuberculosis (TB), and malaria, Pate emphasised that the government decided to take more responsibility by investing domestic resources into critical health programs.
The minister also addressed concerns regarding the potential impact of the US government’s suspension of aid, which has historically supported Nigeria’s healthcare sector, particularly in combating HIV, TB, and malaria.
Pate acknowledged the significant contributions made by the US over the past two decades but stressed that Nigeria is preparing to reduce its reliance on foreign aid.
Recently, in a statement signed by Dr. Temitope Ilori, Director General, National Agency for the Control of AIDS (NACA), he noted that Nigeria remains the biggest donor for treatment programme in the country as their contributions covers approximately 90 per cent of the treatment burden.
He stated that recently Trump Administration issued an executive order halting foreign aid for 90 days, but however, on Tuesday, January 28, 2025, the administration issued a waiver for lifesaving medicines and medical services, offering a reprieve for a worldwide HIV treatment programme. This waiver allows for the continuous distribution of HIV medications (ARVs) and medical services supported by PEPFAR in Nigeria.
He expressed the appreciation of the Nigerian government to the US government waiver and is mindful of the potential change to foreign aid in the near future under the new administration. “The Nigerian government would intensify domestic resource mobilisation strategies towards ownership and sustainability of the HIV response in the country with a view to reducing the risks of donor aid policy shifts to the HIV response while ensuring that the country’s strategic goals and targets in the fight against HIV are achieved. Through effective stakeholder collaboration, creating favourable policies and enabling environment and advocacy to policy makers, Nigeria can still achieve the target of ending AIDS by 2030.”
He encourage the patients community to continue accessing HIV treatment services in service delivery points across the country and appeal to all the state governors, private sector partners, all the members of the National Assembly and State Houses of Assembly, civil society organisations, the media and all other relevant stakeholders, to continue in their commitment and support to the fight against HIV/AIDS in Nigeria.
With this, Osun State has promised to continue to support people living with HIV/AIDS despite the withdrawal of AIDS Relief support to Nigeria. The Executive Secretary of the State Agency for the Control of AIDS (O’SACA), Olusegun Daramola, in a statement stated that the governor, Ademola Adeleke assured the people of the state that the government is working round the clock to bridge the gap of PERFAR’s exit.
“We are actively exploring all available resources to strengthen healthcare services and mobilise community support to ensure uninterrupted access to essential care. Your health, dignity, and rights are of utmost importance. We are committed to providing continuous access to antiretroviral therapy/drugs (ART) and essential medications, regular medical check-ups and monitoring, counselling and psychosocial support, Nutrition and economic assistance,” Daramola said.
Dr Ayodeji Oluwole, Chairman Medical Advisory Committee (CMAC), Lagos University Teaching Hospital (LUTH), speaking on the action of the American president, stated that the United States government must have their reasons for the stoppage that people may not fully understand.
He assured that LUTH is fulfilling its obligations to its patients as the hospital still has adequate storage of ARVs and are also free, adding that LUTH is a federal government hospital that still gets its ARV drugs from the designated federal source.
He stated that the recent development has not affected its workforce, as the unit also caters for other viral diseases in the same class and treatment are still ongoing.
He further stated that the government knows what it needs to do. “Remember that there are multiple international organisations that donate things to Nigeria,” Dr Oluwole added.
Some concerned citizens and health workers too have expressed their concern over the recent decision by the American president. A health worker in one of the private hospitals in Lagos, Rose Michael is worried about the cost of the ARV drugs. “This means that antiretroviral drugs that’s almost free of charge would experience a significant increase in price. It is a bad situation. Most of the HIV patients may find it difficult to purchase the drugs, which might lead to the death of several of them. I pray that Trump would have a rethink to continue to help the countries concerned,” Michael said.
A parent whose child is living with HIV has expressed fear that he might lose his son any time from now. John Okoroafor, who said his son contracted HIV through an infected needle in a hospital, said: “Though my son is an HIV patient, the family has come to live with it, since he takes his monthly drugs which is almost free. With the drugs, we hope and believe that he would live as long as God wants him to. But with this problem, my family is living in fear because the cost of the drugs might go up, and we may not be able to afford it.”
The Director-General, World Trade Organisation (WTO), Dr. Ngozi Okonjo-Iweala, has, however, called on African leaders, including Nigeria, to stop relying on foreign aids and focus on mobilising domestic resources to attract investments and drive economic growth.
Okonjo-Iweala emphasised that African leaders need a mindset shift, saying the continent is blessed with vast untapped financial and natural resources that could drive sustainable development.
While speaking on the sidelines of the African Union meeting in Ethiopia, the WTO Chief advised that foreign aid should be considered a thing of the past. “Africa really needs to change its mindset about access to aid. We should begin to see it as a thing of the past. Our focus should be on two key areas — attracting investment and mobilising domestic resources.”